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

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



Case Details (Reverse Sorted by Onset Date)

This is page 133 out of 6,867

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VAERS ID: 1633107 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

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

Write-up: My muscles in my legs were weak.


VAERS ID: 1633147 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-18
Onset:2021-08-15
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: benzocaine (ORAJEL) 10% mucosal gel Apply topically as needed. 3/30/21 cholecalciferol (VITAMIN D-3) 25 mcg (1,000 units) capsule Take 1 capsule by mouth Daily. 11/26/19 diphenhydrAMINE-lidocaine-aluminum & magnesium hydroxide-simet
Current Illness: Anxiety ? Arthritis osteoarthritis, dupuytrens ? Breast cancer (HCC) 1985 ERP. R mastectomy in 1985. Bx proven recurrence T8 1989, radiation there, remains on tamoxifen ? Chronic low back pain intrathecal pain pump managed & placed initially in 2002 and replaced in 2014. Contains hydromorphone, bupivicaine, and clonidine ? Cyclical vomiting, intractable 2002 ? Diverticulitis ? DJD (degenerative joint disease) ? Fibroid uterine - benign ? Fibromyalgia ? Gastric ulcer gastritis; PPI ? Gastroparesis Thought to be due to chronic opioid use. ? Heart attack (HCC) ? Herpes zoster 2002 ? Hypertension ? Incontinence ? Morbid obesity (HCC) likely obesity hypoventilation ? Radiation midthoracic myelopathy ? Restless leg syndrome Flexeril helped ? Sacral insufficiency fracture multiple, noted on MRI in 2014 ? Scapular fracture ? Sleep apnea 1.5 L of oxygen at night, worsened on CPAP, likely narcotic related. Use BiPap if needed 10/6. ? Thrombocytopenia (HCC) ? Vitamin D deficiency
Preexisting Conditions: See section 11
Allergies: Lamotrigine Nausea And Vomiting ? Lyrica [Pregabalin] Retaining fluids ? Topiramate ? Tramadol Headache and urinary incontinence per pt report ? Acetaminophen Vomiting and migraine, TYLENOL, TYLENOL ? Aspirin Itching, vomiting, migraine, urinary incontinence, ASPIRIN, ASPIRIN ? Codeine Itching, vomiting, migraine, urinary incontinence ? Dexamethasone Vomiting and migraine ? Ergotamine Tartrate Migraine headache ? Gabapentin NEURONTIN-swelling in legs, NEURONTIN ? Hydrocodone Itching, vomiting, migraine, urinary incontinence ? Lidocaine Itching from patch ? Meclizine Kidney problems ? Meperidine Itching, vomiting, migraine, urinary incontinence ? Methadone Itching, vomiting, migraine, urinary incontinence ? Miacalcin ? Morphine Itching, vomiting, migraine, urinary incontinence ? Nsaids Itching, vomiting, migraine, urinary incontinence - to naproxen, etodolac, rofecoxib, voltaren, ketoprofen (can take ibuprofen occasionally) ? Onion Unknown ? Oxycodone Itching, vomiting, migraine, urinary incontinence ? Oyster Unknown ? Oyster Shell Unknown ? Pentazocine Itching, vomiting, migraine, urinary incontinence ? Phenergan [Promethazine] ? Prednisone Vomiting and migraine, PREDNISONE, PREDNISONE ? Propoxyphene Itching, vomiting, migraine, urinary incontinence ? Scopolamine Itching from patch ? Sucralfate
Diagnostic Lab Data: Ordered Test: SARS-CoV-2 RNA Resp Ql NAA+probe Ordered Test Codes: 94500-6/ Status: Final Accession Number: 212270051LP-198922 Specimen Source: SOFT TISSUE SAMPLE Specimen Site: ENTIRE NASOPHARYNX(181200003) Specimen Collection Date/Time: 2021-08-15 22:07:00.0
CDC Split Type:

Write-up: Completed the 2 dose Covid vaccine series on 2/18/21, then was hospitalized for Covid on 8/15/21.


VAERS ID: 1633365 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-25
Onset:2021-08-15
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, Arthralgia, COVID-19, Chills, Cough, Headache, Hyperhidrosis, Nasal congestion, Pyrexia, SARS-CoV-2 test positive, Vertigo
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid positive test 8/25/2021
CDC Split Type:

Write-up: 8-13-21 likely afternoon exposure 8-14-21 all day likely exposure 8-15-21 morning start headache nose, congestion 8-16-21 slight cough, night vertigo fever full body shivers and heavy sweating 8-17-21 deep cough, joint aches, night vertigo fever 8-18-21 deep cough, joint aches, night fever, no vertigo 8-19-21 no headache, lite nose congestion, infrequent deep productive cough, night no smell, no fever, 8-20-21 infrequent deep productive cough, lite sinus congestion, no smell, no fever 8-21-21 no smell, intermittent cough 8-22-21 congestion and cough 8-23-21 congestion and cough 8-24-21 congestion and cough 8-25-21 started on 2 inhaler prescriptions


VAERS ID: 1633591 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Pain, Pain in extremity, Sleep disorder, Ultrasound Doppler
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prozac armor thyroid fish oil progesterone cream
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Emergency Ultra Sound was order and performed to rule out a blood clot. The test was negative.
CDC Split Type:

Write-up: Severe sharp shooting pain in left upper calf. Woke me up in middle of night. The sharp pain comes and goes, but there is always a dull ache in the same area that never fully goes away.


VAERS ID: 1633999 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-15
Onset:2021-08-15
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 UN / UN

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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID positive result on admission despite fully vaccinated May 2021


VAERS ID: 1634192 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Appendicectomy, Blood test, Computerised tomogram, Flank pain, Pathology test, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Cold
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan x2 , Blood work x2, and his appendix went to a lab for testing.
CDC Split Type:

Write-up: My son got his first dose of the Pfizer Covid-19 Vaccine and five days later he had sharp pains in his side followed by vomiting three times and being in pain all night. I took him to pediatrician in morning and was told to go to the ER where they did an emergency appendectomy on the Tuesday following his vaccine. I am not quite sure if it is a direct result of the vaccine but I did research on the website as well as the University and it states a 1/2500 chance through their testing.


VAERS ID: 1636170 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-22
Onset:2021-08-15
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0769 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Nervous Arthralgia Acute lumbar radiculopathy Metatarsalgia Digestive Cervical dysphagia Genitourinary Hydronephrosis with renal calculous obstruction Acute cystitis with hematuria Musculoskeletal Palindromic rheumatism Lumbar degenerative disc disease Endocrine/Metabolic Hyperlipidemia Other BMI 26.0-26.9,adult Overweight(278.02)
Allergies: AmoxicillinHives / Urticaria Sulfa (Sulfonamide Antibiotics)Hives / Urticaria Sulfamethoxazole-trimethoprimHives / Urticaria Celecoxib Hydroxychloroquine
Diagnostic Lab Data: COVID-19 PCR POCT Influenza A/B
CDC Split Type:

Write-up: 1. Cough 2. Sore throat 3. Nasal congestion with rhinorrhea 4. At increased risk of exposure to COVID-19 virus 5. Fever, unspecified fever cause 6. Generalized body aches


VAERS ID: 1636179 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Oropharyngeal pain, Rash, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Mom calling Covid vaccine second shot 8/10/21, after first vaccine red patch on butt size of nickel, not worse, watched- not gone, 5 days after 2nd vaccine rash all over abd and back, not worse/better, not too worried, raised, can feel, patches and dots, some light red, not itchy, feels tired, couple days throat hurt didn''t complain too much, feels fine not, please note anything to do?


VAERS ID: 1636556 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-05
Onset:2021-08-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Intestinal ischaemia
SMQs:, Ischaemic colitis (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: went to the hospital on 8/19/2021 and found out i had a intestinal blood clot. was told it was probably due to the birth control , the vaccine and getting a cold. i was put on blood thinners and will be on it for some months


VAERS ID: 1636573 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Erythema, Inflammation
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro, multivitamin, vitamin C, depo provella
Current Illness:
Preexisting Conditions: seasonal allergies
Allergies: pinto bean and yellow squash
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day of the vaccination, she got an inflamed oval-shaped red ring with some bruising.


VAERS ID: 1636584 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-16
Onset:2021-08-15
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium polycarbophil (FIBERCON) 625 mg tablet escitalopram (LEXAPRO) 10 mg tablet norgestimate-ethinyl estradioL (ORTHO TRI-CYCLEN) 0.18/0.215/0.25 mg-35 mcg (28) per tablet
Current Illness:
Preexisting Conditions: Digestive Obesity Liver cyst Musculoskeletal Scoliosis Endocrine/Metabolic Hypercholesterolemia Other Anxiety BMI 32.0-32.9,adult
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: cough shortness of breath and lightheadedness.


VAERS ID: 1636757 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-05
Onset:2021-08-15
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Borrelia test, Condition aggravated, Hypoaesthesia, Intervertebral disc protrusion, Laboratory test, Muscle spasms, Paraesthesia, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: seen at Hospital - r/o blood clot - Lyme blood test drawn. Pt shares ER felt leg symptoms were r/t her bulging disk in her back (chronic issue she gets cortisone shots for)
CDC Split Type:

Write-up: pt reported numbness, tingling, cramping to back of calf muscle and discoloration dots on feet (smaller than pencil eraser)


VAERS ID: 1637007 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-29
Onset:2021-08-15
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Amolodipine; Atorvastatin
Current Illness: none
Preexisting Conditions: Hypertension, mixed dyslipemia; pre diabetes; general anxiety
Allergies: Augmentin, Lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 day history starting around 8/15/21 of sinus congestion with headache. Has minimal non productive cough. No SOB but had fever yesterday. (8/23/21)


VAERS ID: 1637038 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-11
Onset:2021-08-15
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/11/21 Diagnosed covid positive:08/18/21 Symptom onset:08/15/21 Exposure:Travel Symptoms:cough, fatigue,loss of smell/taste, sorethroat,HA


VAERS ID: 1637042 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-08
Onset:2021-08-15
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Headache, Myalgia, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/11/21 2nd dose02/08/21 Diagnosed covid positive:08/17/21 Symptom onset:08/15/21 Exposure:community Symptoms:cough, fatigue,muscle aches,sore Throat,chills, HA


VAERS ID: 1637065 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-29
Onset:2021-08-15
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/8/21 2nd dose01/29/21 Diagnosed covid positive:08/16/21 Symptom onset:08/15/21 Exposure:community Symptoms: fatigue,loss of smell/taste, runny nose,HA, cough, sorethroat, muscle aches


VAERS ID: 1637384 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Facial paralysis, Ultrasound Doppler
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Carotid Duplex 8/25/2021
CDC Split Type:

Write-up: Partial paralysis of the face. started on 8/15 around 7am.


VAERS ID: 1638054 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-08-15
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bed rest, Bloody discharge, Cervical dilatation, Exposure during pregnancy, Fibronectin increased, Foetal non-stress test abnormal, Premature labour, Secretion discharge, Shortened cervix, Ultrasound scan abnormal, Uterine irritability
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, probiotics, prenatal omega 3, vitamin C, magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: Upon arriving at ER, complete ultrasound was conducted and found shortened cervix, ffn test performed and had positive result, cervical dilation of 2 cm, NST showed that contractions were occurring. Monitored blood pressure, O2 saturation and conducted NST tests every four hours for duration of hospital stay.
CDC Split Type:

Write-up: At 32 weeks 5 days pregnant on 8/15/21, experienced discharge of mucus and blood. Advised by OBGYN nurse line to go to labor & delivery ER. Tests were conducted and determined suspected preterm labor. Was admitted to labor and delivery for treatment and observation. Treated with intravenous magnesium sulfate for about 36 hours and given two doses of betamethasone 24 hours apart. Moved to antepartum for continued monitoring. Contractions still observable by NST monitoring and also determined to be experiencing uterine irritations. Was monitored and observed in the hospital for 5 days for preterm labor before being released home on bed rest on 8/20/21.


VAERS ID: 1638463 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC381010121 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest discomfort, Enlarged uvula, Exposure during pregnancy, Eye pruritus, Eye swelling, Throat irritation, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs, seasonal allergies, cats
Diagnostic Lab Data: None...my doctor said he didn''t know what to do for me
CDC Split Type:

Write-up: I began having itchy throat and eyes, them wheezing, tightness in chest, hives, my body felt like my insides were burning but I did not have a fever. It lasted for a few days and the only thing that helped me was taking Benadryl and Albuterol nebulizer treatments. My eyes were swollen and my uvula was swollen. My heart rate sustained in the 120s. I thought I was having a heart attack. I am 20 weeks pregnant and I am a COVID nurse.


VAERS ID: 1641052 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-08-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Pyrexia, SARS-CoV-2 test positive, Suspected COVID-19
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL ARTHRITIS PAIN) 650 mg 8 hr tablet calcium carbonate-vitamin D3 600 mg(1,500mg) -400 unit per tablet calcium polycarbophiL (FIBERCON) 625 mg tablet coenzyme Q10 (CO Q10) 100 mg capsule diclofenac (VOLTAREN) 50 mg
Current Illness:
Preexisting Conditions: Nervous Arthralgia of lower leg Shoulder joint pain Digestive Gastroesophageal reflux disease Diverticulosis of colon Musculoskeletal Gamekeeper''s thumb of right hand, sequela Primary osteoarthritis of first carpometacarpal joint of right hand Arthritis of scapho-trapezium-trapezoid joint Current tear of medial cartilage or meniscus of knee Derangement of knee Disorder of bursae of shoulder region Fracture with nonunion Localized osteoarthrosis Open fracture of metatarsal bone Primary localized osteoarthrosis of hand Primary localized osteoarthrosis of shoulder region Gamekeeper''s thumb of right hand Skin lesion Endocrine/Metabolic Hypercholesterolemia Elevated fasting blood sugar Mixed hyperlipidemia Other Disinhibition behavior Forgetfulness Learning disability Vertigo Status post fusion of joint of finger S/P wrist surgery Aftercare following surgery of the musculoskeletal system Anxiety Follow-up examination following treatment with high-risk medication History of colon polyps Dizziness Status post right rotator cuff repair
Allergies: AtorvastatinOther (document details in comments) RosuvastatinOther (document details in comments)
Diagnostic Lab Data: Updated Procedure 08/20/21 1456 POCT COVID-19 PCR Collected: 08/20/21 1456 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Point of Care COVID-19 PCR Testing Method Lot Expiration Date 07.24.2022
CDC Split Type:

Write-up: Suspected COVID-19 virus infection, Cough, Exposure to COVID-19 virus Chills ? Fever ? loss of taste


VAERS ID: 1641130 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: I began having period symptoms and started my period a couple days before I was expected to. I''ve always had extremely regular periods so this was uncommon. This period was also unusually heavy and my period symptoms were much worse than normal.


VAERS ID: 1641339 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PHIZER 0.3ML EW / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Fall, Fatigue, Irritability, Migraine, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (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: Zoloft, albuterol, meclizine, rizatriptan
Current Illness: Vertigo
Preexisting Conditions: Chronic migraines, asthma, bronchitis
Allergies: Penicillin and Naproxen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Cold , fatigue, migraines, congestion, runny nose , irritable, confusion, falls


VAERS ID: 1641349 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-08-15
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg chewable tablet betamethasone valerate (VALISONE) 0.1 % lotion blood-glucose meter misc dulaglutide 1.5 mg/0.5 mL pen injector EASY TOUCH TWIST LANCETS 30 gauge misc EMBRACE TALK TEST STRIPS strip fluocinonide (LIDEX) 0.
Current Illness:
Preexisting Conditions: Nervous Acute left-sided low back pain with left-sided sciatica Circulatory Essential hypertension Tachycardia Musculoskeletal Atopic dermatitis Endocrine/Metabolic Type 2 diabetes mellitus (CMS/HCC) Pure hypertriglyceridemia Thyroid nodule Other specified hypothyroidism Other H/O prostate cancer Missed vaccination due to patient refusal
Allergies: CodeineNausea and Vomiting
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: nasal congestion


VAERS ID: 1641363 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-08-15
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Paranasal sinus discomfort, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: loratadine (CLARITIN) 10 mg tablet MEDICAL MARIJUANA
Current Illness:
Preexisting Conditions: Nervous Generalized abdominal cramping Migraine without aura and without status migrainosus, not intractable Respiratory Allergic rhinitis Digestive Nausea Change in stool habits Other Depression
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: sinus pressure chest pain/tightness on the left side


VAERS ID: 1641549 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Tresiba, Janumet XR 100-1000, Telmisartan HCTZ 80-25, Fenofibrate 134, Pioglitazone 15, Omeprazole 20
Current Illness: T2DM, High Blood Pressure
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a blood clot


VAERS ID: 1641797 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Malaise, Rash, Rash pruritic, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Allergies: Almond, pineapple, tree nut, and sesame oil
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s mother, advised that patient had received first dose of Moderna COVID-19 vaccine at about 4pm on 8/15/21; patient started to have an itchy rash on her entire back and her body felt weird. PT Mother advised that, in the middle of the night, patient complained that she did not feel well. At about 9am on 8/16/21, patient got out of bed and was sitting down when patient fainted and had a seizure. Patient was transported to the ER, but was not able to be admitted due to availability issue. Patient was later discharged and is now feeling better.


VAERS ID: 1645127 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Ear pain, Fatigue, Feeling of body temperature change, Headache, Injection site erythema, Injection site pain, Neck pain, Vaccination site nodule
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (had Covid over a month prior to this report and was treated with Regeneron then)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Felt hot and cold; Ear ache; Neck ache; knot at the injection site; weakness; Red at injection site; Injection site soreness; Tiredness; Joint pain in leg and hand; Headache; chills; This spontaneous case was reported by a consumer and describes the occurrence of FEELING OF BODY TEMPERATURE CHANGE (Felt hot and cold), EAR PAIN (Ear ache), NECK PAIN (Neck ache), VACCINATION SITE NODULE (knot at the injection site) and ASTHENIA (weakness) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 (had Covid over a month prior to this report and was treated with Regeneron then) in 2021. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021 at 1:00 PM, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced CHILLS (chills). On 15-Aug-2021 at 4:00 PM, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (Felt hot and cold), EAR PAIN (Ear ache), NECK PAIN (Neck ache), VACCINATION SITE NODULE (knot at the injection site), ASTHENIA (weakness), INJECTION SITE ERYTHEMA (Red at injection site), INJECTION SITE PAIN (Injection site soreness), FATIGUE (Tiredness), ARTHRALGIA (Joint pain in leg and hand) and HEADACHE (Headache). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) 15-Aug-2021 for Adverse event, at a dose of 2 dosage form. At the time of the report, FEELING OF BODY TEMPERATURE CHANGE (Felt hot and cold), EAR PAIN (Ear ache), NECK PAIN (Neck ache), VACCINATION SITE NODULE (knot at the injection site), ASTHENIA (weakness), INJECTION SITE ERYTHEMA (Red at injection site), INJECTION SITE PAIN (Injection site soreness), FATIGUE (Tiredness), ARTHRALGIA (Joint pain in leg and hand), HEADACHE (Headache) and CHILLS (chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported by the reporter. It was reported that the patient waited until she was Covid negative for 2 weeks before getting the vaccine like her physician recommended. Moreover, the patient reported that her symptoms were very similar to when she had Covid-19.


VAERS ID: 1645224 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-08
Onset:2021-08-15
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diverticulitis
SMQs:, Gastrointestinal nonspecific inflammation (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: XTANDI
Current Illness: Prostate cancer (He has been taking Xtandi for prostate Cancer for more than a year.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Diverticulitis inflammation months after second vaccine; This spontaneous case was reported by a consumer and describes the occurrence of DIVERTICULITIS (Diverticulitis inflammation months after second vaccine) in an 84-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Prostate cancer (He has been taking Xtandi for prostate Cancer for more than a year.). Concomitant products included ENZALUTAMIDE (XTANDI) for Prostate cancer. On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced DIVERTICULITIS (Diverticulitis inflammation months after second vaccine) (seriousness criteria hospitalization and medically significant). The patient was hospitalized from 15-Aug-2021 to 16-Aug-2021 due to DIVERTICULITIS. The patient was treated with CIPROFLOXACIN HYDROCHLORIDE MONOHYDRATE (CIPRO [CIPROFLOXACIN HYDROCHLORIDE MONOHYDRATE]) for Adverse event, at an unspecified dose and frequency and METRONIDAZOLE BENZOATE (FLAGYL [METRONIDAZOLE BENZOATE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, DIVERTICULITIS (Diverticulitis inflammation months after second vaccine) outcome was unknown. Action taken with suspect drug was not applicable. Company Comment - Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. However, this patient''s advanced age and diet (Eat too many seeds) remains a contributory factor.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. However, this patient''s advanced age and diet (Eat too many seeds) remains a contributory factor.


VAERS ID: 1645938 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-28
Onset:2021-08-15
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, SARS-CoV-2 test, Upper-airway cough syndrome, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (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: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler amoxicillin (AMOXIL) 500 mg capsule benzonatate (TESSALON) 200 mg capsule bethanechol (URECHOLINE) 25 mg tablet calcium carbonate (OS-CAL) 600 mg calcium (1,500 mg) tablet cholecalcif
Current Illness:
Preexisting Conditions: Foot pain, left, hearing loss, bilateral, knee pain, left, low back pain, neuritis or radiculitis due to rupture of lu
Allergies: Sulfa, Sulfamethoxazole-trimethoprim
Diagnostic Lab Data: POCT COVID-19 Antigen
CDC Split Type:

Write-up: Cough, Wheezing, Post Nasal Drip,


VAERS ID: 1647291 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLOPURINOL; SYNTHROID
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101057314

Write-up: Dizziness; room spinning; Loss of balance; Nausea; This is a spontaneous report received from a contactable consumer (patient). A 65-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE,solution for injection; lot number- EW0176 and expiry date not reported) via an unspecified route of administration into Left arm on 06Aug2021 15:00, at the age of 65-year-old,dose1, single for COVID-19 immunization in a Pharmacy or Drug Store. Relevant medical history includes allergies to Indocin and Tramadol. Concomitant medications include allopurinol and Synthroid. The patient did not receive other vaccine in four weeks. The patient did not have prior COVID vaccination and was not tested post vaccination. On 15Aug2021 9:00,the patient experienced dizziness, room spinning,loss of balance and nausea. The patient did not receive treatment in response to the events. The outcome of the events was not recovered at the time of report.


VAERS ID: 1647319 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: SARS-CoV-2 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101058275

Write-up: Patient got break through COVID; Patient got break through COVID; This is spontaneous report from a contactable consumer. A 59-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date (age at the time of vaccination was 59-year-old) as dose number unknown, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient was not pregnant at time of vaccination. It was unknown if the patient receives any other vaccines within 4 weeks prior to the COVID-19 vaccine. It was unknown if prior to vaccination patient was diagnosed with COVID-19. Since the vaccination the patient had tested for COVID-19. On 15Aug2021, the patient got break through covid (medically significant). It was unknown if patient received the treatment. No hospitalization was reported for AEs. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 15Aug2021. The outcome of events was not recovered. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1651285 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-08
Onset:2021-08-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Menstruation delayed, Paraesthesia, Peripheral swelling, Pregnancy test
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Fertility disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Maca root and SEAMOSS, multi vitamin
Current Illness: No
Preexisting Conditions: anemia
Allergies: No
Diagnostic Lab Data: For lack of period Yes HCG blood test to ensure I want pregnant 8/24/2021
CDC Split Type:

Write-up: Arm swell up, hot to touch are went numb and tingly one week after vaccination. Period is has not come for this month at all currently 13 days late


VAERS ID: 1651436 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocortisone, levothyroxin, triamterine, metformin, multivitamin
Current Illness: None
Preexisting Conditions: Adrenal Insufficiency, hypothyroidism
Allergies: Amoxicillin
Diagnostic Lab Data: Doctor took blood tests Thursday, Aug. 19. All elements came back within the normal ranges.
CDC Split Type:

Write-up: I felt fine when I went to bed Saturday (Aug14th) evening. I did not wake up until midmorning Tuesday, Aug 17th. When I woke, I felt nauseous, dizzy. I experienced sweats, no fever.


VAERS ID: 1653580 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OULF21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, COVID-19, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrodial
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/2021. COVID TEST
CDC Split Type:

Write-up: On 8/15/21 loss of taste, By 8/19/21. Headaches, sore throat. Tested Positive for COVID


VAERS ID: 1653739 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within one hour of injection, a hard and painful red knot appeared roughly 1.5 inches in diameter. This persisted for about 4 days.


VAERS ID: 1653881 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Purulent discharge
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: zyrtec, albuterol
Current Illness:
Preexisting Conditions:
Allergies: nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2-3 days after injection, started to have swollen lymph nodes around his ears bilaterally and initially thought it was a zit but is having purulent drainage from the preauricular area on the right side and cervical lymph nodes also are now enlarged.


VAERS ID: 1654106 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site cellulitis
SMQs:

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

Write-up: ER nurse called pharmacy with adverse event of cellulitis at injection site. patient was prescribed antibiotic for cellulitis on 08/17/2021.


VAERS ID: 1654165 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO181 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest discomfort, Chest pain, Fatigue, Musculoskeletal discomfort, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline HCL 50mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Common symptoms: feverish and tired within 30 mins to 1 hour. Rare symptoms: chest discomfort/ache. It was equal on both sides along the inner pec or breast and back. However, next morning, pain was just on left side and moved more inward over heart. These symptoms went away within 36 hours after vaccine was administered.


VAERS ID: 1655050 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-08-15
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, 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: Medical History/Concurrent Conditions: Penicillin allergy (allergies: penicillin)
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101065862

Write-up: Tested positive to COVID after being vaccinate in March and April/runny nose; Tested positive to COVID after being vaccinate in March and April/runny nose; This is a spontaneous report from a contactable consumer (patient). A 17-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm on 26Mar2021 (at the age of 17-years-old) (Batch/Lot Number: EP6955) as dose 1, single then intramuscular, administered in the left arm on 16Apr2021 (Batch/Lot Number: EP6955) as dose 2, single for COVID-19 immunization. Medical history included allergies: penicillin. Concomitant medications were not reported. On 15Aug2021, the patient experienced runny nose. The patient had a nasal swab on 16Aug2021 that resulted positive. The patient tested positive to COVID after being vaccinate in March and April. The events were considered non-serious by the consumer. The patient was recovering from the events and had no treatment. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1655090 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Electroencephalogram, Investigation, Magnetic resonance imaging heart, Ultrasound scan
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: METFORMIN; GLIMEPIRIDE
Current Illness: Type II diabetes mellitus
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202108; Test Name: EEG of heart; Result Unstructured Data: Test Result:Unknown Result; Test Date: 202108; Test Name: computer scan; Result Unstructured Data: Test Result:Unknown Result; Test Date: 202108; Test Name: MRI heart; Result Unstructured Data: Test Result:Unknown Result; Test Date: 202108; Test Name: sonogram of heart; Result Unstructured Data: Test Result:Unknown Result
CDC Split Type: USPFIZER INC202101083317

Write-up: Stroke; This is a spontaneous report from a contactable consumer (patient). A 57-years-old male patient received first dose of bnt162b2 (PFIZER COVID-19 VACCINE, Batch/Lot Number: FC3181) via an unspecified route of administration in left arm on 14Aug2021 at 11:30 (at the age of 57-years-old) as first dose, single for COVID-19 immunization. Medical history included ongoing diabetic type II. Concomitant medications included metformin 500mg twice a day ongoing and glimepiride 4mg twice a day ongoing; both taken for diabetes/diabetic type II from an unknown date. No prior vaccinations (within 4 weeks). On 15Aug2021 at 12:30 afternoon, the patient experienced stroke. This adverse event required to visit emergency room taken by ambulance and the patient was hospitalized from 15Aug2021 to 18Aug2021. The treatment tPA was received for the stroke and that worked. The other medications he was placed on for stroke was Low dose Aspirin regimen, Plavix 75mg for three weeks and Crestor 40mg as a continuing medication. On an unspecified date, the patient underwent magnetic resonance imaging heart, electroencephalogram (EEG), sonogram of heart and computer scan; all with unknown results. Patient mentioned that it was hard to tell at the moment as far as outcome. He felt that he has recovered yes, but unable tell at this time if there will be any lasting effects. It''s only been a couple days. The outcome of the event was recovered on Aug2021. No follow up attempts are possible. No further information is expected.


VAERS ID: 1655737 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-30
Onset:2021-08-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Headache, Hypoaesthesia, Pollakiuria
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Dehydration (narrow), Sexual dysfunction (broad)

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

Write-up: Numbness in hands and feet, dehydration, healthcare provider has given fluid for dehydration, constant headaches, constant urination.


VAERS ID: 1655799 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-22
Onset:2021-08-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6190 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Feeling abnormal, Nasopharyngitis, SARS-CoV-2 test positive, Sinus headache, Sneezing, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Dementia (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: quinaretic 20 / 12.5
Current Illness: na
Preexisting Conditions: hypertension
Allergies: na
Diagnostic Lab Data: Test for SARS-Cov-2 / COVID 19 administered 8/21/21 was positive. Previous self-administered (8/18/21) nasal swab was negative - I did not trust it as I don''t think I did it correctly (I was outside and it was raining, with a bunch of coughing people around me - I wanted to get away fast!)
CDC Split Type:

Write-up: ** My wife and I were BREAKTHROUGH CV19 cases six months AFTER vaccination ** This is WHY I''m reporting! My adverse response to vaccine was very mild - a slight headache the day following 1st vaccine and a feeling of jet lag the day following the 2nd. We suspect we were infected on plane flight by a coughing, whining young boy sitting behind us. We were wearing masks, but we did not have eyes in back of our head and have no idea what he and his family were doing behind us. When we suspected we were positive (confirmed w positive PCR tests for both of us), we took care to isolate for the CDC recommended time frames and consulted w healthcare professionals. We are always careful to wear masks in indoor public places. Our symptoms were relatively mild, like a modest cold. The worst was bad sinus headache for me. Sneezing and some coughing from nasal drip. Loss of taste and smell (very slowly returning). No fever, no sore throat. I felt fatigued, but never bedridden. On my most tranquil day, per my iPhone, I still logged 12,000+ steps (away from others, of course - easy to isolate). Slowed me down but by no means did it stop me. IGG protecting lungs and other organs worked well - thank you, Phizer /BioNTech. IGA in nasal passage did not work well, obviously.


VAERS ID: 1656006 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-22
Onset:2021-08-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chest pain, Headache, Nasal congestion, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitryptline, prazosin, apri
Current Illness: Nonexistent
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid test PCR 8/16/2021
CDC Split Type:

Write-up: Tested positive for covid, sore throat, headache, fever, runny nose, nasal congestion, mild chest pain


VAERS ID: 1656023 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-09
Onset:2021-08-15
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Influenza A virus test, Influenza B virus test, Metabolic function test, Pneumonia, Respiratory syncytial virus test, Respiratory viral panel, SARS-CoV-2 test positive
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Acute kidney failure Cancer of the colon, lung and peritoneum Urinary calculi
Allergies: No known allergies
Diagnostic Lab Data: Tested positive for COVID-19 on 8/15/21 with this laboratory test: Covid-19 by PCR. Basic metabolic panel done on 8/28 and every oth
CDC Split Type:

Write-up: Client tested positive for COVID-19 on 8/15/21 and was hospitalized. He has been inpatient and still is hospitalized as of 8/30. Was informed patient also had pneumonia.


VAERS ID: 1656035 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Malaise, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Allopurinol, Benicar HCTZ, Wellbutrin, ASA, Zyertec,
Current Illness:
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, Body aches, Fever, Malaise, Congestion, Shortness of breath for 6 days


VAERS ID: 1656278 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-23
Onset:2021-08-15
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dysphonia, Eye pruritus, Fatigue, Hypersomnia, Influenza like illness, Loss of personal independence in daily activities, Oral herpes, Pruritus, Pyrexia, SARS-CoV-2 test, Skin discolouration, Viral test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Flu shot 11 years ago
Other Medications: Soma, oxycodone, adderall,dicyclomine,trazadone,pantoprazole,acyclovir,aspirin,Benadryl tablets,xanax,pepto bismol
Current Illness: Nothing. Had dental work
Preexisting Conditions: Back, neck, bilateral knees and below pain, anxiety, acid reflux, Arm and elbow pain. Sometimes spontaneous nose bleeds
Allergies: None
Diagnostic Lab Data: Explained symptoms over phone about cold sores and fever. Was prescribed an antiviral. After symptoms changed though my previous symptoms now without a fever though exhausted. Went to office and showed photos of side effects and another nasal swab was taken to test for covid and other viruses
CDC Split Type:

Write-up: 2 days after 2nd shot my lips were entirely covered with cold sores bilateral in crease of mouth. Had 102 fever. Extreme fatigue. Following Sunday had unbelievable chills. Fever was 101. Next day after showering my voice became very raspy and though it felt like part of flu symptoms had no other concurrent symptoms to label flu. Last week almost to 2 wk post vaccine thought I felt better. While urinating I had an itch over and all around left eye. Didn''t touch it or anywhere else so I could look in mirror (have photos). It looked like white powder covered my left eye and surrounding areas. There was also white on right area but not as severe. Throughout from 2nd shot the fatigue has left me almost useless except for forcing myself to take care of pets. I''ve been sleeping some days almost 23 hours a day like yesterday, Aug 29th


VAERS ID: 1656350 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-21
Onset:2021-08-15
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril/HCTZ, bio-identical progesterone, testosterone and progesterone, Xanax, Armour thyroid, DIM supplement, Omega 3, Vitamin D3
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Doppler sonogram at nearby urgent care
CDC Split Type:

Write-up: She developed a DVT seemingly out of nowhere in her L lower leg, she has never had a DVT before


VAERS ID: 1656437 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C, B Complex, Magnesium Citrate, K2 and electrolyte powder 1x per day
Current Illness: N/A
Preexisting Conditions: Migraines, previous COVID infection in March/April 2020 that has led to an autoimmune response. I''ve deduced this due to inflammation, pain, swelling and heat in both wrists, thumbs, ankles, knees and hips. I''ve tried to control inflammation with diet and supplements. Currently, it''s only my thumbs and chest (left) that have pain.
Allergies: I have medicines I prefer not to take, but nothing that has caused a full blown allergic reaction.
Diagnostic Lab Data: None, was not recommended for in office appointment Three phone calls, two with the nurse and was told to follow CDC Guidelines.
CDC Split Type:

Write-up: Received the shot Saturday morning about 9:45 and woke up the next morning with chest pains (same pains I had when I had Covid) I rested throughout Saturday and Sunday, but ended up having to take Advil for the pain. I called my doctor''s office the next week to inquire about an appointment and if I should go through with the second shot due to the reaction, and they told me to follow the CDC Guidelines (with no appointment scheduled). I looked up the information on the CDC website and it says to report. I cannot comfortably get a second dose with that severe of chest pains. I heard (from the pharmacist herself that the second dose of the Moderna is where most people had the reaction.


VAERS ID: 1656489 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Fibromyalgia, Joint swelling, Pain in extremity, Rash, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Zoster, developed Shingles 4months (estimated 4 yrs)
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Fibromyalgia
Allergies: N/A
Diagnostic Lab Data: Ultrasound 08/18/2021
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of J&J 08/15/2021, started experiencing symptoms immediately of joint pain, right foot pain, agitation of Fibromyalgia, right ankle swelling, and bumpiness. Primary visit 08/18/2021, Ultrasound preformed (Blood Clot found under knee), several other blood clots found behind the calf area. Recommendation for blood thinners x 3 months. Scheduled for follow-up 08/30/2021 Ultrasound.


VAERS ID: 1657571 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Unknown  
Location: Tennessee  
Vaccinated:2021-02-06
Onset:2021-08-15
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
CHOL: CHOLERA (VAXCHORA) / PAXVAX - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Facial pain, Hyperaesthesia, Pain, Trigeminal neuralgia
SMQs:, Glaucoma (broad), Demyelination (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Novolin70/30 insulin. Pioglitazone, amlodipine, olmesartan, saquinavir, lopinavir, ritonavir, rosuvastatin , vitamin D, aspirin
Current Illness: NA
Preexisting Conditions: Disbetes2, hypertension, hyperlipidemis, chronic renal insufficiency (cr 1.8 mg%) Asymptomatic HIV with low unmeasurable hiv viral Load.
Allergies: Nka
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Onset mid August 2021 6 months after civid 2 jab series, of typical right face/cheek trigeminal neuralgia without dental or sinus etiology persisting now 3 weeks nearly daily with textbook characteristics of shooting lancinating shooting facial pain triggered by lightly touching malar zygoma sea of right cheek. Lasts. Few minutes area is sensitive but not tender.


VAERS ID: 1657855 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-24
Onset:2021-08-15
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CUS8955 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Feeding disorder, Inappropriate schedule of product administration, Insomnia, Malaise, Pyrexia, Seizure, Tremor, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Celiac disease; Gluten intolerance; Irritable bowel syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101057857

Write-up: received the second dose of BNT162B2 via an unspecified route of administration on the right arm on 24Jul2021; fever; seizure; I feel so terrible but cannot afford to go to the hospital.; violently shaking; Now over 48 hours later I cannot eat or sleep; Now over 48 hours later I cannot eat or sleep; I have a terrible rash on my right arm where injected; difficulty breathing; This is a spontaneous report from a contactable consumer (patient). A 22-year-old female patient (not pregnant) received the second dose of BNT162B2 via an unspecified route of administration on the right arm on 24Jul2021 (Lot Number: CUS8955) at the age of 22-year-old as single dose for COVID-19 immunization. Medical history included Celiac and IBS. Known allergy include gluten. The patient didn''t receive other vaccine in four weeks. The patient previously received Gluten and experienced allergy. The patient COVID prior vaccination. The patient didn''t perform COVID test post vaccination. Concomitant medication included multivitamin once a day. The patient previously received the first dose of BNT162B2 via an unspecified route of administration on the right arm on 24Jul2021 at 04:00 PM at the age of 22-year-old as single dose for COVID-19 immunization. On 15Aug2021 at 03:00 AM, with the second dose however, he woke up violently shaking almost seizure like at 3 am the morning after receiving second dose. Now over 48 hours later he cannot eat or sleep. The patient have a terrible rash on right arm where injected. He had difficulty breathing and worse symptoms than previously contracting COVID 19; when it first began In February. This was he being a voice advocating for those without healthcare assistance. He felt so terrible but cannot afford to go to the hospital. The only symptom that has subsided has been the fever. Everything else was just as bad as when it first began. The events resulted in doctor or other healthcare professional office/clinic visit. No treatment was received. The outcome of inappropriate schedule of vaccine administered was unknown. The outcome of fever was recovered. The outcome of other events was not recovered.


VAERS ID: 1657857 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-08-15
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: PCR test; Test Result: Positive; Test Date: 202108; Test Name: rapid antigen tests; Test Result: Negative; Test Date: 202108; Test Name: rapid antigen tests; Test Result: Negative.
CDC Split Type: USPFIZER INC202101058028

Write-up: This is a spontaneous report from a non-contactable consumer from a program. A patient of unspecified age and gender received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 29Jul2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced symptoms of COVID-19 on 07Aug2021 and received two rapid antigen tests and a PCR test to determine presence of COVID-19 infection. Caller stated both rapid tests came back negative, but the PCR test resulted positive on 15Aug2021. The patient outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1657873 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-18
Onset:2021-08-15
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: SARS-CoV-2 test, SARS-CoV-2 test positive, 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: LOSARTAN; DAILY VITAMINS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high
Allergies:
Diagnostic Lab Data: Test Date: 20210816; Test Name: COVID-19 test; Test Result: Positive
CDC Split Type: USPFIZER INC202101064357

Write-up: Tested positive to covid; Tested positive to covid; This is a spontaneous report from a contactable consumer (patient herself). A non-pregnant 55-year-old female patient received BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine), dose 1 via an unspecified route of administration, administered in left arm, on 25Feb2021 (Batch/Lot Number: EL3247) as DOSE 1, SINGLE, and dose 2 via an unspecified route of administration, administered in left arm, on 18Mar2021 (Batch/Lot Number: EL3247) as DOSE 2, SINGLE, for COVID-19 immunization, Age at Vaccination: 55 years (as reported). Relevant medical history includes high blood pressure. Prior to vaccination, the patient was not diagnosed with COVID-19. Patient had no known allergies. Concomitant medications included losartan and vitamins nos (DAILY VITAMINS), both taken for an unspecified indication, start and stop date were not reported. On 15Aug2021, patient had runny nose, cough, headache, sore throat, chills without fever, watery eyes, heavy eyes. Then on 16Aug2021, patient tested positive to COVID. No treatment was received for the events. Since the vaccination, the patient had been tested for COVID-19 via nasal swab on 16Aug2021 with result positive. Facility where the most recent COVID-19 vaccine was administered was at a workplace clinic. The outcome of the events was not recovered.


VAERS ID: 1657898 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-07
Onset:2021-08-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Brain injury, Emotional disorder, Inflammation, Investigation, Malaise, Pain, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: microscopic research; Result Unstructured Data: Test Result:dangers possibility of blood clotting
CDC Split Type: USPFIZER INC202101097612

Write-up: i see stacked cells and dangers possibility of blood clotting; Feeling deathly ill; Cellularly my body having difficult time communicating to my brain; Inflammation of many internal organs; physical internal pain; i am deeply intuitively feeling that this is spiritual warfare; This is a spontaneous report from a contactable consumer (patient). A 28-year-old male patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration, administered in arm right on 07Aug2021 14:00 (Lot Number: EW0217) at age of 28-year-old as single dose for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. No other vaccine in four weeks.The patient experienced Its a poison to my body, Feeling deathly ill, Cellularly my body having difficult time communicating to my brain., Inflammation of many internal organs never felt this way ever in my life. After conducting microscopic research with microscope I see stacked cells and dangers possibility of blood clotting. As a spiritual being who communicates with divine entities, This is 100% the work of the devil. Not only am I receiving physical internal pain but I am deeply intuitively feeling that this is spiritual warfare. Adverse event start date was 15Aug2021 at time of 14:00. AE resulted in: Life threatening illness (immediate risk of death from the event). No treatment received. No covid prior vaccination. No covid tested post vaccination. The outcome of events was not recovered. No follow up attempts are possible. No further information is expected.


VAERS ID: 1658365 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-04
Onset:2021-08-15
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 8/15/21 = 30.6
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1658583 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Viibryd 40mg, Trazadone 100mg, zolpidem 5mg, atorvastatin 20mg, vitamin B12, astaxathin
Current Illness: High cholesterol
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No nurse at the doctor office said it''s normal side effects
CDC Split Type:

Write-up: Extreme headache, fatigue, tiredness, muscle pain for the past 14 days. Lack of energy to perform on a daily basis, Taking Excedrin daily by pain comes back after 3 hours of taking it.


VAERS ID: 1658652 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-21
Onset:2021-08-15
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Constipation, Decreased appetite, Dyspnoea, Infrequent bowel movements, Oxygen saturation decreased, Pneumonia
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), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, bisoprolol, levothyroxine, rosuvastatin, spironolactone
Current Illness:
Preexisting Conditions: hypertension, MI, hyperlipidemia, and hypothyroidism
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/15/21: Presenting today for evaluation of shortness of breath and constipation. According to EMS report patient oxygen saturation was 90% on room air and was placed on 4 L oxygen with brought patient oxygen saturation up to 97%.. She reported her last bowel movement was 3 days ago, she has been experiencing decreased appetite for the past 7-10 days. Note: patient previously received the COVID-19 Moderna Vaccine: First dose: 03/24/21 Lot Number 0474A21A; Second dose: 04/21/21 Lot Number 039B21A Diagnosed with acute hypoxic resp failure due to COVID, pneumonia 8/18/21: patient discharged


VAERS ID: 1658777 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-28
Onset:2021-08-15
   Days after vaccination:140
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Decreased appetite, Nausea, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Anemia Bradycardia Cognitive impairment COPD type A DM2 (diabetes mellitus, type 2) HTN (hypertension) Hypertension
Allergies: No Known
Diagnostic Lab Data: 8/29/2021: SARS COV2PCR Positive
CDC Split Type:

Write-up: Patient is a 65-year-old male who presents to the hospital brought in by his family for generalized weakness and decreased appetite for about 2 weeks. Patient also complains of nausea without any vomiting and shortness of breath.


VAERS ID: 1658816 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-08-15
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: diabetes, hypertension
Allergies:
Diagnostic Lab Data: Cycle threshold 8/14/21 = 29.7
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1658820 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-20
Onset:2021-08-15
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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: Cycle threshold 8/15/2021 = 25
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1658859 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Peripheral artery occlusion, Peripheral artery thrombosis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Telmisartan, Fenofibrate, Actos, Janumet, Tresiba, Omeprazole
Current Illness: None
Preexisting Conditions: Diabetic
Allergies: None
Diagnostic Lab Data: Dr visit . Hospital for ultrasound.
CDC Split Type:

Write-up: Blood clots in left leg. Ultrasound results Femoral Vein Thrombus present in femoral vein in distal thigh. Popliteal Vein Occlusive thrombus present. Calf Veins Visualized tibial veins demonstrate thrombus.


VAERS ID: 1658964 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-08-15
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Diarrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate, allopurinol, amitriptyline, atorvastatin, buspirone, carvedilol, cholecalciferol, escitalopram, omeprazole, senna
Current Illness:
Preexisting Conditions: CVA with residual left side hemiparesis, MI, hypertension, epilepsy, Crohn''s disease, anemia, chronic kidney disease, seizure disorder, anxiety and depression.
Allergies: sulfa, codiene
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/15/21: admitted. presented to the ER for further evaluation of Vomiting and diarrhea for the past week. tested positive for covid on 8/15/21. diagnosed with covid 19 pneumonia. Note, patient previously vaccinated with J&J vaccine on 3/13/21. 8/21/21: Discharged to home.


VAERS ID: 1659002 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-08-15
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bombivent Resppimat inhalation aerosol, ASA, Plavix, esomeprazole, levothyroxine, montelukast, rosuvastin, Wellbutrin XL, depakote, symbicort inhalation aerosol, Topral XL, sertaline, metformin, topiramate, donepezil, vitamin C, ProAir HFA
Current Illness:
Preexisting Conditions: Bipolar, COPD, CHF, GERD, Coronary arteriosclerosis, hyperlipidemia, PTSD, impaired glucose tolerance, poss dementia
Allergies: no known
Diagnostic Lab Data: Positive COVID test 8/14/2021
CDC Split Type:

Write-up: 8/15/2021 Admit to hospital with breakthrough COVID. Cough, SOB, body aches and chest tightness. Diagnosed with COVID pneumonitis. Note: patient previously vaccinated with Pfizer COVID-19 vaccine, 2nd dose on 5/5/21. 8/20/21: DIscharged on 2 weeks of outpatient IV antibiotics.


VAERS ID: 1659131 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-07
Onset:2021-08-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Fatigue, Heart rate increased, Muscle spasms, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: 2 weeks after shot: extreme pins and needles in arm and legs, fatigue, dizziness, nausea, muscle spasms 3 weeks after shot: pins and needles went away, now having high resting heart rate at 90bpm, goes up to 130 when standing. Gi issues, fatigue/dizziness comes and goes. Muscle spasms still but now occasional.


VAERS ID: 1659190 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-08-15
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, hypertension
Allergies:
Diagnostic Lab Data: Cycle threshold 8/15/21 = 29.2
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1659205 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-22
Onset:2021-08-15
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 8/15/21 = 22.3
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1659232 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-08-15
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cycle threshold 8/15/21 = 26.8
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1659465 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Hypoaesthesia, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Started cramping a few days after shot and my period had ended a whole week before the shot? Constant Tingling, numbness over the pass few weeks
Allergies: None
Diagnostic Lab Data: None as of yet
CDC Split Type:

Write-up: Tingling, numbness in legs and arms over weeks? random abdominal cramping


VAERS ID: 1661044 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-01-01
Onset:2021-08-15
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphonia, Extra dose administered, Fatigue, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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: JUBLIA; ATORVASTATIN; GLIPIZIDE; METFORMIN; TIVICAY; FEBUXOSTAT; LORAZEPAM
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: heavy voice; sore throat; fever; fatigue; Extra dose administered; This spontaneous case was reported by a consumer and describes the occurrence of DYSPHONIA (heavy voice), OROPHARYNGEAL PAIN (sore throat), EXTRA DOSE ADMINISTERED (Extra dose administered), PYREXIA (fever) and FATIGUE (fatigue) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 066D21A) for COVID-19 vaccination. Concomitant products included EFINACONAZOLE (JUBLIA), ATORVASTATIN, GLIPIZIDE, METFORMIN, DOLUTEGRAVIR SODIUM (TIVICAY), FEBUXOSTAT and LORAZEPAM for an unknown indication. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Aug-2021, the patient experienced EXTRA DOSE ADMINISTERED (Extra dose administered). On 16-Aug-2021, the patient experienced DYSPHONIA (heavy voice), OROPHARYNGEAL PAIN (sore throat), PYREXIA (fever) and FATIGUE (fatigue). At the time of the report, DYSPHONIA (heavy voice), OROPHARYNGEAL PAIN (sore throat), EXTRA DOSE ADMINISTERED (Extra dose administered), PYREXIA (fever) and FATIGUE (fatigue) outcome was unknown. Treatment information was also not reported.


VAERS ID: 1661152 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Fatigue, Headache, Heart rate increased, Hot flush, Hyperhidrosis, Myalgia, Pyrexia, Syncope, Vaccination site bruising, Vaccination site pain
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIIBRYD; HAILEY 1.5/30; CLARITIN-D; PROBIOTIC 10
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy narcotic/opioid pain medications, Pregabalin; Endometriosis; Fibromyalgia; Myofascial pain syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101069954

Write-up: This is a spontaneous report from a contactable consumer (patient). A 26-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FC3181 and expiration date was not reported), dose 1 via an unspecified route of administration, administered in Arm Left on 15Aug2021 at 11:15 AM as a single dose for covid-19 immunization (at the age of 26-years-old). Medical history included fibromyalgia, myofascial pain syndrome, and endometriosis. Concomitant medications included VIIBRYD, HAILEY 1.5/30, CLARITIN-D, and PROBIOTIC 10 taken for an unspecified indication. The patient had known allergies of took opioids (narcotic/opioid pain medications) and pregabalin. Patient had not been diagnosed with COVID-19 prior to vaccination and had not been tested for COVID-19 since the vaccination. Patient did not receive other vaccine within 4 weeks prior to the COVID vaccine. The patient had not taken any treatment for reported events. On 15Aug2021 at 12:15 PM, the patient experienced dizziness, confusion/difficulty focusing, fever, fatigue/tiredness, weakness/fainting, fast heartbeat, muscle aches, headache, injection site pain, and bruising and hot flashes/sweating. The outcome of all the events was recovering.


VAERS ID: 1661227 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-18
Onset:2021-08-15
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Dysgeusia, Fatigue, Joint stiffness, Nasal congestion, Nasopharyngitis, Parosmia, Pyrexia, SARS-CoV-2 test, Taste disorder, Throat irritation, Tongue discomfort, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Test Date: 202108; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101091573

Write-up: Breakthrough COVID/ PCR: Nasal Swab: Positive; Breakthrough COVID/ PCR: Nasal Swab: Positive; Breakthrough COVID-acidic mouth; burnt tongue sensation; scratchy throat; mild cold symptoms; cough/ dry hacking cough; Congestion/Nasal stuffiness; joint stiffness; low grade fever; limited taste and smell; limited taste and smell; fatigues; This is a spontaneous report from a contactable consumer or other non-HCP. A 57-year-old female patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- EL9264) intramuscularly on 28Jan2021 as dose 1, single and received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- EM9809) intramuscularly on 18Feb2021 as dose 2, single (at the age of 57-years-old) for COVID-19 immunization. Patient was not pregnant at the time of vaccination. Patient did not have COVID-19 prior to vaccination and was tested for COVID-19 post vaccination. Vaccination facility type was reported as Pharmacy or Drug Store. It was unknown if patient received any other vaccine in four weeks. The patient medical history and concomitant medications were not reported. The patient experienced break-through COVID-19, COVID/PCR (nasal swab) test with result as positive (COVID-19), breakthrough covid-acidic mouth, burnt tongue sensation, scratchy throat, mild cold symptoms, stuffy nose, cough/dry hacking cough, congestion, joint stiffness, low grade fever, limited taste and smell, fatigue on 15Aug2021 20:00. Patient did not receive any treatment for the adverse events. The patient underwent lab tests and procedures which included Sars Cov-2 PCR Test Nasal Test (reported as polymerase chain reaction (Nasal Swab)) with result as positive on an unspecified date in Aug2021. The outcome of events was resolved on an unspecified date in Aug2021. Follow-up (26Aug2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1662239 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-24
Onset:2021-08-15
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Body temperature increased, COVID-19, Cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin; Lisinopril; Acetamide; Carbinol; Nasacort; Multivitamin
Current Illness: N/a
Preexisting Conditions: Heart disease; chronic lung condition bronchiectasis; history of pneumonia
Allergies: N/a
Diagnostic Lab Data: Covid PCR test 8/17/2021 positive
CDC Split Type: vsafe

Write-up: On August 15th I have a temperature elevation and deep in the lung coughing, body weakness and loss of taste and smell. August 17th, 2021, I was positive for Covid 19. No treatment was received, I was home and rested and recovered in eight days. I had maintained 98% O2 saturation throughout the week and that is all the information I have. I had contacted the Dr. on Monday August 16th and that was why I went to get tested.


VAERS ID: 1662322 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram thorax normal, Dizziness, Electrocardiogram abnormal, Electrocardiogram ambulatory, Full blood count normal, Hypoaesthesia, Metabolic function test, Paraesthesia, Scan with contrast, Tachycardia, Troponin normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ollie Probiotics to help support the immune system Ollie Prenatal to help hormones to get pregnant Albuteral inhaler as needed Flonase daily
Current Illness: N/A
Preexisting Conditions: Polycystic Ovarian Syndrome Elevated prolactin level Pituitary abnormally Pituitary microadenoma
Allergies: N/A
Diagnostic Lab Data: Chest X-Ray, Chest CT with and without contrast, Troponin levels, EKG 12 Lead, CBC Panel, and a Basic Metabolic Panel. All completed on 8/23/21 in the emergency department. All showed no signs of myocarditis or pericarditis, was diagnosed with tachycardia and sent to my primary for a follow up. Was given a 48-Hour Holter monitor on Thursday 8/26/21 and am waiting the results of that.
CDC Split Type:

Write-up: Numbness, tingling in arms and legs started 3 days after second shot, worsening this will be going on week three with no relief Tachycardia started during week two, visited my primary and hospital Lightheaded/Dizziness started three days after the second shot, worsens with activity and sudden standing going on week three with no relief Had a visit with my primary doctor on 9/1/21 and was told to file a report with VAERS and given a referral to neurology. I will also be taking Claritin and Pepcid to try to curve and give relief to the symptoms I am having, this was recommended by my primary doctor.


VAERS ID: 1662492 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3118 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None only had health decline after mRNA specifically myocarditis and brain fog
Current Illness: None I am really healthy
Preexisting Conditions: None
Allergies: None am non allergic
Diagnostic Lab Data: The mRNA vaccine that?s giving people long COVID cause it is improperly designed
CDC Split Type:

Write-up: I would not loose things or be slow to remember them as I do now and when I get anxiety it is completely different it?s like my heart is trying to lose control


VAERS ID: 1662517 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-02
Onset:2021-08-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Circumstance or information capable of leading to medication error, Extra 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received first dose of J+J on 8/2/2021 Lot # 043A21A. Then returned with a different ID stating - same DOB but different address on 8/15/2021 to our location and received dose #2 of J+J to right arm again that Lot # is- 042A21A.


VAERS ID: 1662608 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Gait disturbance, Inflammation, Laboratory test, Loss of personal independence in daily activities, Magnetic resonance imaging, Nausea, VIIIth nerve injury, Vertigo, Vestibular disorder, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast- 10mg, Trazadone 75mg at bedtime
Current Illness: Zero
Preexisting Conditions: Asthma
Allergies: Zero
Diagnostic Lab Data: MRI, blood work, ENT visits, Vestibular Neurology Specialist appointment. Many tests performed. Diagnosed with vestibular nerve damage & inflammation. Have been put on several new drugs including diuretic, Klonopin, Vatrex (on 3rd round). Also referred for vestibular rehab to help me be able to function since this is very dangerous since I live alone!
CDC Split Type:

Write-up: Vestibular/neurological issues. Very severe vertigo, nausea, difficulty walking, focusing, and doing everyday functions!!!


VAERS ID: 1662954 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Paraesthesia, Peripheral swelling, Sleep disorder, Throat irritation
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: 1st covid vaccine in July: fatigue, fever for 4 days. 2nd dose of covid vaccine: itchy throat, burning paresthesias of arms, swelling of hands x 2 weeks. Improved on ibuprofen and acetaminophen. Can''t sleep due to her paresthesias.


VAERS ID: 1663008 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-02
Onset:2021-08-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood iron, Full blood count, Haemoglobin, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Vitamin D deficiency
Allergies: NKDA
Diagnostic Lab Data: CBC, iron panel, hcg
CDC Split Type:

Write-up: abnormal vaginal bleeding 2 weeks after vaccine. Occurred 2 weeks after normal menstural cycle.


VAERS ID: 1663611 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-09
Onset:2021-08-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood pressure fluctuation, Chest pain, Feeling cold, Feeling hot, Heart rate irregular, Insomnia, Oropharyngeal pain, SARS-CoV-2 test negative, Sensory disturbance, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Famotidine, Super C, D3 2000, B100 Complex,
Current Illness: Gall stones, headaches - slight, but bothersome, slight high blood pressure
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: ER did not find anything. Said it is related to gall stones and reflux. I told the doctor that I had some of the same symptoms when I had Covid back in May 2021 before I had the vaccination. He said that even though I did not test positive for Covid again, it could be symptoms still hanging on. There has not been enough study of Covid or the vaccination to know.
CDC Split Type:

Write-up: My body was not the same as before the shot! I have a strange sensation throughout my body almost constantly. I have chest pain or center back pain. It is hard to tell. My blood pressure and heart rate have been all over the place. I have cold & hot sensations. My throat is sore & feels like it is closing in on me sometimes. I can''t seem to sleep longer than four hours at a time most nights, even with a sleeping pill.


VAERS ID: 1665385 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Blood test, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: Medical History/Concurrent Conditions: Prostate cancer (Patient had been treated and was remission); Comments: No known allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: Blood test; Result Unstructured Data: Not reported; Test Date: 20210815; Test Name: Antibody test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210854788

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 62 year old, male. The patient''s height, and weight were not reported. The patient''s past medical history included diagnosed with prostate. Other pre-existing medical conditions included No known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: 23-AUG-2021) dose was not reported, frequency one total, administered on 05-MAY-2021 for prophylactic vaccination on left arm. No concomitant medications were reported. Patient got the JNJ Covid 19 vaccine on 05-MAY-2021. He had a blood work done with an antibody test on 15-AUG-2021 result was negative (coded to confirmed immunological vaccine failure). He did not mentioned the name of the antibody test. He also stated that he did not had the confidence in the JNJ booster shot since the first shot did not worked. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000191134.; Sender''s Comments: V0:20210854788-Covid-19 vaccine ad26.cov2.s- confirmed immunological vaccine failure. This event is considered not related. The event 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 than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1665433 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-15
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Constipation, Deep vein thrombosis, Fatigue, Insomnia, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210859224

Write-up: ABDOMINAL PAIN WHICH WAS REALLY UNCOMFORTABLE/STOMACH CRAMPING THAT WAS BRUTAL; TROUBLE SLEEPING; CONSTIPATED; FATIGUE; DEEP VEIN THROMBOSIS; STOMACH BLOATING; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, 1 total start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 15-AUG-2021, the patient experienced stomach bloating. The patient felt "blocked up", and thought it was just fatigue. The patient had stomach cramping that was brutal. The patient had a bowel movement the night before reporting that brought some relief, but then the pain started across his abdomen, which he described as really uncomfortable. It was reported that, he was given one dose on the day of discharge from the hospital, then was taking two XARELTO tablets daily for his deep vein thrombosis. The patient felt like someone took their fist and punched him hard in the stomach. On an unspecified date, the patient was constipated and had trouble sleeping. The patient took covid-19 test and it was negative. The patient was thinking to visit the emergency room, but was not certain if he should go. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from stomach bloating on 19-AUG-2021, had not recovered from constipated, and the outcome of fatigue, abdominal pain which was really uncomfortable/stomach cramping that was brutal, trouble sleeping and deep vein thrombosis was not reported. This report was serious (Hospitalization Caused / Prolonged). This case, involving the same patient is linked to 20210843197.; Sender''s Comments: V0:20210859224-JANSSEN COVID-19 VACCINE Ad26.COV2.S - deep vein thrombosis, stomach bloating ,abdominal pain which was really uncomfortable ,constipated, trouble sleeping - This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). V0: 20210859224-JANSSEN COVID-19 VACCINE Ad26.COV2.S- fatigue-This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1665584 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-07
Onset:2021-08-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest injury, Erythema, Limb discomfort, Limb injury, Mobility decreased, Swelling, Vaccination site erythema
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Accidents and injuries (narrow), 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? 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.MOD20212

Write-up: Something hit his shoulder,It''s a pretty hard hit; there is a little red on the top of his shoulder; there is a little swelling on the top of his shoulder; Turned red around the skin area where he got the vaccine; something hit his chest; His right hand feels very heavy; He could hardly lift it up to his head level; This spontaneous case was reported by a consumer and describes the occurrence of CHEST INJURY (something hit his chest) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 091D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 07-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Aug-2021, the patient experienced LIMB DISCOMFORT (His right hand feels very heavy) and MOBILITY DECREASED (He could hardly lift it up to his head level). On an unknown date, the patient experienced CHEST INJURY (something hit his chest) (seriousness criterion medically significant), LIMB INJURY (Something hit his shoulder,It''s a pretty hard hit), ERYTHEMA (there is a little red on the top of his shoulder), SWELLING (there is a little swelling on the top of his shoulder) and VACCINATION SITE ERYTHEMA (Turned red around the skin area where he got the vaccine). At the time of the report, CHEST INJURY (something hit his chest), LIMB DISCOMFORT (His right hand feels very heavy), MOBILITY DECREASED (He could hardly lift it up to his head level), LIMB INJURY (Something hit his shoulder,It''s a pretty hard hit), ERYTHEMA (there is a little red on the top of his shoulder), SWELLING (there is a little swelling on the top of his shoulder) and VACCINATION SITE ERYTHEMA (Turned red around the skin area where he got the vaccine) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No relevant concomitant medications were reported No treatment information was provided.


VAERS ID: 1665628 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088021A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Allergy to vaccine, Fatigue, Lymphadenopathy, Myalgia, Urticaria, Vaccination site pain, Vaccination site rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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.MOD20212

Write-up: Had an allergic reaction to Moderna Covid-19 vaccine; Broke out in hives around eyes/broke out in hives on nose/broke out in hives behind her ears; Broke out in rash on her injection site right arm.; Broke out in Hives on her injection site right arm.; Achy; Tired; Swollen lymph nodes in my right arm pit; Sore right injection site arm; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Broke out in Hives on her injection site right arm.), ALLERGY TO VACCINE (Had an allergic reaction to Moderna Covid-19 vaccine), URTICARIA (Broke out in hives around eyes/broke out in hives on nose/broke out in hives behind her ears), VACCINATION SITE PAIN (Sore right injection site arm) and VACCINATION SITE RASH (Broke out in rash on her injection site right arm.) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 088021A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Aug-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE PAIN (Sore right injection site arm). On 18-Aug-2021, the patient experienced LYMPHADENOPATHY (Swollen lymph nodes in my right arm pit). On 19-Aug-2021, the patient experienced MYALGIA (Achy) and FATIGUE (Tired). On 20-Aug-2021, the patient experienced URTICARIA (Broke out in Hives on her injection site right arm.) and VACCINATION SITE RASH (Broke out in rash on her injection site right arm.). On 24-Aug-2021, the patient experienced URTICARIA (Broke out in hives around eyes/broke out in hives on nose/broke out in hives behind her ears). On an unknown date, the patient experienced ALLERGY TO VACCINE (Had an allergic reaction to Moderna Covid-19 vaccine). On 20-Aug-2021, MYALGIA (Achy) and FATIGUE (Tired) had resolved. At the time of the report, URTICARIA (Broke out in Hives on her injection site right arm.), ALLERGY TO VACCINE (Had an allergic reaction to Moderna Covid-19 vaccine), URTICARIA (Broke out in hives around eyes/broke out in hives on nose/broke out in hives behind her ears), VACCINATION SITE PAIN (Sore right injection site arm), VACCINATION SITE RASH (Broke out in rash on her injection site right arm.) and LYMPHADENOPATHY (Swollen lymph nodes in my right arm pit) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication not reported. Treatment medication not reported. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of events, a causal relationship cannot be excluded. Case downgraded to non-serious due to the lack of evidence of seriousness from a regulatory or clinical standpoint for the events.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of events, a causal relationship cannot be excluded. Case downgraded to non-serious due to the lack of evidence of seriousness from a regulatory or clinical standpoint for the events.


VAERS ID: 1665726 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1665731 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1665986 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1665987 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1666076 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1666079 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1666108 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1666133 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1666255 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-25
Onset:2021-08-15
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Blood sodium decreased, COVID-19, Chest X-ray, Chills, Cough, Decreased appetite, Dyspnoea, Dyspnoea exertional, Fatigue, Headache, Hyponatraemia, Hypophagia, Oropharyngeal pain, Oxygen saturation decreased, Pain, Pyrexia, SARS-CoV-2 test positive, Tachypnoea, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin (ADULT LOW DOSE ASPIRIN) 81 mg Oral Tab Takes Regularly Sig: Take 81 mg by mouth daily Atorvastatin (LIPITOR) 20 mg Oral Tab Takes Regularly Sig: Take 1 tablet by mouth daily TO PREVENT HEART ATTACKS AND STROKES Benzonatate (TESSALO
Current Illness: None
Preexisting Conditions: history of hypertension, hyperlipidemia, diabetes mellitus type 2
Allergies: Metformin - Tolerates it but has some loose stools
Diagnostic Lab Data: 8/21/2021 19:53 NA: 121 (L) 8/21/2021 21:20 NA: 123 (L) 8/22/2021 05:35 NA: 128 (L) 8/23/2021 07:21 NA: 131 (L) 8/24/2021 06:28 NA: 133 (L) 8/26/2021 06:13 NA: 136 XRAY CHEST ** HISTORY **: 57 years old, COUGH Possible COVID patient ** TECHNIQUE **: 1 view of the chest acquired. COMPARISON: Radiograph 3/9/2020 ** FINDINGS **: LUNGS: There are subtle patchy opacities in the midlungs bilaterally. No effusion. MEDIASTINUM/OTHER: Normal cardiomediastinal silhouette.
CDC Split Type:

Write-up: 57 Y male with with history of hypertension, hyperlipidemia, diabetes mellitus type 2, received 2 doses of Pfizer COVID19 vaccines on 4/2021 presents on 8/21/21 with shortness of breath. Patient had URI symptoms with cough since 8/15/21 that progressed to fever, chills and body aches on 8/16/21 then was seen in clinic on 8/18/21 for fever of 102F and sore throat, tested positive for COVID-19 on 8/19/21. Patient had a follow up telephone appointment with his doctor on 8/20/21 for persistent fever, fatigue, body aches and headache, then another telephone appointment on 8/21/2021 where patient reported SpO2 90-93% at rest with mild shortness of breath and was advised to go to the emergency department if his SpO2 dropped to less than 90%. Patient noted SpO2 drop to 88% so he presented to the emergency department on 8/21/2021, was noted to have SpO2 89% with ambulation with tachypnea and increased work of breathing so hospital medicine was consulted. Patient was also found to be hyponatremia at 121, repeat was 123. Patient reports shortness of breath with exertion but not too bad when resting. Patient reports poor oral intake in the past 4 days due to poor appetite but drinking lots of water (10 bottles per day). FAILURE (8/21/2021) Symptom onset on 8/15/21. COVID positive on 8/19/21. He completed a 5 day course of remdesivir. His O2 remains stable at 2L at rest and 4L with exertion. He will complete his decadron course at home with 4 more doses. He is referred to oxygen clinic as well as for sleep study due to his concern for OSA. HYPERLIPIDEMIA (2/7/2011) He was continued on his PTA statin. DM 2 (4/10/2012) Patient takes Glipizide and Metformin as outpatient which have been held. He was on NPH 6u BID and ISS while admitted. His PTA meds were resumed at discharge. HYPONATREMIA (8/21/2021) Etiology most likely secondary to poor oral intake; patient also reported drinking increased water prior to admission. On date of discharge Na was WNL at 136. Reason for Hospital Admission (Admitting Diagnosis): Acute hypoxemic respiratory failure - Pt Discharged on 8/26/21


VAERS ID: 1666501 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Lethargy
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis 5 mg, Sotalol 80 mg, Furosemide 20 mg, Ocuvite eye health gummies, Womens once a day vitamins
Current Illness: None but had a heart ablation on June 8th, 2021
Preexisting Conditions: Have been fighting AFib since November 2020.
Allergies: Latex adhesive and Streptomycin
Diagnostic Lab Data: None to date. Have appt with cardiologist on Sept. 29th, 2021
CDC Split Type:

Write-up: Shortness of breath, lightheadedness, lethargy


VAERS ID: 1666605 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-14
Onset:2021-08-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053B21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation
SMQs:, Peripheral neuropathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: risteridone quetiatine ergocalciferol pravatin
Current Illness:
Preexisting Conditions:
Allergies: latuda laminal bruspar
Diagnostic Lab Data: went to clinic the following sunday and they just told her to take ibuprofen
CDC Split Type:

Write-up: Intense burning throughout whole body, lasted full day after the vax on 8/14


VAERS ID: 1666758 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-15
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, COVID-19, Chills, Diarrhoea, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:08/23/21 Symptom onset:08/15/21 Exposure:Home Symptoms:fever,muscle aches, abd pain, loss of smell/taste, sore throat,diarrhea, runny nose chills.


VAERS ID: 1666847 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Desvenlafaxine
Current Illness: None
Preexisting Conditions: Anxiety, Panic Attacks
Allergies: Fin Fish, Shellfish
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: I have had (2) cases of urticaria in a short period of time since my vaccination and have not eaten any foods that can trigger my food allergy. Any epinephrine injection was required to combat anaphylaxis. Stomach issues still persist.


VAERS ID: 1666848 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-08-12
Onset:2021-08-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Gastric disorder, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Desvenlafaxine
Current Illness: None
Preexisting Conditions: Anxiety, Panic Attacks
Allergies: Fin Fish, Shellfish
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: I have had (2) cases of urticaria in a short period of time since my vaccination and have not eaten any foods that can trigger my food allergy. Any epinephrine injection was required to combat anaphylaxis. Stomach issues still persist.


VAERS ID: 1669852 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Booster Given Too Late-


VAERS ID: 1670619 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-15
Onset:2021-08-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1670662 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-27
Onset:2021-08-15
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Hallucination, Neurological examination, Pericardial effusion, Pericardial excision, Pericardial haemorrhage, Pulmonary mass, X-ray
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril Metformin Amlodipine besylate One a day multivitamin Aredds 2
Current Illness: N/A
Preexisting Conditions: High blood pressure Diabetic
Allergies: Codeine Hydromet Zithromax
Diagnostic Lab Data: CAT scans, EKG, XRay, Blood work, Neurological evaluation, pericardial window placed. August 19, 2021- August 31, 2021.
CDC Split Type:

Write-up: Blood and fluid in pericardial sac, hallucinations, mass in lung


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