National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

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

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

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 131 out of 10,493

Result pages: prev   32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230   next


VAERS ID: 1989555 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-01
Onset:2021-12-28
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Axillary pain, Headache, Mobility decreased, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Gabapentin, Effexor XR, Remeron, Tizanidine, OTC Allergy meds/nasal spray As needed for migraines: Zomig, Butorphanol Vit C, B, D, Elderberry and Calcium
Current Illness: Migraines
Preexisting Conditions: Migraines, Breast Cancer survifor
Allergies: Flexaril, Erythromycin, Levaquin, sulfa drugs, flu vaccine; seasonal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely sore arm, difficult to raise above my head. Lump in armpit making that area extremely sore [this is of concern as I am a breast cancer survivor] Pounding headache Overall achy body Nausea, no vomiting


VAERS ID: 1989698 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-22
Onset:2021-12-28
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EI1283 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ? / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Uk
Current Illness: None
Preexisting Conditions: Dementia and on hospice
Allergies: UK
Diagnostic Lab Data: BinaxNow Rapid Antigen 12/28/2021
CDC Split Type:

Write-up: Asymptomatic but tested positive for Covid-19


VAERS ID: 1989706 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Condition aggravated, 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: At age 59, in April 2021, after taking Moderna COVID-19 vaccine, had high fever, chills, muscle aches.
Other Medications: Amlodipine, Olmesartan, Montelucast, Claritin
Current Illness:
Preexisting Conditions: Asthma, high blood pressure
Allergies: Sulfa, Lisinopril, Hydrochlorothiazide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever over 103?F, chills


VAERS ID: 1989726 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-01
Onset:2021-12-28
   Days after vaccination:330
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: rapid test for Covid + on 12/28/2021
CDC Split Type:

Write-up: Client vaccinated with Moderna vaccines x 2 in February 2021. Not boosted. Symptoms started on 12/28 - fatigue, nasal congestion. Exposed on 12/25.


VAERS ID: 1989830 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030H21B / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Staff gave a low dose of Moderna vaccine to patient. She administered .25 ml as if the patient was getting a booster when he should have received the .5 ml Primary dose. The error was caught at the end of the patients observation time. My supervisor was notified and I was told to follow guidelines and administer another .25ml to acquire the equivalent of .5ml which would be a primary dose. The patient received the second half with no complications after observing him again for an additional 15 minutes.


VAERS ID: 1989843 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Effexor
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 12 hours after injection developed fever, chills, body ache, loss of appetite, sweating and headache.


VAERS ID: 1989847 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bone pain, Chills, Condition aggravated, Crying, Feeling cold, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Intense muscular/bone pain from second round of Moderna vaccine, but not nearly as severe as booster (3rd round).
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe muscular and bone pain/aches. Aches were so intense they led me to tears. Fever of 102.5 F. (sustained fever between 100-102.5 for 6 hours). Chills and susceptibility to cold. Painful, but less severe aches continued through the next day (24+ hours).


VAERS ID: 1989850 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site erythema, Injection site pain, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 30
Other Medications: Wellbutrin XL Nuvaring levothyroxine zyrtec
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: All starting around 6:00 PM the same day Chills Fatigue Headache Sore arm Red raised injection site


VAERS ID: 1989865 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330258D / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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: Mild headache, fever, chills, body ache, lack of energy. I still have a very strong pain in my left arm where I received the vaccine.


VAERS ID: 1990020 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-18
Onset:2021-12-28
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Goitre, Thyroid pain
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen and over the counter 24 hour antihistamine.
Current Illness: None
Preexisting Conditions: Endometriosis/Pelvic Congestion Syndrome.
Allergies: Season allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had an enlarged and painful thyroid for 48 hours starting 10 days after my COVID 19 booster shot.


VAERS ID: 1991124 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J211A / 3 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Injection site pain, Lethargy, Myalgia, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: COVID-19 MRNA Moderna
Other Medications: Concerta ER 36mg. Celexa 10mg. Daily multi-vitamin.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None known.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Injection occurred at approximately 1015am local on 12/28. Extreme lethargy began at approximately 8pm. At 2am following morning (12/29), I woke and was unable to return to sleep. I had extreme back and muscle main, as well as pain at injection site. I had a low grade fever. I took ibuprofen and/or acetaminophen every 4-6 hours. Low grade fever subsided by mid-day, however muscle pain and injection site pain continues at time of this report (12/30 at 0730). I am applying topical pain relievers to assist with muscle pain.


VAERS ID: 1991131 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H213B / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Erythema, Pain, Peripheral swelling, Pruritus, Skin warm, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Taste and smell disorders (narrow), 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: tetanus 1964
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: bees, oregano, black pepper, caramel, hops
Diagnostic Lab Data:
CDC Split Type:

Write-up: metallic taste , arm swelling, itchy arm, 50cent size raised swelling, red, painful hot to touch. 24 hours later 3x2 inch swelling raised area, hot to touch arm swelling


VAERS ID: 1991132 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (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: Pfizer - Dose #2
Other Medications: Vitamin gummies, but none taken days before or day of.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: First dose Pfizer had no reaction other than sore arm. At that time, injection given in left arm. Second dose in June had injection same arm but severe chills that started around 8:30pm. Simultaneously, I also experienced numbness in my face but subtle and I chaulked it up to chills I had. Two days ago I got Pfizer Booster around 10:30am injected in right arm this time. I got slight chills around 6:30pm. They subsided but I had severe facial numbness on my left side and no signs of stroke. It feels like the numbness wearing off from a dental procedure. Yet, two days later I am still having facial numbness on my left side. No chills or other issues other than standard sore arm.


VAERS ID: 1991197 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / N/A LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Lymphadenopathy, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore arm, swollen lymph nodes, chest pains


VAERS ID: 1991201 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-12-09
Onset:2021-12-28
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018F21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute pulmonary oedema, Arteriogram coronary abnormal, Condition aggravated, Coronary artery bypass, Coronary artery disease, Ejection fraction decreased, Myocardial ischaemia, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Cardiac failure (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Embolic and thrombotic events, arterial (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: benzonatate (TESSALON) 100 mg capsule Take 100-200 mg by mouth 3 times a day losartan 25 mg tablet Take 12.5 mg by mouth 1 time per day magnesium oxide 500 mg TABS tablet Take 500 mg by mouth 1 time per day metoprolol succinate (TOPROL X
Current Illness:
Preexisting Conditions: CAD, COPD, CKD, CHF, A fib
Allergies: ACE, azithromycin, lipitor
Diagnostic Lab Data: Coronary angiogram showed severe 2 vessel CAD with planned CABG 12/30 when he developed acute pulmonary edema 0100 on 12/30.
CDC Split Type:

Write-up: Presented in Ventricular tachycardia with acute cardiac ischemia and further reduced EF to 15% from previous baseline of 30%.


VAERS ID: 1991663 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-12-28
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211261189

Write-up: VACCINE ADMINISTERED 13 HOURS AFTER INITIAL PUNCTURE; INCORRECTLY STORED VACCINE ADMINISTRATED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 211D21A expiry: 11-APR-2022) dose was not reported, administered on 28-DEC-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-DEC-2021, the patient experienced vaccine administered 13 hours after initial puncture, and incorrectly stored vaccine administrated. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered 13 hours after initial puncture and incorrectly stored vaccine administrated was not reported. This report was non-serious.


VAERS ID: 1991888 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 2 LA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1991900 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 LA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: Patient reports his face is flushed with redness, he also has swelling in the face and itching of the face. He took benadryl. He did not have trouble breathing. This began about 24 hours after vaccination.


VAERS ID: 1991901 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330308D / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Tinnitus
SMQs:, Hearing impairment (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: Swollen arm pit , ear ringing
Other Medications: No
Current Illness: The earring started after my dose 12/4 but it was very mild . I wear high end ear protection while playing drums and thought odd my ears just started ringing out the blue. 12/29 I had a full work up done on my ears by an audiologist . She said I have the best hearing she ever tested and started to ask other questions . The only thing change in a month was he vaccine shot . She said there has been minor reporting of ear ringing .
Preexisting Conditions: No
Allergies: Shell fish , bees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes under arm pit Ringing of ears


VAERS ID: 1991904 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Malaise, Restlessness, Slow speech
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: none
Current Illness: Slight prolonged QT interval (EKG confirmed)
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt was vaccinated by RN @ 12:01 pm. At 12:06pm, the pt stated she was feeling unwell. While sitting in the observation area, the patient experienced restlessness, slowed speech, and weakness. EMT intervened right away for support. A set of vitals were taken. BP - 80/52, 02 @ 98%, HR 70. Mom denied PMH and no current medications. Mom reported patient being seen by a Cardiologist 2 weeks prior d/t a history of and abnormal EKG: slight prolonged QT interval. Pt transported to South Shore Hospital by EMS for further evaluation. Follow up call to Mom on 12/29/2021: Mom stated that no intervention needed. The patient was feeling much better after an hour and was released to home.


VAERS ID: 1991905 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL3197 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling, Injection site vesicles
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Bruising at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: A GRANULE BLISTER AT SITE OF INJECTION WITH REDNESS AND SWELLING IN THE SURROUNDING AREA-Mild, Additional Details: Patient reported a blister with fluid the size of granule at the injection site with redness and swelling at the surrounding area. Pt will monitor and report if there is any worsening or no improvement after a few days.


VAERS ID: 1992079 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-10-14
Onset:2021-12-28
   Days after vaccination:75
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 3 LA / SYR

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: Contracted COVID despite full vaccination + boosted status


VAERS ID: 1992096 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 060H219 / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Condition aggravated, Fatigue, Feeling cold, Headache, Impaired work ability, Myalgia, Nausea, Palpitations, Tremor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose Moderna: extreme fatigue. 2nd dose of Moderna: extreme fatigue, body aches, tremors from shivering, headache. 3rd doe
Other Medications: Vitamin C, Vitamin B, multi-vitamin. I use an albuterol inhaler if I am exposed to tobacco smoke.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Allergic to tobacco smoke.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Extreme fatigue, nausea and vomiting, muscle aches and pains, extreme tremors from shivering, feeling very cold, headache, minor heart palpitations. Out of work for two-and-a-half days.


VAERS ID: 1992099 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose chill, 2nd dose fever 3rd dose both and longer time
Other Medications: Women multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Mone
CDC Split Type:

Write-up: Pain on the right arm at least 3 days. Chill 2 days and 2 days fever and took Tylenol cold and flu total of 8 tablets (4 day time and 4 night time)


VAERS ID: 1992120 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-12-28
   Days after vaccination:286
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A PATIENT NOT / 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:
Allergies:
Diagnostic Lab Data: Positive COVID-19 PCR test 12/28/2021
CDC Split Type:

Write-up: Patient received 1 dose of Janssen COVID-19 vaccine on 3/17/2021 per Database, subsequently tested positive for COVID-19


VAERS ID: 1992191 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating (BUD) as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that he receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient was given this information and will schedule if feels it is necessary.


VAERS ID: 1992204 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating (BUD) as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that he receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient was given this information and scheduled an additional dose.


VAERS ID: 1992209 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Headache, Myalgia, Pain, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin Duloxitine Premarin Meloxicam
Current Illness:
Preexisting Conditions: Osteoarthritis Fibromyalgia
Allergies: PCN Z Pak Dairy Sensitive
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore body Muscle aches Back pain Blurred vision Headache


VAERS ID: 1992219 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Extra dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair 10mg
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Nickel and Pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating (BUD) as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that he receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient was given this information and received dose today.


VAERS ID: 1992226 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-25
Onset:2021-12-28
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN FB-1808980 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Vertigo positional
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: right arm muscle weakness, flu vaccine, 2011?
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies: niaspan, sesame
Diagnostic Lab Data:
CDC Split Type:

Write-up: Benign paroxysmal positional vertigo (BPPV), epley maneuver, mild improvement


VAERS ID: 1992228 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

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

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

Write-up: No adverse events have been reported. This is vaccine error. Booster dose not recommended for 13 year and 7 month.


VAERS ID: 1992242 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvastatin 10mg, Toprol XL 50mg, alprazolam 0.5mg, losartan/hctz 100-12.5mg, Levoxyl 88mcg
Current Illness: none
Preexisting Conditions: dyslipidemia, hypertension, hypothyroidism.
Allergies: ACEI, latex, powder in gloves.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that he receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient was given this information and will schedule if feels it is necessary.


VAERS ID: 1992255 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Impaired work ability, Pain, Pruritus, Renal pain, 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: 1991- Measles vaccine, got swollenness.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Erythromycin; Penicillin; Gluten sensitivity to food rise
Diagnostic Lab Data: No test performed.
CDC Split Type: vsafe

Write-up: With first vaccine, I had delayed reaction, covid arm. I had a series for really bug blotchy hives. With my second vaccine, a couple hours later, my whole truck and abdomen covered with tiny hives all over and they are like sandpaper, have to take Benadryl medication. My hives are very itch, almost like a dermatitis, it is my whole truck from my rib cage all the way to my hip areas. Full of hives since receiving the vaccine. I am constantly drinking water. I also have extreme fatigue, body aches. I did have pain in my kidney area also, it feels like someone kicks me in my kidneys in my back. I spoke to my doctor over the phone and have taken pictures for my doctor to see my hives incase my hives get worse. I still continue to take Benadryl medication and have not recovered. My energy is bit better but I still have the hives and can not go to work today.


VAERS ID: 1992269 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 5mg, loratadine 10mg, medroxyprogesterone 150mg, Singulair 10mg Seroquel 100mg
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Kiwi and Calamine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating (BUD) as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that he receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient was given this information and will schedule if feels it is necessary.


VAERS ID: 1992282 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg and Vit D. 400 IU
Current Illness: None
Preexisting Conditions: Allergies
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received a dose of Pfizer vaccine where the dose exceeded beyond use dating (BUD) as determined by manufacturer by 5 days. As advised by Pfizer, they recommended that she receive an additional dose of vaccine as soon as possible to ensure appropriate protection. Patient''s Mom was given this information and will schedule if feels it is necessary.


VAERS ID: 1992297 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Feeling of body temperature change, Nausea, Neck pain, Rash macular
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, sertraline, clonazepam, propazole, Eloquis, desmopresson
Current Illness:
Preexisting Conditions: PTSD anxiety depression, nightmare disorder, lymphoma, emphysema
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, weakness, burning hot to freezing cold, extreme fatigue, nausea, chronic pain in neck, red blotchy skin arms, back and chest. Today I''m starting 3rd day of symptoms.


VAERS ID: 1992313 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Headache, Interchange of vaccine products, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (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: Johnson and Johnson covid vaccine 3/31/21. High fever, chills, pain, nausea
Other Medications: oral birth control
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: This was a booster. I had Johnson and Johnson for primary course on 3/31/21. Symptoms of nausea, headache, fever, pain began about 4-6 hours after the injection and became worse over the next 12 hours. Fever waned around 24 hours, with pain and nausea continuing. Diarrhea began around 30 hours and has not resolved.


VAERS ID: 1992336 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-08-23
Onset:2021-12-28
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821287 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inhaler PRN Breo Ellipta inhaler qd Diltiazem po tid Flecainide po bid HCTZ po qd Lipitor po qd Uloric po qd Xarelto po q hs
Current Illness: Asthma, A-fib, coronary artery disease, HTN, former smoker, gout, OSA on CPAP,
Preexisting Conditions: Asthma, A-fib, coronary artery disease, HTN, former smoker, gout, OSA on CPAP, Prostate cancer
Allergies: No known allergies
Diagnostic Lab Data: Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe (SARS CoV-2 PCR (In House)) Status: Final Specimen Source: Nasopharynx Specimen Site: Specimen Collection Date/Time: 2021-12-28 21:44:00.0 Results: * Resulted Test: SARS-CoV-2 RNA Resp Ql NAA+probe (SARS CoV-2 PCR (COVID-19)) Coded Result: Positive (LOCAL) Numeric Result: Units: Text Result: Reference Range From: Negative Reference Range To: Performing Facility Details: Date/Time: 2021-12-28 22:43:52.0 Interpretation: Abnormal Result Method: (SARS-Co) Status: Final Result Comments: Positive results are indicative of active infection with SARS-CoV-2. Positive results do not rule out bacterial infection or co-infection with other viruses.
CDC Split Type: 1279399

Write-up: Case was vaccinated for Covid in August 2021, then hospitalized for Covid in December 2021. Case hospitalized for Shortness of breath, started on Oxygen, remdesivir, dexamethosone, self proning. Weaned off oxygen by discharge.


VAERS ID: 1992349 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: COVID test 12/30 - negative
CDC Split Type:

Write-up: The day after vaccine - Fever, body ache, headache Second and third day after vaccine - throbbing headache only on left side of my head, swollen lymph node, sore throat. Headache is not going away.


VAERS ID: 1992387 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058H21A / 3 LA / IM

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

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

Write-up: Moderna approved for this age group, no ASE to this patient.


VAERS ID: 1992404 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058H21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood gases, Blood lactic acid, Blood magnesium, Blood thyroid stimulating hormone, Brain death, Brain natriuretic peptide, Cardiac arrest, Cardio-respiratory arrest, Chest X-ray, Drug screen, Dyspnoea, Fibrin D dimer, Full blood count, International normalised ratio, Life support, Loss of consciousness, Metabolic function test, Prothrombin time, Red blood cell sedimentation rate, SARS-CoV-2 test, Troponin, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: carvedilol, furosemide, spironolactone, amiodarone
Current Illness: none known
Preexisting Conditions: history of CHF
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, lactic, BNP, troponin, ABG, UDS, UA, d-dimer, magnesium level, PT/INR, PTT, TSH, ESR, Covid PCR, chest Xray at our facility. Family reports further testing at a local health care facility.
CDC Split Type:

Write-up: Received covid vaccine at county health department on 12/27/21. C/o sudden onset dyspnea at home just PTA to ER. Less than 5 minute drive to ER. Arrived at ER at 11:27. Loss consciousness, followed by cardiac arrest, shortly after arrive to ER parking lot. ROSC achieved, but coded two more times in ER. Transferred to higher level of care facility. Per family, is declared braindead and is being removed from life support on 12/30/21.


VAERS ID: 1992428 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Incorrect dose administered, Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Nurse administered 0.3mL of Covid Vaccine to Right deltoid in error. Guardian brought pt, for booster dose to early. Only outcome patient had was a sore arm and a headache


VAERS ID: 1992470 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-12
Onset:2021-12-28
   Days after vaccination:319
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK LA / 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? 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: Hospitalization 12/28/21 2nd Pfizer covid shot 3/5/21, EN6205, IM/RD 3rd Pfizer covid shot 9/9/21, FE3592, IM/LD


VAERS ID: 1992485 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-12-28
   Days after vaccination:284
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 160 mg/5 mL oral Liquid liquid albuterol HFA (PROVENTIL;VENTOLIN HFA) 90 mcg/actuation Inhl inhaler cholecalciferol, vitamin D3, 25 mcg, 1000 unit, 25 mcg (1,000 unit) oral tablet cyanocobalamin 1,000 mcg oral tablet
Current Illness:
Preexisting Conditions: Acanthosis nigricans ? Genital HSV ? Methamphetamine abuse 2012-7/2021 in remission ? Morbid obesity due to excess calories ? Tonsillitis ? Vitamin D deficiency
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 12/26/2021
CDC Split Type:

Write-up: FEVER, SWEATS, CHILLS, FATIGUE, HEADACHE, REDUCED APPETITE, COUGH, AND BODY ACHES


VAERS ID: 1992491 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Headache, Injection site pain, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd Covid shot from Pfizer. Same strong reaction
Other Medications: Multi-vitamin, Magnesium, Potassium, Glucosamine/chondroitin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Morphine, Fluorescein, Cayenne peppers.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started with shot site pain on first day, then second day had fever (100.5), extremely painful headache, body aches, nausea. Couldn''t eat or drink liquids. Third day fever and most body aches gone, but headache and nausea persisted, which prevented me from eating and drinking liquids.


VAERS ID: 1992497 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-12-28
   Days after vaccination:277
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: BREO ELLIPTA 100-25 MCG/INH inhalation inhalation docusate sodium (COLACE) 100 mg oral capsule budesonide-formoterol (SYMBICORT) 160-4.5 mcg/puff inhalation inhaler albuterol-ipratropium (DUONEB) 2.5-0.5 mg/3 mL inhalation solution vi
Current Illness:
Preexisting Conditions: Anemia of chronic disease AKI Uremia, acute Hyperglycemia Hypertension Stage III CKD
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 12/27/2021
CDC Split Type:

Write-up: SOB


VAERS ID: 1992498 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 3 LA / IM

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

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

Write-up: Patient came in with his family for Pfizer booster shots. During verification of age, patient''s father stated he was 16 years old and the vaccination was administered. Upon processing paperwork later, it was discovered he was 15 instead and therefore not eligible for the booster dose of Pfizer. Patient''s parents were contacted and informed, his mother verified his age and stated he was fine.


VAERS ID: 1992515 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-12-28
   Days after vaccination:286
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breast operation
SMQs:

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

Write-up: Hospitalized for breast procedure not related to covid.


VAERS ID: 1992529 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-20
Onset:2021-12-28
   Days after vaccination:311
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ProAif, Flomax, Eliquis, Lipitor, Coreg, Lisinopril, OxyContin, Ambien, Lasix, Pulmicort, Synthroid, Allopurinol, Proscar.
Current Illness:
Preexisting Conditions: A-fib, DVT, BPH, HTN, Hypothyroidism, OSA, Cardiomyopathy, Renal Cell Carcinoma, Depression, COPD, Gout.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/28/21 -- $g COVID positive


VAERS ID: 1992533 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-12-28
   Days after vaccination:294
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest discomfort, Dyspnoea, Epigastric discomfort, Hypoxia, Lung infiltration, N-terminal prohormone brain natriuretic peptide increased, Nausea, Polyuria, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: ADMISSION: 12282021 - 70-year-old male presents to the emergency room with acute onset of shortness of breath and chest discomfort this evening. Patient states that he was getting ready for bed when he had a sudden onset of shortness of breath and epigastric discomfort and burning sensation. Patient has had some nausea. Patient has a history of coronary artery disease and has had a coronary artery bypass graft approximately 5 years ago at a local Hospital. Patient is from another area. He is in the area currently visiting his children. Patient has not had a cough or fever. He has been fully vaccinated for COVID plus a booster. He has not had any known exposure. His COVID swab is positive in the emergency room tonight. Prior to his sudden onset of symptoms this evening he reports that he was feeling good and was not having any symptoms. Patient reports that he has a past history of coronary artery disease, hypertension, diabetes mellitus, hyperlipidemia. He is a nonsmoker. No alcohol use. His current home medications are unknown. At the time that I have been notified to admit the patient his serial troponins are pending. A CBC is pending. The patient has a minimally elevated proBNP. Chest x-ray does show bilateral infiltrates which could be consistent with pulmonary edema or COVID. Patient denies having a history of congestive heart failure. He has been given Lasix in the emergency room and has had a brisk diuresis. He reports that overall he has been feeling better after his diuresis. I have been asked to admit the patient for COVID pneumonia with hypoxia. The patient was hypoxic on presentation and initially required 6 liters/minute of oxygen by nasal cannula. He currently has been weaned down to 3 liters/minute. PATIENT IS STILL INPATIENT AT THIS TIME.


VAERS ID: 1992538 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013H21B / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Migraine, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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: Junel Fe 1.5mg/30mcg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever (100.9 degrees fahrenheit), migraine, nausea, vomiting, fatigue, dizziness


VAERS ID: 1992542 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 3 LA / IM

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

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

Write-up: Pfizer Booster given to 13 y/o patient. No adverse reaction was reported. Pts mother was present during the time of the vaccine and also notified after that the booster is not approved for 13 y/o


VAERS ID: 1992543 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-16
Onset:2021-12-28
   Days after vaccination:287
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad)

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

Write-up: Hospitalized with cough, congestion, and weakness.


VAERS ID: 1992560 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-12-28
   Days after vaccination:264
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalized covid 12/17 and acute onset dyspnea with bilateral pulmonary emboli on date of admit


VAERS ID: 1992582 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL8095 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Child received a 15mcg dose instead of a 10mcg dose. Mother reports no side effects following vaccination.


VAERS ID: 1992591 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL8095 / 2 LA / IM

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

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

Write-up: Child receive 15mcg dose instead of 10mcg dose. Mother reports no side effects following vaccine.


VAERS ID: 1992601 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL8095 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Incorrect dose administered, Myalgia, Pyrexia
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Child receive 15mcg dose instead of 10mcg dose. Father reports fatigue, muscle aches, low grade fever, decreased appetite x2 days


VAERS ID: 1992606 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL8095 / 2 RA / IM

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

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

Write-up: Child received 15mcg dose instead of 10mcg dose. Father reports no side effects following vaccination.


VAERS ID: 1992626 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-26
Onset:2021-12-28
   Days after vaccination:305
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypervolaemia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Respiratory failure (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalized transferred from an outside facility with fluid overload and worsening hypoxic respiratory failure.


VAERS ID: 1992634 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33025BD / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Heart rate increased, Laboratory test
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer lot EW0162 - 1st dose, shortness of breath and high pulse, 4/15/2021 age 42.
Other Medications: Multi vitamin, Zyrtec
Current Illness: Ear infection
Preexisting Conditions: Asthma, allergies, psoriasis, autoimmune progesterone dermatitis, autism spectrum disorder level 1, anxiety, OCD, depression, arthritis, chronic pain, migraines, venous reflux (had venous ablation to greater saphenous in both legs).
Allergies: Sulfa drugs, Valium, kiwi fruit, pollen, dander, dust mites, mold
Diagnostic Lab Data: On 12/29/2021: EKG, labs at Hospital.
CDC Split Type:

Write-up: Heart rate of 110 to 125 while at rest and chest pain. It started at about 6pm the day of the vaccine. I hoped it would pass by morning but it had not ceased. I was monitoring my pulse via fitbit. I went to the Hospital ER at about 9am the next morning, 12/29/21. They did an EKG, ran labs and gave me fluids then sent me home and said to rest.


VAERS ID: 1992640 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-22
Onset:2021-12-28
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 LA / IM

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

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

Write-up: General rash (round red spots) over most of body. does not look like hives. no treatment to date


VAERS ID: 1992641 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: severe anaphylactic reaction in Fall 2018. Age 49.
Other Medications: ARIPiprazole 2 mg, FLUoxetine 10 mg, lisdexamfetamine 30mg
Current Illness: None
Preexisting Conditions: Major depressive disorder
Allergies: mango flavor
Diagnostic Lab Data:
CDC Split Type:

Write-up: 14 yo F was given Covid 19 booster when it is currently not indicated for this age group. Mistake was made when the medical assistant forgot to check this person''s age and the other two family members also present in the same clinic officer were 16 years of age and older.


VAERS ID: 1992644 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-12-01
Onset:2021-12-28
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthetic Rosuvastatin Zyrtec Prilosec Multivitamin Omega 3 Listen D3 B12 Resveratol Turmeric Cinnamon Black Elderberry Prebiotic/Probiotic
Current Illness: N/A
Preexisting Conditions: Hypothyroidism High Cholesterol
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, aches, joint pain, nausea, vomiting, diarrhea


VAERS ID: 1992648 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-12-28
   Days after vaccination:277
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Plasma cell myeloma
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Haematological malignant tumours (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for cough, dyspnea and diarrhea currently on treatment for multiple myeloma.


VAERS ID: 1992699 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / UNK - / IM

Administered by: Work       Purchased by: ?
Symptoms: Muscle swelling, Musculoskeletal chest pain, Oedema peripheral, Skin swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Diffuse swelling and tenderness over the left upper chest, axilla, and trapezius area


VAERS ID: 1992706 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Swollen lymph nodes sore under injection site arm


VAERS ID: 1992731 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

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

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

Write-up: Patient was given Moderna as a booster (limited age eligibility to 18 and older) when patient is 17 and 6 months years old.


VAERS ID: 1992739 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 3 RA / IM

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

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

Write-up: 16 year old patient was administered Moderna COVID-19 vaccination booster dose of 0.25mL. No treatments or negative outcomes reported by patient 2 days post vaccination.


VAERS ID: 1992743 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 060H21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Cough, Pruritus, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (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: Prenatal pills
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Nuts, peaches, cherries, Kiwi, cantaloupe, honeydew
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Experiencing itchiness, wheezing, cough and chest tightness following 1st dose of Moderna Covid19 vaccine. Currently taking Benadryl every 6 hours to ease symptoms. Still experiencing chest tightness and itchiness.


VAERS ID: 1992744 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33025BD / UNK LA / IM

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

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

Write-up: pt received regeneron on 12/14, should not have received 1st dose Pfizer until 90 days post mab infusion. Will delay 2nd dose until after 90 days per current CDC guidance.


VAERS ID: 1992757 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33025BD / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Speech disorder, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: This was the booster shot I had visuals and my speech was affected for about 10 min while I was at work it took about 4 hours after the shot to show symptoms!


VAERS ID: 1992790 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Influenza, Psoriasis, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Flu symptoms for two days and extreme psoriasis outbreak manifesting as a red rash across face.


VAERS ID: 1992859 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330258D / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Dizziness, Exposure during pregnancy, Injection site induration, Injection site mass, Injection site pain, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Noninfectious diarrhoea (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 14 weeks pregnant Estimated due date is June 2022. Uncontrollable diarrhoea. Drowsiness. Lack of appetite. Dizziness arm tenderness at injection site. Hard limp at injection site.


VAERS ID: 1992976 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058H21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Injection site pruritus, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote Venlafaxine Paxil Metoprolol Montelukast Benadryl Pantoprazole Xyzal
Current Illness: None
Preexisting Conditions: Hypertension Migraines Anxiety, Stress
Allergies: Morphine Demerol Codeine Bee stings
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pronounced Headache (3 days) Nausea (24 hours) Vomiting (30 minutes) Extreme fatigue (24 hours) Injection site pain (extreme 2 days) Injection site itching (2 days)


VAERS ID: 1992984 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-12-18
Onset:2021-12-28
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Pain, Rash, Rash papular, Skin discolouration, Skin lesion
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (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: Methylphenidate
Current Illness: None
Preexisting Conditions:
Allergies: Gluten and dairy sensitivities, no allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Painful sores on two toes of the right foot. Round raised bumps that are purple and painful.


VAERS ID: 1993000 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site erythema, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROCHLORPERZINE XAREL OXYCONTIN 20 MG OXYCODONE HCL 10 MG
Current Illness:
Preexisting Conditions: CANCER
Allergies: SULFUR
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: WITHIN 2 HOURS OF THE SHOT FELT PAIN IN BOTH LEGS . NEXT DAY SEVERE HEADACHE AND LEG PAIN , LARGE RED AREA AT SHOT . FEELING BETTER 2ND DAY , REDNESS STILL ON ARM .


VAERS ID: 1993251 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027H21B / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Myalgia, Nasal congestion, Neck pain, Pain in extremity, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna, both original covid doses, short reaction lasting only 30 minutes, but severe dizziness, almost passed out, nausea, fa
Other Medications: vitamin C, vitamin D, Vitamin B gummies
Current Illness: no
Preexisting Conditions:
Allergies: mo
Diagnostic Lab Data: 6:30 am Dec 30th Positive Covid Rapid test, PCR test taken at 10:30 am, waiting for results.
CDC Split Type:

Write-up: 15 hours after booster dose, muscle aches, neck pain, stuffy nose, arm sore. extreme fatique around 20 hours, muscle aches continued, post nasal drip 40 hours after dose - mild fatigue, cough, stuffy nose, muscle aches 60 hours after dose - extreme sore through, stuffy nose turned to very runny nose, chest congestion, dry cough, arm not sore anymore 72 hours after does, dry cough and nasal congestions, chest congestion (all milder)


VAERS ID: 1993426 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Dyspnoea exertional, Erythema, Fatigue, Lymph node pain, Musculoskeletal discomfort, Nausea, Pain in extremity, Painful respiration, Peripheral swelling, Skin warm, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pain and swelling at injection site
Other Medications: Lisinopril, metoprolol, zetia, provastatin, ibuprofen otc, zoloft, buspar, albuterol inhaler, ativan
Current Illness: None
Preexisting Conditions: Rheumatoid arthritis, asthma, SVT, Hypertension, migraines, hyperlipidemia, anxiety, allergies
Allergies: ERythromyocin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I started with fatigue day after receiving vaccine. Last night my glands started hurting and i was short of breath wth exertion. Today, I am extremely short of breath and pain and pressure in chest and back when I take a deap breath.I have had nausea and vomitting since i got the vaccine. Also, my arm was sore, red, swollen, and hot


VAERS ID: 1993588 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Inflammation, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Inflamed and tender left armpit. Have taken acetaminophen the following day. Stiffness also present in neck.


VAERS ID: 1993592 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330258D / 3 LA / IM

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

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

Write-up: Patient was 14 at time of booster shot and has no side effect


VAERS ID: 1993601 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 38030BD / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dehydration, Laboratory test, Nausea, Pyrexia, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Testosterone .5 ml weekly for Gender Dysphoria (transgender - female to male)
Current Illness: N/A
Preexisting Conditions: Mitrovalve prolapse (MVP)
Allergies: Penicillin, codine
Diagnostic Lab Data: My labs were taken at the Urgent Treatment Clinic so they could show my results and temperature on 12/28 after 5 hours of vomiting and high temps.
CDC Split Type:

Write-up: 12/28 I woke up at 3:10am with nausea and 101.5 fever. I started vomiting and was unable to stop. My fever continue to climb over 102 and I was unable to get any medicine to stay down due to vomiting. I went the urgent treatment clinic that morning where I was treated for dehydration and given medication to help me fight the fever. My fever remained over 101 ever time I was due for more medication to keep down till 10:00am 12/30 when I was able to keep it down with just Tylenol. I have lost 5lbs since getting my vaccine due to everything.


VAERS ID: 2000753 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:2021-12-28
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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

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

Write-up: I have an IUD that has stopped my menstrual cycle for the last 3 years. When I received the Pfizer Covid booster I started spotting. First time in 3 years.


VAERS ID: 2000763 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-28
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

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

Write-up: Severe Vertigo when I woke up in the morning of 12/26/2021, after administration of Pfizer COVID-19 booster on 12/24/2021.


VAERS ID: 1994569 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-12-28
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855191 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211262111

Write-up: VACCINE ADMINISTERED TO A PATIENT 30 MINUTES PAST THE 6 HOUR MARK OF INITIAL PUNCTURE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1855191, expiry: 11-APR-2022) dose was not reported (Dose number in series:1), administered on 28-DEC-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-DEC-2021, the patient experienced vaccine administered to a patient 30 minutes past the 6 hour mark of initial puncture.(Dose number in series:1) The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine administered to a patient 30 minutes past the 6 hour mark of initial puncture was not reported. This report was non-serious.


VAERS ID: 1994577 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Alaska  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / OT

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211263307

Write-up: RECEIVED AN EXPIRED JANSSEN COVID-19 VACCINE; This spontaneous report received from a health care professional concerned a 26 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (dose number in series: 1) (suspension for injection, route of admin not reported, batch number: 201A21A expiry: 21-SEP-2021) dose was not reported, administered on 28-DEC-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-DEC-2021, the patient experienced received an expired janssen covid-19 vaccine (dose number in series: 1). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received an expired janssen covid-19 vaccine was not reported. This report was non-serious.


VAERS ID: 1994586 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-12-28
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient''s family members were tested positive for covid-19 and patient was exposed by his son who was unvaccinated and was currently experiencing severe covid-19 symptoms.
Allergies:
Diagnostic Lab Data: Test Date: 20211229; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20211264179

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 57 year old male. The patient''s height, and weight were not reported. The patient''s family members were tested positive for covid-19 and patient was exposed by his son who was unvaccinated and was currently experiencing severe covid-19 symptoms. The patient received covid-19 vaccine ad26.cov2.s (Dose number in series 1) (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, 1 total administered to right arm on 24-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-DEC-2021, the patient was asymptomatic during the day until he had chills at night. The patient had symptoms of light headedness, fatigue, lower part of back was hurting and little congestion (coded as suspected covid-19 infection, suspected clinical vaccination failure). The patient took cold and flu medications and Mucinex which had helped him for a couple of hours. It was reported that the patient has not had any booster dose of any vaccine. On 29-DEC-2021, the patient was tested positive for covid-19 with a home kit test. The patient had not taken polymerase chain reaction (PCR) test yet. (Dose number in series 1). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This case was associated with product quality complaint.; Sender''s Comments: V0: 20211264179-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1994737 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Paraesthesia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Muscle pain in legs Joint pain in legs Rash Tingling


VAERS ID: 1994740 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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: Swollen lymph nodes under arms. Pain and swelling began under left arm and moved to both mid-day 12/30/2021.


VAERS ID: 1994991 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 37F21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Dose administered greater than 12 hours post puncture; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours post puncture) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 37F21A) for COVID-19 vaccination. No Medical History information was reported. On 28-Dec-2021 at 2:45 PM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 28-Dec-2021 at 2:45 PM, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours post puncture). On 28-Dec-2021 at 2:45 PM, EXPIRED PRODUCT ADMINISTERED (Dose administered greater than 12 hours post puncture) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Date and time vial was first punctured: 27-Dec-2021 at 3 PM. The vial was stored in the refrigerator post puncture for 23 hours and 45 minutes. Date of administration of vaccine-28DEC2021 last shot at 2:45PM.Patients have not reported side effects No concomitant medication were reported. No Treatment information was provided.


VAERS ID: 1994998 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Colorado  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: 0.25ml booster administered as first dose; This spontaneous case was reported by a pharmacist and describes the occurrence of INCORRECT DOSE ADMINISTERED (0.25ml booster administered as first dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 28-Dec-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) .25 ml. On 28-Dec-2021, the patient experienced INCORRECT DOSE ADMINISTERED (0.25ml booster administered as first dose). On 28-Dec-2021, INCORRECT DOSE ADMINISTERED (0.25ml booster administered as first dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter. Reporter did not allow further contact


VAERS ID: 1995036 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-16
Onset:2021-12-28
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cardiac function test, Dyspnoea, Electrocardiogram, Fatigue, Illness, Influenza like illness, Loss of personal independence in daily activities, Myocardial necrosis marker, Nasopharyngitis, Nausea, Oropharyngeal pain, SARS-CoV-2 test, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: cardiac test; Result Unstructured Data: Results not reported; Test Name: ECG; Result Unstructured Data: Results not reported; Test Name: cardiac enzymes; Result Unstructured Data: Results not reported; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Tested negative for COVID 6 times since her 2nd dose
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Wheezing; Can''t breathe/short of breath/gets short of breath during the walks and that has gotten worse; Has been sick; Feels weak; Sore throat; Feeling like she is about to get the flu; Had a cold; Ttired; Nausea; threw up last night; could not get out of bed for 2 days; This spontaneous case was reported by a consumer and describes the occurrence of WHEEZING (Wheezing), DYSPNOEA (Can''t breathe/short of breath/gets short of breath during the walks and that has gotten worse), ILLNESS (Has been sick), ASTHENIA (Feels weak) and OROPHARYNGEAL PAIN (Sore throat) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A and 003C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 16-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 28-Dec-2021, the patient experienced VOMITING (threw up last night). On an unknown date, the patient experienced WHEEZING (Wheezing), DYSPNOEA (Can''t breathe/short of breath/gets short of breath during the walks and that has gotten worse), ILLNESS (Has been sick), ASTHENIA (Feels weak), OROPHARYNGEAL PAIN (Sore throat), INFLUENZA LIKE ILLNESS (Feeling like she is about to get the flu), NASOPHARYNGITIS (Had a cold), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (could not get out of bed for 2 days), FATIGUE (Ttired) and NAUSEA (Nausea). At the time of the report, WHEEZING (Wheezing) and DYSPNOEA (Can''t breathe/short of breath/gets short of breath during the walks and that has gotten worse) had not resolved, ILLNESS (Has been sick), ASTHENIA (Feels weak), OROPHARYNGEAL PAIN (Sore throat), INFLUENZA LIKE ILLNESS (Feeling like she is about to get the flu), NASOPHARYNGITIS (Had a cold), FATIGUE (Ttired), NAUSEA (Nausea) and VOMITING (threw up last night) outcome was unknown and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (could not get out of bed for 2 days) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Cardiac function test: results not reported Results not reported. On an unknown date, Electrocardiogram: results not reported Results not reported. On an unknown date, Myocardial necrosis marker: results not reported Results not reported. On an unknown date, SARS-CoV-2 test: negative (Negative) Tested negative for COVID 6 times since her 2nd dose. No concomitant medication was reported. No treatment medication was reported. Patient went to a local urgent card in September or October after her 2nd dose and they told patient had a cold. Patient went to her doctor five or six weeks ago and they told her she had a cold as well. It was reported that the patient goes for walks of up to seven miles they take longer than usual, gets short of breath during them, & that has gotten worse. The breathing problems did not start immediately after the second dose and some days are worse than others.


VAERS ID: 1995048 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Dose administered $g12 hours post puncture; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered $g12 hours post puncture) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 28-Dec-2021 at 12:00 PM, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Dec-2021 at 12:00 PM, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered $g12 hours post puncture). On 28-Dec-2021 at 12:00 PM, EXPIRED PRODUCT ADMINISTERED (Dose administered $g12 hours post puncture) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were reported. Date and time vial was first punctured: 27-Dec-2021 at 3 PM. The vial was stored in the refrigerator post puncture for 23 hours and 45 minutes. No treatment medication were reported.


VAERS ID: 1995630 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 3 LA / IM

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: 1995632 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 3 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Mild


VAERS ID: 1995644 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-17
Onset:2021-12-28
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Mechanical urticaria, 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: Isotretinoin 30 mg BID
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Full body Urticaria, dermatographia with associated priorities. Occurs daily, still occurring at present. Responds partially to Zyrtec 10 mg four times daily.


VAERS ID: 1995780 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-17
Onset:2021-12-28
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: 02/03/21 Moderna 010M20A (Mall Site), age 56, Itching/hives - torso and feet, no swelling lasting more than 1 week, but bearable
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Levaquin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: As happened with my 2nd Moderna vaccine, I developed hives a little over a week after the shot. Last time it was on my torso and feet with intense itching usually around 7-8 pm (I thought that the timing thing was really strange). This time around it manifested on my head, forearms, buttocks and, now, clavicle area. The itching was even more intense and then came the swelling of my head. I woke on the second day of this with swelling around my head, from the temple area, behind the ears and around the back of my head. It felt like the reaction I get to a bee sting, like a thick pad of something forming beneath my skin. I had taken a Benadryl before bed, then a Zyrtec in the morning to keep the itching at bay (with varying results). I iced the swollen area and the swelling subsided after an hour, but the temple are remained swollen. The swelling was moving too close to my eye for comfort, so I went to the local clinic to be examined. I was prescribed a steroid, which seems to have helped. The only itching and hives are now around my neck/clavicle area.


VAERS ID: 1995862 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza vaccine in 2008 and 2009
Other Medications: Losartan 50 mg 1 tablet PO QD, Omeprazole 20mg 1 capsule PO BID, amitripyline 50mg 1 tablet PO QD
Current Illness: none
Preexisting Conditions: hypertension
Allergies: Augmentin, clindamycin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pruritus on soles of feet and palms of hands.


VAERS ID: 1995878 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-12-28
Onset:2021-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034F1A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Cold sweat, Condition aggravated, Fatigue, Headache, Heart rate, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Interchange of vaccine products, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (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: COVID Vaccinations: 4/2/21 - Phfzer BioNTech and 4/26/21-Pfizer BioNTech - 68 years old -same reactions as booster but didn''t vo
Other Medications: Metoprolol and Bupropion
Current Illness: none
Preexisting Conditions: no
Allergies: sulfa, bee stings, spider bites
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Tues, 12/28 -7 hours after booster - chills, fever, and body aches started Wednesday 12/29 -The next day - fever continued 101.2, chills, body aches, weakness, heart rate 11, vomiting, fatigue, cold sweats, awful headache Thursday 12/30 - could control fever and body aches with naproxen; however-OTC pain meds did not touch the headache, noticed injection site is red, swollen, warm, and itching Friday - arm still red and itching, tired


VAERS ID: 1995894 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-03
Onset:2021-12-28
   Days after vaccination:328
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Headache, 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested positive for COVID-19. Experienced headache, fever and chills.


VAERS ID: 1995911 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-12-27
Onset:2021-12-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vomiting and Nausea from 0100 28 DEC til 0900 30DEC


Result pages: prev   32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=131&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166