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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 131 out of 6,867

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VAERS ID: 1577644 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-10
Onset:2021-08-15
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Superior sagittal sinus thrombosis, Venogram abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin 20 mg daily calcium 1800 mg daily Vit D 1000 unit daily estrace cream vaginally twice weekly loratidine 10 mg daily metoclopramide 10 mg prn q6 nausea multivitamin mycolog ointment to vulva prn benicar 20/12.5 mg daily omeprazo
Current Illness:
Preexisting Conditions: depression, HTN
Allergies: PCN
Diagnostic Lab Data: MRV of brain
CDC Split Type:

Write-up: Thrombosis of superior sagittal sinus


VAERS ID: 1577648 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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: 1577838 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypomenorrhoea, Induration
SMQs:, Extravasation events (injections, infusions and implants) (broad), Fertility disorders (broad)

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

Write-up: Period is normally 7 days, ended at day 4. Lump underneath collar bone


VAERS ID: 1577855 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-08-15
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling drunk, Sensitive skin, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Vestibular 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: Only minor soreness on arm after 1st shot, ditto 2nd second, but developed COVID toe $g2 weeks after 2nd dose,
Other Medications: Vitamin, low dose aspirin and nothing else
Current Illness: None
Preexisting Conditions: None
Allergies: Not aware of any
Diagnostic Lab Data: None, took care of myself at home
CDC Split Type:

Write-up: My little toe of the right feet developed something like frost bite, it is hyper-sensitive to touch, note this is my 3rd dose, also this dose I developed side effects 36h later, light headed, drunken like and fatigue on Fri afternoon and got worse on Sat, by late Sunday it is almost gone and fully recovered on Monday Previously ~2 weeks after 2nd dose ( Lot ER8729), I developed similar issue on my big toe on the right feet as well, it was also excruciating and very very hypersensitive, only recovered 3 weeks later, in both cases, the toe issue developed $g 2 weeks after vaccination.


VAERS ID: 1577881 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWASI / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ipsilateral axillary swelling to a lesser degree than 2nd dose
Other Medications: none
Current Illness: none
Preexisting Conditions: tiny ventral septal defect
Allergies: none
Diagnostic Lab Data: none mother is pediatric NP, therefore no office visit needed
CDC Split Type:

Write-up: ipsilateral axillary swelling & pain warranting advil, tylenol & self advocated activity restrictions. difficult to discern lot # due to poor handwriting


VAERS ID: 1577923 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-25
Onset:2021-08-15
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 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: albuterol HFA 108/90 mcg/ACT inhaler 2 puffs q4-6 h PRN, allopurinol 300 mg daily, tamsulosin 0.4 mg daily, celecoxib 200 mg daily, levothyroxine 125 mcg daily, simbrinza 1-0.2% suspension opthalmic 1 drop daily to LEFT eye, CBD oil gummy d
Current Illness: none
Preexisting Conditions: Respiratory Mild intermittent asthma without complication Endocrine Gout Hypothyroidism Blood Iron deficiency anemia secondary to inadequate dietary iron intake Gastrointestinal Diverticulitis of large intestine without perforation or abscess without bleeding Genitourinary Single kidney Benign prostatic hyperplasia with urinary retention Rheumatology Arthritis
Allergies: environmental allergens
Diagnostic Lab Data: PCR swab
CDC Split Type:

Write-up: Patient has contracted Covid 19


VAERS ID: 1577986 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Epistaxis
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: Spironolactone, birth control, Topamax, Effexor
Current Illness:
Preexisting Conditions: PCOS
Allergies: omincef, biaxin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started having nose bleeds on 8/22/21


VAERS ID: 1577993 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-08-15
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V asymptomatic POSITIVE
CDC Split Type:

Write-up: patient had MVA and was brought to the ED and found to be COVID+


VAERS ID: 1578027 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: severe body aches, severe headache, fever 102, chills, fatigue


VAERS ID: 1578056 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-22
Onset:2021-08-15
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Dizziness, Fall, Nausea, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, Benzonatate, Donepezil, Levothyroine, Meclizine
Current Illness: Unknown
Preexisting Conditions: HTN, Hypothyroid, CHronic adrenal insufficiency, urinary retention, dementia, Chronic dizziness, vertigo Hyponatremia
Allergies: No known allergies
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: The patient presents with Fall, just prior to arrival. Per EMS report, pt experienced a ground level fall at Cove assisted living. At ED, pt reports to have been feeling general weakness, dizziness, and nausea. Pt is currently COVID-19 positive and has been medicating with Doxycycline for an UTI. Associated symptoms: nausea, dizziness, General weakness.


VAERS ID: 1578059 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-08-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Road traffic accident, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (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: acetaminophen (TYLENOL) 325 mg tablet ergocalciferol (VITAMIN D) 50,000 unit capsule fluticasone (FLONASE) 50 mcg/actuation nasal spray ibuprofen (MOTRIN) 400 mg tablet levothyroxine (SYNTHROID, LEVOTHROID) 137 mcg tablet sulfamethoxazole-t
Current Illness: None
Preexisting Conditions: Respiratory Allergic rhinitis Musculoskeletal Trauma Closed displaced fracture of right clavicle, initial encounter Closed traumatic minimally displaced fracture of proximal end of left humerus, initial encounter Closed fracture of superior ramus of right pubis, initial encounter Closed fracture of right inferior pubic ramus, initial encounter Minimally displaced zone i fracture of sacrum, initial encounter for closed fracture Multiple rib fractures involving first rib Endocrine/Metabolic Hypothyroidism Other Anxiety Depression Motorcycle accident
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 (SARS CoV-2 RNA, RT-PCR)
CDC Split Type:

Write-up: Tested positive to COVID-19


VAERS ID: 1578065 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Pravastatin, Invokana, Glipizide, Sildenafil, Lisinopril, Levothyroxine
Current Illness: none
Preexisting Conditions: diabetes, hypertension
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Redness, swelling to left arm injection sight starting on 8/15/21 - 2 days after injection


VAERS ID: 1578074 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-08-15
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Nasopharyngitis, Pyrexia, Respiratory tract congestion
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Claritin
Current Illness: none
Preexisting Conditions: seasonal allergies
Allergies: seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: cold like symptoms, congestion, fever


VAERS ID: 1578091 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-24
Onset:2021-08-15
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 UN / IM

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

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: Patient has is in holding in Emergency department.


VAERS ID: 1578099 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-03
Onset:2021-08-15
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrial fibrillation, Blood test, Chest X-ray, Dyspnoea, Electrocardiogram, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Multiple EKGs (8/15/21 & 8/17/21), chest x-ray and blood tests 8/15/21
CDC Split Type:

Write-up: Diagnosis - atrial fibrillation Treatment - asprin Symptoms - 8/15/2021 9:30 p.m. shortness of breath, heart palpitations. aFib seized 8/16/2021 at 6:30 a.m.


VAERS ID: 1578102 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-08-15
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: Pt developed fever and was tested for COVID which was positive. Due to history of leukemia on chemo she was admitted to the hospital


VAERS ID: 1578105 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-09
Onset:2021-08-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 RA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Sofia Antigen COVID-19 test with a positive result
CDC Split Type:

Write-up: Patient was fully vaccinated when he tested positive for COVID-19 on 8/15/21.


VAERS ID: 1578139 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-01-21
Onset:2021-08-15
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 2 RA / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Antigen COVID-19 test with a positive result
CDC Split Type:

Write-up: The patient received the Pfizer vaccine on 12/30/20 and 1/21/21 and was fully vaccinated when she tested positive for COVID-19 on 8/15/21.


VAERS ID: 1578162 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna 1st dose
Other Medications: Bupropion Seroquel Ziprasidone
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Redness and itchiness


VAERS ID: 1578163 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-08-15
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / -

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: history of severe COPD
Allergies:
Diagnostic Lab Data: Positive COVID-19 PCR test
CDC Split Type:

Write-up: Hospitalization with Positive COVID Test


VAERS ID: 1578232 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/AN/A
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Approximately one hour after receiving the Pfizer vaccine in the left arm, I experienced left sided facial numbness that lasted all day. On the second day after receiving the vaccine, I noticed a rash on my chest.


VAERS ID: 1578244 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac function test normal, Chest pain, Electrocardiogram ST segment elevation, Myocarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), 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? 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: Fever with Tmax 101.6F starting approximately 6hours after vaccination. On 8/15/2021, developed chest pain. Presented to ED where found to have elevated troponin (17.8) and EKG with ST segment changes, consistent with myopericarditis. Normal cardiac function at this time. Treating with NSAIDs.


VAERS ID: 1578306 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Ophthalmic herpes zoster
SMQs:, Ocular infections (narrow), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Augmentin
Diagnostic Lab Data: Unsure what tests were conducted. Seen and diagnosed on Monday 16 August 2021, at Optometry Clinic at approximately 1245pm. Patient was deployed the next day. Outcome unknown at this time.
CDC Split Type:

Write-up: Herpes Zoster Ophthalmicus to the left eye. Given 7-day course of Valacyclovir, two types of eye drops and an eye ointment. Patient was deployed the next day. Outcome unknown at this time.


VAERS ID: 1578363 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-09
Onset:2021-08-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Janssen on 3/9. Positive on 8/10 admitted on 8/15-current


VAERS ID: 1578373 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-06
Onset:2021-08-15
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Janssen on 5/6. Positive on 8/9 admitted on 8/15-current


VAERS ID: 1578393 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Deep vein thrombosis, Embolism venous, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: 3-4 day history of URI (rhinorrhea, non-productive cough, congestion) prior to vaccination. Also bitten by a dog a few day prior to vaccination
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: 8/16/2021 CT PE protocol and venous duplex study diagnosing VTE
CDC Split Type:

Write-up: right popliteal DVT and bilateral pulmonary emboli


VAERS ID: 1578499 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-08-15
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Brain natriuretic peptide, Chest X-ray, Chest pain, Costochondritis, Differential white blood cell count, Full blood count, International normalised ratio, Prothrombin time, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: chest xray, pt/inr, cbc with diff, BNP, troponin
CDC Split Type:

Write-up: chest pain, Costochondritis


VAERS ID: 1578505 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: Pain in the armpit/lymph nodes


VAERS ID: 1578523 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood ketone body, Myalgia, Nasal congestion, Pain, Product administered to patient of inappropriate age, Protein total, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: He was not on prescription or over-the-counter medications prior to vaccination
Current Illness: No illness at the time of vaccination are up to 1 month prior to vaccination
Preexisting Conditions: No chronic or longstanding health conditions
Allergies: No known drug allergies
Diagnostic Lab Data: Urine dipstick in the office showed ketones and protein. CBC, CMP and COVID-19 test results are pending.
CDC Split Type:

Write-up: He received modern a COVID-19 vaccine at 17 years 10 months of age by mistake. He started having runny nose and left arms own as the next day. 2 days later he started having fevers. He did not check the temperature initially. T-max went up to 102?. He took over-the-counter acetaminophen, ibuprofen and take will. Fever improved this afternoon. He has nasal congestion, fever, body aches, myalgias.


VAERS ID: 1578576 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-11
Onset:2021-08-15
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chlamydia test negative, Computerised tomogram abdomen, Computerised tomogram pelvis, Dysuria, Full blood count, Metabolic function test, Pollakiuria, Urinary tract pain, Urine analysis
SMQs:

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: Tests performed: CBC, BMP, chlamydia, gonorrhea, urinalysis, CT abdomen pelvis
CDC Split Type:

Write-up: urinary pain, increased frequency, and urinary burning. DX: dysuria


VAERS ID: 1578614 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Fatigue, Headache, Malaise, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: quetiapine fumarate Buspirone
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin, abilify, tegratol, Bactrim, doxycycline Cinnamon
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, nausea, joint pain, arm pit pain, shoulder and neck pain, tiredness, feeling unwell


VAERS ID: 1578627 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Lethargy, Myalgia, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D
Current Illness: 3 weeks prior, head cold, negative COVID test
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 8-10 hours: dull headache, fever of 100-101, severe aches, joint and muscle aches, lethargy, and severe left arm pain for about 24 hours from collarbone to wrist.


VAERS ID: 1578663 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lips swelled and i broke out in a rash from my stomach all the way down my legs and feet


VAERS ID: 1578731 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

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

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

Write-up: Red raised area at injection site warm to touch and itches


VAERS ID: 1578968 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

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

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

Write-up: headache, sleepy, tiredness


VAERS ID: 1578982 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Electrocardiogram, Heart rate increased, Hot flush, Hypoacusis, Immediate post-injection reaction, Nausea, Paraesthesia, Sinus rhythm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), 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: METOPROLOL 25 MG TOPAMAX 50 MG ALBUTEROL INHALER PRN
Current Illness: NO
Preexisting Conditions: ASHTHMA PVC''S AND PAC''S MIGRAINE BURSTS
Allergies: BACTRIM
Diagnostic Lab Data:
CDC Split Type:

Write-up: IMMEDIATE BODY TINGLING, IMMEDIATE DIZZINESS, MUFFELED HEARING, HEAT WAVE, CHEST WAS TIGHT, RAPID HEART RATE, NUSEA. TREATMENT WAS OBSERVATION, OJ, WATER, CRACKERS, ICE TO THE WRISTS AND NECK. ULTIMATELY EMS FOR EVALUATION. HOOKED 4 LEAD EKG AND BP AND SINUS RHYTHM WAS NORMAL. DID NOT TRANSPORT.


VAERS ID: 1579196 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-10
Onset:2021-08-15
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 9267 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Inflammation, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Facial fillers. Face, except for mouth area and lips, is horribley swollen, red, and hot. In particular areas treated with fillers. Fillers done years ago.
Current Illness: None
Preexisting Conditions: Extrinsic asthma.
Allergies: Sulfa medications, pollens, dust mites.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have facial fillers. My face is hot, red and very inflamed, except my forehead (no fillers) area around mouth (lip fillers). Has lasted more than 2 days. Visited physician thinking I had a sinus infection and was give 4 days of 40 mg steroids and augmenten anitbiotic. Have taken 2 doses and little improvement.


VAERS ID: 1579217 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none per mom
Preexisting Conditions:
Allergies: topiramate, sertraline (allergy per mom, sounds like ADR)
Diagnostic Lab Data:
CDC Split Type:

Write-up: bilateral forearm and shoulder rash, back, torso, and hip included. rash is red, raised, but not itchy nor painful. No known allergy to anything in past besides those ADRs to sertraline or topiramate


VAERS ID: 1579765 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Injection site erythema, Migraine, Pruritus, Pyrexia, Rhinitis allergic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bayer aspirin, Women''s One a Day Multi-Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Pepper family
Diagnostic Lab Data: None
CDC Split Type:

Write-up: High fever, chills, migraine, nausea, large red swollen area on arm where shot was administered, itching arm; no appetite as of today, Aug 18th


VAERS ID: 1582136 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Wrong Route (SC, IM, etc.)-


VAERS ID: 1582146 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Fever-Mild


VAERS ID: 1582166 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023D21A / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: 5 MINUTES POST VACCINATION, PATIENT FAINTED BUT BUT REMAINED CONSCIOUSNESS. PT WAS INSTRUCTED TO LIE FLAT WITH ELEVATED FEET. FAMILY MEMBER CALLED 911 AND HE WAS TAKEN TO ER. NEXT DAY, SISTER INFORMED PHARMACY THAT HE WAS RELEASED SAME DAY, AND HE WAS RESTING AT HOME.


VAERS ID: 1582167 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-23
Onset:2021-08-15
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Tested Positive for Covid


VAERS ID: 1582294 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

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

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

Write-up: rash hives on arms, thighs, chest, back and itchiness in body


VAERS ID: 1582305 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: per mom, patient had hx of feeling faint after vaccines but did not name any particular ones
Other Medications:
Current Illness:
Preexisting Conditions: History of feeling faint after vaccinations.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was accompanied by mother. Patient was visibly anxious prior to and during immunization; his mother notified me he has a history of feeling faint after immunizations. I acknowledged this, deposited the syringe in the sharps container, told patient and mother to stay in the store for at least 15 minutes to make sure he felt okay afterwards, and patient was lightheaded. Mom asked if they could stay there a minute, to which I said yes, and I stayed there to assist if he passed out. He experienced a brief loss of consciousness while seated; this was accompanied by loss of bladder control and brief twitching in legs. He was awake shortly after and given water and instant cold packs. Mom and him were given privacy in the room per her request and I told her to come get me if they needed any assistance at all; about 20 minutes later, they exited the room and asked if they could leave if he felt fine. I told them yes but to call us if they ran into any other issues.


VAERS ID: 1582309 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Difficulty breathing the day after dose 2 in series, complains of cough, struggling to breath at night, returned to on 8/17 and admit to hospital the same day. Currently admitted


VAERS ID: 1582314 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: chest pain 48hr after 2nd Pfizer COVID-19 vaccine


VAERS ID: 1582356 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-23
Onset:2021-08-15
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / UNK LA / IM

Administered by: Pharmacy       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: Tested positive for covid-19 after being fully vaccinated.


VAERS ID: 1582428 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-08-15
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pleural effusion
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: Pleural effusion


VAERS ID: 1582445 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-18
Onset:2021-08-15
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / -

Administered by: Public       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? 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: Dose 1 4/14/2021 Pfizer EW0169 pt has covid 19


VAERS ID: 1582476 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-29
Onset:2021-08-15
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / UNK LA / IM

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

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

Write-up: Tested positive for covid-19 after being fully vaccinated.


VAERS ID: 1582478 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site swelling, Pain, Pain in extremity, Pyrexia, Rash erythematous, Rash macular, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril lovastatin prempro tresibia fiasp
Current Illness:
Preexisting Conditions: diabetic celiac disease
Allergies: pcn cephalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, chills, body aches, headache, sore arm 24 hrs after vaccine 2 days after vaccine, swollen arm at vaccine site with red splotches, 3rd day, red circular rash, hot to the touch


VAERS ID: 1582580 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Testicular pain
SMQs:, Sexual dysfunction (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: Claritin, Flonase, Multi-vitamin
Current Illness: None
Preexisting Conditions: Seasonal Allergies
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Painful (right side) testicle


VAERS ID: 1582621 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-17
Onset:2021-08-15
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Inappropriate schedule of product administration, SARS-CoV-2 test positive
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 PCR test with a result of detected.
CDC Split Type:

Write-up: Patient received the COVID-19 vaccine on 2/18/21 and 3/17/21, so was fully vaccinated when she tested positive for COVID-19 on 8/15/21.


VAERS ID: 1582668 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (narrow)

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

Write-up: Miscarriage


VAERS ID: 1582684 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

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

Write-up: Pulmonary Embolism


VAERS ID: 1582747 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-18
Onset:2021-08-15
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM

Administered by: Private       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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID-19 hospitalization Only received 1 shot of 2 shot series


VAERS ID: 1582755 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-28
Onset:2021-08-15
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 RA / IM

Administered by: Work       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/17/21 COVID-19/SARS COV2, NAAT, positive
CDC Split Type:

Write-up: COVID-19 positive $g14 days post vaccine series.


VAERS ID: 1582793 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-08-15
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / IM

Administered by: Private       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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID 19 hospitalization


VAERS ID: 1582811 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lipitor, prozente mhfa, pradaxa, metrocolo
Current Illness: no
Preexisting Conditions: copd, asthma, afib, eye stroke, vocal cord paralysis, diverticulitis, ulcers
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: got Shingles after taking the shot, had red splotch on left side, waist was hurting


VAERS ID: 1582865 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01H2 / 1 LA / IM

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

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

Write-up: Lymph nodes in left arm swollen


VAERS ID: 1582882 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Echocardiogram, Electrocardiogram, Laboratory test, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ekg, chest xray, ultrasound of heart, labs in facility troponin levels
CDC Split Type:

Write-up: Myocarditis hospitalization troponin elevated at 5200


VAERS ID: 1582931 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red, tender, and indurated vaccination site that started the day of the vaccination and progressively worsened since vaccination date. Associated with axillary lymphadenopathy on affected side.


VAERS ID: 1582948 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-10
Onset:2021-08-15
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dehydration, Dyspnoea, Fatigue, Oxygen saturation abnormal, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Dehydration (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: Metoprolol, Losartan, Rosuvastatin
Current Illness: unknown
Preexisting Conditions: HTN, Cardiac arrhythmia s/p defibrillator, MI, Colon Surgery
Allergies: No known allergies
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/15/2021
CDC Split Type:

Write-up: he patient presents with SOB x a few days ago with associated fatigue. Pt was COVID-19 positive 1.5 weeks ago and had the Pfizer COVID-19 vaccine in March 2021. Pt was placed on 2L nasal cannula upon arrival to the ED and notes that her oxygen saturation was 84% on room air while at home. Diagnostic Impression: Acute hypoxic respiratory failure due to COVID-19 pneumonia Bilateral viral COVID-19 pneumonia Mild dehydration History of hypertension History of fatal arrhythmia status post AICD placement COVID-19 vaccinated, March 2021, Pfizer


VAERS ID: 1582967 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-08-15
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Irregular menstrual bleeding. My regular period came very early, lasted much longer and was harder than a typical period. A week after that period ended I started bleeding again for 4 full days (still hasn''t stopped), again harder than a typical period. I track my periods using a fitness tracker so I am certain that my regular period was atypical and I''ve never experienced mid-cycle bleeding before now.


VAERS ID: 1582995 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatinine normal, Dyspnoea, Joint stiffness, Joint swelling, Laboratory test normal, Musculoskeletal chest pain, Myocarditis, Peripheral swelling, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Skin warm, Systemic inflammatory response syndrome
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Degenerative disc disease
Allergies: None
Diagnostic Lab Data: UricA plus ESR WES plus ENA plus RF QN plus CR... (Tuesday) normal results Awaiting Echocardiogram
CDC Split Type:

Write-up: Two days the vaccination, patient experienced joint stiffness, tenderness, and soreness. Starting the morning of the third day, patient experienced swelling of the wrist, hands, and fingers with difficulty opening left hand. Patient visited prescriber and was given a toradol injection which didn''t ease any symptoms. Prescriber told patient that she may be experiencing reactive arthritis and performed blood work. Starting on the fourth day, symptoms worsened to widespread joint pain, warmth, and swelling (knees and ankles). Patient also is experiencing chest tenderness and difficulty breathing which has improved over the day. Prescriber believes that it is myocarditis with systemic inflammation and prescribed prednisone, which patient is awaiting the fill at the pharmacy.


VAERS ID: 1583014 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

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

Write-up: Patient stated after the 2nd dose that she had the J and J vaccine in the past. She said she wanted to get this vaccine since she felt that the J and J did not work for her. She informed us after she got the 2 nd dose.


VAERS ID: 1583055 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01800 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling cold, Hyperventilation, Nervousness
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (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: Systemic: Chills-Medium, Systemic: Hyperventilation-Mild, Additional Details: about 8 min after injection patient was nervous and was hyper ventalting, we deep deep breathing and that was better. got her a water and then said she was cold all over then husband picked her up and they are not ansering phone to see how she is doing


VAERS ID: 1583152 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-30
Onset:2021-08-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac arrest, Upper respiratory tract infection
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: HTN, hyperlipidemia, diabetes
Preexisting Conditions: HTN, hyperlipidemia, diabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt presented with URI infectious symptoms for 5 days starting on 08/10/21 after receiving Moderna vaccine, pt went into cardiac arrest on 08/15/21, 5 days after symptom onset.


VAERS ID: 1583178 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-01
Onset:2021-08-15
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, lisinopril, bystolic, eliquis.
Current Illness: n/a
Preexisting Conditions: dyslipidemia, HTN, hx prostate cancer, hx PE,
Allergies: NKA
Diagnostic Lab Data: COVID PCR
CDC Split Type:

Write-up: Pt positive covid test 8/19/2021 after being fully vaccinated in 3/2021


VAERS ID: 1583346 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-27
Onset:2021-08-15
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test negative, Influenza B virus test, Oropharyngeal pain, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sinus congestion
SMQs:, 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: Levothyroxine, Vitamine D
Current Illness: None
Preexisting Conditions: Thyroiditis, HTN, Hypothyroidism associated with Hashimotto tyroiditis,
Allergies: No allergies
Diagnostic Lab Data: Aug 15, 2021@14:37:40 FLU A (CEPHEID) NEGATIVE , FLU B (CEPHEID) NEGATIVE , RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: 8.15.2021 congestion in her sinuses and a sore throat for 3 days.


VAERS ID: 1583355 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nervousness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Each morning 1 of each is taken: 88mg Levothroxine thyroid Multivitamin Vitamin C Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the shot around 3:30PM, I had a very slight headache so I took aspirin around 8:00PM to avoid it from getting worse. Other than that I felt fine, the only strange effect was later as I went to bed around 11:30PM and work up around 1:30AM to use the restroom and that is when I notice that my eye vision was blurry. I went to the microwave digital clock and could not make out the numbers at all. I was up for an hour or so and my vision was coming and going while looking at the computer screen. I called the local hospital to report the vision issue, they just advise that I could come in to get it checked out. I just decided to just go back to bed and see how it is in the morning, I got up around 6:00AM and my vision was back to normal and has been to date. I just want to report it, nervous about 2nd dose as I do not read this as a side affect for the Moderna shot. I did read that it is rare for the shot. I reported to pharmacy. Thank You.


VAERS ID: 1583362 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

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

Write-up: Severe chills and fever of up to 102.8F. Headache and body aches. Took over an hour to get over chills the first time. It happened twice more. At noon on the 15th and again around midnight the 15th. Fever got the highest that night. Took Tylenol for the fever.


VAERS ID: 1583371 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

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

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

Write-up: red rash down to elbow


VAERS ID: 1583384 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-07
Onset:2021-08-15
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Influenza A virus test negative, Influenza B virus test, Nasal congestion, Respiratory syncytial virus test negative, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, Calcium, Fluticasone, Furosemide, Glybueride/metrormin, Hydrophilic cream, top. Insulin, lisinopril, loratadine, magnesium oxide, mentholatum vaporize rub, multivitamin, omeprazole, Psyllium Husk, semaglutide, vitamin D3.
Current Illness: none
Preexisting Conditions: HTN, Hyperlipidemia, knee joint effusion, GERDS, Adjustment disorder, eating disorder, Obesity, asthma, DMN type 2, Backache, Asymmetrical sensorineural hearing loss, osteoarthritis, skin tags
Allergies: Tramadol
Diagnostic Lab Data: Aug 15, 2021@13:45 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: 8.15.2021 runny nose, congestion, headache for 5 days


VAERS ID: 1583576 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-02-08
Onset:2021-08-15
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 138K20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Ocular discomfort, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Throat irritation
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: None
Current Illness: None
Preexisting Conditions: Arthritis, Alcoholism, Alcohol dependence, Anxiety
Allergies: Morphine
Diagnostic Lab Data: Aug 15, 2021@13:23:20 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: 8.15.2021 HA/eye pressure/scratchy throat/dry cough


VAERS ID: 1583577 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Head injury, Skin laceration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NO
Preexisting Conditions: UNKNOWN
Allergies: NO
Diagnostic Lab Data: NO RESULT HAVE BEEN GIVEN TO US AS TO WHAT TEST WERE RAN .
CDC Split Type:

Write-up: PATIENT WAS IN WAITING PHASE AFTER VACCINE GIVEN , SITTING IN CHAIR AND FAINTED , HIT HEAD ON FLOOR CAUSING A 1 INCH GASH ABOVE RIGHT EYE BROW . EMT CAME AND TRANSPORTED TO ER , BECAUSE OF GASH IN HEAD, PATIENT WAS ALERT AND SAID SHE HAD FAINTED BEFORE TAKING SHOTS, BUT ON RTELEASE FORM CHECKED NO , PROBABLY JUST AN OVERSIGHT FOR PATIENT, TEXT HER MOTHER AND TRYED TO CALL WITH NO RESULTS.


VAERS ID: 1584001 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms, Postmenopausal haemorrhage, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: Synthroid, Lexapro
Current Illness:
Preexisting Conditions: Asthmatic, hypothyroidism
Allergies: Shellfish, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cramps, vaginal bleeding (post menopause)


VAERS ID: 1585382 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-12
Onset:2021-08-15
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Haemorrhage urinary tract, Menstruation irregular, Muscle spasms, Polymenorrhoea, Skin odour abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Whenever I get the flu shot I have a very sore arms similar to the covid-19 vaccination and don''t feel well. This has been ever
Other Medications: I did not take my medicine the day of the vaccination.
Current Illness: None
Preexisting Conditions: Congestive heart failure, high blood pressure, and stage 3 kidney disease / mild.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Initially I did not get a period at all for the month of July and the period that I had in June mid to late June was abnormal. It was very short and almost nothing. For the month of July I did not get a period at all but I did experience some cramps. Now it''s August and the period finally came but it started out very dark and not a lot of it but very stinky, as in the end of period when the dark but or clots leave the body. It has been like that for 4 days slow, dark, stinky, and with blood clots as if I was having a regular period but I am not. I am experiencing heavy cramping as if it is a full-grown period but that is not the case and it is very concerning. It is concerning because I''ve never had an abnormal period and never had one to smell the way that this smells. I am on day 4 and I have been taking short notes about each day not knowing how long that it''s going to last.


VAERS ID: 1586266 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Medium, Additional Details: received at 12:15. advised to sit in chair or bench near pharmacy. he was up walking and fainted at 12:22. unresponsive for 15sec. bp 96/75 and pulse 75 after awake and sitting upright. ems called immediately and he left with them at 12:35.


VAERS ID: 1586267 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthritis, Joint range of motion decreased, Nodule, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Hypersensitivity (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol, sulfasalizine, Lisinopril, methotrexate, diloxetine, Omeprazole, aspirin, multi vitamin, gabapentin, calcium. ACV, honey, tumeric
Current Illness: Edema, shortness of breath
Preexisting Conditions: Rheumatoid arthritis, CHF, IBS, HBP, DEPRESSION, ANXIETY, INSOMNIA, CHRONIC PAIN, HEARING LOSS, VISION GOING BAD, EDEMA, SHORTNESS OF BREATH
Allergies: Erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have a big bump, or knot, a big LUMP on my arm and it hurts, itches and I can''t lift my arm


VAERS ID: 1586360 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

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

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

Write-up: Site: Redness at Injection Site-Medium


VAERS ID: 1586569 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-08-15
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, Anxiety disorder, Blood lactic acid increased, C-reactive protein increased, COVID-19, Computerised tomogram thorax abnormal, Deep vein thrombosis, Hypotension, Hypothyroidism, Hypovolaemic shock, Respiratory failure, SARS-CoV-2 test positive, Sepsis, Thrombocytopenia, Ultrasound Doppler, Unresponsive to stimuli
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypothyroidism (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (narrow), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto 15mg
Current Illness: Acute hypoxemic respiratory failure due to COVID-19 (HCC) 08/16/2021 Yes ? AKI (acute kidney injury) (HCC) 08/16/2021 Yes ? Sepsis (HCC) 08/16/2021 Yes ? Thrombocytopenia (HCC) 08/16/2021 Yes ? Other specified anxiety disorders 08/16/2021 Yes ? Acquired hypothyroidism 08/16/2021 Yes ? Hypovolemic shock (HCC) 08/15/2021 Yes ? Coronary artery disease involving native coronary artery of native heart
Preexisting Conditions: Gastroesophageal reflux disease 03/16/2021 Unknown ? Gout 03/16/2021 Unknown ? Hypertension 03/16/2021 Unknown ? Scrotal abscess 03/06/2021 Unknown ? Scrotal hematoma 02/12/2021 Unknown ? Preoperative cardiovascular examination 02/03/2021 Unknown ? Renal insufficiency 09/28/2020 Unknown ? Edema 07/11/2019 Unknown ? Dyslipidemia 06/10/2019 Unknown ? S/P CABG x 5 04/30/2019 Unknown ? Cervical spondylosis with radiculopathy 01/25/2018 Unknown ? History of rectal cancer 11/12/2017 Unknown ? Essential hypertension, benign 11/10/2015 Unknown ? History of tobacco use
Allergies: Atorvastatin, fentanyl, methadone
Diagnostic Lab Data: Covid19 PCR- Positve
CDC Split Type:

Write-up: is a 64 year old male with past medical history significant for CAD s/p CABG x5, HLD, HTN, colon cancer. He was reportedly diagnosed with COVID one week prior to presentation. On 8/15, patient developed respiratory distress and EMS was called. He was found unresponsive with oxugen sats in the 70s. Patient had GCS of 3 upon arrival to ED with associated hypotension. He was started on epinephrine. He was given 4L total of iv fluids. As ED was preparing to intubate, patient began to wake up and was eventually A&O x4 therefore was not intubated. He was started on empiric zosyn, vancomycin, and azithromycin. He was started on Decadron for COVID. He was weaned from epi briefly after 4 hours on it evening of 8/15 to 8/16.. CT thorax ordered 8/16 consistent with COVID pneumonia. he transferred to IM service on 8/16. He had aki on ckd (baseline cr 1.5) but cr up to 2.7 on admission with elevated lactic acid. Both of these normalized while here. He had dopplers done + for LLE DVT so heparin gtt was started. He did not get hyperglycemic while on decadron and A1c 5.6. He weaned from O2 and discharged with 7 days further of decadron to complete a 10 day course and a xarelto starter pack.


VAERS ID: 1586634 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-08-15
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram thorax, Pulmonary embolism, Scan with contrast
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, opthalmic drops for glaucoma
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data: Chest, X-ray, CT with contrast
CDC Split Type:

Write-up: Right lower lobe pulmonary embolism


VAERS ID: 1586702 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-08-15
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Cough, Dyspnoea, Fatigue, Hypoxia, Pyrexia, Respiratory symptom, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) , Micro detected on 8/18/21
CDC Split Type:

Write-up: symptomatic covid positive breakthrough case. cough, shortness of breath, subjective fever/chills, fatigue, weakness, hypoxia onset date 8/15/21. Pt did have hx of respiratory symptoms in July but was not tested at that time


VAERS ID: 1586794 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-14
Onset:2021-08-15
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 UN / IM

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: pt. fully vaccinated with Pfizer vaccine. Dose 1: 3/17/21 EN6270; Dose 2: 4/14/21 EW0161. S/O 8/15/21, + test 8/16/21.


VAERS ID: 1586885 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oxecarbezine, guanfacine, lexapro, NAC, topamax, multivitamin
Current Illness:
Preexisting Conditions: high functioning autism, congenital anosmia, cyclic vomiting syndrome, migraines, eating disorder, speech delay
Allergies: Artificial color dye causes extreme anger, aggression, impulsive x 5+ days (per allergy testing patient is allergic to dogs, cats, horses, mold)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up next day with 100.1 fever, vomiting, headache, fatigue, sore arm Sent email to Dr. to notify him and make note in file.


VAERS ID: 1586951 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-31
Onset:2021-08-15
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 2 LA / IM

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and was diagnosed and hospitalized with COVID on 8/15/21. Patient recovered and was discharged on 8/18/21


VAERS ID: 1586971 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-05
Onset:2021-08-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 RA / SYR

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

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

Write-up: VACCINE SITE HAD KNOT AND GREW RED AND HOT TWO DAYS BEFORE RASH DEVELOPED OVER BODY


VAERS ID: 1586980 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Electrocardiogram normal, Fatigue, Feeling cold, Pain, Pyrexia, Troponin normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Tylenol
Current Illness: No
Preexisting Conditions: Auto immune disorder
Allergies: Sulfa
Diagnostic Lab Data: Troponin(results normal), EKG (results normal)
CDC Split Type: vsafe

Write-up: I got chills, body aches and fever on Saturday. I started on Sunday night. Back aches, body fatigue lasted Tuesday morning.


VAERS ID: 1587034 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Per patient wife ; Rash with blisters associated with burning and itching on butt, arm , back


VAERS ID: 1587058 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-01-08
Onset:2021-08-15
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH COVID / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Nausea, Pyrexia, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Acute pancreatitis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Nexium, Lexapro
Current Illness: None
Preexisting Conditions: Allergies, reflux, depression
Allergies: None
Diagnostic Lab Data: 8/13/2021 Over the counter COVID test - Positive and CVS COVID test - positive
CDC Split Type:

Write-up: Symptoms: Fever 100 to 101, diarrhea, nausea, sinus congestion Treatment: Tylenol, over the counter decongestant Outcome: Return to work on 8/16/2021


VAERS ID: 1587081 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Haematemesis, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient stated that within 24 hours he was coughing and throwing up blood. Patient stated that this lasted for about a few hours. Patient also stated that he had sore arm.


VAERS ID: 1587280 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient said he is unable to move his arm and it is in extreme pain. He picked up a medrol dose pack, tramadol, and ibuprofen.


VAERS ID: 1587330 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Anthrax Vaccine #4 age, 34, severe ITP Platelets were zero. Hospitalized for 7 days.
Other Medications: lisinopril
Current Illness: None
Preexisting Conditions: Mild Hypertension
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Severe Outbreak of Morbilliform Eruptions. Extreme rash and maculopapular skin eruptions and Papules on lower half of body. Very itchy. Treatment was Hydrocortisone and Benadryl topical. As of Aug 19, symptoms still persist.


VAERS ID: 1587351 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-12
Onset:2021-08-15
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR
CDC Split Type:

Write-up: Tested Covid -19 positive 08/16/2021 with onset of symptoms 08/15/2021


VAERS ID: 1587379 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-08-15
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 RA / IM

Administered by: Private       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Strattera 80mg daily multivitamin with minerals daily
Current Illness: None Documented
Preexisting Conditions: Attention deficit hyperactive disorder sleep apnea urinary frequency
Allergies: No known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1587385 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies: I am allergic to antibiotics
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I experienced a slight fever, shortness of breath and chest pains.


VAERS ID: 1587413 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-28
Onset:2021-08-15
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 24C21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (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: Metformin, levothyroxine, simvastatin
Current Illness: None
Preexisting Conditions: Hyperlipidemia, diabetes mellitus, hypertension
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed House-Brackmann Grade VI (total paralysis) Bell''s Palsy. No other explanation for this occurrence other than his recent vaccination. Currently under treatment with prednisone.


VAERS ID: 1587448 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patients spouse reported patients arm swollen and extreme itching.


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