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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 123 out of 3,524

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VAERS ID: 1347660 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
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 004C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Wrong product administered
SMQs:, Medication errors (narrow)

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

Write-up: Pt came to vaccine clinic on 5/20/2021, filled out encounter as this being the 1st dose of COVID vaccine, on encounter the answer no is checked where asking, "Have you ever received a dose of COVID 19 vaccine?" When the encounter was entered into , it was discovered the pt had received a dose of Pfizer vaccine on 4/2/2021. After multiple attempts to contact pt, this nurse spoke with her on the phone 5/25/21, pt confirmed receiving Pfizer vaccine on 4/2/21. She was advised by a pharmacist and Dr. to restart the vaccine series using Moderna. This nurse advised pt she did not need to restart the vaccine, that she had received to doses and this should complete the ser


VAERS ID: 1347677 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Virginia  
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 004C21A / 1 RA / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt came to vaccine clinic run by a local facility on 5/20/2021, filled out encounter as this being the 1st dose of COVID vaccine, on encounter the answer no is checked where asking, "Have you ever received a dose of COVID 19 vaccine?" When the encounter was entered into the portal, it was discovered the pt had received a dose of Pfizer vaccine on 4/2/2021. After multiple attempts to contact pt, this nurse spoke with her on the phone 5/25/21, pt confirmed receiving Pfizer vaccine on 4/2/21. She was advised by a pharmacist and Dr. to restart the vaccine series using Moderna. This nurse advised pt she did not need to restart the vaccine, that she had received two doses and this should complete the series for her. Pt plans to consult with her doctor as to whether to get a second dose of Moderna. This nurse advised it is unnecessary to receive another moderna vaccine and it is not recommended to mix the vaccine brands. Pt verbalized understanding.


VAERS ID: 1347701 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
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 EW0183 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Injected limb mobility decreased, Muscle spasms
SMQs:, Dystonia (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: blood thinner depakote and triacetone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Left arm, Epilepsy (Parkinsons) Can?t lift arm, muscles cramp, hurts under his arm, never had this problem before, Received Moderna May 20th. Takes blood thinner depakote and triacetone,. Being seen by Health Department.


VAERS ID: 1347704 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
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 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Facial paralysis, Hemiparesis, Hemiplegia, Hypoaesthesia, Magnetic resonance imaging abnormal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluticasone Fexofenadine Proventil Baclofen Vit B12 Topiramate Vit D
Current Illness: None
Preexisting Conditions: Osteoarthritis GERD Hyperlipidemia RLS Multiple Sclerosis
Allergies: Penicillin Copaxone
Diagnostic Lab Data: MRI 5/20: acute infarct within the left frontal lobe
CDC Split Type:

Write-up: On 5/20 patient started experiencing right arm and leg weakness, accompanied by right sided facial numbness and facial droop. She was taken to the ER and admitted to the hospital for right sided hemiplegia and left sided frontal lobe stroke per MRI. No signs of atrial fibrillation. Hospital notes indicate that etiology of stroke is unclear.


VAERS ID: 1347748 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-05-20
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A LA / IM

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

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

Write-up: Patient received Covid-19 Janssen vaccine 3/17/2021. Patient tested positive for COVID-19 on 5/20


VAERS ID: 1347782 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
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 EW0168 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Muscle tightness, Ocular discomfort, Vertigo
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (narrow)

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

Write-up: hours after administration, patient experienced dizziness / vertigo. She felt like her eyes were in a haze / cloudy. there was muscle tensions through the legs (not arms)


VAERS ID: 1347834 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
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 009C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Rash/red/itching all over body 24 hours after vaccine.


VAERS ID: 1347839 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-03
Onset:2021-05-20
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute left ventricular failure, Catheterisation cardiac normal, Ejection fraction decreased, Myocarditis, Syncope, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, docosahexaenoic acid-epa (Fish Oil), finasteride, multivitamin, Tamsulosin
Current Illness: none
Preexisting Conditions: HTN, HLD, and BPH
Allergies: none
Diagnostic Lab Data: EF 20%, elevated troponin and normal cardiac cath
CDC Split Type:

Write-up: Syncope on 5/20, found to have acute myocarditis with acute systolic heart failure


VAERS ID: 1347872 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Vermont  
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 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Enlarged uvula, Eye swelling, Fatigue, Lip swelling, Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: One week after receiving the vaccine I woke up on 5/21 with a mild rash. As the day went on the rash progressed and swelling of lips and uvula occurred around 5pm. I was taken to an urgent care who transferred me to a hospital via rescue. I spent the night at the hospital receiving multiple epi pen injections, and fluids. I was discharged 5/22 with a dose of prednisone. I was fatigued all day. On 5/23 I woke up to swollen eyes and lips and covered in hives again. I went to the ER where I was given steroids and fluids again. The hives went down but did not go away. One 5/24 I took multiple doses of Benadryl and dose of prednisone and in the evening time the hives progressed. Today 5/25 I woke up with swollen lips and checks and hives. I went to my doctors office to be evaluated.


VAERS ID: 1347879 (history)  
Form: Version 2.0  
Age: 73.0  
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 EW0161 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Fatigue, Influenza like illness, Lymph node pain, Nausea, Pain, Pain in extremity, Poor quality sleep
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit. E 400IU - Breathe-X - 1 Body Adrenal Support - Vit. D3 5000IU - Magnesium Citrate 420mg - Alfalfa 650mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: May 20 Had felt "fatigued" most of day - attributed it to having to rise earlier than usual and having not slept well. Evening of 2nd dose date I began to feel somewhat more fatigued. (Had also drank a shot of tequila before dinner and had a glass of white wine with. Was also smoking high quality cannabis in moderation.) At 11:00 pm I rose from my chair having been seated for probably an hour and symptoms hit me full force: chills, the mild soreness in my upper arm became moderate to severe and spread to my shoulder and lower back, whole body particularly joints (including fingers of left hand) aches, mild nausea. Rough night May 21 Symptoms continue with less severity. Especially notice pain in lymph gland areas - armpits, lower back, sides of neck. by evening (with the help of 1/2 Percocet (10/325) I was feeling ok and stayed up til 1:30am May 22 Awake @ 8am. whole body particularly joints still ache including left hand (exacerbated by phone use). Upper left arm & shoulder still sore but mid-back left side more so. May 23 Pretty much back to normal. "Flu symptoms" ran their course. Still have a tough immune system at 73yo apparently (I rarely get sick at all)


VAERS ID: 1347887 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Kansas  
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 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Condition aggravated, Dysgeusia, Headache, Pain in extremity, Pulmonary pain
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Varicose veins in lower below knee legs
Allergies: None
Diagnostic Lab Data: I will schedule future leg vein scans for my right leg
CDC Split Type:

Write-up: This is to report my side effects since the vaccine shot, because I haven?t heard any of these regarding this vaccine. Lower leg below the knee on the left and right leg varicose veins have constantly burned and ached. Only my right leg had previous varicose veins that would burn ache in the evenings following a day of manual labor. From Friday morning to Monday late night my left temple would randomly throb. Same days either my lower left or right lung would ache or be sore. For about 2 hours everyday same days above I would have a metallic taste in my mouth no matter what I ate or drank. No pain ever severe enough for immediate medical attention


VAERS ID: 1347907 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Kansas  
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 8W0175 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blue toe syndrome, Macule, Peripheral coldness
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonics, Losartan, 81 mg aspirin
Current Illness: None
Preexisting Conditions: Sinus infections - high. Blood pressure
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fingers turned ice cold - toes turned blue and ice cold - 2nd toe on each foot had large purple patch. Symptoms lasted for over an hour. Vitals stayed fine.


VAERS ID: 1347918 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Arizona  
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 EW0176 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Fatigue, Feeling abnormal, Headache, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: - Typical sore arm and fatigue in Day 1 & 2 - 4 days of severe headache from Day 1 through Day 4 - Day 4 severe diarrhea - Day 4 & 5 foggy "brain" - Muscle aches and weakness Day 2 - 4 - Potential menstrual period interruption


VAERS ID: 1347921 (history)  
Form: Version 2.0  
Age: 53.0  
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 034C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 had syncope within 15 minutes following vaccine. Loss of consciousness <15 seconds, recovered quickly.


VAERS ID: 1348023 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Rhode Island  
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 EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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), 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: patient reported similar response to TB shot at age 16
Other Medications:
Current Illness:
Preexisting Conditions: obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out after the vaccine....He had mentioned a history of vaso-vagel response when he got a shot as a teenager. He was sitting for about 5 minutes then told us he didn''t feel well, then passed out. However, he came to very quickly. He was given a cold compress, some water and was sitting with legs up. We observed him for 45 minutes until he felt well enough to leave. I don''t think this was a problem with the vaccine due to a similar history while receiving a different vaccine in the past.


VAERS ID: 1348050 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-15
Onset:2021-05-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebral disorder, Computerised tomogram, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: light fever & severe headache
Preexisting Conditions: No
Allergies: No Allergies
Diagnostic Lab Data: CT Scan 05/25/2021
CDC Split Type:

Write-up: Blook Glock in the brain cause severe headache


VAERS ID: 1348081 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / -

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

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

Write-up: on 5/20/21, I felt itchy on my back and started seeing rash near mid, left side of my back. The rash area grew larger over the time and I started feeling the pain the following day. I went to the urgent care on Monday morning and the doctor confirmed that I got shingles. I started antiviral (Valacyclovir) medicine now.


VAERS ID: 1348082 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Virginia  
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 EW0176 / 1 LA / SYR

Administered by: Pharmacy       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: Carvedilol Hydrochlorothiazide Losartan Potassium Simvastatin Levothyroxine Omeprazole Miralax Centrum Silver Vitamin D
Current Illness: None
Preexisting Conditions:
Allergies: Morphin Unysen Pineapple
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA


VAERS ID: 1348092 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Starting approx 5 days ago pt states that she has a constant ammonia smell that nobody else can smell. Does not smell if holds nose or breaths through mouth.


VAERS ID: 1348277 (history)  
Form: Version 2.0  
Age: 49.0  
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 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature fluctuation, Concussion, Contusion, Dizziness, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme body temperature fluctuating; severe dizziness; passed out for 5 seconds (as a result fell to the floor and caused severe bruising - possible concussion sustained)


VAERS ID: 1348318 (history)  
Form: Version 2.0  
Age: 29.0  
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 EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Feeling abnormal, Insomnia, Migraine, Myalgia, Nausea, Neuropathy peripheral, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mild flu-like symptoms lasting for 4-5 days after first Covid-19 vaccination
Other Medications: Spironolactone 50mg QD Bumetanide 1mg 1-2 times/day Toresemide 20mg PRN Methimazole 5mg QD Metoprolol Tartate 25mg BID Cymbalta 60 mg QD Dronabinol 10mg BID Losartan Potassium 100mg QD Montelukast 10mg QD Oxcarbazepine 300mg BID Restasis em
Current Illness:
Preexisting Conditions: Lyme Disease Peripheral neuropathy hyperthyroidism Fibromyalgia CIRS MCAS CIDP Ocular migraines
Allergies: Amoxicillin/Penicillin Bactroban Morphine Benzodiazepines Eggs Gluten Casein Animal products
Diagnostic Lab Data: None done at this time
CDC Split Type:

Write-up: Nausea, vomiting, diarrhea, low-grade fever (99.9 degrees Fahrenheit) intense migraine, extreme muscle pain, brain fog, going back and forth between insomnia and exhaustion, intermittent neuropathy primarily in feet/toes


VAERS ID: 1348323 (history)  
Form: Version 2.0  
Age: 39.0  
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 (MODERNA)) / MODERNA 024C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Contusion, Injected limb mobility decreased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme pain in arm pit of the arm where Covid vaccine given (NOT at injection site) almost unable to move arm for 24 hours. Felt like stabbing pain in underarm. 5 days later noticed significant bruising along underside of arm radiating down from armpit to elbow. Bruising also noted on the right side of torso (along area of bra strap line). Both sides of bruising look like they ?spread? from arm pit area and ran down side of torso and arm to elbow. Bruising is not at all painful.


VAERS ID: 1348327 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Virginia  
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 EW0167 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ProAir Respiclick Albuterol, Advair, Allerclear, Benadryl, Teen Multivitamin, Vitamin D 1000 units
Current Illness: n/a
Preexisting Conditions: Asthma
Allergies: Diary, eggs, nuts, environmental (grass, dust, pollen), pet dander
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient felt itchy throat (discomfort at a 4 out of 10 scale) and difficulty breathing (discomfort at a 5 out of 10 scale) with 5 minutes of being vaccinated. Vaccine administering pharmacist gave Patient a 25 mg Benadryl tablet , which provided no relief 10 minutes later. Pharmacist then injected .3 MG Epinephrine shot in Patient''s left quadricep which provided instant relief for about 30 minutes. Patient then proceeded to the ER where he was given a 20 MG Pepcid tablet, Two 20 MG Prednisone tablets and discharged a few hours later with the instructions to: take One 25 mg Benadryl tablet every 6 hours as needed; One 20 MG Pepcid tablet twice a day and Two 20 MG Prednisone tablets for Five days with a follow up visit to Patient''s allergist.


VAERS ID: 1348468 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-25
Onset:2021-05-20
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Rash pruritic, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartin /hct 25, milk thistle, heal n soothe back herbal, perservision, nician
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash itching burning


VAERS ID: 1348473 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Minnesota  
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 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site inflammation, Lymph node pain, Lymphadenopathy, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Unilateral axillary lymphadenopathy on the left side of the body, inflammation at injection site, muscle aches, fatigue. Moving the left arm causes moderate discomfort due to tenderness of lymph node. Symptoms were most severe for the first 4 days after onset and seem to be slowly receding after that point.


VAERS ID: 1348479 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-21
Onset:2021-05-20
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram, Musculoskeletal chest pain, Pain in extremity, Pulmonary embolism, Pulmonary infarction, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: After a tetanus shot, I experienced extreme jaw pain and had difficulty opening my mouth for about 4 days
Other Medications: Adderall
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Bakers and brewers yeast
Diagnostic Lab Data: Cat scan 5/20 - blood clot in left lung Heart ultrasound 5/20 & 5/21
CDC Split Type:

Write-up: On May 15, I experienced severe pain in my right thigh. By May 17, I was experiencing extreme shortness of breath and pain in my chest and ribs. I ended up in the emergency room on May 20th and was diagnosed with a pulmonary embolism with infarction.


VAERS ID: 1348631 (history)  
Form: Version 2.0  
Age: 59.0  
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 035C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Fatigue, Impaired work ability, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Thursday morning 9 am vaccine. Worked a normal after that. Arm ached as it had the fist time. Nausea and vomiting around midnight. Slept after I lost my dinner. Friday: Slept with intense fatigue and tried to sip water. Intake about 6 oz. Saturday: was able to get up. Took temperature - 100.6 Remained high all day - I slept, drank 12 oz water Sunday: much improved but still felt week. Temp just under 100 all day. Ate and drank lightly Monday: temp only mildly elevated. went back to work. fatigued - cancelled half day Tuesday: no temp. back to work sorry if that''s too much information - thanks for compiling data!


VAERS ID: 1348828 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
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 EWO185 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Hyperhidrosis, Mobility decreased, Nausea, Nervousness
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No prescriptions. Vitamin E, B12, B4, Vitamin D, DHEA
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dizzy, nausea, extreme tiredness (slept for 6 hours after returning home). Tiredness lasted for over a day. The best I can explain this is "internal shaking". I was so weak that when I tried to get up and move, my body would shake internally. Hard to explain. When I first woke up after sleeping 6 straight hours, I was sweating but I don''t know if I had a fever.


VAERS ID: 1348834 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Malaise, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol Hydrochlorothiazide Losartan Potassum Simvastatin Levothyroxine Omeprazole Miralax Centrum Silver Vitamin D
Current Illness: None
Preexisting Conditions: Hypertensive Disorder controlled with medication Hypercholesterolemia controlled with medication Sleep Apnea Abnormal Cervical Papanicolaou Smear
Allergies: Morphin Unysen Pineapple
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA Symptoms: injection site pain, tiredness, headache, muscle pain, chills, fever, nausea, feeling unwell, arm pain Recovered - symptoms lasted 48 hours


VAERS ID: 1348841 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-04
Onset:2021-05-20
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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: Zoloft, Trazadone
Current Illness: None
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was diagnosed with shingles on 5/20/21. I was prescribed valtrex and gabapentin. I am still in the middle of my treatment.


VAERS ID: 1348867 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-12
Onset:2021-05-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Rectal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (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: desmopressin acetate, generic Flonase
Current Illness: none
Preexisting Conditions: diabetes insipidis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rectal bleeding since 5/20/21 through today, 5/26/21 so far. The Nurse Practioner, Dr. diagnosed as hemmoroids. from a photograph. It was not the result of constipation or straining. I have never experienced rectal bleeding before. Very unusual. Doesn''t seem like hemmoroids to me. If it doesn''t get better soon, I will see a GI specialist.


VAERS ID: 1349038 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544784

Write-up: MILD HEADACHE; MILD FEVER; MUSCLE SPASMS ALL OVER BODY FROM TONGUE TO LEGS CONTINUOUSLY INCREASING IN SEVERITY BUT NOT ASSOCIATED WITH PAIN; This spontaneous report received from a consumer 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, and batch number were not reported) dose was not reported, administered on 20-MAY-2021 16:00 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 20-MAY-2021, the subject experienced muscle spasms all over body from tongue to legs continuously increasing in severity but not associated with pain. On 21-MAY-2021, the subject experienced mild headache. On 21-MAY-2021, the subject experienced mild fever. Treatment medications included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from muscle spasms all over body from tongue to legs continuously increasing in severity but not associated with pain, mild headache, and mild fever. This report was non-serious.


VAERS ID: 1349044 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (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: Diabetic
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544923

Write-up: TINGLING IN THE FEET/TINGLING RADIATED UP THROUGH HER BODY; This spontaneous report received from a pharmacist concerned a 47 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetic, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042A21A, expiry: 21-JUN-2021) .5 ml, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced tingling in the feet/tingling radiated up through her body. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from tingling in the feet/tingling radiated up through her body. This report was non-serious.


VAERS ID: 1349050 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545190

Write-up: WHEALS; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-MAY-2021, the subject experienced wheals. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wheals was not reported. This report was non-serious.


VAERS ID: 1349054 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (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:
Current Illness: Allergy to gold; Allergy to metals; Penicillin allergy; Shellfish allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545243

Write-up: ITCHING ALL OVER; This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included penicillin allergy, shell fish allergy, gold allergy, and silver allergy. The patient experienced drug allergy when treated with pethidine hydrochloride for drug used for unknown indication. 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 itching all over. Treatment medications included: cetirizine hydrochloride, and loratadine. On 21-MAY-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from itching all over. This report was non-serious.


VAERS ID: 1349056 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, 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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545428

Write-up: BODY ACHE; CHILLS; FEVER; FATIGUE; This spontaneous report received from a consumer concerned a 36 year old male. 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: 180095, and expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced body ache. On 20-MAY-2021, the subject experienced chills. On 20-MAY-2021, the subject experienced fever. On 20-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, chills, fever, and fatigue on MAY-2021. This report was non-serious.


VAERS ID: 1349058 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Illness, Impaired work ability, Influenza
SMQs:, Infective pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545484

Write-up: BAD CASE OF THE FLU; GOT REALLY SICK; HAD TO TAKE OFF WORK; This spontaneous report received from a patient via a company representative concerned a 34 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported 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 got really sick. On 20-MAY-2021, the subject experienced had to take off work. On an unspecified date, the subject experienced bad case of the flu. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the bad case of the flu, got really sick and had to take off work was not reported. This report was non-serious. This case, from the same reporter is linked to 20210544577.


VAERS ID: 1349693 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Pharyngeal swelling, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: AMITRIPTYLINE; RIZATRIPTAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Migraine; Peanut allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576137

Write-up: I felt like my throat was swelling and closing up followed by swelling of the lip; I felt like my throat was swelling and closing up followed by swelling of the lip; I felt like my throat was swelling and closing up followed by swelling of the lip; This is a spontaneous report from a contactable consumer (patient). A 33-year-old female patient (non-pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Lot Number: ew0182), via an unspecified route of administration at Left arm on 20May2021 12:00 (at the age of 33-year-old) as single for COVID-19 immunisation. Medical history included migraine, asthma and peanut allergy. Concomitant medications included rizatriptan and amitriptyline. Patient was not pregnant at the time of vaccination. Facility where the most recent COVID-19 vaccine was administered was Pharmacy or Drug Store. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 20May2021 at 12:15, patient experienced i felt like my throat was swelling and closing up followed by swelling of the lip. Patient received Benadryl and Ventolin as treatment for event to reduced symptoms. The events were assessed as non-serious, did not result in death, not life threatening, did not cause/prolonged hospitalization, not disabling/incapacitating, did not cause congenital anomaly/birth defect. Treatment was not received. Therapeutic measures were taken as a result of i felt like my throat was swelling and closing up followed by swelling of the lip. The outcome of the events was recovering.


VAERS ID: 1349694 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, 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: LEVOTHYROXINE; SINGULAIR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Graves'' disease; Sulfonamide allergy (known_allergies: Sulfa drug)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021577422

Write-up: This is a spontaneous report from a contactable consumer (patient). A 43-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: unknown and expiration date was not reported), via an unspecified route of administration in left arm, on 19May2021 at 10:00 (at the age of 43 years old) as second dose, single for COVID-19 immunization in pharmacy/drug store. Medical history included grave''s disease. The patient had sulfa drug allergy. Concomitant medications included levothyroxine and montelukast sodium (SINGULAIR). Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: unknown and expiration date was not reported), via an unspecified route of administration in left arm, on 26Apr2021 at 11:30 (at the age of 43 years old) as first dose, single for COVID-19 immunization. The patient was not pregnant and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was never tested for COVID-19. The patient experienced chills and headache on 20May2021. No treatment was received by the patient due to these events. The outcome of these events was recovering at the time of report. Information on the lot/batch number has been requested.


VAERS ID: 1349752 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210520; Test Name: COVID-19 antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210546789

Write-up: Confirmed Immunological Vaccine Failure; This spontaneous report received from a patient concerned a 20 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, 1 total administered on 10-APR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the patient experienced confirmed immunological vaccine failure. Laboratory data included: COVID-19 antibody test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint.; Sender''s Comments: V0.20210546789-covid-19 vaccine ad26.cov2.s -confirmed immunological vaccine failure . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1350295 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1350379 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: This person is in Jail did not inform me that she had another dose of COVID-10 on 4/19/2021 Pfizer ER8731 lot number.


VAERS ID: 1350394 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt is in Jail and did not inform us that she had a vaccine on 4/30/21 a Moderna Lot# 043B21A.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: received this as a second dose received first dose 4/30/21 Moderna lot #043B21A


VAERS ID: 1350436 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Headache, Sore Throat, Body Aches, Fever


VAERS ID: 1350456 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site hypoaesthesia, Injection site pain, Injection site paraesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Additional Details: pt complains of numbness/ tingling in arm of injection


VAERS ID: 1350523 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness
SMQs:

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

Write-up: Flu like symptoms


VAERS ID: 1350623 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-15
Onset:2021-05-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Burning sensation, Hypoaesthesia, Hypoaesthesia oral, Lip swelling, Oral discomfort, Paraesthesia, Paraesthesia oral, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin b12, Levothyroxine, Lisinopril, Atorvastatin
Current Illness: NONE
Preexisting Conditions: Hypertension, Hyperglycemia, Vitamin b12 deficiency, Hypothyroid
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 days after injection developed right sided face and lip numbness, tingling, burning, swelling. Diagnosis: Bells Palsy


VAERS ID: 1350701 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Mouth swelling, Paraesthesia oral, Pharyngeal paraesthesia, Pharyngeal swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillin, atenolol, baclofen, cyclobenzaprine, hyoscyamine, lithium, meclizine, sulfa, tetracaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the Emergency Room via EMS with lip, palette, and throat swelling and tingling, itching, and hives. The patient was treated with epinephrine x 2 doses and diphenhydramine. The patient began having symptoms soon after receiving the Johnson and Johnson COVID 19 vaccine.


VAERS ID: 1350702 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-11
Onset:2021-05-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood homocysteine normal, Cardiolipin antibody, Chest pain, Coagulation factor V level normal, Computerised tomogram thorax abnormal, Dyspnoea, Fibrin D dimer increased, Liver function test normal, Platelet count normal, Protein C, Protein S normal, Prothrombin level normal, Prothrombin time prolonged, Pulmonary embolism, Renal function test normal, SARS-CoV-2 test negative, Ultrasound Doppler normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: At the ED (5/22/2021), physical examination was unremarkable. Blood tests (renal, hepatic function) were normal and labs resulted in D-dimer 0.86 mcg (FEU)/mL and platelet count 288k (Baseline of 200-250k). CT showed suspected very subtle segmental and subsegmental PE involving the left lower lobe. Duplex did not show evidence of DVT in either lower extremity. Given the family history of DVT, hypercoaguable workup was done with the following results: homocysteine level 5.5, thrombin time 14.9, negative factor II and V mutations, cardiolipin Ab IgG < 1.6 GPL (normal range < 20 GPL), lupus anticoagulant with reflex indeterminate, protein C activity 92 (normal range 70-130%) and protein S activity 67 (normal range 65-140%).
CDC Split Type:

Write-up: A 31=year-old female received the first dose of mRNA Covid-19 vaccine (EW0179, Pfizer) IM on May 11th, 2021, without any reported clinical problem. Patient has no known medical illness and no previous history of DVT or PE. Patient had negative COVID-19 PCR on April 16th, 2021. She had 3 healthy pregnancies and no miscarriages. She did not have any long flights or car rides for the last several months, except for over 2 months ago. Patient denies any allergic problems, smoking tobacco or use any oral contraceptives. However, patient stated patient''s father has a history of unprovoked DVT. On May 20th, 2021 patient experienced worsening of left-sided chest pain and shortness and visit ED on May 22nd, 2021. At the ED, physical examination was unremarkable. Blood tests (renal, hepatic function) were normal and labs resulted in D-dimer 0.86 mcg (FEU)/mL and platelet count 288k (Baseline of 200-250k). CT showed suspected very subtle segmental and subsegmental PE involving the left lower lobe. Duplex did not show evidence of DVT in either lower extremity. Given the family history of DVT, hypercoaguable workup was done with the following results: homocysteine level 5.5, thrombin time 14.9, negative factor II and V mutations, cardiolipin Ab IgG < 1.6 GPL (normal range < 20 GPL), lupus anticoagulant with reflex indeterminate, protein C activity 92 (normal range 70-130%) and protein S activity 67 (normal range 65-140%). Patient was admitted to the hospital. At the ED, enoxaparin 60 mg x 1 and morphine 4 mg x 1 were given. Later, it was switched to apixaban 10 mg BID on the floor and patient was discharged with apixaban 5 mg BID x 7 days and once daily BID. Patient is scheduled to follow up with her PCP in regards to the duration of therapy.


VAERS ID: 1350711 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ulnar neuritis
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: EpiPen 2-Pak (0.3MG/0.3ML Soln Auto-inj, 1 (one) Injection as needed for allergic reaction, Taken starting 09/18/2020) Active. hydroCHLOROthiazide (50MG Tablet, 1 Oral daily, Taken starting 11/16/2020) Active. Omeprazole (20MG Tablet DR,
Current Illness: none on file
Preexisting Conditions: type 2 diabetes mellitus, hypothyroid
Allergies: penicillAMINE *CHEMICALS* Hives, Respiratory distress. COCONUT
Diagnostic Lab Data: none on file
CDC Split Type:

Write-up: ulnar neuropathy at the elbow


VAERS ID: 1350718 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Transverse sinus thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan of the head
CDC Split Type:

Write-up: Thrombosis of transverse and sigmoid dural venous sinus


VAERS ID: 1350734 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-17
Onset:2021-05-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FISH OIL... ACID REFLUX MED. AND LIPITOR
Current Illness: NONE
Preexisting Conditions: GERD ... AND CHROHNS
Allergies: NONE
Diagnostic Lab Data: EKG ON 5/20/21
CDC Split Type:

Write-up: SHORTNESSS OF BREATH AND CHEST PAINS


VAERS ID: 1350774 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-27
Onset:2021-05-20
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphonia, Headache, Nasal congestion, Paranasal sinus discomfort, Productive cough, Respiratory tract congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Hypersensitivity (broad), Infective pneumonia (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: Wellbutrin 300mg daily, Zoloft 200mg daily
Current Illness: None
Preexisting Conditions: Obesity, Sleep Apnea
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting 5/20 at around 2PM, experiencing cough (productive), nasal congestion, sinus pressure, slight headache. 5/21 - 5/22 symptoms were cough (productive), chest congestion, sneezing 5/23 - cough (productive), nasal congestion, chest congestion, sneezing, very raspy voice 5/24 through present - cough (productive), chest congestion, raspy voice


VAERS ID: 1350833 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling of body temperature change, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot - general feeling of illness, bloodshot eyes
Other Medications: Fluoxetine
Current Illness:
Preexisting Conditions: hypertension, severe depression
Allergies: sulfa, erythromycin, amoxicillin, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: nausea and vomiting the next day with chills through the night; extreme fatigue and hot and cold spells lasting a week (at least)


VAERS ID: 1350850 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: arm became red and hot to touch at site of injection
Current Illness: none
Preexisting Conditions: chronic fatigue, chronic pain
Allergies: vicodan and doxycycline
Diagnostic Lab Data: none
CDC Split Type:

Write-up: arm became hot to touch and red rash size of nickel at injection site


VAERS ID: 1350893 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-26
Onset:2021-05-20
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 80 mg tablet cholecalciferol, vitamin D3, 25 mcg (1,000 unit) tablet COMBIVENT RESPIMAT 20-100 mcg/actuation inhaler diphenhydrAMINE-acetaminophen (TYLENOL PM EXTRA STRENGTH) 25-500 mg tablet fenofibrate (TRIGLIDE) 16
Current Illness:
Preexisting Conditions: Respiratory Allergic rhinitis Chronic obstructive lung disease (CMS/HCC) Circulatory Benign essential hypertension Flush Digestive Gastroesophageal reflux disease Obesity Genitourinary Urinary frequency Chronic renal insufficiency, stage III (moderate) Musculoskeletal Osteoarthritis of left knee Primary localized osteoarthrosis of left lower leg Primary osteoarthritis of right knee Endocrine/Metabolic Hyperlipidemia Hematologic Iron deficiency anemia B-cell chronic lymphocytic leukemia (CMS/HCC) Diffuse well-differentiated lymphocytic lymphoma (CMS/HCC) Immune Hypogammaglobulinemia (CMS/HCC) IgG2 subclass deficiency (CMS/HCC) Selective deficiency of IgG (CMS/HCC) Other Multiple squamous cell carcinomata
Allergies: LisinoprilCoughing Other Acetaminophen Hydrocodone Morphine
Diagnostic Lab Data: 05/21/21 1710 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/20/21 1620 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Cough Exposure to COVID-19 virus Fatigue, unspecified type


VAERS ID: 1350922 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-05-20
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Covid symptoms started 5/20/21 with body aches, headache, slight cough and fever. Tested positive 5/25/21 due to symptoms continuing. His symptoms are getting better, he is taking some pain meds to help with fever and the body aches. He has no underlying health conditions and wasn''t seen at the hospital for covid-19. Vaccinated 4/8/21 with J&J.


VAERS ID: 1350938 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Diarrhoea, Electrocardiogram, Feeling hot, Gait disturbance, Head discomfort, Hyperhidrosis, Nausea, Palpitations, Sleep disorder, Tremor, Urine analysis, Vaccine positive rechallenge
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: After 1st vaccine I experienced "shakiness" and sweating, but that subsided
Other Medications: Lunesta 3mg, Ativan .5mg, Trulance 3mg, Vitamin C 1000 mg, B12 1000 mcg
Current Illness: None
Preexisting Conditions: Chronic back pain
Allergies: Intolerance to Prednisone and seafood
Diagnostic Lab Data: Chest X-Ray Blood work Urinalysis EKG I do not have the results of the lab work
CDC Split Type:

Write-up: I received my 2nd vaccine on Thursday, May 20th. Within hours after receiving my 2nd vaccine, my hands began to shake, I was very hot with persistent sweating. I never ran a fever. I felt heart palpitations. I experienced extreme nausea, but did not vomit. I had 2 episodes of diarrhea. My head felt very "heavy". When I stood up to walk my gait was very unsteady and I could not walk straight. I was unable to sleep. I followed the advice of the nurse who administered the vaccine - she informed me that I may experience symptoms for 24-48 hours after the shot. For that length of time, I did nothing about the symptoms, assuming they would go away. However, the symptoms persisted (except for the diarrhea) without subsiding until Monday, May 24th. I contacted my primary healthcare provider via patient portal. She was concerned about the length of time I was experiencing such extreme nausea . She felt that I may have been dehydrated and told me to go to the ER. I was admitted to the ER. A chest x-ray was taken. Blood work was taken, urinalysis was conducted, IV fluids with anti-nausea medications and Benadryl were administered. I was discharged from the ER after several hours with minimal symptom relief


VAERS ID: 1350950 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Pain
SMQs:

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

Write-up: Tired and bodyaches


VAERS ID: 1350969 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site rash, Injection site warmth, Musculoskeletal stiffness, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bruising that grew at injection site with redness that developed into larger and larger slightly raised rash over upper arm - very tender and warm to the touch on skin and painful down into arm for several days. Rash was itchy as well from days 2 through 6. Bruising spread about 2.5 inches out and is yellow in color on day 6 - still slightly tender to the touch. Upper arm was stiff down to elbow joint if not moved enough over days 1 and 2.


VAERS ID: 1351104 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C214 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Diarrhoea, Injection site pain, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram 20mg daily, Topiramate 25mg twice daily, Bupropion 300mg daily
Current Illness: Chronic migraines
Preexisting Conditions: Major depression, anxiety disorder
Allergies: Lactose intolerant, seasonal allergies, cat dander
Diagnostic Lab Data:
CDC Split Type:

Write-up: May 20-22: full body joint & muscle aches, low-grade fever, pain at injection site, rotator cuff of the same shoulder was sore longer than the rest of my body. The worst day was the 21st. Ibuprofen (generic, 600mg) helped alleviate most symptoms. May 23-25: nausea, vomiting, diarrhea, abdominal pain. Primarily abdominal pain (lower quadrants of abdomen) and diarrhea. No discoloration (no blood). Abdominal pain was moderate 23-24. Diarrhea stopped on the 25th. Abdominal pain still present, but mild, on the 26th.


VAERS ID: 1351197 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Deafness unilateral, Fatigue, Headache, Oral pain, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hearing impairment (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: Flu Vaccine - childhood through age 26, annually. Flu symptoms. Dr. advised to stop receiving vaccine. Received most recent flu
Other Medications: Norgeste
Current Illness: None
Preexisting Conditions: None
Allergies: Erythromycin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Day 1: hearing loss in left ear, face felt sunburned, pain at surgical site (had oral surgery 4/15/21), fatigue, headache Day 2: fatigue, headache Day 3: fatigue, headache Days 4-6: headache


VAERS ID: 1351206 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Odynophagia, Pharyngeal swelling, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient received the vaccine at 4:15 pm. 4:27 staff notified of symptom onset. 4:30 BP 110/88 P 92 Patient reports feeling lightheaded and throat feels swollen 4:35 Lightheadedness comes in waves. Last ate around 12 noon. Feels like "lump in throat" slight pain with swallowing. Denes SOB, itching or N/V 4:57 No progression of symptoms, no new onset of symptoms. educated patient and Dad on signs and symptoms of severe reaction. Left with Dad at 4:57


VAERS ID: 1351222 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: DEVELOPED ACUTE SHINGLES ON THE EVENING OF 2ND MODERNA VACCINE


VAERS ID: 1351261 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Cold sweat, Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin, Zyrtec prn
Current Illness: none
Preexisting Conditions: None
Allergies: unknown
Diagnostic Lab Data: Advised to see physician
CDC Split Type:

Write-up: Could not control movements from waist up. Having spasms of muscles from waist to head. Could move legs and feet purposely. No seizure activity. BP 116/70, HR 72 Reg, R 18 Skin cold and clammy. Laid him down, elevated feet, covered with blankets. Unable to obtain O2 sat with pulse oximeter. He could not communicate orally. Only by blinking. Event started at 2:30 am about 13 hours after vaccine. Symptoms slowly resolved over 2 hours until he was able to rest. Administered ( 2) 325 mg Tylenol at 4:30 am. Able to communicate orally, squeeze both hands, awake, alert and oriented. All symptoms subsided. O2 sat 99. Next day only extremely sore muscles from waist up


VAERS ID: 1351265 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Answered "No" to screening question "Have you ever had a serious or life-threatening allergic reaction, such as hives, or difficulty breathing to any vaccine or shot?" Any other allergies are unknown.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient does not meet minimum age to receive pfizer vaccine, but received it anyway. No adverse events noted during 15 minute waiting period. Registrar acknowledged patient was 11 and EMR did not let registrar check patient in due to age requirement, but registrar sent through anyway. Vaccinator did not notice patient was underage when vaccinated.


VAERS ID: 1351274 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Finastride
Current Illness: No
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: COVID19 PCR pending.
CDC Split Type:

Write-up: Persistent subjective fever, myalgia, and mild headache few hrs. post second dose on 05/20/2021. Moderna COVID19 dose #1 Lot #020B21 on 04/22/2021 at Health Center.


VAERS ID: 1351314 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Loss of consciousness, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NO MEDICAL HISTORY OTHER THAN MORBID OBESITY
Allergies: CATS
Diagnostic Lab Data:
CDC Split Type:

Write-up: FEVER, PASSED OUT, CARDIACT ARREST


VAERS ID: 1351379 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-04
Onset:2021-05-20
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test abnormal, Cerebral venous sinus thrombosis, Cerebrovascular accident, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal, Platelet count decreased, Seizure
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: CT scan, blood work, MRI
CDC Split Type:

Write-up: On 5/20/21 I suffered from a CVST stroke with low platletes and a seizure


VAERS ID: 1351455 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Impaired driving ability
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: none known
Preexisting Conditions: none known
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: C/o severe headache approximately 10 minutes after receiving Moderna vaccine. BP 100/72 initial check, then 10 minutes later went to 140/100. Patient refused evaluation by EMT. Called husband to come get pick her up. Tried to notify patient but no answer.


VAERS ID: 1351502 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving the shot the patient stiffened in her chair and then passed out for a second. She woke up immediately and the technician and mother stayed next to the patient while the pharmacist contacted 911. She stayed seated and was given something to drink. She seemed to be ok by the time the paramedics arrived. They checked her over and took her vitals and then allowed her to leave the store after observation. Called the store about an hour later and stated the patient was ok.


VAERS ID: 1351580 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-12
Onset:2021-05-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Musculoskeletal stiffness, Myalgia, Neck pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: similar symptoms as described but milder and went quickly.
Other Medications: Allerclear
Current Illness:
Preexisting Conditions:
Allergies: penicillin, asperin
Diagnostic Lab Data: I have not gone to a medical professional because I do not have health care insurance.
CDC Split Type:

Write-up: I began experiencing severe muscle pain and stiffness near the injection site beginning 8 days after vaccination. Pain is in my shoulder and bicep and radiates all the way down my arm and up to my neck. I experienced moderate muscle pain for about 24 hours beginning about 8 hours after vaccination with both doses (first on was April 24), but that resolved both times and did not return after the first vaccination. When I was receiving the injection on May 12 I felt a sharp pain deep that radiated to my back as the injection was given. I did not have that experience with the vaccination on April 24.


VAERS ID: 1351605 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / -

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Came in a week early


VAERS ID: 1351631 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / -

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

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

Write-up: Too early for 2nd dose


VAERS ID: 1351637 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / -

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

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

Write-up: Too early for 2nd dose


VAERS ID: 1351648 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Mobility decreased, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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:
Other Medications: None reported
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 05/20/21 patient began experiencing tingling and limited mobility in her left leg. On 5/25/21 her face began to droop.


VAERS ID: 1351658 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / UNK - / -

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

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

Write-up: Came in one week early


VAERS ID: 1351689 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acoustic stimulation tests normal, Chills, Headache, Nausea, Photosensitivity reaction, Pyrexia, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion HCl SR, Mirtazapine
Current Illness: None
Preexisting Conditions: None
Allergies: Wheat
Diagnostic Lab Data: Hearing test May 25 2021 still shows normal hearing. But that does not address tinnitus.
CDC Split Type:

Write-up: Fever, Chills, Nausea, Photosensitivity, Headache and Tinnitus within first day. After second day all returned to normal, except the Tinnitus. It is persistent, severe and worse on one side.


VAERS ID: 1351726 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Lethargy, Pyrexia, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Embrel
Current Illness: Still not 100% since 1st vaccine
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: WIthin 30 minutes, same symptoms as 1st dose. Severe stomach pain, fever, dizziness, vertigo, lethargy. These symptoms lasted almost 1 week and he is still not right.


VAERS ID: 1351865 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood creatine phosphokinase, Blood culture, Chest X-ray, Chills, Clostridium test, Computerised tomogram abdomen, Computerised tomogram head, Computerised tomogram pelvis, Computerised tomogram thorax, Culture stool, Culture urine, Diarrhoea, Erythema, Full blood count, Headache, Legionella test, Metabolic function test, Nausea, Parasite blood test, Pruritus, Pyrexia, Rash, Rheumatoid factor, Septic shock, Staphylococcus test, Streptococcus test, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Patient intermittently received ''steroid'' injections from allergist. Otherwise, no known home medications.
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: None
Diagnostic Lab Data: 5/23/21: Blood culture, MRSA nares culture, Urine cutlure, Chest X-ray, CT chest/abd/pelvis w/o contrast 5/24/21: Blood parasite smear micro, O&P micro, Chest X-ray, Anti-streptolysin AB, C. diff EIA, Coccidioides immunidiffusion, Coccidioides complement fixation, CCP Ab, Legionella , Rheumatoid factor 5/25/21 Chest X-ray 5/26/21 CT head w/o contrast, creatinine kinase, 5/23/21-5/26/21: CBC, BMP
CDC Split Type:

Write-up: Patient received ''steroid'' injection from allergist and 3 days later received 1st dose of Pfizer COVID-19 vaccine, then 3 days later received another ''steroid'' injection. Patient then developed headache associated with fever and chills for 1 day. The patient travelled at which time his symptoms came back now with nausea, vomiting and diarrhea. Patient also noted to have erythema and itchiness for 3 days prior to coming to the hospital. Patient has a rash on left arm, as well as bilateral lower extremities. Patient was admitted for septic shock with an AKI. Patient received IV fluids, Levophed, vasopressin, IV Fentanyl, IV antibiotics, and IV steroids. Patient is now off of vasopressors and is improving.


VAERS ID: 1351903 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Discomfort, Hypoaesthesia, Pain, Skin warm
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (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: LOSARTAN VENLAFAXINE, CHILDRENS VITAMINS, B12, HYDROCHLOROTHIAZIDE
Current Illness: Patient HAD PANIC ATTACK NIGHT BEFORE MOTHER''S DAY
Preexisting Conditions: HYPERTENSION
Allergies: Ibuprofen , Baby Oil
Diagnostic Lab Data: None
CDC Split Type:

Write-up: PATIENT RECEIVED JANSSEN VACCINE ON 5/19/21. PATIENT COMPLAINED NEXT DAY, THAT SHE DEVELOPED A BRUISE ABOUT THE 1/4 INCH X 1/4 INCH ON THE INSIDE OF ARM WHERE YOU GET BLOOD DRAWN ON VEIN. The upper arm was , was clear and no problem. Patient says that bruise went away, but her arm gets nump and falls asleep. On May 26, 2021 patient called and complained got outer left leg thigh bruise blue in color, the spot is 2 inch x 2 inch in diameter and is hard and hurts. The pain radiates out about the size of palm of her hand and is warm to touch. Patient says she did not bump herself , and attributes to her Janssen vaccine. Patient feels the pressure, in the area of the bruise when she stands at work. Patient has put call in to doctor. Patient was counseled to go to hospital.


VAERS ID: 1352542 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Haemorrhage intracranial, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Pt initally had heache dizzines, n/v . ON 5/26 admited with intracranial hemorrhage.


VAERS ID: 1352712 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: Saline Diluent from prior vial used to mix a second pfizer vial.


VAERS ID: 1352717 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Saline diluent used a second time for a second pfizer vial . No adverse events reported


VAERS ID: 1352729 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Saline diluent used a second time for a second pfizer vial . No adverse events reported


VAERS ID: 1352730 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR

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

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

Write-up: Swollen lymph nodes left side


VAERS ID: 1352736 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: Swollen lymph nodes left side


VAERS ID: 1352776 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discomfort
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: clobetasol, Vitamin D3, AREDS, BiotinLevaquin
Current Illness: None
Preexisting Conditions: Lichens sclerosis
Allergies: Levaquin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 10 to 15 minutes after the injection, I had a slight pressure on the right side of my neck that went up to my right jaw, and up in front of my right ear and up to my cheekbone. That pressure lasted the rest of that day. When I went to bed around 10:30 pm, I took one 325mg tylenol. In the morning, the pressure was still there but lessened. It continued on and off the second day but by nighttime was mostly gone.


VAERS ID: 1352782 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Lymphadenopathy
SMQs:, Dementia (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: Fluticasone Zetia Estradiol .05 Alvesco inhaler Medroxypr
Current Illness: None
Preexisting Conditions: High cholesterol Allergic Asthma
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 7 days so far of swollen left armpit gland 7 days so far of morning or evening headache General fogginess


VAERS ID: 1352987 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, Body temperature, Chills, Ear pain, Headache, Neck pain, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210520; Test Name: Body temperature; Result Unstructured Data: 103 F
CDC Split Type: USJNJFOC20210544562

Write-up: NECK PAIN; BODY ACHES; EARS HURT; BACK PAIN; THROAT KIND OF STINGS; CHILLS; NO STRENGTH; HEAD ACHE; ACHE IN ARM; FEVER; This spontaneous report received from a patient 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: 203A21A expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 18:00 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced ache in arm. On 20-MAY-2021, the subject experienced fever. On 20-MAY-2021, the subject experienced head ache. Laboratory data included: Body temperature (NR: not provided) 103 F. On 22-MAY-2021, the subject experienced neck pain. On 22-MAY-2021, the subject experienced body aches. On 22-MAY-2021, the subject experienced ears hurt. On 22-MAY-2021, the subject experienced back pain. On 22-MAY-2021, the subject experienced throat kind of stings. On 22-MAY-2021, the subject experienced chills. On 22-MAY-2021, the subject experienced no strength. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from fever, ache in arm, head ache, neck pain, throat kind of stings, ears hurt, chills, body aches, no strength, and back pain. This report was non-serious.


VAERS ID: 1352993 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 023A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Influenza like illness, Paraesthesia
SMQs:, Peripheral neuropathy (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: USJNJFOC20210544787

Write-up: FLU LIKE SYMPTOMS (BAD CHILLS, FEVER, FATIGUE, BODY ACHES AND CONSTANT HEADACHE); TINGLING FEELING THROUGH THE BACK ON THE SPINE AND ON THE STOMACH; This spontaneous report received from a patient concerned a 34 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: 023A21A expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced flu like symptoms (bad chills, fever, fatigue, body aches and constant headache). On 20-MAY-2021, the subject experienced tingling feeling through the back on the spine and on the stomach. The action taken with covid-19 vaccine was not applicable. The patient recovered from flu like symptoms (bad chills, fever, fatigue, body aches and constant headache) on 22-MAY-2021, and had not recovered from tingling feeling through the back on the spine and on the stomach. This report was non-serious.


VAERS ID: 1353050 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Body temperature, Chest discomfort, Chills, Dizziness, Dyspnoea, Fatigue, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: DESVENLAFAXINE
Current Illness: Depression
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210520; Test Name: Body temperature; Result Unstructured Data: Between 100.3 -102.7
CDC Split Type: USJNJFOC20210549318

Write-up: BACK PAIN; SHORTNESS OF BREATH; CHEST TIGHTNESS; EXHAUSTED/VERY TIRED; HEADACHE; CHILLS; FEVER; DIZZINESS; This spontaneous report received from a patient concerned a 24 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included depression, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. Concomitant medications included desvenlafaxine for depression. On 20-MAY-2021, the subject experienced dizziness. On 20-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) Between 100.3 -102.7. Treatment medications included: acetylsalicylic acid/chlorphenamine maleate/phenylpropanolamine hydrochloride. On 21-MAY-2021, the subject experienced chills. On 21-MAY-2021, the subject experienced headache. On 22-MAY-2021, the subject experienced back pain. On 22-MAY-2021, the subject experienced exhausted. On 22-MAY-2021, the subject experienced shortness of breath. On 22-MAY-2021, the subject experienced chest tightness. The action taken with covid-19 vaccine was not applicable. The patient recovered from dizziness on 22-MAY-2021, and fever on 21-MAY-2021, had not recovered from headache, back pain, exhausted, shortness of breath, and chest tightness, and the outcome of chills was not reported. This report was non-serious.


VAERS ID: 1353613 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0172 / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADHD; Anxiety; Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576082

Write-up: Abnormal thought process; This is a spontaneous report from a non-contactable consumer (patient). A 26-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW 0172), via an unspecified route, administered in left arm on 20May2021 at 08:15 (at the age of 26-year-old) as 2ND DOSE, SINGLE for COVID-19 immunization. Medical history included attention deficit hyperactivity disorder (ADHD), depression and anxiety. There were no concomitant medications. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: ER8736), via an unspecified route, administered in left arm on 28Apr2021 at 10:00 (at the age of 26-year-old) as 1ST DOSE, SINGLE for COVID-19 immunization. The patient did not receive any other medications the patient within 2 weeks of vaccination. The patient was not pregnant at the time of vaccination. The patient did not have any allergies. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was never tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 20May2021 at 12:00, the patient had abnormal thought process. The events were reported as non serious. The outcome was not recovered for the reported event. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1353615 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Pain, 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: LORAZEPAM; GABAPENTIN; MIRTAZAPINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576128

Write-up: Body aches; loss of appetite; tinnitus; This is a spontaneous report from a contactable consumer (patient). A 21-year-old female patient received BNT162B2 (PFIZER BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), dose 2 via an unspecified route of administration in left arm on 19May2021 13:45 (at the age of 21-years-old) as second dose, single for COVID-19 immunization. Medical history included COVID-19. Historical vaccine included BNT162B2 (PFIZER BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), dose 1 via an unspecified route of administration in left arm on 28Apr2021 13:45 as first dose, single for COVID-19 immunization. Prior to vaccination, the patient did not receive any vaccines within four weeks and was not pregnant. Concomitant medications included lorazepam, gabapentin, and mirtazapine. The patient experienced body aches, loss of appetite and tinnitus on 20May2021 12:00. Since the vaccination, patient has not been tested for COVID-19. No treatment was received for the events. Outcome of the events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1353616 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Headache, Musculoskeletal stiffness, Pallor
SMQs:, Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SARECYCLINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576140

Write-up: Headache; Episode of stiffness, going pale; Episode of stiffness, going pale; 15 seconds of memory loss; This is a spontaneous report from a non-contactable female other HCP reported for herself. A 19-year-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via intramuscular route of administration on 19May2021 16:45 (at the age of 19-year-old) as single dose for COVID-19 immunization. Medical history was none, and no allergies were reported. Concomitant medication included sarecycline(SARECYCLINE) contraceptive pill via oral route of administration. On 20May2021 11:00 AM, the patient experienced headache, episode of stiffness, going pale, 15 seconds of memory loss. Adverse events resulted in doctor or other healthcare professional office/clinic visit. The patient did not receive any treatment medications for events. It was unknown whether the patient received any other vaccines within 4 weeks prior to the COVID vaccine, diagnosed with COVID-19 prior to vaccination and has been tested for COVID-19 since the vaccination. The events were reported as non-serious. Outcome of the events was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained


VAERS ID: 1353767 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-20
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysstasia, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: USJNJFOC20210549836

Write-up: COULD NOT STAND UP; COULD NOT WALK; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) 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 could not stand up. On 20-MAY-2021, the subject experienced could not walk. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the could not stand up and could not walk was not reported. This report was non-serious.


VAERS ID: 1354170 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-20
Onset:2021-05-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Influenza like illness, Nausea, Pain
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: Patient experienced nausea, aches, and flu-like symptoms.


VAERS ID: 1354173 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, SARS-CoV-2 test positive, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I have repeatedly done the epley maneuver daily without resolution.
CDC Split Type:

Write-up: I had the covid disease via a PCR test on dec 24th, 2020 and receive first dose of vaccine resulting in dizziness and vertigo not resolved presently after 7days. I will seek an Ent appointment next week if necessary


VAERS ID: 1354276 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-19
Onset:2021-05-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Xerelto, Levothroxine, Alendronate, Flecanide (heart), multi-vitamin, 1,000 units of Vitamin D
Current Illness: None
Preexisting Conditions: Paroxsamal Afib
Allergies: ampicilian, coedeine, bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: The second day, I started experiencing consistent elevated heart rates with an average of 112. This lasted for the better part of the day but by the next day, I was only experiencing ''episodes'' of elevated HR.


VAERS ID: 1354346 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness unilateral, Dizziness, Hypoaesthesia, Paraesthesia, Tinnitus, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Vestibular disorders (narrow)

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

Write-up: Systemic: Dizziness / Lightheadness-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tinnitus-Severe, Additional Details: Pt called the pharmacy reporting that she has tingling sensation on the arm that is opposite of the arm that got the injection last week, and then she had extreme vertigo and dizziness which resulted her admitted to the ER. Pt also claims that she cannot hear from one side of the ears few days after the vaccine. Pt was advised to consult with a physician, and was also given the janseen phone number to ask about the side effects.


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