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

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



Case Details (Reverse Sorted by Onset Date)

This is page 122 out of 3,524

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VAERS ID: 1343242 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Gait disturbance, Malaise, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Day 6 post vaccine patient began complaining of bilateral anterior ankle pain, and L hip pain. She had a low grade fever of 99.8 at that time. The following day Day 7, she had general fatigue, bilateral angle pain, and malaise. On Saturday, Day 8 she was unable to stand for periods of 15 minutes or longer due to pain in both ankles, and her knees, and elbows began to hurt. On this day she was given advil 400mg without relief, she then took Tylenol 650mg and the joint pain decreased from a 9 to a 6. We have had to continue alternating tylenol and advil since Saturday and she is unable to stand or walk for prolonged periods.


VAERS ID: 1343245 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SC

Administered by: Unknown       Purchased by: ?
Symptoms: Gout, Pain in extremity
SMQs:, Arthritis (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin. Multi-vitamin.
Current Illness: None
Preexisting Conditions: Asthma
Allergies: MRI injection dye, pollen, ragweed and animal dander.
Diagnostic Lab Data: No tests. Took prednisone pill, 2 alleve, ginger, tumeric tea. Put foot in epsom salt bath.
CDC Split Type:

Write-up: Excruciating pain in right foot. Very similar to gout attack. Was it a gout attack? My prior gout attacks affected right big toe.


VAERS ID: 1343290 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-04-21
Onset:2021-05-20
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 UN / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen 650mg PO PRN for mild pain or fever, aspirin 81mg enteric coated PO Daily, carvedilol 6.25mg BID with meals, cyanocobalamin 1000mcg PO daily, cyclobenzaprine 5 or 10mg at bedtime PRN, ferrous sulfate 325mg PO daily, folic aci
Current Illness: unknown
Preexisting Conditions: lupus, HTN, hypokalemia, heart disease (1st degree AV block by EKG) syncopal episodes, renal disease, gastritis,
Allergies: erythromycin base, hydromorphone, macrolide antibiotics, sulfonamide antibiotics, sulfisoxazole
Diagnostic Lab Data: PCR COVID 19 05/20/2021
CDC Split Type:

Write-up: Patient tested positive for COVID-19 on 05/20/2021, and received monoclonal antibody therapy on 05/21/2021.


VAERS ID: 1343328 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Eye disorder, Headache, Joint swelling, Muscle spasms, Vision blurred, Vitreous floaters
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu
Other Medications: Synthroid Contrave
Current Illness: None
Preexisting Conditions: None. Obese but no other issues. Some osteo arthritis in joints due to aging
Allergies: Opioids, Codiene, flu shots
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: 2nd shot. Work up next morning severe headache, fuzzy vision. Had reoccurrence of black floaters in both eyes still happening on day 5 no sign of them leaving. These floaters have been gone for 2 years. Day 1: floaters vision issues, headaches, slept 21 hours, leg cramping. Joint swelling Day2: slept 18 hours left knee swollen, could not put weight on it by afternoon. Eye floaters continued headache Day 3: left knee still swollen could not walk on it without brace, floaters continued, slept 14 hours Day 4: left knee swollen, swelling in bone of left hand that has arthritis. Floaters still in eye Day 5 left knee swollen but can put weight on it. Floaters in eyes still bad.


VAERS ID: 1343344 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

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

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

Write-up: Insomnia (36 hours, Fever (highest at 101.5), body aches (36 hours), headache (on and off )


VAERS ID: 1343363 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Panic attack, Throat tightness, Tremor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Within 5 minutes of vaccine administration, patient appeared shaky and reported tightness in throat. Pharmacy staff suspected anxiety/panic attack as symptoms appeared to be triggered by pharmacist stating that patient must remain on site for a 15 minute observation period in case of an immediate and serious reaction. Out of an abundance of caution, EMS was called and reported to the pharmacy. EMS stated airway was clear, and patient did not appear to be in anaphylaxis. Because patient was wheezing, epinephrine was administered, and patient was taken to local hospital. Patient was discharged around 10:00pm (approximately 5 hours after the incident).


VAERS ID: 1343399 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 024C21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Joints ache, chills, rash on trunk of body, several inches to the left of the injection site raised, red, painful and itchy.


VAERS ID: 1343447 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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: reports severe sensitivity to multiple vaccinations
Other Medications: Zyrtec 10mg daily, Benadryl, multivitamin, Singulair
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Ibuprofen, Cats and Dogs, Eggs
Diagnostic Lab Data: Seen in emergency room on 5/21/21 at 1433 with physical exam completed. No lab. Given IM epinephrine and 8 mg IM Decadron. Observed and discharged home. Returned to emergency room on 5/22/21 presents after auto injection of epi pen at home after concern of ongoing anaphylaxis reaction. Again felt as though throat was closing and short of breath. In ER oxygen saturations 100%, normal breath sounds, no mucus membrane swelling, no urtica reaction or skin reactions. Prescribed Prednisone
CDC Split Type:

Write-up: About 30 minutes following vaccine developed arm pain and a sensation that her throat was closing and wheezing. Took a Benadryl tablet. Presented to emergency department the following day at 1433 at that time no feeling of throat closing. No swelling of the uvula or any tissues examined in the pharynx. No wheezing.


VAERS ID: 1343458 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure decreased, Body temperature decreased, Disorientation, Dizziness, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Disorientation, severe dizziness, upset stomach, pale, decreased temperature and blood pressure. Pharmacist on duty called 911, patient declined hospital.


VAERS ID: 1343462 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: Red, raised rash approx 4 inches in diameter. Very hot to the touch and painful.


VAERS ID: 1343492 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram, Electrocardiogram, Electrocardiogram repolarisation abnormality, Myocarditis, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 3 days
CDC Split Type:

Write-up: Myocarditis, recurrent chest pain over 3 days time, resolved with NSAIDS, EKG with repolarization changes and elevated serum troponin levels. Normal echocardiogram


VAERS ID: 1343513 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003021A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness postural, Fatigue, Feeling abnormal, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: nausea, body aches, exhaustion, chills, low grade temp, got dizzy while standing, eyes were going fuzzy and felt as if I was going to pass out.


VAERS ID: 1343545 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

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

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

Write-up: FEVER BODY ACHES DIZZINESS


VAERS ID: 1343552 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-15
Onset:2021-05-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA TD210515237W61 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Chalazion, Hypoaesthesia, Paraesthesia, Pruritus, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamins
Current Illness: none
Preexisting Conditions: none
Allergies: ?
Diagnostic Lab Data: Self-diagnosis on 05/24/2021
CDC Split Type:

Write-up: Multiple symptoms started 5-7 days after 2nd dose, as intermittent numbing, burning & tingling from left toes upwards along side of my leg to my hip. At the same time I accidentally hit my bare left foot & ankle on the edge of furniture, where small fluid-filled blisters appeared at the sites of contact. I noticed bumps & a red rash on my left instep & the back of my left calf. Hours later I began to itch all over, accompanied by itching hives at forehead hairline & between brows. Also a Meibomium cyst on lower left lash line started to swell up. Ball of my left foot & under the big toe is sensitive to pressure from body weight when I stand on it.


VAERS ID: 1343559 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Blindness, Chest discomfort, Disorientation, Dizziness, Electrocardiogram normal, Feeling hot, Headache, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill
Current Illness: N/A
Preexisting Conditions: Asthma, has an inhaler to use as needed
Allergies: Allergic to bee stings, nothing else
Diagnostic Lab Data: We went to the emergency room, just to make sure she was fine. They said all her vitals were normal and did an EKG, which was normal as well.
CDC Split Type:

Write-up: Approximately 2 hours after receiving her first covid vaccine, my 14 year old fainted. She was standing in our kitchen at home and became dizzy and started falling backwards. She said her vision was black, she was hot, her head hurt, I could see sweat on her face and chest, and she said she was having tightness in her chest/not able to get full breaths. She didn''t totally lose consciousness, but she was disoriented. These symptoms lasted a few minutes, then she felt fine.


VAERS ID: 1343566 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Dehydration, Dyspnoea, Electrocardiogram ST-T change, Electrocardiogram normal, Headache, Palpitations
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (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: Pepcid 20 mg oral tablet, 20 mg= 1 tab, Oral, BID
Current Illness: unknown
Preexisting Conditions: none
Allergies: no known allergies
Diagnostic Lab Data: 5/21/21 Chest x ray-no acute disease 5/21/21 EKG-ED Provider Interpretation ECG Heart Rate: 90 bpm ECG Time Read: 05/21/21 14:58:00 ED ECG Interpreted By: MD ED ECG Rhythm: NSR ED ECG ST/T Segments: Non-specific ST changes ED ECG Stemi: No ED Normal ECG: No
CDC Split Type:

Write-up: This is a 18 Years old Female presenting with chest pain for [a couple hours last night]. Pain started [gradually]. It is described as [dull and aching], radiating into [nowhere]. Pain is described as [moderate] upon onset and is currently [mild]. [No] history of the same. Pain [is not] worse with exercise. Patient [has no] decrease in exercise tolerance recently. Patient states that she received her second dose of her Pfizer vaccination 3 days ago, and last night she started to experience chest pain, headache, palpitations, and shortness of breath, and feeling dehydrated.


VAERS ID: 1343569 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

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

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

Write-up: CHILLS FEVER HEADACHE


VAERS ID: 1343607 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-05-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Pyrexia, Rash, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? 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: Headache, Fever (99F), Ache in joints (+1 days from 2nd dose and lasting 2 days) Burning Rash on Torso, Back, Neck and Arms (+8 days from 2nd dose and still ongoing)


VAERS ID: 1343608 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Fatigue, Feeling abnormal, Mental disorder, Mobility decreased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Xeralto, magnesium l-threonate, vitamin d3, zinc, vitamin c, zrtec
Current Illness:
Preexisting Conditions: a fib, macular degeneration, one kidney
Allergies: feels sick when taking morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Clouded mental state, very "foggy". Trouble communicating verbally. Muscle weakness, trouble moving and standing. Very tired. Got better after a long night''s sleep, mobility retuned as did mental capabilities.


VAERS ID: 1343615 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid
Current Illness: none
Preexisting Conditions: low thyroid due to thyroid having been removed 8 years ago
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Ran a fever of 105.2 from 2 a.m. until 6 p.m. nothing I tried including cooling measures would lower it.


VAERS ID: 1343616 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 RA / IM

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

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

Write-up: FEVER CHILLS BODYACHES HEADACHES


VAERS ID: 1343631 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-31
Onset:2021-05-20
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PT tested positive for COVID-19 5/20/2021 via nasal swab.
CDC Split Type:

Write-up: Patient reported received Pfizer COVID-19 vaccine 2 dose series 3/4/2021 and 3/31/2021. PT tested positive for COVID-19 5/20/2021 via nasal swab.


VAERS ID: 1343634 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Headache, Pain
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Heavy headache, body aches for a week with few occasion of diarhea


VAERS ID: 1343636 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: HEADACHES SORE ARM FEVER CHILLS FATIGUE


VAERS ID: 1343665 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No e
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1343684 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysarthria, Oxygen saturation decreased
SMQs:, Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

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

Write-up: Blood oxygen level dropped rapidly to 86 about 30min after shot. Caused a feeling of hypoxia and slurred speech.


VAERS ID: 1343747 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Headache, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: probiotics, vitamin C, zinc, Claritin
Current Illness:
Preexisting Conditions: SVT, mitral valve regurgitation, low blood pressure, Lyme disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: When Observation Staff was releasing patient, patient reported not feeling well some itching on her neck, asked her if she could walk to the tent, she replied yes. She grabbed her belongings and walked to the tent, sat in the chair without assistance. I asked if she preferred to lay down on the cot, she replied, ?yes, that is probably a good idea?. She complained of itching on her neck, hands bilaterally, and lower leg bilaterally for the last 5 minutes that ?feels like a bad sunburn?. She reported this is has happened before, several times, and is seeing a ?Functional Medicine Doctor? for the past 2 months to try and diagnose this condition. She mentioned the functional medicine doctor recommended she receive the COVID-19 vaccine. She also began to feel a headache, dizzy ?but not because my head is spinning but because the ground is unstable?. No visual rash present on areas reported as itchy. She reported a history of low blood pressure, SVT, mitral valve regurgitation, hives, and Lyme disease. She mentioned her dad drove her here and is waiting in the parking lot. Reported she does not take any prescription medication only takes vitamin C, Zinc, a probiotic, and Claritin as needed for the itching. She mentioned she had some blood work done recently due to hormonal imbalance, digestive discomfort, and her history of Lyme disease. Orthostatic laying: BP 105/64, HR 90 SPO2 99, BPM 19, 4/10 pain with the burning sensation Sitting: BP 105/62, HR 90 SPO2 99, BPM 18 Standing: BP 117/64, HR 90 SPO2 99, BPM 18 able to stand with out feeling dizzy or lightheaded for 5 minutes Took vital signs and chatted with the patient about her symptoms and she reported this reaction is similar to what she has been feeling in the past and why she is seeing her Functional Medicine Doctor. She had not taken Benadryl for this reaction recently and said it made her feel ?really drowsy? and does not remember it helping much. She brought Claritin 10 mg and took it since it what her fictional medicine doctor recommended. Since her vital signs were WNL, she denied feeling worse, history of similar symptoms and events, patient was escorted out in a wheelchair for safety. She said she felt like she could walk on her own but agreed to be escorted out in the wheelchair. Wheeled out by PHN, patient was able to get out of wheelchair and into the SUV without assistance.


VAERS ID: 1343754 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

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

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

Write-up: He was administered Vaccination at 2:47pm. He stood up at about 3pm and collapsed to the floor and started to get unresponsive. I administered 1 dose of epipen 0.3mg and he started to get better. 911 arrived and patient was feeling better so he refused to go to hospital. He is in good spirits and said he was OK that day. He said he will follow up with his doctor . Tried to follow up but have not been able to reach patient but have left a couple of voice messages.


VAERS ID: 1343763 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Human chorionic gonadotropin, Pathology test
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None known
Allergies: Ampicillin, Penicillins class
Diagnostic Lab Data: HCG, surgical pathology of POC.
CDC Split Type:

Write-up: Miscarriage 5/20/2021


VAERS ID: 1343802 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Bruise at the injection site


VAERS ID: 1343887 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypoacusis, Injection site haemorrhage, Nausea, Syncope, Thirst
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: vasovagal syncope bleeding at injection site nausea excessive thirst lightheadedness sweating feeling faint sense of doom tunnel hearing


VAERS ID: 1343889 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pruritus, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had the second Pfizer vaccine on Monday 5/17/2021 at 3:30PM. He was fine until Tuesday 5/18 around 3:00PM. He started feeling tired and had a fever. We gave him Tylenol and he was OK that night. On Wednesday 5/19, he had fever again. He took Tylenol again and was fine until the next day. On Thurday 5/20, he started feeling itchy on his legs. He claimed that he had some mosquito bites. On Friday night 5/21, He felt itchy all over his body, except his face. Now the red spots are bigger. Like mosquito bites but bigger. We gave him Benadryl and Cortizone. It helped. On Sartuday 5/22, he had rashes again, we gave him Benadryl and Cortizone twice. It helped. On Sunday 5/23, it completely cleared.


VAERS ID: 1343892 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-20
Onset:2021-05-20
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood potassium decreased, Blood test, Blood thyroid stimulating hormone decreased, Chest X-ray normal, Electrocardiogram normal, Face and mouth X-ray normal, Heart rate increased, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Dehydration (broad), Hypokalaemia (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: Walmart women''s multi vitamin 10 mg Lexapro
Current Illness: None
Preexisting Conditions: Sinus Tachychardia
Allergies: Sulpha Drugs Penecillin Drugs
Diagnostic Lab Data: chest Exray- clear Nasal Xray- Clear EKG- Clear Blood Tests- Thyroid slighty decreased, potassium slightly decreased
CDC Split Type:

Write-up: Numbness and tingling in feet, hands and lower legs. Heart rate over 130 even after taking Adavan.


VAERS ID: 1343894 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Alanine aminotransferase increased, Aspartate aminotransferase increased, Bilirubin conjugated increased, Blood bilirubin increased, Blood creatinine increased, Blood fibrinogen decreased, Blood lactic acid increased, Chest X-ray abnormal, Computerised tomogram head normal, Computerised tomogram spine, Disseminated intravascular coagulation, Drug screen negative, Endotracheal intubation, Gastrointestinal pathogen panel, HIV test negative, Haemoglobin decreased, Hepatitis viral test negative, Hypotension, International normalised ratio increased, Ischaemic hepatitis, Lung opacity, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Metabolic acidosis, Pulmonary embolism, Respiratory viral panel, Rocky mountain spotted fever, SARS-CoV-2 test negative, Staphylococcus test positive, Thrombectomy, Toxicologic test normal, Transaminases increased, Transfusion, Viral test negative, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Lactic acidosis (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Biliary system related investigations, signs and symptoms (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension, opioid abuse
Allergies: none
Diagnostic Lab Data: WBC 40s Hb as low as 6.5 Fibrinogen 90s, INR 9, improved after transfusions AST/ALT peaked at 6000s T bili 11, D bili 9 lactate peaked at 27 CT head negative. CT c spine with age indeterminate c4/5 fracture MRI brain and c spine pending cxr improving after developing L lung white out
CDC Split Type:

Write-up: Patient presented to the ED after being found down outside. Initially hypotensive, was intubated in ED. Required increasing pressor support. Found to have profound anion gap metabolic acidosis with lactate peaking at $g27. Initial workup also significant for WBC 40s, AKI with Cr peak at 2.5. Transaminitis likely 2/2 shock liver. Toxicologic workup was negative for alcohol, Tylenol, salicylates, urine drug screen. Blood cultures grew S. hominis. Other infectious workup including covid, hepatitis, hiv, rocky mountain spotted fever, respiratory panel, GI PCR, all negative. Also found to have a PE which was removed via thrombectomy. Developed DIC requiring multiple transfusions of cryo, FFP, and RBCs. Condition improved slowly with lactate downtrending currently and pressor requirement weaning.


VAERS ID: 1343958 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 LA / IM

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

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

Write-up: Swollen, red, warm and itchy area at injection site that started six days after vaccine. Still experiencing symptoms to date of this report.


VAERS ID: 1343963 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Diarrhoea, Fatigue, Injection site inflammation, Injection site pruritus, Injection site swelling, Injection site vesicles, Injection site warmth, Nausea, Pain, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient reported the onset of side effects/adverse reaction beginning the evening after her vaccination. Temperature of 104.8, nausea, vomiting, diarrhea, fatigue, body aches, chills. A baseball sized area of inflammation at injection site that was swollen, hot to the touch, itched, and had blisters in the center. Entire body itching.


VAERS ID: 1343973 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-11
Onset:2021-05-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Oral herpes, Rash macular
SMQs:, Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily women''s multi vitamin - olly brand vitamins
Current Illness: none
Preexisting Conditions: none
Allergies: none that I know of
Diagnostic Lab Data: none available
CDC Split Type:

Write-up: 5/11/21 Day 1 (within in 12 hours) - 3 cold sores appeared on left side of mouth the same side as shot. lasted for over 10 days. 5/20/21 - brown spots appear on left side hand (top of hand near thumb) 5/21/21 - browns spots increase on left side hand (top of hand near thumb and in the middle) total of 8 or more brown spots and 1 smaller sized brown patch on left hand 5/24/21 - brown spots and patches are still present but not increasing as of today


VAERS ID: 1344002 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Patient began sweating and feeling lightheaded shortly after vaccination at approximately 1125. Patient then fainted in his chair and was initially non-responsive to the nurse. At this time I called 911. The nurse administered a single epi pen in patient''s quad and he woke up. The nurse then took patient''s vitals at 1138: BP - 109/73; P-84; SPO2-99%; T-97.4; R-16. Patient stating he was still feeling dizzy and fatigued. The paramedics arrived and took patient to hospital for continued evaluation. I called patient later in the afternoon and he had already been discharged and was at home resting and feeling better.


VAERS ID: 1344005 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site bruising, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN, glimiperide, tizanidine, hydrocodone/apap, atorvastatin and benazapril
Current Illness: NONE, goes to therapy for hip
Preexisting Conditions: diabetes, hypertension
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient comes into pharmacy on 05/24/21 with 2inch by 2 inch bruise on left deltoid muscle at injection site. She states the bruise appeared the next day after the vaccine and has gotten bigger in size. She reports little bit of headache that didn''t last long . Her had arm soreness for 3 days but now it doesn''t hurt and she has no need to seek medical attention.


VAERS ID: 1344018 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiomegaly, Dyspnoea, Heart rate increased, Hepatomegaly, Nausea, Splenomegaly, Vomiting
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: rapid heart rate, shortness of breath, nausea and vomiting


VAERS ID: 1344065 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Levothyroxine 50 mcg, NAC 1000 mg, Ovasitol, fish oil 1000 mg, probiotic
Current Illness: N/A
Preexisting Conditions: Thyroid disease, PCOS
Allergies: Vicodin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I experienced abnormal vagina bleeding outside of my regular monthly menstrual cycle following the vaccination for 4 days from 5/20-5/23.


VAERS ID: 1344067 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: 6 days after the vaccine was given the patient reported redness and swelling at the injection site. She went to see her doctor who informed her that she had cellulitis. She was treated with antibiotics and pain medication.


VAERS ID: 1344097 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test, Arthralgia, Chills, Dysgeusia, Dyspnoea, Fatigue, Fibrin D dimer, Headache, Injection site pain, Insomnia, Lymphadenopathy, Mouth breathing, Musculoskeletal stiffness, Neck pain, Somnolence, Urine odour abnormal, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I had a antibody and D dimer test on Monday May 17th to check for blood clots, antibodies as I wanted the J&J one dose but it was nowhere to be found in my area.
CDC Split Type:

Write-up: Date of shot-May 20, 2021 (Thurs) injection site right arm slightly sore. Had chemical taste in mouth within 30 minutes after shot; urine had chemical odor after shot. May 21, 2021 (Fri) injection site right arm more sore and could not turn my head to the right as my right neck (lymph nodes) were all swollen. Had chills, headache, fatigued and threw up after eating light breakfast. I iced and took Advil. PM/Bedtime-could not get deep breaths through nose breathing/had to mouth breath-hardly slept. May 22, 2021 (Sat) called emergency room and Pharmacist (primary Pharmacist still on vacation) was told to switch to HEAT pad on my neck, take Advil. Right arm injection site, up the arm, across collar bone, up the right neck to ear lobe all swollen and painful since Friday-hardly any change. May 23, 2021 (Sun) so tired from not sleeping well (could not lay on right side since the shot) and slept mostly all day. May 24, 2021 (Mon) feel a little better but neck is still swollen and sore. 50% motion back to turn my head to the right. Breathing better when laying down through my nose as well. I would like to talk with a Doctor at the CDC as I do not have a Primary Doctor, and was just referred to one, but cannot schedule to see him until mid June. I am nervous if the 1st Moderna shot is causing internal swelling, bleeding, etc. ? And I am not planning on getting a 2nd Moderna shot after this severe reaction caused by the 1st shot. I am healthy, never take drugs, get flu shots, etc. and my body felt like it was fighting a battle...and I am not 100% myself. I want to know WHEN my neck will heal, WHEN my motion will be back to 100% as it is making driving challenging, and what next steps you recommend. Please advise.


VAERS ID: 1344162 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ear discomfort, Ear pain, Head discomfort, Headache, Hypoaesthesia, Injection site pain, Neuralgia, Pain, Paraesthesia, Paraesthesia oral, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Approximately 3 hours after vaccine, I began to have tingling on my upper lip (area where I typically get a cold sore). Tingling continued to spread to the left side of my face, including my eyebrow, eye and temple area of my head. Tingling has persisted to both of my arms, hands, legs and feet. It comes and goes, and has continued through-out the day. Itching has now developed on my arms, right breast (nipple area) and feet. I have a general "internal" itch that I can''t seem to scratch on my arms, legs and feet. On Saturday 5/22, Sunday 5/23 and Monday 5/24 I have also experienced strong nerve pain in my left eye and the lower right side of my head. The pain is sudden, strong but goes away fairly quickly. My left large tie also has developed a numbness, started off with a lot of tingling in that toe. My head generally has a fullness feeling, specifically my ears have a throbbing sensation that I also equate to a similar feeling when my cold sores are active. There is a dull ache behind my ears and the lower back of my head. I developed a headache starting on 5/20 (over the counter meds helped with that) Pain at injection site lasted for 3 days, but was manageable and did not interfere with daily activities. I have not had a cold sore develop as my dr told me to take Valtrex, I have taken one pill of that on 5/24. I also have taken Tylenol on 5/20, 5/21, 5/22 - 500mg 2 times a day.


VAERS ID: 1344168 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre 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: escitalopram, Sprintec BC pills, hydroxyzine
Current Illness: Being treated for anxiety/panic attacks
Preexisting Conditions: anxiety/panic attacks
Allergies: None
Diagnostic Lab Data: Don''t know
CDC Split Type:

Write-up: Numbness of arms and legs, back pain, body aches. Went to ER 4 days after receiving vaccination. Don''t know outcome yet.


VAERS ID: 1344184 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN (NOT GI / 1 UN / UN

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

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

Write-up: patient first received Pfizer at another pharmacy and then came in to our pharmacy 2 weeks later and got the second shot- but was given moderna by mistake. Patient was feeling under the weather for a few days but is now feeling better


VAERS ID: 1344230 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: tiny blood spots under the skin beyond the site of injection both arms and front and back of upper body


VAERS ID: 1344263 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood potassium decreased, Blood test, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: nkda
Diagnostic Lab Data: 05/20/21 blood work all data unknown
CDC Split Type:

Write-up: The patient collapsed, was brought to hospital, had low blood pressure and low potassium


VAERS ID: 1344346 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Insomnia, Poor quality sleep, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (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: age 22; Feb 1976; swine flu vaccine; fever within 24 hours; severe case of the flu and walking pneumonia; I missed work for 3 we
Other Medications: Vitamins C, B complex, B12 sublingual, E, D/K, Fish oil, lysine, milk thistle, CoQ10, lutein topical estrogen: E2 (.25)/E3(2.0) 100 mg progesterone
Current Illness: none
Preexisting Conditions: seasonal allergies (cat allergy developed in 2019); herpes simplex one (?)
Allergies: penicillin drugs, chili peppers, cats
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 4 hours after the vaccine, a dull headache; restless sleep/insomnia throughout the night. 24 hours after the vaccine two rashes appeared (upper back behind left shoulder; and on the underside of left breast); they are suspected as herpes zoster. Rx is 800mg acylovire 5x/day for 7 days with advil or tylenol for pain, caladryl for itching and ice. Pain is localized and severe. No fever.


VAERS ID: 1344583 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Electrocardiogram abnormal, Fatigue, Palpitations, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypokalaemia (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: 5/24/2021 - ECG performed which diagnosed as premature ventricular contractions by a doctor
CDC Split Type:

Write-up: heart palpitations, dizziness, fatigue, shortness of breath (diagnosed as premature ventricular contractions by a doctor based on ECG results)


VAERS ID: 1344598 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: haloperidol 10mg po BID haloperidol decanoate 200mg IM q2 weeks olanzapine 10mg po HS
Current Illness:
Preexisting Conditions: schizophrenia overweight
Allergies: NKA
Diagnostic Lab Data: Vital signs shortly after vaccination - Temp 97.1, Pulse 65, Resp 17, BP 122/78
CDC Split Type:

Write-up: Patient received 2 doses of Janssen covid vaccine, a single dose vaccine. The staff had given the Janssen Covid vaccine when they discovered the patient had received the same vaccine a week before (5/13/21), prior to admission. As of 5/24/21, no reaction noted to the vaccine.


VAERS ID: 1344638 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-06
Onset:2021-05-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Appendicitis, Computerised tomogram abdomen abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT Abdomen 05/22/2021 FINDINGS ARE COMPATIBLE WITH RUPTURED APPENDICITIS
CDC Split Type:

Write-up: Abdominal pain - patient was diagnosed with acute RUPTURED APPENDICITIS . I am not sure if this is related or not but given prior reports of similar issue after the vaccine and the fact this happened right after the vaccination I thought it might be related.


VAERS ID: 1344649 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein, Chest discomfort, Chest pain, Electrocardiogram, Myocardial necrosis marker, Red blood cell sedimentation rate, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at this time that is known
Current Illness:
Preexisting Conditions:
Allergies: Denies
Diagnostic Lab Data: Sent to Urgent Care for further evaluation including labs-- recommended COVID-19 PCR test, EKG, +/- cardiac biomarkers and ESR/CRP
CDC Split Type:

Write-up: Received dose #1 on the 17th, about 3-4 days later noticed having chest pain, described as a "pressure" that is worse with deep breathing and lying down. This was a telemedicine visit. She was well appearing, but sent her to urgent care for further eval.


VAERS ID: 1344663 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Heart rate increased, Immediate post-injection reaction, Muscular weakness, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Patient immediately felt dizzy, broke out in hives on bilateral arms from elbow up, chest, neck, mouth area, muscle weakness in bilateral lower extremities. Increased heart rate from 110 at lying to standing at 146 bpm. Administered 25 mg of Benadryl By mouth with water. Within 20 minutes hives on face disappeared but remained in all other areas and none of her symptoms went away. Called 911 had her transported on a stretcher in an ambulance for further observation.


VAERS ID: 1345424 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dehydration, Headache, Heart rate increased, Hypertension, Pyrexia, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Thyroid Medication.
Current Illness:
Preexisting Conditions: Thyroid- Palpitation periodically cased by thyroid.
Allergies: Aspirin
Diagnostic Lab Data: I was treated for my symptoms at Health Center on 5/21/2021
CDC Split Type:

Write-up: I had high fever for about 16 hours. Felt like vomiting, dehydration, blood pressure was very high, heartrate was very high and continues headache. After about 16 hours I ended up going to the Emergency Room. I was treated for high blood pressure, high heartrate, fever, dehydration and headache. I have never experience all of these symptoms at one time in my life. It was a very expensive experience for me. I was fine Thursdays all day until I got the vaccine, A few minutes after I got the Vaccine I felt a little bump on my forehead. I am usually very sensitive to a lot of things so i assumed it was noting. The actual fever didn''t occur until 5 am in the morning. I know this experience is better than getting the actual COVID I just thought I would share my situation.


VAERS ID: 1345778 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Nausea, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN
Current Illness: Thyroid disorder; Type II diabetes mellitus (Husband gave patient muscle relaxant.)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544414

Write-up: VOMITING; SLEEPINESS; FEVER; NAUSEA; EXCESSIVELY TIRED; This spontaneous report received from a consumer concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included type-2 diabetes, and thyroid issues. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included metformin for type-2 diabetes. On 20-MAY-2021, the subject experienced vomiting. On 20-MAY-2021, the subject experienced sleepiness. On 20-MAY-2021, the subject experienced fever. On 20-MAY-2021, the subject experienced nausea. On 20-MAY-2021, the subject experienced excessively tired. Treatment medications (dates unspecified) included: tramadol, and paracetamol. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from fever, nausea, vomiting, excessively tired, and sleepiness, and the outcome of sick was not reported. This report was non-serious.


VAERS ID: 1345792 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544743

Write-up: DROWSINESS; TIREDNESS; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-MAY-2021, the subject experienced drowsiness. On 20-MAY-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from drowsiness, and tiredness on 20-MAY-2021. This report was non-serious. This case, from the same reporter is linked to 20210544414.


VAERS ID: 1345794 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Diplopia, Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544866

Write-up: DOUBLE VISION; BLURRED VISION (HAD TROUBLE LOOKING AT THINGS); FEELING DIZZY; This spontaneous report received from a consumer concerned a 54 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1816022 expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, treatment medications included: acetylsalicylic acid. On 20-MAY-2021, the subject experienced double vision. On 20-MAY-2021, the subject experienced blurred vision (had trouble looking at things). On 20-MAY-2021, the subject experienced feeling dizzy. The action taken with covid-19 vaccine was not applicable. The outcome of the double vision, blurred vision (had trouble looking at things) and feeling dizzy was not reported. This report was non-serious.


VAERS ID: 1345797 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Rhode Island  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545147

Write-up: VACCINE KEPT AT ROOM TEMPERATURE FOR OVER 2 HOURS AFTER FIRST PUNCTURE; ADMINISTRATION OF IMPROPERLY STORED VACCINE; This spontaneous report received from a pharmacist concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: 23/JUN/2021) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced administration of improperly stored vaccine. On an unspecified date, the subject experienced vaccine kept at room temperature for over 2 hours after first puncture. The action taken with covid-19 vaccine was not applicable. The outcome of the administration of improperly stored vaccine and vaccine kept at room temperature for over 2 hours after first puncture was not reported. This report was non-serious. This case, from the same reporter is linked to 20210544367, 20210544466, 20210544591 and 20210544384.


VAERS ID: 1345798 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545155

Write-up: ACHEY; MILD HEADACHE; LIGHT HEADED/DIZZINESS; This spontaneous report received from a patient concerned a 37 year old female. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204a21a, expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, treatment medications included: paracetamol. On 20-MAY-2021, the subject experienced light headed/dizziness. On 21-MAY-2021, the subject experienced achey. On 21-MAY-2021, the subject experienced mild headache. The action taken with covid-19 vaccine was not applicable. The patient recovered from achey, and mild headache on 21-MAY-2021, and was recovering from light headed/dizziness. This report was non-serious.


VAERS ID: 1346430 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: Beginning at 10pm: chills, fever (102), headache, body aches 4am: took Aleve (2 caplets) 6am: fever (100), body aches, headache 9am: temperature returned to ~98.8 Body aches and fatigue continued until about 5pm


VAERS ID: 1346446 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Erythema, Fatigue, Headache, Injection site erythema, Injection site rash, Injection site warmth, Nausea, Pain in extremity, Rash macular, Skin tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: codeine allergy
Diagnostic Lab Data: Did not go to the doctor for side effects
CDC Split Type:

Write-up: 5/20-day after vaccine was extremely fatigued, a strong headache (took Tylenol for it), a bit nauseous, diarrhea once, and arm very sore. 5/21-felt almost 100% but noticed rash developing on arm where vaccine was given. Red and blotchy. 5/22-arm soreness gone with just a tiny bit of tightness. Rash still present. 5/24: rash fading. 5/25-rash back and worse than ever. About 4 inches across, red, and warm to the touch. No itchiness or pain.


VAERS ID: 1346463 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 received first dose of Pfizer COVID Vaccine and second dose was Moderna. No visible adverse events at this time.


VAERS ID: 1346493 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / N/A LA / IM

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

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

Write-up: THE CLIENT HAD ALREADY RECIEVED 2 DOSES OF MODERNA (ON 01/18/21 AND 02/18/21). THE CLIENT INADVERTENTLY RECEIVED A THIRD DOSE OF COVID-19 VACCINE (PFIZER) ON 05/20/21.


VAERS ID: 1346519 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-02-01
Onset:2021-05-20
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Adverse reaction, Allergy to arthropod sting, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: EXCESSIVE SWELLING FOLLOWING A BEE STING


VAERS ID: 1346534 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-30
Onset:2021-05-20
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood lactic acid, Chest X-ray, Differential white blood cell count, Dyspnoea, Full blood count, Headache, Metabolic function test, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC with Differential Comprehensive Metabolic Panel Lactic Acid CK XR Chest PA and Lateral
CDC Split Type:

Write-up: High Fever - 102.0 to 103.5 Extreme body aches Shortness of Breath Headaches - Extreme Rash


VAERS ID: 1346539 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: c/o of nausea after taking the vaccine. Denies past medical history and allergic reaction. pt. verbalized feeling better prior to leaving the parking lot.


VAERS ID: 1346548 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Facial discomfort, 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: c/o facial tightness and left arm pain after taking the vaccine. pt. stated that she always feel that way when her BP is elevated. BP was 150/101, and patient had just taken her BP medications. Monitored pt. for 20 mins. and proposed rechecking BP, but she refused. Pt. verbalized feeling better prior to leaving the parking lot. Advice pt. to recheck BP at home and f/u with PCP if need be.


VAERS ID: 1346555 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: c/o of nausea and dizziness . weakness. symptoms resolved and pt went home


VAERS ID: 1346564 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle tightness, Skin tightness
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: c/o tightness of her left arm and jaw and also c/o facial numbness. BP 150/101, HR 87, pt. went home after symptoms was resolved.


VAERS ID: 1346573 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

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

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

Write-up: c/o of slight headache after taking the first dose of vaccine. No medical history reported. no history of allergic reaction reported. vital signs stable. BP 129/74, O2 98, P 93, R 18. Pt. verbalized feeling better prior to mom driving her home. Advice mom to monitor pt. and report to PCP and abnormal changes.


VAERS ID: 1346592 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Fatigue
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

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

Write-up: Systemic: Patient felt extremely tired soon after receiving her vaccination. I monitored patient for 40 min. and then called to check on her later that night and then again after the weekend as well. Patient was recovered when I called to check on her on 5/24/21.-Mild, Systemic: Hypertension-Mild, Additional Details: The patient''s blood pressure was elevated during the monitoring period, but I am unsure of her baseline/normal blood pressure. I recommended the patient and her caregiver to follow up with her primary care provider to be evaluated for pediatric hypertension.


VAERS ID: 1346616 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient complains of itching and tingling. Benadryl was given patient stated feeling better and left.


VAERS ID: 1346646 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

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

Write-up: Pt. stated he felt a little dizzy and that is the last thing he remembers. Patient passed out and was found on the floor. Denies hitting head. Patient was diaphoretic blood sugar was taken and was 71 . Patient drank juice and ate crackers. Sugar was rechecked and was 101. BP 145/83 HR- 67. Patient was feeling much better and left.


VAERS ID: 1346726 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, chills, swollen lymph nodes


VAERS ID: 1346745 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60mg Camrese 1.5
Current Illness: None
Preexisting Conditions: None
Allergies: Cats
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Tightness in chest for about 2 days. Resolved All over body tingling for about 2 days Resolved


VAERS ID: 1346770 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-05-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: klonopin 1 mg bid gabapentin 100 mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports on and off palpitations and smoking more due to anxiety


VAERS ID: 1346775 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-05-20
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor Apresoline Clozaril
Current Illness: unknown
Preexisting Conditions: HTN Parkinson''s hypercholesterolemia hypothyroidism
Allergies: Morphine Codeine Zoloft
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 2. Pulmonary embolism without acute cor pulmonale, unspecified chronicity, unspecified pulmonary embolism type


VAERS ID: 1346790 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-05-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Gait disturbance, Hypoaesthesia, Pain in extremity, Ultrasound Doppler, Ultrasound scan abnormal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control; Blisovi 24
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Blood work/ DDVT (tests to see if it is a blood clot) : result was abnormally high count. Sonogram which solidified the presence of a blood clot and its extent.
CDC Split Type:

Write-up: I got the second dose of the vaccine on May 11th 2020. I am currently on my second week for completing the vaccine. When it all started I was just laying down on my couch watching Netflix with my laptop on my lap (this was Thursday night, May 20th). My leg fell asleep but I didn?t think anything of it because once I started walking around it went back fine. However, On May 21st, Friday morning I was having serious pain in my left thigh. I believed it was a muscle strain. I did a cold compress, warm bath and took Tylenol from Friday to Saturday. I thought it got better but however by May 23rd, Sunday night I was incapable of walking on my own and needed assistance just to go to the bathroom. On May 24th I went to Urgent Care and they stated that I may have a blood clot so I went to the ER. While at the ER they stated I had a massive blood clot that would need a procedure done to remove it and was later admitted into the hospital and scheduled for the procedure. The blood clot travels from my groin to my ankle on my left thigh. They stated the reason for my blood clot would of been because of my birth control. And it?s possible reaction to me also taking the Pfizer vaccine. I have been on birth control for over 5 years and have not had any problems until now. I also do not have any history or family history of blood clots. I did not hit my thigh or have done any exercises for this to occur.


VAERS ID: 1346809 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Lacrimation increased, Pain, Presyncope, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness:
Preexisting Conditions: assaulted by sledgehammer 2 years ago
Allergies: pcn
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1755 vaccine given by RN 1800 ptx pain, difficulty breathing, BP 140/70/72 1805 ptx sweaty palms, vagal symptoms, watery eyes, BP 99/42/70 1810 ptx dizzy, leaning back, I cant breath, Epipen given in left thigh 1812 ptx vomited large amount 1815 ptx improving, talking, paramedics called 1820 Paramedics arrived BP 137/73/70 1825 ptx transported to local hospital for follow up evaluation


VAERS ID: 1346831 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pregnancy test false positive
SMQs:

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

Write-up: False positive pregnancy test


VAERS ID: 1346849 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 - / IM

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

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

Write-up: Inadvertently given Janssen at 2nd dose visit - was supposed to get Pfizer.


VAERS ID: 1346930 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Work       Purchased by: ?
Symptoms: Headache, Hypertension, Hypoaesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ondansetron Benzonatate Iprateopium Albuterol HFA Albuterol ( PROVENTIL) Montelukast Cholecalciferol Hydrochlorothiazide Fluticasone Tretinoin Acetaminophen Pantoprazole Famotidine Nifedipine Hudroxyzine Ibuprofen Methylprednisolone
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, fever, numbness in leg and hypertension.


VAERS ID: 1346982 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg, Lipitor 10mg, women?s daily vitamin, Benadryl, Claritin
Current Illness: Seasonal allergies
Preexisting Conditions: PCOS
Allergies: Sulfa, latex, surgical adhesives
Diagnostic Lab Data: Went to ER on 05/23/2021 after to speaking to nurse the night before. No tests. Just evaluated and release with prescription for steroids if the rash worsened. Prescription was not filled, and I do not seem to need it at this time.
CDC Split Type:

Write-up: The night after army second does I started breaking out in bumps on my chest and face. Over the next couple days I the rash increased on my face and chest, and spread to my neck, behind my ears, on one ear, and also a small patch on my neck, as well as few on y arms and fingers. Rash was of varying size, clustered as well as single, and extremely itchy. Today is the fifth day, and I don?t appear to have any new bumps.


VAERS ID: 1347102 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chills, Condition aggravated, Coordination abnormal, Disorientation, Disturbance in attention, Fatigue, Feeling abnormal, Headache, Heavy menstrual bleeding, Increased appetite, Injection site pain, Injection site warmth, Insomnia, Lymphadenopathy, Menstruation irregular, Myalgia, Oropharyngeal pain, Pyrexia, Somnolence, Tinnitus, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LamoTRIgine 200mg/daily Vitamin D 2000gm/daily
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 0 (injection) : soreness, pain, and heat at injection site. Swelling of lymph node under left armpit AND lymph nodes at throat and mouth. Headache, fever (99.8F), chills, very strong shivering, fatigue, strong aches and pains in muscles, unusual joint pain, loss of concentration or brain fog, disorientation, drowsiness. Increased tinnitus. Sore throat. Chest tightness. Increased appetite. Day 1: soreness and pain at injection site. Lymph nodes at armpit and throat/mouth still a little swollen. Headache all day. Disorientation or brain fog. Major fatigue. Sore throat. Tinnitus. Lack of appetite. Day 2-4: Insomnia (inability to fall asleep, easily awoken, unable to fall back to sleep, unable to sleep for more than 3 hours at a time). Minor psychedelic visual effects (auras around objects, long tracers following moving objects, brighter or more intense colors). Headache (minor, all day). Drowsiness. Loss of coordination (minor). Brain fog. Day 4 specifically: Irregular menstrual cycle, my period immediately began 1.5 weeks early and very heavy. Flow is unusually fluid and more like the consistency of blood, not viscous like usual.


VAERS ID: 1347108 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Body temperature increased, Cough, Eye pain, Fatigue, Feeling abnormal, Headache, Nausea, Neck pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: thyroid medicine
Current Illness: cough off and on since the first vaccination on 4/21
Preexisting Conditions: hypothyroid
Allergies: flagyl, Bactrium, and an anti depressant i dont remember
Diagnostic Lab Data:
CDC Split Type:

Write-up: My first shot on April 21, i woke up on the 22 with a terrible headache, nauseus, my shoulder hurt to my neck, and I ached like i had hte flu, shaking, and did not eat until the afternoon of the 23rd when all the symptoms subsided. On the24th i started coughing for a few days.. i thought at the time mabye i have allergies this year, i coughed a day here and there until the night of Friday May14th- i coughed noon stop all day until Tuesday night, the 18th. I was fine Wedn day and got my second shot ( i let them know about the coughing) i woke up Thursday with a 100 temp and all the same exact symptoms as above..thursday night i called dr because my fever got to 102 and i was really nauseus, headache, eyes hurt, i couldnt break the fever and i was so miserable and a little scared. Friday the 21st my fevor broke in the afternoon. I woke up on the 22 coughing really bad again with headache and its still lingering. I am exhusted, my head hurts, but am feeling better. i called dr last night and he said to try allergy medicine to see if that can help he symptoms. and to follow up in a few days.


VAERS ID: 1347115 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (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: flonase
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: muscle spasms, around entire body


VAERS ID: 1347185 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Fatigue, Hyperhidrosis, Injection site pain, Muscle spasms, Musculoskeletal stiffness, Pyrexia, Therapeutic response delayed
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ASTHMA
Allergies: NONENONE
Diagnostic Lab Data: NONE, BUT ADVISED PATIENT TO SEEK MEDICAL HELP.
CDC Split Type:

Write-up: PATIENT RECEIVED VACCINE AT 4:15PM ON 5-20-21. EXPERICENCED FEVER, SWEATING, FATIGUE, AND INJECTION SITE PAIN WITHIN HOURS OF VACCINE. NEXT MORNING PATIENT EXPERIENCED ARM, SHOULDER, FINGER OF LEFT ARM MUSCLE SPASMS. LEFT HAND STIFFENED AND LOCKED IN POSTION FOR COUPLE MINUTES DURING DAY. PATIENT DID NOT SEEK MEDICAL ATTENTION BECAUSE SHE SAID SHE WAS TO WEAK TO CALL FOR HELP AND JUST SLEPT. SHE THOUGHT IT WOULD BE BETTER ONCE SHE AWOKE. PATINET DID FEEL SOMEWHAT BETTER NEXT DAY, BUT STILL EXPERIENCING MUSCLE SPASMS AND WEAKNESS AND HAVING DELAYED RESPONSE FOR MUSCLE CONTRACTION. SPOKE TO MD BECAUSE SHE COULD NOT GET APPOINTMENT 2 DAYS AFTER SHOT AND WAS TOLD TO TAKE TYLENOL, BENADRYL FOR SYMPTOMS. PATIENT DID NOT SEEK MEDICAL HELP AT ER DUE TO NO INSURANCE COVERAGE.


VAERS ID: 1347237 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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? 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: Severe itching day of injection (and again today, 5 days after vaccine). Swelling day(s) after swelling (to date - 5 days after vaccine).


VAERS ID: 1347255 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dehydration, Hyperhidrosis, Pyrexia, Somnolence
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: Dupixent, triamcinalone, multivitamin, Zyrtec
Current Illness: None
Preexisting Conditions: Excema
Allergies: Herring, chromate, methelethel......
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Had a fever ranging from 101 to 104F as measured by temporal scan for a period of around 30 hours. Sweats, dehydration and drowsiness as would be common with such a fever. Recovered on own at home.


VAERS ID: 1347285 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Fatigue, Headache, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Headache,lightheaded,weakness,tire,sleepy,lost of breath


VAERS ID: 1347319 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Fall, Malaise, Musculoskeletal stiffness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Was doing fine for about 20 minutes while in observation. Then fell out of his chair, was confused, body went stiff, and didn''t feel well.


VAERS ID: 1347337 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Dysstasia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none documented
Current Illness: Mast cell activation syndrome
Preexisting Conditions: Mast cell activation syndrome
Allergies: Gelatin, eggs, other.
Diagnostic Lab Data: was sent to ER.
CDC Split Type:

Write-up: Patient felt throat closing, she had a very hard time breathing. She was dizzy, almost couldn''t stand, she was coughing non stop (barking cough).


VAERS ID: 1347375 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Cardiovascular evaluation, Chest discomfort, Chest pain, Dyspnoea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: zyrtec
Current Illness: none
Preexisting Conditions: Chronic tension headaches, osgood-schlatter
Allergies: none
Diagnostic Lab Data: heart monitor in ED
CDC Split Type:

Write-up: 2 days after vaccine was give on 5/20/21 around 430 she complained of chest pain that was sharp and pressure and that it was hard to breath. She was taken to the ED for evaluation. At the time of exam she was feeling better in her chest and complained that the pain had moved to her upper abdomen. There were no findings on physical exam or heart monitor. Her heart rate was elevated mostly in the 90''s and low 100''s. No further complaints of chest pain, but continues to be achy 1 week post vaccine especially in her knees.


VAERS ID: 1347379 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Feeling hot, Headache, Injection site pain, Malaise, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: 24 hours post 1st vaccine, she started to get a pounding headache, muscle weakness, injection site soreness, malaise, felt warm . She has been taking Tylenol 4-6 hours. Currently the head ache has improved, but still felling weakness and low energy but improving.


VAERS ID: 1347395 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Catheterisation cardiac, Chest pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control pill, escitalopram
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Morphine
Diagnostic Lab Data: Troponin Left Heart Cath
CDC Split Type:

Write-up: mid sternal non-radiating chest pain, generalized weakness, elevated Troponin, Left heart catheterization


VAERS ID: 1347535 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK LA / IM

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

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

Write-up: Patient was only 11 at time of vaccination. Parent wrote "12" in age box on COVID-19 Vaccine Consent Form. No adverse events were reported.


VAERS ID: 1347552 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: I have constant ringing in my ears - I was told this is called tinnitus. I HAVE NEVER HAD THIS UNTIL AFTER THE 2ND SHOT. Started about 10 minutes after the shot and has never stopped.


VAERS ID: 1347598 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

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

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

Write-up: Patient received first dose of Pfizer before the age of 11.


VAERS ID: 1347623 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolog Insulin via pump
Current Illness: None
Preexisting Conditions: Type 1 Diabetes
Allergies: NKA
Diagnostic Lab Data: None, Notified Doctors office and will was advised to monitor symptoms at that time. Also notified her pediatric endocrinologist.
CDC Split Type:

Write-up: Patient started having paresthesia to right foot the night of the vaccine. She felt like her foot was "asleep"...and heavy. Sunday morning she reports the symptoms were gone. SO, Thursday night, Friday, and Saturday she had the symptoms.


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