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From the 9/10/2021 release of VAERS data:

Found 686,636 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 127 out of 6,867

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VAERS ID: 1623725 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-04
Onset:2021-08-16
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The vaccine was maintained at proper refrigeration temperatures, but for longer than 31 days. 7/29/21 was day 31 at refrigeration temps and vaccine was given on 8/16/21. No adverse events have been reported by patient. Error discovered on 8/16/21.


VAERS ID: 1623727 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The vaccine was maintained at proper refrigeration temperatures, but for longer than 31 days. 7/29/21 was day 31 at refrigeration temps and vaccine was given on 8/16/21. No adverse events have been reported by patient. Error discovered on 8/16/21


VAERS ID: 1623731 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: The vaccine was maintained at proper refrigeration temperatures, but for longer than 31 days. 7/29/21 was day 31 at refrigeration temps and vaccine was given on 8/13/21. No adverse events have been reported by patient. Error discovered on 8/16/21.


VAERS ID: 1623790 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac stress test, Catheterisation cardiac, Chest discomfort, Chest pain, Chills, Electrocardiogram normal, Left ventricular end-diastolic pressure, Myocarditis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: MVI Albuterol Amitriptyline 10 mg TRICO 145 mg UBRELVY 50 mg Valsartan 80 mg COLCRYS 0,6 mg
Current Illness:
Preexisting Conditions: HTN Asthma Migraines Hypertriglyceridemia Sinus Arrhythmia
Allergies: NKA
Diagnostic Lab Data: EKG normal Stress test BSA 2.29 8/17 Cardiac Cath no obstructive CAD , normal LVEPP, likely myocarditis 2nd to COVID vaccine
CDC Split Type:

Write-up: Received vaccine 8/12 on 8/16 contacted PCP stated had fever , chills and temp at home 101 now having chest pain. Instructed to call 911..patietn refused and wife took to ED In Ed described chest pain as pressure and heaviness in center of chest VS Temp 36.1, pulse 102, BP 144/96 Patient admitted to hospital and discharged 8/19


VAERS ID: 1623798 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-23
Onset:2021-08-16
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies: UNK
Diagnostic Lab Data: positive antigen test on 8/16/21
CDC Split Type:

Write-up: tested positive for covid, after being fully vaccinated. asymptomatic.


VAERS ID: 1623825 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-09
Onset:2021-08-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / IM

Administered by: Military       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Duloxetine 60mg daily Viagra 50mg prn
Current Illness: None. However COVID infection in April 2021
Preexisting Conditions: Sleep apnea
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted to hospital on 16AUG21 with bilateral pulmonary emboli. Received dose #2 of Pfizer COVID vaccine on 09AUG21. No history of coagulation disorder or previous emboli


VAERS ID: 1623838 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood pressure decreased, Dizziness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine (twice daily) Hydralazine (twice daily)
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: All cillins Keflex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Blood pressure dropped, became increasingly dizzy, abdominal pains upper left quadrant that lasted for 3 days.


VAERS ID: 1623856 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-25
Onset:2021-08-16
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

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

Write-up: Positive COVID mild symptoms, had infusion treatment symptoms improving. had contact to positive case


VAERS ID: 1623857 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-18
Onset:2021-08-16
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Herpes zoster, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: REBOUNDING HEADACHES, LIGHT HEADED
Preexisting Conditions: DIABETES, GRAVES DISEASE, HIGH BLOOD PRESSURE
Allergies: FLU VACCINE, AUGMENTIN, SULFA
Diagnostic Lab Data: PCP DIAGNOSE
CDC Split Type:

Write-up: SHINGLES, BURNING SKIN


VAERS ID: 1623885 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-08-16
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Ear discomfort, Eye pruritus, Headache, Sinus congestion, Sneezing, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc, Sotalol, Metoprolol; Amlopipine; Claritin, multiviatamins; Vitamin C and D; Aspirin; Metformin; HCTZ; Low-ogestrel; Atorvastatin; Glimepiride
Current Illness: none
Preexisting Conditions: Diabetes, type 2; Hypertension; dyslipemia; migranes; paroxysmal atrial fibrillation, GERD; OSA, acute gout, left ankle
Allergies: Demerol; Lisinopril, Derma bond
Diagnostic Lab Data: sinus congestion, headache, cough, post nasal drainage, ear fullness, sneezing, itchy eyes.
CDC Split Type:

Write-up: sinus congestion, headache, cough, post nasal drainage, ear fullness, sneezing, itchy eyes. starting on 8/16/2021


VAERS ID: 1623921 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-24
Onset:2021-08-16
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of TIA, GERD, CVA
Allergies: beta blockers, macrolides, tetracyclines, azithromycin, doxycycline, losartan, lipitor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for COVID-19 on 8/16/21. Admitted for severe generalized weakness. Patient still receiving hospital treatment.


VAERS ID: 1624029 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-20
Onset:2021-08-16
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not specified
Current Illness: Not specified
Preexisting Conditions: none reported
Allergies: Not specified
Diagnostic Lab Data: 8/16/21 RT PCR Positive at clinic 8/23/21 RT PCR Positive at hospital (upper respiratory sample)
CDC Split Type:

Write-up: Received Postive Covid-19 test results. Admission to Hospital for diagnosis that included cough, shortness of breath, pneumonia. Per notification, patient has not been admitted to an intensive care unit and has not required any mechanical ventilation during hospitalization to date. It is unknown if he has been discharged from the hospital at this time.


VAERS ID: 1624032 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-25
Onset:2021-08-16
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / UNK LA / IM

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

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

Write-up: PATIENT TESTED POSITIVE FOR COVID-19 ON 8/16/21


VAERS ID: 1624043 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Heart rate increased, Loss of personal independence in daily activities
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira 40 mg / week
Current Illness: None
Preexisting Conditions: Psoriatic arthritis
Allergies: gluten sensitivity
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe headaches, increased heart rate, exercise intolerance


VAERS ID: 1624048 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-08-16
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.
Current Illness: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.
Preexisting Conditions: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.
Allergies: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.
Diagnostic Lab Data: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.
CDC Split Type:

Write-up: UNKNOWN PRIMARY CARE PROVIDER. ONLY INTERACTION WITH PATIENT WAS COVID-19 SWAB.


VAERS ID: 1624056 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of Gullian-Barre, COVID-19 Infection (November 2020).
Allergies: Prochlorperazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Individual reported receiving COVID-19 vaccine from a retail pharmacy on 8/16/2021. Later that day at 2300 individual reports loss of feeling in legs. Fire department was contacted and individual was transported to Hospital. Patient reports treatment with IVIG infusion, and received a lumbar puncture. Patient reports having feeling in legs, but that they are still weak.


VAERS ID: 1624083 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SC

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Ibuprofen, Benadryl, Loratidine, Carvedilol, Levothyroxine, Hyoscyamine
Current Illness: None
Preexisting Conditions: Parkinson''s, High Blood Pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Redness over the left arm approximately 7 inches in length and 2 to 3 inches wide down arm toward elbow. Warm to the touch. Slight pain


VAERS ID: 1624137 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Tension
SMQs:, Hypoglycaemia (broad)

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

Write-up: PATIENT WAS VERY NERVOUS PRIOR TO GETTING VACCINATION. HER DAUGHTER HELD HER HAND DURING THE SHOT. I ASK THE PATIENT TO REMAIN SEATED FOR 15 MINUTES AFTER THE SHOT. PATIENT WAS ANXIOUS AT THAT TIME AND REMAINED SEATED. A FEW MOMENTS LATER HER DAUGHTER NOTIFIED US THAT HER MOTHER WAS FEELING VERY ANXIOUS AND TENSE. PATIENT AS BROUGHT INTO THE CONSULTATION ROOM, AND WISHED TO SIT ON THE FLOOR. SHE WAS GIVEN A BOTTLE OF WATER TO DRINK. I ASK HER QUESTIONS ABOUT HOW SHE WAS FEELING, IF THERE WAS TROUBLE BREATHING, OR FEELING FAINT. SHE REPLIED NO, THAT SHE HAD ALWAYS HAD A FEAR OF VACCINATIONS AND THAT WAS THE REASON SHE WAS REACTING AS SHE HAD. HER HUSBAND WAS CALLED. HE CAME IN SHORTLY. THE PATIENT SAT IN THE CONSULTATION ROOM FOR A FEW MORE MINUTES WITH HER HUSBAND AND DAUGHTER, THEN WAS AMBULATORY AND LEFT WITH HER FAMILLY


VAERS ID: 1624149 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

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

Write-up: Pt reports "I''m not feeling right" about 5 minutes after receiving vaccine. Pt instructed to sit down and prop feet up. Pt''s eyes immediately closed and he began shaking. Pt was lowered to the floor and was responding to verbal stimuli. Pt. was evaluated by a physician and escorted to the ED.


VAERS ID: 1624170 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Feeling abnormal, Feeling hot, Hyperhidrosis, Nausea, Nervousness, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Pt c/o of being nauseated ~10 minutes after 1st dose of vaccine. Pt instructed to prop feet up. He was pale, hot, and diaphoretic. Vitals reviewed and WNL. Pt provided water and snack and cold water bottle placed on neck. Pt reports still feeling "weird" but a little better and still c/o light headedness. Vitals continually monitored. Responding physician requested a pediatrician be notified. Pt also started reporting feeling shaky. Pediatrician arrived and evaluated pt. Blood sugar reviewed and WNL. Pt reports feeling okay to go home. Pt dc'' d home with grandma and given ED precautions.


VAERS ID: 1624262 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-22
Onset:2021-08-16
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / SYR

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

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

Write-up: Have had normal menstrual periods right up to the vaccine now I just barely spot, practically no period at all.


VAERS ID: 1624291 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Testicular swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: n/a
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s girlfriend called and stated that his testicles swelled immediately after receiving the vaccine and have not gotten any better in the last week. I advised her to have him go to the ER since they do not have a PCP.


VAERS ID: 1624600 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate, spiractolane, fluoxotine
Current Illness: Bronchitis about 2 weeks prior
Preexisting Conditions: Chronic migraines
Allergies: N/A
Diagnostic Lab Data: Labs done 8/23/2021, EEG going to be done - date: TBD
CDC Split Type:

Write-up: Passed out about 5-10 minutes after shot then had a seizure


VAERS ID: 1625287 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient previously received full series of Moderna vaccine. Presented to the pharmacy for a booster dose. Was given Pfizer in error. As of 08-23-21, patient reports no adverse health/medical events.


VAERS ID: 1625946 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210842909

Write-up: SEVERE HEADACHE; LITTLE DIZZY; NECK WAS ITCHING AND BREAKING OUT/ RASH AND A BUMP ON HIS NECK; SORE ARM; This spontaneous report received from a parent concerned a 21 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: 204A21A, and expiry: UNKNOWN) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-AUG-2021, the patient experienced little dizzy. On 16-AUG-2021, the patient experienced neck was itching and breaking out/ rash and a bump on his neck. On 16-AUG-2021, the patient experienced sore arm. On 17-AUG-2021, the patient experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headache, little dizzy, and neck was itching and breaking out/ rash and a bump on his neck, and the outcome of sore arm was not reported. This report was non-serious.


VAERS ID: 1627973 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Fatigue, Injection site mass, Injection site pain, Injection site pruritus, Injection site rash, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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

Write-up: Basic fatigue and arm tenderness with in 24hours. Symptoms went away. Few days later servers pain in left underarm near lymph nodes. Pain lasted 5 days. Pain became less intense day 2 but developed intense itch at injection site. Lump, rash, tenderness, and pain developed at injection site again and lasted for 5 days.


VAERS ID: 1628132 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-18
Onset:2021-08-16
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ7686 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for COVID 8/16/21-8/23/21. Treated with dexamethasone 6 mg IV daily; Remdesivir for 5 days.


VAERS ID: 1628225 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 - / -

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

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

Write-up: Itching on left arm, elbow down to wrist on both arms had hives, took Benadryl and hives cleared.


VAERS ID: 1628283 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-08-16
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMLODIPINE, PANTOPRAZOLE, METFORMIN, GLIMEPIRIDE, GABAPENTIN, PROCHLORPERAZINE, CLOPIDOGREL, HYDRALAZINE, ATORVASTATIN, CLONIDINE, CARVEDILOL, ALBUTEROL
Current Illness:
Preexisting Conditions: Dialysis patient End stage renal disease on dialysis
Allergies: KNA
Diagnostic Lab Data: POSITIVE COVID TESTING 08/24/2021 @ 0529
CDC Split Type:

Write-up: pt arrives via EMS, pt c/o generalized weakness and not eating for several days. missed dialysis


VAERS ID: 1628405 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: loratadine 10mg, diazepam 5mg, losartan 50mg, armour thyroid 30mg, estradiol 1mg
Current Illness:
Preexisting Conditions: immunologic disease, multiple sclerosis, migraines
Allergies: ACE inhibitors
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Covid rash. turned into swelling. patient wanted us to report for her. no other symptoms


VAERS ID: 1628420 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain
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: Flu-years ago- urticaria, lip edema
Other Medications: Stelara, methotrexate, naproxen, cymbalta
Current Illness: N/a
Preexisting Conditions: Psoriatic arthritis
Allergies: Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache, body aches, fatigue starting evening after receiving shot, peak for 24 hours (8/17/2021) then gradually better over 4 days.


VAERS ID: 1628476 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Asthenia, Bloody discharge, Complication associated with device, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (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: none, but I do have an IUD
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day I got the vaccine I had severe abdominal cramping. I was laying down and twice felt discomfort to the point were I felt I needed to stand up and move around to try and alleviate the cramping despite the fact I had no energy and all my muscles felt sore. Not a huge deal.........but it has been just over a week and I am still "spotting". I am having a bloody discharge that is not typical for me, even on a monthly basis as I have an IUD and have not had a period in many years. This was first noticed the morning after I had the vaccine and I have no doubt it is in direct relation to the cramping and vaccine from the day before.


VAERS ID: 1628522 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-23
Onset:2021-08-16
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 08/18/21 1658 POCT COVID-19 PCR Collected: 08/18/21 1658 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000277738 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 07/17/2022 COVID-19 PCR Date: 08/18/21 1532 | | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Cough Congestion or running nose Diarrhea Chills Fever


VAERS ID: 1628575 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Discomfort, Pain, Pain in extremity, Skin tightness, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure/losartan prilosec/omeprazole
Current Illness: none
Preexisting Conditions: fibromyalgia
Allergies: none
Diagnostic Lab Data: I went to an urgent care clinic, but there was a 3 hour wait, so I left.
CDC Split Type:

Write-up: My underarm area and the length of my arm began to feel tight and hurt when I lifted it or stretched it out. The following morning, there was extreme swelling in my armpit shaped like an oblong water balloon and much pain was associated with it whenever I stretched my arm. I could not lift my arm over my head without pain. This swelling lasted 7 days, and is now subsided almost entirely. I applied heat for comfort and then ice for the swelling. I took Aleve every 8 hours for pain and discomfort.


VAERS ID: 1628597 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-29
Onset:2021-08-16
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nasal congestion, Nausea, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), 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: amphetamine-dextroamphetamine XR (ADDERALL XR) 20 mg 24 hr capsule dextroamphetamine-amphetamine (ADDERALL) 5 mg tablet norgestimate-ethinyl estradiol (ORTHO-CYCLEN) 0.25-35 mg-mcg per tablet
Current Illness:
Preexisting Conditions: NONE
Allergies: AmoxicillinNausea and Vomiting
Diagnostic Lab Data: Updated Procedure 08/20/21 0421 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/19/21 1846 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/20/21 0421 COVID-19 PCR Collected: 08/19/21 1846 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Fever or Chills Cough Shortness of Breath Fatigue Muscle or body aches Headache Sore throat Congestion or running nose Nausea or vomiting Diarrhea


VAERS ID: 1628661 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-02
Onset:2021-08-16
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: carbidopa-levodopa (SINEMET) 25-100 mg per tablet levonorgestreL (MIRENA) 52 mg IUD losartan (COZAAR) 50 mg tablet pramipexole (MIRAPEX ER) 1.5 mg spironolactone (ALDACTONE) 25 mg tablet
Current Illness:
Preexisting Conditions: Nervous Parkinson''s disease Circulatory Benign essential hypertension Endocrine/Metabolic Hyperlipidemia Impaired fasting glucose Metabolic syndrome X
Allergies: NKA
Diagnostic Lab Data: 08/17/21 2334 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/17/21 0929 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/17/21 2334 COVID-19 PCR Collected: 08/17/21 0929 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Fever or Chills Cough Headache Sore throat Congestion or running nose


VAERS ID: 1628719 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-08
Onset:2021-08-16
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, SARS-CoV-2 test
SMQs:, COVID-19 (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:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: 08/16/21 1418 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/16/21 0908 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: UNKNOWN


VAERS ID: 1628823 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-02-01
Onset:2021-08-16
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: alendronate, metoprolol 25 mg, pravastatin, xarelto, levothyroxine, lasix
Current Illness: none
Preexisting Conditions: CAD s/p CABG htn, osteoporosis, diastolic heart failure, hypothyroid hx of breast ca but in remission
Allergies: Keflex [cephalexin] High Other Throat swelling Codeine Phosphate Not Specified Other Some mild abd discomfort Lipitor [atorvastatin Calcium] Not Specified Other uncertain Losartan Potassium Not Specified Other Insomnia Diff urinating Phenobarbital Not Specified Rash Trazodone Hydrochloride Low
Diagnostic Lab Data: covid test, positive
CDC Split Type:

Write-up: patient vaccinated and developed covid infection


VAERS ID: 1629057 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-17
Onset:2021-08-16
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: I had both Pfizer vaccinations the 2nd on 4-7-2021 and got the varriant infection for covid and lost my sense of smell and taste


VAERS ID: 1629066 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-13
Onset:2021-08-16
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 1629528 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Delirium, Heart rate decreased, Heavy menstrual bleeding, Menstruation irregular, Pyrexia, Renal disorder, Sleep disorder, Thrombosis, Urinary retention
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MHMR booster- (2003)? caused 4 hrs blindness and drop in BP and HR
Other Medications: clonazepam .025 for panic disorder
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Levaquin and petroleum based plastic products
Diagnostic Lab Data: saw virtual Dr. via app following the rules mandated: they confirmed ''Allergic Reaction''. I was unable to be hospitalized- the two rural hospital heres were full.
CDC Split Type:

Write-up: immediate drop in heart rate: 123 to 71 BPM within minute of receiving. Experienced kidney difficulty/failure (severe back pain and inability to urinate after shot at 3 PM Mon until 7:30 pm the following day, Tues and low grade fever persisted. Tuesday Night/Wed AM following vaccination I awoke from fevered delirious sleep to what can only be described as labor contractions. This pain was So Bad it Really was worse than when I gave birth to my son naturally!: menstruation started 11 days sooner than it should (and I have Never been a day early or late). Approx. 3x heavier than any period experienced: similar to ''afterbirth'' with deeply coagulated chunks so large each time i urinated, they clogged the bath facilities, and shower drain.


VAERS ID: 1631071 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210843193

Write-up: LOW GRADE HEADACHE; This spontaneous report received from a patient concerned a 65 year old female. The patient''s weight, height, and medical history were not reported. The patient experienced drug allergy when treated with phenytoin 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: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 16-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-AUG-2021, the patient experienced low grade headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from low grade headache on 16-AUG-2021. This report was non-serious.


VAERS ID: 1631995 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to animal, Food allergy
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: Metformin 500mg
Current Illness:
Preexisting Conditions: Asthma, diabetes, neuropathy, osteoarthritis, apnea and sinusitis
Allergies: Aspirin and raw seafood
Diagnostic Lab Data:
CDC Split Type:

Write-up: Food allergies and animal touch.


VAERS ID: 1632021 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-08-16
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chills, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Parosmia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Cardiovascular disease
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR = Positive on 8/19/21
CDC Split Type:

Write-up: As of disease investigation on 8/23/21 case reported onset of symptoms as 8/16/21 which included subjective fever, chills, rigors, muscle aches, runny nose, sore throat, new olfactory disorders, headache, fatigue, cough, wheezing, shortness of breath, nausea, abdominal pain, diarrhea and loss of appetite.


VAERS ID: 1632024 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7487 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Headache, Myalgia, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), COVID-19 (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:
Preexisting Conditions: Respiratory Snoring Other BMI 30.0-30.9,adult
Allergies: No Known allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Fever or Chills Cough Muscle or body aches Headache


VAERS ID: 1632218 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-07
Onset:2021-08-16
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, SARS-CoV-2 test, Upper-airway cough syndrome
SMQs:, COVID-19 (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: cetirizine 10 mg capsule
Current Illness:
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: bilateral temple headache with postnasal drainage.


VAERS ID: 1632242 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-11
Onset:2021-08-16
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: busPIRone (BUSPAR) 15 mg tablet; cyanocobalamin, vitamin B-12, 1,000 mcg tablet escitalopram (LEXAPRO) 10 mg tablet Lorazepam (ATIVAN) 0.5 mg tablet norethin-e.estradiol triphasic 7/7/7, 28,) 0.5/0.75/1 mg- 35 mcg per tablet VITAMIN D2
Current Illness:
Preexisting Conditions: Other Generalized anxiety disorder Insomnia High risk medication use
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR COVID-19 (SARS CoV-2,RNA Molecular Amplification)
CDC Split Type:

Write-up: Positive COVID-19 results


VAERS ID: 1632251 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chest discomfort, Rash, Rash macular
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions: None.
Allergies: Penicillin, Codeine, Amitriptyline, Cipro, Cymbalta, Sioricet, Imitrex, Moxifloxacin, Mucinex, Sudafed, Vitamin D 2 gel tablets, Erythromycin, Metoclopramide, Prednisone.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on face, legs, and arms. Burning sensation with rash, blotchiness on skin and scalp, tightness in chest.


VAERS ID: 1632266 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-25
Onset:2021-08-16
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (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: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler (Expired)
Current Illness:
Preexisting Conditions: Respiratory Mild intermittent asthma, unspecified whether complicated Musculoskeletal Acne, unspecified acne type Other Body mass index (BMI) of 21.0-21.9 in adult Former smoker Anxiety
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Cough Headaches, Congestion or runny nose Diarrhea sore throat


VAERS ID: 1632370 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-05
Onset:2021-08-16
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Extremely Painful menses Heavy bleeding 10 days and I?m still bleeding


VAERS ID: 1632374 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-30
Onset:2021-08-16
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Rheumatoid arthritis
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis 2x day Baby asprin 81 mg 1x daily Norvasc 5mg 1x daily Crestor 5 mg 1x daily
Current Illness: None
Preexisting Conditions: Had a stroke 1 1/2 years ago..
Allergies: Penicillin Bananas Bee venom Laytex
Diagnostic Lab Data: Bloodwork was taken 8/16/21..
CDC Split Type:

Write-up: Was recently diagnosed with Rheumatoid Arthritis..never had that diagnosis prior to my covid shot yet had tons of blood tests a year ago and tests came up negative for RA.


VAERS ID: 1632470 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-15
Onset:2021-08-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052EZ24A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Gait inability, Vertigo
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (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: Omeprazole, Probiotic, Liver MD, Zinc
Current Illness: Barrett''s Syndrome, fatty liver
Preexisting Conditions: Barrett''s Syndrome, IBS
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme vertigo; unable to walk with any steadiness. Dizziness has continued for the 10 days since.


VAERS ID: 1632601 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-08-16
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Bacterial sepsis, Encephalopathy
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin enteric coated Lexapro Lipitor Plavix Vitamin D3 valproic acid pantoprazole warfarin melatonin seroquel Tresiba Vitamin B12 Folic acid
Current Illness:
Preexisting Conditions: dementia depression ESRD on dialysis hyperlipidemia lymphedema peripheral artery disease Type 2 DM
Allergies: NKMA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted for encephalopathy, bacterial sepsis with concerns for pneumonia and diabetic hypoglycemia.


VAERS ID: 1632657 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

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

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

Write-up: Patient received her first dose of Moderna at Pharmacy after getting a previous dose of Pfizer. Patient has a history of rheumatoid arthritis and tested for no antibodies after the first dose of Pfizer. Patient switched to Moderna per her rheumatology specialist''s instruction. Patient exhibited no adverse symptoms after vaccination.


VAERS ID: 1632660 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-01
Onset:2021-08-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Pain, SARS-CoV-2 test, Vaccination site induration, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), COVID-19 (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: Levothyroxin. Simvastatin. Irradiance. Rebellsus. Janumet. Protonix. Buscar. Amitryptilyn. Depakote. Lamictal. Melatonin
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Covid test
CDC Split Type:

Write-up: Swelled and red spot at vacinnation site. It''s hard like a softball and that area is tennis ball size. It is red, hot and has fever also itches terribly. Cannot overextend my reach without pain in the swelled area.


VAERS ID: 1632740 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-01
Onset:2021-08-16
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

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

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

Write-up: positive covid test 08/2021


VAERS ID: 1632808 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-25
Onset:2021-08-16
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Dyspnoea, Fatigue, Malaise, Pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypertension, asthma, obesity
Allergies: nitroglycerin, contrast dye, clindamycin, propranolol, sumatriptan
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is a 57-year-old female with a history of hypertension, asthma, obesity who presents to the emergency department after being diagnosed with COVID-19 on 8/11/2021, having symptoms since 8/10/21 consisting of shortness of breath, diarrhea, vomiting, malaise, body aches, fatigue. Denies urinary symptoms, abnormal vaginal discharge/bleeding, swelling in her legs bilaterally. She is vaccinated for COVID-19, receiving the Moderna vaccine back in February of this year. The patient denies tobacco use, reports occasional alcohol use, denies illicit drugs.


VAERS ID: 1632811 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Pain in extremity, Pain of skin, Skin induration, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Arm pain starting 7-8 hours post vaccine, followed by localized firmness under skin with continued localized tenderness. Skin is slightly warm to touch. Affected area is about 2 inchs circular in diameter. Patient also notes some mild shortness and breath developing about 6 days later.


VAERS ID: 1632868 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Rash, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: Rash generalized


VAERS ID: 1632983 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-07-29
Onset:2021-08-16
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash, Rash macular, 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: Hypertension
Allergies: PCN, Keflex, Sulfa, Propranolol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria throughout scalp, ears, neck; diffuse macular rash to upper and lower extremities Most severe for 48 hours, now over 2 weeks of continued intermittent symptoms


VAERS ID: 1633005 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient fainted in passenger seat of car within seconds of vaccine. She recovered to baseline slowly over 30 minutes and improved markedly with snacks. She reports not having eaten lunch.


VAERS ID: 1633035 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-19
Onset:2021-08-16
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Computerised tomogram spine, Culture urine, Differential white blood cell count, Electrocardiogram, Full blood count, Gait disturbance, Headache, Hypertension, Influenza virus test, Ischaemic stroke, Magnetic resonance imaging head abnormal, Metabolic function test, Muscular weakness, Respiratory syncytial virus test, SARS-CoV-2 test, Spinal X-ray, Troponin, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/23: CMP, CBC with diff, urine culture, Sars/flu/RSV panel, troponin, urine , CT head, CT spine, EKG, Xray spine, MRI
CDC Split Type:

Write-up: 1. Nonintractable headache, unspecified chronicity pattern, unspecified headache type 2. Unstable gait 3. Upper extremity weakness 4. Hypertension, unspecified type right frontal lobe nonspecific attenuation which could be a CVA (abnormal CT, needed MRI) MRI revealing multifocal areas of right ACA territory infarct. Ischemic stroke


VAERS ID: 1633149 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / N/A LA / IM

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

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

Write-up: The have been no adverse effects reports, but received double dose.


VAERS ID: 1633321 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Blood test abnormal, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol Celebrex Norvasc tramadol hydrocodone acetaminophen tizanidine losartan Lyrica albuterol prednisone Humira
Current Illness: none
Preexisting Conditions: hypertension rheumatoid arthritis morbid obesity obstructive sleep apnea peripheral neuropathy
Allergies: Topamax
Diagnostic Lab Data: blood tests including elevated D-dimer and CTA confirming pulmonary embolism
CDC Split Type:

Write-up: patient developed a large saddle pulmonary embolism and is currently in hospital receiving standard treatment for such


VAERS ID: 1633347 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-31
Onset:2021-08-16
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Fatigue, Headache, Insomnia, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: Pt complains of tiredness and headache. Also nausea, blurry vision and anxiety. Has trouble sleeping. These symptoms started about 2 or 3 weeks after the vaccination and have been getting progressively worse.


VAERS ID: 1633563 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-01
Onset:2021-08-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Knot started the day after injection. Still growing. Large knot at injection site. 5in by 2 in. Red and hot. Painful to touch.


VAERS ID: 1636115 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-08-16
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (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:
Preexisting Conditions: None
Allergies: Not on file
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Congestion Runny nose Sore throat


VAERS ID: 1636124 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-08-16
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol, vitamin D3, 2,000 unit capsule co-enzyme Q-10 50 mg capsule fluticasone (FLONASE) 50 mcg/actuation nasal spray metFORMIN (GLUCOPHAGE) 500 mg tablet montelukast (SINGULAIR) 10 mg tablet omega-3 fatty acids-fish oil (FIS
Current Illness:
Preexisting Conditions: Nervous Breast pain, right Respiratory Allergic rhinitis Circulatory White coat syndrome with hypertension Parietal lobe infarction (CMS/HCC) PFO (patent foramen ovale) Digestive Esophageal reflux Irritable bowel syndrome Vitamin D deficiency Musculoskeletal Basal cell carcinoma of skin Disc degeneration, lumbar Osteoporosis Rosacea Sacroiliac joint dysfunction of left side Compression fracture of L4 lumbar vertebra, sequela Endocrine/Metabolic Hashimoto''s thyroiditis Hypercalcemia Hyperlipidemia Non-toxic multinodular goiter Type 2 diabetes mellitus without complication, without long-term current use of insulin (CMS/HCC) Other Breast microcalcification, mammographic Fatigue History of temporal arteritis
Allergies: Iv Dye [Gadolinium-containing Contrast Media]Swelling Dye ParoxetineDiarrhea
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: fever, fatigue, nasal congestion, sore throat, headache and cough


VAERS ID: 1636141 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Gait disturbance, Headache, Hemiplegia, Hypoaesthesia, Migraine, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no medical history.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210848879

Write-up: BECAME PHYSICALLY RIGHT SIDE PARALYZED (COULD NOT FEEL HALF OF HER BODY); CHEST PAIN; BARELY WALK FLUCTUATES BACK AND FORTH; MIGRAINES; TINGLING; NUMBNESS ALL OVER HER BODY; FEVER; HEADACHE; This spontaneous report received from a parent concerned a 28 year old female of unknown race and ethnicity. The patient''s height, and weight were not reported. The patient''s had no medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: unknown) dose was not reported,1 total, administered on 16-AUG-2021 right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. Patient took vaccine on 16-AUG-2021 since then she experienced chest pain, migraine, headache, tingling, numbness all over her body, fever and can barely walk fluctuates back and forth. On 20-AUG-2021, the patient became physically right side paralyzed (could not feel half of her body). Patient went to emergency room. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chest pain, migraines, headache, became physically right side paralyzed (could not feel half of her body), tingling, numbness all over her body, fever and barely walk fluctuates back and forth was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210848879- covid-19 vaccine ad26.cov2.s - Became physically right side paralyzed (could not feel half of her body). 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: 1636166 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-22
Onset:2021-08-16
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: bisoprolol-hydrochlorothiazide (ZIAC) 2.5-6.25 mg per tablet cyanocobalamin 100 mcg tablet levothyroxine (SYNTHROID, LEVOTHROID) 150 mcg tablet multivitamin 400 mcg tablet
Current Illness:
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Tested positive for COVID-19


VAERS ID: 1636175 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-21
Onset:2021-08-16
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Nasal congestion, Nausea, Pain, Respiratory tract congestion, SARS-CoV-2 test, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), COVID-19 (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: clotrimazole-betamethasone (LOTRISONE) cream dextroamphetamine-amphetamine (AdderalL) 15 mg tablet DULoxetine (CYMBALTA) 60 mg capsule lamoTRIgine (LaMICtaL) 100 mg tablet
Current Illness:
Preexisting Conditions: Nervous Acute non intractable tension-type headache Cubital tunnel syndrome on right Respiratory Obstructive sleep apnea Snoring Musculoskeletal Primary osteoarthritis of left knee Quadriceps tendinitis Trigger middle finger of right hand Trigger ring finger of right hand Trigger little finger of right hand Impingement syndrome of left shoulder Closed displaced fracture of distal phalanx of left index finger, initial encounter Closed displaced fracture of distal phalanx of left index finger with routine healing, subsequent encounter Other Episode of recurrent major depressive disorder, unspecified depression episode severity Well adult exam Depressive disorder Controlled substance agreement signed Attention deficit disorder (ADD) without hyperactivity Daytime hypersomnolence
Allergies: AmpicillinHives / Urticaria, Rash
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: cough, nasal congestion, body aches, congestion in my chest, dizziness , nausea etc. at times a little vertigo.


VAERS ID: 1636380 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-16
Onset:2021-08-16
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, COVID-19, Clostridium difficile infection, Clostridium test positive, Cough, Decreased appetite, Diarrhoea, Electrolyte imbalance, End stage renal disease, Hypokalaemia, Hypophagia, Immunodeficiency, Metabolic encephalopathy, Peritoneal dialysis, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, atorvastatin, bumetanide, calcitrol, carvedilol. cetirizine, clindamycin, docusate sodium, estradiol topical, etanercept, fenofibrate, fluticasone nasal, multivitamin, hydralazine, insulin aspart, insulin glargine, isos
Current Illness:
Preexisting Conditions: anemia, anxiety, asthma, cataracts, CHF, CKD stage 4, chronic pain, constipation, diabetic retinopathy, DM type 2, stress incontinence, GERD, HX GI bleeding, HX of colonic polyps, hyperlipidemia, HTN, lumbar radiculopathy, lung disorder, LV dysfunction, macular edema, mitral valve stenosis, obesity, palpitations, HX panic attacks, past pericardial effusion, polyneuropathy, pulmonary artery hypertension, rheumatoid arthritis.
Allergies: Ace inhibitors, infliximab, lansoprazole, penicillins, sulfa antibiotics, trimethoprim, clonidine, enalapril, methotrexate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received both doses of the Pfizer COVID vaccine (on 1/26/2021 and 2/16/2021). On 8/16/2021, she tested positive for COVID 19 via PCR. Notes: " She then presented to care on 8/16 with cough, congestion, and fever. Patient was found to be COVID-19 positive. Patient was hemodynamically stable, and safe for discharge home. Patient was immunized in February of this year with Pfizer vaccine. Patient reports she has not been eating and drinking well because she has had "no appetite. She reports a dry cough and some congestion. She has had "a little" diarrhea. She states she has been urinating normally. She has had no evidence of black or tarry stools. She reports no chest pain or pressure." She had 2 unresponsive episodes on 8/21/2020 and was admitted to the hospital. Provider notes: "Patient is at risk secondary to her immune compromised status for not having robust immune response to the vaccine" "acute metabolic encephalopathy-worsening daily +c.dif, + COVID 8/16/21 despite vaccine status -witnessed x 2 8/23 and 8/24, 2/2 narcotics, did improve with narcan -more sick than usually see with c.dif alone -pt also tested + covid, suspect more susp given cardiorenal failure and chronic pred use -will hold bumex given persistent diarrhea with hypokalemia -electrolyte abnl-stable, noted anion gap but pt is ESRD on PD with persistent gap noted -noted dx c.dif and covid, possible two infections together could cause degree of encephalopathy -not safe to return home,not safe to discharge period -placed palliative care consult and asked for a family meeting tomorrow"


VAERS ID: 1636530 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chills, Cough, Discomfort, Dyspnoea, Electrocardiogram normal, Fatigue, Fibrin D dimer, Headache, Human chorionic gonadotropin, Hyperhidrosis, Laboratory test normal, Menstruation irregular, Pain, Pyrexia, Troponin
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: latex
Diagnostic Lab Data: d-dimer, troponin 1, hcg, serum, qualitative istat 8 profile: Normal ecg 12 lead, x ray chest 1 view: Normal poct troponin, poct, istat chem 8: Normal Normal the doctor told me.
CDC Split Type:

Write-up: At 9pm of the day of the vaccination (Monday August 16) I came down with a fever, body aches, chills, headache, extreme fatigue, pain, shortness of breath, and pressure in my chest/heart/lungs/upper back area. On Thursday the symptoms resolved EXCEPT for a continued headache, shortness of breath, unproductive cough, and pressure in my chest/heart/lungs/upper back area and they continue even today, August 26. I started my menstral cycle a week early, The Thursday after vaccination instead of the following week. I bled for 6 days instead of 3 days and before this, my periods have been consistent to the exact day for a solid 12+ years, since after my last pregancy, every 28 days. Every day since the vaccination, multiple times a day, I break into a sweat as if I have a fever for no apparent reason and then it passes. The pressure in my chest is still present as I am typing now, it has not subsided.


VAERS ID: 1636541 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017EUA / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Palpitations, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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: Small pox
Other Medications: Losarten pot hydrochlorothiazide 50-12.5. Mg Simvistatin 20mg. Vitamin d-3 125mcg. multi vitamin
Current Illness: None
Preexisting Conditions: Lyme disease 1994-2000 in remission not active
Allergies: Pinapples...small pox vaccine..textricycline doxycycline
Diagnostic Lab Data: labs 08 27 2021 covid 19 test results neg
CDC Split Type:

Write-up: Chest pain. Shortness of breathe extreme fatigue heart papitations


VAERS ID: 1636616 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Angiogram normal, C-reactive protein normal, Chest pain, Condition aggravated, Dyspnoea, Electrocardiogram ST-T change, Full blood count normal, Herpes zoster, Myocardial necrosis marker normal, Pericarditis, Troponin normal, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nothing
Current Illness: had cold like illness 1-3 weeks before, shingles outbreak after onset of pericarditis symptoms
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CBC, troponin, crp all normal. EKG w/ diffuse ST changes, CT PE angio normal
CDC Split Type:

Write-up: Patient developed chest pain and shortness of breath 3 days after his 2nd moderna vaccine. Was diagnosised and treated for acute pericarditis. Cardiac enzymes were normal so no myocarditis. He did have a viral URI illness 1-3 weeks before his 2nd vaccine and also developed shingles 3 days after the vaccine.


VAERS ID: 1636665 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Light headed daily that lasts for hours at a time.


VAERS ID: 1636739 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

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

Write-up: U07.1 - COVID-19


VAERS ID: 1636746 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypersomnia, Oral herpes
SMQs:, Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Opportunistic infections (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: Slept all day the following next day. Second day I woke up with fever blisters covering my mouth and inside my nose.


VAERS ID: 1636749 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

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

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

Write-up: Unknown


VAERS ID: 1636794 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-08-16
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Mechanical ventilation, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension, Arthritis
Allergies: No known allergies
Diagnostic Lab Data: 8/16/2021_SARS CoV-2 PCR Test: Positive
CDC Split Type:

Write-up: On 8/17/2021 patient was hospitalized due to acute COVID infection, requiring mechanical ventilation


VAERS ID: 1636867 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Tingling in arms and hands. Constant on the first day and lasting on and off for 3 days. Feelings of itching and burning on 2nd and 3 rd days.


VAERS ID: 1636903 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-01-11
Onset:2021-08-16
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Differential white blood cell count, Full blood count, Liver function test, Metabolic function test, Thrombophlebitis superficial, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: Ultrasound Blood work (Comprehensive metabolic panel, hepatic function, cbc differential auto)
CDC Split Type:

Write-up: Superficial Thrombophlebitis.


VAERS ID: 1637059 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-13
Onset:2021-08-16
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/20 2nd dose01/13/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:work Symptoms HA, sinus pressure.


VAERS ID: 1637062 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-28
Onset:2021-08-16
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (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), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/7/21 2nd dose01/28/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:Home Symptoms:fever, fatigue,muscle aches,loss of smell/taste, nausea, HA


VAERS ID: 1637068 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-10
Onset:2021-08-16
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/2020 2nd dose01/10/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:work Symptoms:loss of smell/taste, runny nose,congestion


VAERS ID: 1637094 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-18
Onset:2021-08-16
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Diarrhoea, Dizziness, Dyspnoea, Fatigue, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt Was admitted on 08/16/2021 Still in the hospital tested positive on 08/16/2021. Pt was admitted with 2 days of diarreah , fatigue, Weakness, dizzyness and difficulty breathing with a pulse ox. of 81%. Pt was Place on high flow Nasal cannula at 40% o2. On Solumedrel and completed Remdesivir on 8/21. Given one dose actemra Given on 8/17.


VAERS ID: 1637151 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Injection site erythema, Injection site reaction, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrada Maxalt Doxycycline
Current Illness:
Preexisting Conditions:
Allergies: Spironolactone
Diagnostic Lab Data: Contacted primary but not in till next week, nurse suggested I have covid and to go to ER
CDC Split Type:

Write-up: 1st day sore arm, diarrhea 2nd day fever 3rd day shortness of breath when working out 4th day shortness of breath when working out 5th day headache 6th day large red raise circle at injection site 7th day injection site reaction still there 8th day injection site reaction still there 9th day injection site reaction still there, also that night sweating and felt faint


VAERS ID: 1637195 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-06
Onset:2021-08-16
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose04/15/21 2nd dose05/06/21 Diagnosed covid positive:08/16/21 Symptom onset:08/18/21 Exposure: Symptoms:Cough, fatigue,runny nose,HA, sore throat.


VAERS ID: 1640744 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1640941 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-15
Onset:2021-08-16
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Bordetella test negative, COVID-19, Chest X-ray normal, Chest discomfort, Chest pain, Cough, Diarrhoea, Dyspnoea, Electrocardiogram normal, Human metapneumovirus test, Influenza B virus test, Influenza virus test negative, Neck pain, Pain in extremity, Respiratory syncytial virus test, Respiratory tract congestion, Respiratory viral panel, SARS-CoV-2 test positive, Troponin normal
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet ADVAIR HFA 230-21 mcg/actuation inhaler albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 40 mg tab
Current Illness:
Preexisting Conditions: Nervous Chronic bilateral low back pain without sciatica Painful breathing Respiratory Obstructive sleep apnea (adult) (pediatric) Chronic bronchitis (CMS/HCC) COPD, severe (CMS/HCC) Nocturnal hypoxia Pneumonitis Asthma Pulmonary disease due to mycobacteria (CMS/HCC) Multiple nodules of lung Aspiration into respiratory tract Circulatory Chronic diastolic congestive heart failure (CMS/HCC) Hypertension Coronary artery disease Essential hypertension Digestive Gastroesophageal reflux disease without esophagitis Gastroesophageal reflux disease Hepatitis C Genitourinary CKD (chronic kidney disease), stage II Musculoskeletal Encounter for post surgical wound check Endocrine/Metabolic Acquired hypothyroidism Dyslipidemia Infectious/Inflammatory Thrush Other Abnormal CT of the chest BMI 31.0-31.9,adult Anxiety about health Current moderate episode of major depressive disorder without prior episode (CMS/HCC) S/P coronary artery stent placement Obesity, Class II, BMI 35-39.9 Controlled substance agreement signed Encounter for weight management S/P bariatric surgery Umbilical hernia without obstruction and without gangrene Physical deconditioning Screening for respiratory organ cancer S/P umbilical hernia repair, follow-up exam Anxiety disorder, unspecified BMI 32.0-32.9,adult
Allergies: LevofloxacinOther (document details in comments) LisinoprilCoughing
Diagnostic Lab Data: 08/16/21 2051 Respiratory virus detection panel Collected: 08/16/21 1922 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view [3298075521] Resulted: 08/17/21 1236 Order Status: Completed Updated: 08/16/21 2013 Narrative: XR CHEST 1 VW INDICATION: chest pain today, congestion yesterday, chronic cough Chest pain. TECHNIQUE: Portable AP projection of the chest is acquired. COMPARISON: 4/13/2021 FINDINGS: The heart size is normal. The vascular distribution is normal. The hilar and mediastinal silhouettes appear unremarkable. The lungs are clear. No pleural effusion is identified. There is no evidence of pneumothorax. There are no significant bony findings. Vagal nerve stimulator is suggested overlying right chest. IMPRESSION: No acute pulmonary findings. END OF IMPRESSION:
CDC Split Type:

Write-up: ED Discharged 8/16/2021 (2 hours) Hospital ER Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath ? Chest Pain Chief complaint ED Provider Notes MD (Physician) ? ? Emergency Medicine Expand AllCollapse All ED PROVIDER NOTE MRN: 008001133 Medical Decision Making HPI as documented, differential diagnosis includes but not limited to COVID-19, pneumonia, COPD exacerbation 64-year-old male presenting today with shortness of breath, history of chronic bronchitis and COPD, vaccinated for Covid, presenting with upper respiratory symptoms, cough and congestion. EKG is without acute ischemic change, troponin is negative, x-ray unremarkable, he is positive for COVID-19.He is not tachycardic, does not appear consistent with PE at this time. He was given albuterol, steroids, feels safe for outpatient at this time as he is not hypoxic, will discharge History of Present Illness Client is a 64 y.o. yo male presenting to the ED with cough, URI, chest pain and arm numbness. Very pleasant 64 year old male presenting with URI symptoms, congestion, cough productive of an occassional sputum, chest tightness starting today with pain into his neck and left arm. No pain /numbness to left arm currently. Did have some associated diarrhea today. No sick contacts. Did receive covid vaccine. States has COPD but no problems in recent years. H/o CAD s/p stenting


VAERS ID: 1640961 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Aphasia, Blood test, Bone pain, Computerised tomogram head, Headache, Loss of consciousness, Magnetic resonance imaging head, Pain, Pain in extremity, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: topamax birth control zyrtec pepcid
Current Illness: none
Preexisting Conditions: I had COVID in Feb of 2021 (diagnosed Feb 3) and had residual breathing problems, fatigue and reactive arthritis (got it Feb 13)... the reactive arthritis lasted 3 months.
Allergies: cats seasonal allergies
Diagnostic Lab Data: CT scan 8/15 MRI 8/24 Blood Work 8/15 8/19 8/23
CDC Split Type:

Write-up: I received the first dose of the Moderna vaccine in my left arm Saturday morning around 8:30, I felt fine through out the day... a little tired but nothing unusual. By the next day body aches were building and I had a slight headache... and I took Ibuprofen to combat these symptoms. As Sunday continued the body aches became worse and by Sunday night the body aches became what I would describe as bone pain especially in arms. A little after 12:00 I went to the kitchen with my daughter who had a headache and asked for medicine (I was also going to take more ibuprofen) and as I was walking down our hallway I could feel this pain building to an unbearable level in my arms, upper torso and head... I managed to pour my daughter some medicine and as soon as I sat it on the counter and turned to get the ibuprofen from a small cabinet by the stove my upper body was filled with this metallic electrical energy. I began convulsing slamming on the counter and partway on the stove. My daughter screamed I turned the stove on and I was semi conscious and could see the red burner I was able to move my hand a little and turn it off and then lost consciousness again. She ran and got my husband and he carried me in out living room where he said I was "talking gibberish" and still shaking. Once came to my brain was wiped clean, I could not talk for a minute or two... we went to the ER. I have since had a CT scan, blood work, and MRI, I have had issues with certain tasks, headaches, and short term memory .


VAERS ID: 1641010 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-08-16
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 RA / IM

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

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

Write-up: Moderna was given patient is 17 years of age- patient waited 30 min for observation, no symptoms.


VAERS ID: 1641138 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-02
Onset:2021-08-16
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Aspartate aminotransferase increased, Blood chloride decreased, Blood creatinine normal, Blood potassium decreased, Blood urea normal, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Chills, Chlamydia test negative, Condition aggravated, Coronavirus test negative, Cough, Dyspnoea, Enterovirus test negative, Human metapneumovirus test, Human rhinovirus test, Hypophagia, Influenza A virus test negative, Influenza B virus test, Lymphocyte count decreased, Myalgia, Mycoplasma test negative, Nausea, Pyrexia, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Total lung capacity decreased, Vomiting, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ZITHROMAX 250 mg PLAVIX 75 mg LASIX 20 mg APRESOLINE 10 mg LANTUS SOLOSTAR 100 unit/mL (3 mL) insulin pen TOPROL-XL 100 mg NOVOLOG FLEXPEN 100 unit/mL insulin pen BENICAR 5 mg PROTONIX 40 mg PRANDIN 0.5 mg CRESTOR 20 mg XARELTO
Current Illness:
Preexisting Conditions: Ischemic cardiomyopathy Bundle branch block, left Chronic systolic congestive heart failure Dyslipidemia
Allergies: Amiodarone
Diagnostic Lab Data: 08/22/21 0932 Respiratory virus detection panel Collected: 08/22/21 0804 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 08/16/21 1811 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/16/21 1345 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical IMAGING: X-ray chest 1 view, Portable Result Date: 8/22/2021 XR CHEST 1 VW PORT IMPRESSION: Some cardiomegaly changes and low lung volumes and bilateral patchy interstitial alveolar lung infiltrates. Cannot exclude pneumonia changes versus CHF. END OF IMPRESSION: INDICATION: SOB. TECHNIQUE: Single AP projection of the chest is acquired. COMPARISON: Chest radiograph dated September 26, 2017. FINDINGS: Low lung volumes limit assessment. Cardiomegaly changes are noted. Diffuse interstitial alveolar patchy lung infiltrates are noted suspicious of COVID-19 infection or edema changes or other infectious etiology. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Medical Decision Making/ Level of Risk: high Total time spent on review of chart, development of management plan, discussion with patient/family/other providers is greater than 35 minutes, with greater than 50% of this time spent in face-to-face interaction.
CDC Split Type:

Write-up: Cough, Shortness of breath, Non-intractable vomiting with nausea, unspecified vomiting type. ED to Hospital Admission Current 8/22/2021 to present for 5 days. Pneumonia due to COVID-19 virus a Principal problem. Patient presents with Vomiting. History of Present Illness A 73 y.o. male who presented to the ED with chief complaint of nausea and vomiting and decreased po intake for 5 days. Patient reported there is tested positive for Covid on Tuesday. Patient symptoms are getting worse which made him come to the ER for further evaluation and treatment. He reports fever, chills, myalgias, and shortness of breath associated with nausea and vomiting. He denied chest pain and palpitations. Patient was vaccinated for Covid in March with Pfizer. Patient past medical history significant for hypertension uncontrolled diabetes mellitus coronary artery disease, hyperlipidemia atrial fibrillation, and CHF. Patient appears to be comfortable not in acute distress requiring 2 L of oxygen to keep saturations above 90. White count is 3.2 with a low lymphocytes, potassium is 3.3 chloride, 96 AST is mildly elevated to 53, BUN and creatinine are within normal limits. Chest x-ray is consistent with atypical pneumonia.


VAERS ID: 1641149 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-03
Onset:2021-08-16
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: Updated Procedure 08/20/21 1046 COVID-19 EXTERNAL (NON WELLSPAN OR NON INTERFACED LAB) Collected: 08/16/21 1257 | Final result COVID-19 Overall Result External DetectedAbnormal
CDC Split Type:

Write-up: Acute nasopharyngiti


VAERS ID: 1641157 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-03
Onset:2021-08-16
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, SARS-CoV-2 test positive, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acyclovir (ZOVIRAX) 400 mg tablet albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler anastrozole (ARIMIDEX) 1 mg chemo tablet ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet aspirin 81 mg tablet buPROPion XL (WELLBUTRIN XL
Current Illness:
Preexisting Conditions: Nervous Aromatase inhibitor-associated arthralgia Respiratory Obstructive sleep apnea Circulatory Essential hypertension Genitourinary Postmenopausal status Musculoskeletal Lichen sclerosus et atrophicus Alopecia Osteopenia of neck of left femur Endocrine/Metabolic Type 2 diabetes mellitus Hypothyroidism Hyperlipidemia Other Stage 1 infiltrating ductal carcinoma of right female breast Estrogen receptor positive tumor status Adjustment disorder with mixed emotional features Malignant neoplasm of female breast Encounter for monitoring aromatase inhibitor therapy Hx of colonic polyps Depression
Allergies: Bee Venom Protein (Honey Bee)Shortness of breath / Dyspnea, Hives / Urticaria Sulfa (Sulfonamide Antibiotics)Anaphylaxis, Hives / Urticaria PenicillinHives / Urticaria CodeineNausea And Vomiting OtherItching
Diagnostic Lab Data: Updated Procedure 08/17/21 1918 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/16/21 1605 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/17/21 1918 COVID-19 PCR Collected: 08/16/21 1605 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: Dx Cough ? Headache ? Sore Throat ? Fatigue Upper respiratory tract infection, unspecified type Loss of taste


VAERS ID: 1641197 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-05
Onset:2021-08-16
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet ADVAIR HFA 230-21 mcg/actuation inhaler albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler aspirin 81 mg tablet atorvastatin (LIPITOR) 20 mg tablet cholecalciferol, vitamin D3, (cholecalci
Current Illness:
Preexisting Conditions: Non-recurrent unilateral inguinal hernia without obstruction or gangrene
Allergies: NKA
Diagnostic Lab Data: Updated Procedure 08/16/21 2022 COVID-19 (SARS CoV-2,) Collected: 08/16/21 1500 | Final result | Specimen: Swab COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/16/21 2022 COVID-19 PCR Collected: 08/16/21 1500 | Final result | Specimen: Swab
CDC Split Type:

Write-up: UNKNOWN


VAERS ID: 1641209 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-05
Onset:2021-08-16
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Angiogram pulmonary abnormal, Atelectasis, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea, Fatigue, Flatulence, Headache, Kyphosis, Lung infiltration, Lung opacity, Musculoskeletal disorder, Pain, Pneumonia viral, Pulmonary mass, Pyrexia, SARS-CoV-2 test positive, Scan with contrast abnormal, Spinal cord compression, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet aspirin 81 mg tablet bisacodyL (DULCOLAX, BISACODYL,) 10 mg suppository calcium carbonate (OS-CAL) 1250 mg (500 mg calcium) tablet cetirizine (ZyrTEC)
Current Illness:
Preexisting Conditions: Nervous Mixed conductive and sensorineural hearing loss, bilateral Chronic serous otitis media Chronic pain syndrome Respiratory Incidental lung nodule Mild intermittent asthma Extrinsic asthma without status asthmaticus Chronic obstructive lung disease (CMS/HCC) Chronic respiratory failure with hypoxia (CMS/HCC) Pneumonia due to infectious organism Pneumonia due to COVID-19 virus Circulatory Essential hypertension Digestive Irritable bowel syndrome Gastroesophageal reflux disease Musculoskeletal Restless legs Osteoporosis Generalized hyperhidrosis Arthropathy Fracture of acetabulum (CMS/HCC) Fracture of head of radius Age-related osteoporosis without current pathological fracture Age-related osteoporosis without current pathological fracture Endocrine/Metabolic Mixed hyperlipidemia Impaired fasting glucose Hypothyroidism Hypomagnesemia Hashimoto''s thyroiditis Hypoxemia Infectious/Inflammatory COVID-19 virus infection Other Anxiety Encounter for long-term (current) use of medications
Allergies: AmoxicillinHives / Urticaria AzithromycinHives / Urticaria CefaclorHives / Urticaria Sulfamethoxazole-trimethoprimHives / Urticaria
Diagnostic Lab Data: Contains abnormal data COVID-19: Probable Infection Onset 8/17/2021 Probable COVID-19 Specimen information: Swab / Nares Added: 8/17/2021 by POCT COVID-19 Antigen (Collected 08/17/21) Onset date: 8/17/2021 Resolve Add: Rule-Out COVID-19 and Respiratory Viruses Add: SARS-CoV-2 (related to COVID-19) Add: Rule-Out SARS-CoV-2 (related to COVID-19) Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast [3298267638] Resulted: 08/23/21 1121 Order Status: Completed Updated: 08/20/21 0757 Addenda: Addendum: There are 4-5 nodules measuring between 3 and 5 mm. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Signed: 08/20/21 0757 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: There is no filling defect in either pulmonary artery. There is no aortic aneurysm or dissection. There is no adenopathy. There is hazy groundglass type density in the lungs bilaterally which can be seen with viral or interstitial type pneumonitis. There are several nodular densities in the right lower lobe. Follow-up CT scan chest in 6 months recommended to reevaluate. Findings are new from prior. END OF IMPRESSION: INDICATION: sob, covid+. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CTA scan of the chest was performed from the lung apices to below the diaphragm, including the pulmonary artery. 2 mm axial reconstruction with MPR coronal, oblique and sagittal images were created. 3D post processing imaging were obtained and stored. CONTRAST: 100mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was adequate. COMPARISON: 12/8/2016 FINDINGS: There is no filling defect in the pulmonary arteries. There is no aortic aneurysm or dissection. There is no cardiomegaly. The esophagus is decompressed throughout its course. The lungs bilaterally demonstrate patchy hazy opacity suggests groundglass type density. There is no tracheobronchial compromise. There is no pleural effusion, consolidation or pneumothorax. There is no bulky adenopathy in the mediastinal or hilar regions. Images extending into the upper abdomen demonstrate no acute finding. There is degenerative change of the skeleton. There is multilevel compression deformity creating kyphosis. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3298267611] Resulted: 08/17/21 1915 Order Status: Completed Updated: 08/17/21 1915 Narrative: XR CHEST 1 VW PORT IMPRESSION: Linear density right midlung zone which can be seen with subsegmental atelectasis or developing infiltrates END OF IMPRESSION: INDICATION: Shortness of Breath. 65 years TECHNIQUE: PA chest COMPARISON: 10/22/2019 FINDINGS: The heart is normal in size. There is some linear or density in the right midlung zone. There is no pleural effusion. There is no pneumothorax.
CDC Split Type:

Write-up: FEVER, right abdominal pain, body aches, headaches, fatigue, and gas ED to Hosp-Admission Discharged 8/17/2021 - 8/19/2021 (2 days) Hospital COVID-19 virus infection Pneumonia due to infectious organism Pneumonia due to COVID-19 virus Hospital Course: Patient is a pleasant 65-year-old female presented due to generalized fatigue tiredness and progressive shortness of breath with nonproductive cough. She denied any chest pain or tightness patient had Oxygen saturation of 94% and elevated white count. Chest x-ray showed linear density in the right middle lobe. Patient did have Covid and chest CTA which showed hazy groundglass type density in the lungs bilaterally seen with viral or interstitial type pneumonitis. Patient was treated with steroids, supplemental oxygen and bronchodilators along with antibiotics patient slowly continued to improve she did require home oxygen which was set up prior to discharge. She will continue on antibiotics and supplemental oxygen


VAERS ID: 1641326 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-21
Onset:2021-08-16
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discomfort, Laboratory test normal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol and Aleve as needed
Current Illness: n/a
Preexisting Conditions: Obesity
Allergies: N/a
Diagnostic Lab Data: Lab work - negative for kidney infection - 8/16/2021
CDC Split Type: vsafe

Write-up: Well I was experiencing a low grade fever and pressure on my left side. I thought it might me a kidney infection. I went to the Urgent Care on Wednesday the 18th of August 2021. I was at the urgent care maybe thirty minutes. My symptoms are still happening, this began on the 16th of August. The urgent care doctor did not give me any medication or help my situation. I have an appointment with a PCD later in August.


VAERS ID: 1641452 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-06
Onset:2021-08-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Breast discharge, Breast pain, Eye pain, Headache, Mammogram
SMQs:, Glaucoma (broad), Lipodystrophy (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: Armour Thyroid; Metformin; Bisoprolol
Current Illness: no
Preexisting Conditions: just high BP and Hypothyroidism
Allergies: no
Diagnostic Lab Data: Mammogram-08/20/2021-normal but because the liquid out of the breast became bloody. I am to have an MRI with and without contrast on my breast soon.
CDC Split Type: vsafe

Write-up: 08/16/2021-I was having a lot of pain in my breast, my right breast on this morning has a lot of discharge, and it turned to blood. Also, back part of my eye it hurts a lot and a lot of headaches. All these things have continued as of today.


VAERS ID: 1641704 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-16
Onset:2021-08-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Extra dose administered, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown - pt does not fill any medications at our pharmacy
Current Illness: none reported
Preexisting Conditions: Rheumatoid arthritis (known condition - unknown if others)
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient started experiencing chest pain, fever and chills 3 hours after receiving his third dose of Moderna. Chest pain, fever and chills continued into Tuesday. Early Wednesday morning, the chest pain had not lessened, so the patient went to the emergency room. Emergency room visit showed no sign of a heart attack or other critical medical condition and patient was sent home. Doctor believed all symptoms to be related to his third shot. He received his first shot 2/5/21 and second shot 3/5/21. Symptoms of fever, chills and chest pain lasted for 8 days after his third shot. He had no reports of side effects after his first and second shot.


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