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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 136 out of 6,867

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VAERS ID: 1571222 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Famvir 250mg 2x a day
Current Illness:
Preexisting Conditions:
Allergies: Iodine contrast, wheat sensitivity.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large red welt at injection site


VAERS ID: 1573320 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram ST segment abnormal, Myocarditis, Painful respiration, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient received his second dose of Pfeizer''s COVID-19 vaccine on 8/12/2021; on 8/14/2021, the patient developed chest pain. On 8/15/2021, the patient had recurrence and worsening of his chest pain. He was admitted to the hospital and was found to have elevated troponins, electrocardiogram with nonspecific ST changes. His chest pain also worsens with deep inspirations. There was suspicion for Myopericarditis.


VAERS ID: 1573588 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Lymphadenopathy, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Swelling at Injection Site-Mild, Systemic: Lymph Node Swelling-Mild, Additional Details: Patient came to pharmacy with slightly swollen arm at site of injection, warm to touch and a swollen lymph node slightly red in appearance, warm to touch on the left side of patient''s body near the neck. Patient was instructed to take benadryl and to draw a circle around both sites of swelling to monitor. This started about 24 hours post-vaccination. Patient was instructed to seek help at Urgent Care or ER regarding further treatment if swelling did not go away.


VAERS ID: 1573592 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient received vaccine, sat for 15 mins. After 15 min patient walked around and faint. Patient recover consciousness and EMT arrived to check vitals which were all normal. Patient was followed up and feeling better.


VAERS ID: 1573632 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

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

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

Write-up: By about 18 hrs (@ 10:00AM on 8/14/21) after 2nd dose of my Pfizer Covid vaccine, the headache started and then by 21 hrs (@ 1:00 PM on 8/14/21) vomiting began. Felt better after vomiting but still had a headache. Then by 31hrs (@11:00PM on 8/14/21) vomiting began again, but felt some relief immediately after. After first event, (2) 500mg Acetaminophen (@1:30 on 8/14/21) tablets were taken and then (@10:00AM on 8/15/21) because headache was still present. Then, (@ 7:00AM on 8/16/21) due to persistent headache.


VAERS ID: 1573794 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Migraine, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nausea, vomiting, migraine, fever (100?), body aches, fatigue


VAERS ID: 1573796 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-26
Onset:2021-08-14
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: patient has no COVID related symptom but has admitted with hypotensive event


VAERS ID: 1573820 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-07
Onset:2021-08-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

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

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

Write-up: swelling/ redness/itching on left arm at injection site.


VAERS ID: 1573843 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-07
Onset:2021-08-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multivitamin, daily Allegra for seasonal allergies
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Hives all over body. First observed on forearms and lower back. They were then observed all over the body. I went to the ER at hospital in city, state. They administered Prednisone, Benedryl, and Pepcid. I was discharged from the hospital with a script for prednisone. Symptoms started occurring the following day (Sun 8/15) and benedryl/prednisone combination appeared to help symptoms. The next morning (Mon 8/16) symptoms arose again, with hives on arms, legs, neck, feet, and head. Doctor visit is scheduled but if symptoms do not subside I will need to visit the ER again (Mon 8/16).


VAERS ID: 1573847 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-15
Onset:2021-08-14
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Diarrhoea, Nausea, Pain, SARS-CoV-2 test positive, Suicidal ideation, Vaccine breakthrough infection
SMQs:, Acute pancreatitis (broad), Suicide/self-injury (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: EtOH abuse, schizoaffective/bipolar disorder, polysubstance abuse
Allergies: buspirone (palpitations), clozapine (palpitations), nicotine patch (dermatitis), olanzapine (palpitations), haloperidol (GI intolerance)
Diagnostic Lab Data: 8/14/21 SARS-CoV-2 detected.
CDC Split Type:

Write-up: Breakthrough COVID (partially vs fully vaccinated?). Patient received one dose of Pfizer vaccine, but states he completed 2 shots of Pfizer in July. Could not be confirmed. Admitted for suicidal ideation with an incidental finding of COVID. Patient is symptomatic with chills, body aches, diarrhea, nausea, but no respiratory symptoms.


VAERS ID: 1573851 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-02
Onset:2021-08-14
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Coreg, Vitamin D, Vitamin B, Digoxin, glipizide, Synthroid, metformin ER, Xarelto, onglyza
Current Illness:
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was fully vaccinated as of April 2021 and resulted in testing positive for COVID on 8/14/2021 and has been admitted to the hospital


VAERS ID: 1573858 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-29
Onset:2021-08-14
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA, Norvasc, Lipitor, Jardiance, Vitamin D3, Lasix, glipizide, metformin, actos, ozempic, Zoloft, testosterone
Current Illness:
Preexisting Conditions: DM II, HTN, Sleep apnea
Allergies: Not on file
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated in April 2021. Now presented to ED and has been hospitalized with COVID-19 infection.


VAERS ID: 1573861 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Tingling in arm half of face swollen back pain


VAERS ID: 1573888 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Discomfort, Oedema peripheral, Pain, Sleep disorder, Vaccination site pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: current: Vitamin B, Nicotinamide, Vitamin D, Resveratrol 3- days prior to vaccination: completed 7 day course of Amoxicillin post tooth extraction
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: none to date
CDC Split Type:

Write-up: 34+ hours post vaccination noted swelling of left armpit. Swelling feels large and soft and localized in armpit- approximately 2 inches long x 1 inch wide - enough to make bring arm from open to closed position noticeable and uncomfortable. Some pain toward back of armpit that caused me to wake up when changing positions during sleep. Vaccination site in left arm tender but not red or swollen. No other noticeable side effects.


VAERS ID: 1573894 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue
SMQs:

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

Write-up: Fatigue lasted for 12 hours, then returned the next day not as bad


VAERS ID: 1573898 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-08-14
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/14/21 COVID-19/SARS-COV2, NAAT POSITIVE
CDC Split Type:

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


VAERS ID: 1573952 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-08-14
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Constipation, Cough, Diarrhoea, Drainage, Dysuria, Flank pain, Influenza like illness, Nausea, Oropharyngeal pain, Pain, Pollakiuria, Proctalgia, Prostate examination normal, Prostatic specific antigen, Pyrexia, SARS-CoV-2 test positive, Scrotal pain, Urine abnormality, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Proteinuria (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:
Current Illness:
Preexisting Conditions: Allergic rhinitis, cause unspecified Biliary stricture Common bile duct stone GERD Heartburn Hypospadias and epispadias and other penile anomalies Lumbago Mixed hyperlipidemia Motion sickness PONV Pruritus ani Chronic back pain
Allergies: The patient denies any known medication allergies.
Diagnostic Lab Data: Positive for SARS-CoV-2 RNA by PCR Abnormal E Gene Ct cycles 18.4 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. N2 Gene Ct cycles 20.6 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. Resulting Agency MGHL Specimen Collected: 08/13/21 23:37 Last Resulted: 08/14/21 00:19
CDC Split Type:

Write-up: Patient is a 61 y.o. male with history of hypospadias/epispadias who presents to the emergency department for evaluation of urinary issues. A few days ago the patient noticed burning pain in his penis with urination and some residual pain, urinary frequency, and difficulty holding in his urine. The symptoms came on subtly, but have progressively worsened. He urinated 2 times at night last night, which was very unusual. He called a doctor and was told to come in. No hematuria, cloudy urine, fever, chest pain, scrotal pain, penile drainage, nausea, vomiting, constipation, diarrhea, abdominal pain, flank pain, or rectal pain. He denies dietary or lifestyle changes. He is married and not concerned for sexually transmitted infection. As well, the patient has had 4-5 days of sore throat and cough, and was put on a z-pack by his telemedicine doctor 3 days ago. He has taken 2 days of that. He notes he initially had flu-type symptoms, but they have resolved. He has a COVID test scheduled for tomorrow. He has been vaccinated with the Johnson & Johnson COVID-19 vaccine. He had a physical exam 2 months ago, and he reports he had a normal prostate and PSA. He has no history of UTI.


VAERS ID: 1573962 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EW0175 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Feeling hot, Migraine, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: I got light-headed and dizzy and no energy and then I started having a very very very very bad migraine headache I still have somewhat of today and I was burning up I felt like my body was on fire I was really really really hot and I was throwing up


VAERS ID: 1573963 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocarditis, Troponin
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin 903
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1573970 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Headache, Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site warmth, Pyrexia, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mega food blood builder, levothyroxine, allopurinol, metoprolol, enalapril, pantoprazole, ofloxacin
Current Illness: Ear infection
Preexisting Conditions: Hypertension, anemia, obesity, diabetes, hypothyroidism, gout, Gerd, ibs, diverticulitis
Allergies: Bactrim
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Broke out with hives within 2 hours and had a scratchy throat, hard lump at the injection site that grew in size and became red, hot, tender and itchy. Severe diarrhea the following day along with headache, chills, fever, fatigue and joint pain.


VAERS ID: 1573978 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-09
Onset:2021-08-14
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dizziness, Dyspnoea, SARS-CoV-2 RNA increased, SARS-CoV-2 test positive, Suspected COVID-19
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 40 mg oral tablet cyanocobalamin 500 mcg oral Tab glimepiride (AMARYL) 2 mg oral tablet lisinopriL (PRINIVIL) 40 mg oral tablet metFORMIN (GLUCOPHAGE
Current Illness:
Preexisting Conditions: Chronic back pain DVT (deep venous thrombosis) Glaucoma HTN Hypercholesteremia Obesity Pancreatitis Sleep apnea Diabetes mellitus, Type II
Allergies: Fish Oil
Diagnostic Lab Data: PCR Positive for SARS-CoV-2 RNA by PCR Abnormal E Gene Ct cycles 27.0 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. N2 Gene Ct cycles 29.6 Comment: Cycle threshold (Ct) values are not comparable between tests and may not be comparable between different lots of the same test. Currently there is no consensus as to whether or not particular Ct values correlate with a person being or not being infectious or risk level for disease severity. So, appropriate care should be taken with interpretation of Ct values. Resulting Agency Specimen Collected: 08/14/21 08:00 Last Resulted: 08/14/21 09:36
CDC Split Type:

Write-up: Patient is a 57 y.o. male on warfarin with a history of DVT, type II diabetes mellitus, hypertension, and glaucoma who presents to the emergency department alone for evaluation of COVID suspected. The patient states that he developed a cough yesterday and began feeling weak, short of breath, and dizzy. The patient comes to the ED today because he wants to be tested for COVID-19. Here in the ED, the patient endorses cough and light-headedness. The patient denies any known sick contacts. Of note, the patient is vaccinated and works in the hospital. He may have had some contacts secondary to that. He denies any exertional symptoms or chest pain.


VAERS ID: 1573991 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-28
Onset:2021-08-14
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FIORICET FOSAMAX ADDERALL BUSPAR CIPRO VITAMIN B-12 GABAPENTIN MIRTAZAPINE OMEPRAZOLE ZOFRAN OXYBUTYNIN PERCOCET PROMETHAZINE
Current Illness:
Preexisting Conditions: GERD, MMD, ANXIETY, NEUROPATHY, CHRONIC BACK PAIN
Allergies: N/A
Diagnostic Lab Data: POSITIVE COVID TEST
CDC Split Type:

Write-up: WEAKNESS, NAUSEA, DIARRHEA


VAERS ID: 1573997 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA2485 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Crying, Fear, Hallucination
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Of note, he received a series of vaccines at his doctor''s office one week prior to this adverse event.
CDC Split Type:

Write-up: Experienced hallucinations (no history) of his dead relative. He hallucinated once when he walked outside and then again later that day when he walked outside in the yard. By the time I was with him, I checked his temperature which was 100.4 degrees F and I continued to monitor him. He had no further hallucinations since, but he was quite scared and crying at the time.


VAERS ID: 1574008 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-08-14
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 UN / IM

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

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

Write-up: This is a 82-year-old male with past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus, COPD/emphysema with chronic hypoxic respiratory failure requiring 2 L oxygen via nasal cannua every night, obstructive sleep apnea on CPAP every night, paroxysmal atrial fibrillation not on chronic anticoagulation due to history of intracranial bleed in 2020 , sarcoidosis, resident of assisted facility. He has been having symptoms for the last 2 days with cough and shortness of breath. Major symptoms the cough without any significant expectoration. He denies any subjective fevers but does have some chills. Denies any loss of taste or smell. Denies any chest pain or palp 8/14/2021 tested positive This is a 82-year-old male with past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus, COPD/emphysema with chronic hypoxic respiratory failure requiring 2 L oxygen via nasal cannula every night, obstructive sleep apnea on CPAP every night, He has been having symptoms for the last 2 days with cough and shortness of breath. Major symptoms the cough without any significant expectoration. He denies any subjective fevers but does have some chills. Denies any loss of taste of smell. Denies any chest pain or palpitations. Denies any abdominal pain, nausea, vomiting, burning or panful urination, diarrhea. Patient reports that he has been vaccinated with Pfizer vaccine in March and April respectively.


VAERS ID: 1574009 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-23
Onset:2021-08-14
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, Fall, Pelvic pain, SARS-CoV-2 test positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia dementia, history of CVA, history of colon cancer status post resection currently under remission
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: this is a 97-year-old female with past medical history of hypertension, hyperlipidemia dementia, history of CVA, history of colon cancer status post resection currently under remission, DNR, resident of assisted living facility . She came to the hospital with a chief complaint of mechanical fall. Patient reported that she a collapsed on the floor and fell and since then she has been having significant pain in the back and the pelvic region for the last 1 day. History taking limited from the patient due to dementia. Called patient''s daughter on the number listed on the face sheet. Most of the history was obtained from her. The patient lives in an assisted living facility and the staff reported that she collapsed and fell and was complaining of some pain so she was sent to the hospital for further evaluation and treatment. Patient herself denies any other symptoms otherwise apart from pelvic pain. 8/14/2021 tested positive


VAERS ID: 1574018 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-08-14
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 UN / IM

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

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

Write-up: pt experienced a fall from a horse, upon admission to the hospital she was tested for COVID and was positive


VAERS ID: 1574064 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-08-14
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Condition aggravated, Feeling abnormal, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), 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), Dementia (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), 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: unknown, not given in this facility
Current Illness: unknown, not given at this facility
Preexisting Conditions: a fib, hypothyroid,
Allergies: Fluoxetine
Diagnostic Lab Data: SARS-COV-2 PCR
CDC Split Type:

Write-up: Patient reports not feeling quite right with vague symptoms x 1 week. Presented to ED on 8/14 and tested positive for COVID. On 8/15 she came back to facility and was hospitalized. She is also in Afib RVR. Diagnosed with COVID pneumonia, and acuts hopyxemic respiratory failure.


VAERS ID: 1574067 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderma
Other Medications: Symbicort, Spiriva, levothyroxine , losartan, leflunomide , diclofenac, hydroxychloroquine
Current Illness:
Preexisting Conditions: Copd Cavity in rt lung
Allergies: Ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, pain, chills, diarrhea since 08/14/2021 6:00 pm


VAERS ID: 1574072 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Cough, Fatigue, Injection site pain, Lymph node pain, Migraine, Myalgia, Neck pain, Pyrexia, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm soreness at injection site, chills, fever, migraine, muscle pain, fatigue, cough, wheezing, pain in lymph nodes in right armpit and right side of neck


VAERS ID: 1574085 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blister, Chest pain, Fatigue, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Extreme fatigue, weakness, fever, blister around eye , chest pain.


VAERS ID: 1574136 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Confusional state, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Headaches starting around 8 hours after vaccination. Felt around top + front of head. Around 12 hours after vaccination, headaches became severe. Woke up confused, dazed. Lasted 8+ hours. Relieved with Tylenol and ibuprofen.


VAERS ID: 1574183 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Pain, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VitaminD, vitamin C, Vitamin B12, ivermectin, Quercetin 500mg, aspirin 325 mg, melatonin
Current Illness: None
Preexisting Conditions: None
Allergies: Biaxin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, severe, fatigue, severe bodyaches, severe itchiness, pain at site of shot


VAERS ID: 1574184 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-13
Onset:2021-08-14
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Bilevel positive airway pressure, Brain natriuretic peptide increased, Chest X-ray abnormal, Fibrin D dimer, Intensive care, Lung infiltration, Mental status changes, Respiratory distress, Troponin T increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Myocardial infarction (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown;
Current Illness: Unknown;
Preexisting Conditions: A-Fib, COPD, HTN, Obesity; Hyperglycemia; Heart failure; Fibromyalgia; DM;
Allergies: NKDA
Diagnostic Lab Data: 8/14/21 Laborary results: BNP 1260, D-dimer 1.1, troponin T of 36. Chest x ray: multifocal infiltrates
CDC Split Type:

Write-up: Patient hospitalized beginning 8/14/2021..Symptoms:altered mental status, respiratory distress; Nonrebreather mask; BiPAP setting above 90%; Treatment: dexathasone and remdesivir, Vancomycin and Rocephin. Hospitalization ongoing in CCU.


VAERS ID: 1574204 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: patient reported, fever of 101.5, chills, headache, body aches, and fatigue <24 hours after vaccination. on 2nd day following vaccination, on 8/15/2021, patient reported swollen lymph nodes in left under arm, several swollen lymph nodes, tender the the touch. fever resolved within 24 hours, headache, fatigue, and body aches persisted through the weekend. Lymph nodes still swollen/tender 8/16/2021. all other s/sxs improving at this time.


VAERS ID: 1574209 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Change of bowel habit, Fatigue, Hyperhidrosis, Respiratory tract congestion, Sleep disorder, Urine output increased
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (broad), Hypoglycaemia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, multi-viramin, C, Calcium, Osto-Biflex, Selenium, lutien, Turmeric-Curcumin, lecithin
Current Illness:
Preexisting Conditions: Brown-Sequard moderate
Allergies: Prednisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme fatigue, chest coughing, felt needed to take deep breaths after few hours let-up with mild congestion, heavy urine output up 4x thru evening every hour upon waking, heavy sweating when moving around, BP 157/92 for hours up and down by 10 on PM of 8/15. Bp. 135/92 on waking.. .. continued throughout day.


VAERS ID: 1574210 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Tic
SMQs:, Dyskinesia (broad), Dystonia (broad)

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

Write-up: Motor tic to face and r hand


VAERS ID: 1574211 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Fever, body aches, headache


VAERS ID: 1574226 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Heart rate increased, Limb discomfort, Painful respiration, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Dehydration (broad)

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

Write-up: Within 2 minutes of vaccine, my heart rate was very high. I could feel a radiating feeling down my arm. For the next several hours, my heart rate was very high and I could feel my heart thumping. The next day and a half my heart has hurt if I took a deep breath in.


VAERS ID: 1574227 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Pain, Pain in extremity, Pyrexia, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft Allegra
Current Illness:
Preexisting Conditions: Overweight
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Slight soreness in arm and slight headache day of vaccination into next day. 24 hours after vaccine on 8/14 experienced headache, fever, chills, body aches, extreme fatigue, excessive thirst and sweats for about 12 hours. 8/15 continued with fatigue.


VAERS ID: 1574235 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: PT RECEIVED J&J VACCINE ON 4/10/21 AT PHARMACY AND PFIZER 1ST DOSE AT A DIFFERENT LOCATION ON 8/14/21.


VAERS ID: 1574264 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-23
Onset:2021-08-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Hypomenorrhoea, Postmenopause
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ (diuretic) and Flonase
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa Codeine Bacitracin Band AIDS
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have been post menopause for two years and after receiving shot on July 23 I got a very light period on August 14


VAERS ID: 1574272 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-11
Onset:2021-08-14
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Cardiac disease
Preexisting Conditions: CHF
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized with COVID 19


VAERS ID: 1574287 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-04
Onset:2021-08-14
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

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

Write-up: Patient has been fully vaccinated as of 2/4/21. Patient has tested positive as of 8/14/21


VAERS ID: 1574288 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Dizziness, Fatigue, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine made her very sick.
Other Medications: Coalmine
Current Illness:
Preexisting Conditions: Rare blood Type (AB Positives) (RH Negative) Vertigo
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that she was been having Dizziness since 8/14/2021. She stated that she received loose stool and extreme fatigue. She is also experiencing nausea and no apatite.


VAERS ID: 1574299 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-01
Onset:2021-08-14
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Myalgia, Pyrexia, Rhinorrhoea, Sinus operation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: five months later patient tested positive. c/o fever, chills, muscle aches, runny nose, cough, sob, nasal drainage


VAERS ID: 1574301 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0164 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Not known
Preexisting Conditions: Not known
Allergies: No known allergies.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received a pfizer dose and it was discovered after that the patient received a Janssen dose in 04/2021.


VAERS ID: 1574313 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-12-28
Onset:2021-08-14
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: bimatoprost (LATISSE) 0.03 % ophthalmic solution fexofenadine (ALLEGRA) 180 mg tablet LORazepam (ATIVAN) 0.5 mg tablet pantoprazole (PROTONIX) 40 mg DR tablet sertraline (ZOLOFT) 50 mg tablet topiramate (TOPAMAX) 50 mg tablet triamterene-hy
Current Illness: tension migraines
Preexisting Conditions: Non-Hospital Anxiety Depression Low blood potassium Menorrhagia Palpitations Leg swelling Gastroesophageal reflux disease without esophagitis Bloating Change in bowel habit Constipation Elevated AST (SGOT) Epigastric pain Overweight Intussusception of rectum Pelvic floor dysfunction in female Cystocele with uterine prolapse Posterior vaginal wall prolapse Right carpal tunnel syndrome Thoracic outlet syndrome Left carpal tunnel syndrome Postoperative visit S/P hemorrhoidectomy
Allergies: Covid-19 Vaccine, Mrna, Bnt162b2, Lnp-s (Pfizer)Shortness of breath / Dyspnea, Itching, Dizziness / Lightheaded, Flushed BuspironeDizziness / Lightheaded EscitalopramOther (document details in comments) ParoxetineOther (document details in comments) VenlafaxineOther (document details in comments)
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Sore throat Congestion or running nose


VAERS ID: 1574323 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Cyanosis, Dizziness, Dyskinesia, Headache, Seizure, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Pt.''s Mother states that after receiving the 2nd dose of Phizer 08/14/2021, started experiencing symptoms 08/14/2021 3mins after injection of dizziness, head jerking (seizure activity), confusion, and blueish color to the lips. Vitals were taking, possibly blood sugar suggested being low. 10mins later pt. states everything was blurry and not bright. Treated with a Poweraid, 15mins vision finally clearing with 15mins of observation. Pt. and Mother stayed for 45mins to continue to monitor. Symptoms have subsided besides a headache. (Appt. for 04:10pm, Mother was told that facility was out of vaccinations but then @ 04:30pm was administered, questioning expiration dates of vaccines provided.)


VAERS ID: 1574328 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FO8448 / 1 LA / IM

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

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

Write-up: Chills, malaise, vomiting, nausea


VAERS ID: 1574345 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-08-14
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LL / IM

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

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

Write-up: Pt received Pfizer x2. Admitted to the hospital on 8/14 for COVID but without sustained hypoxia


VAERS ID: 1574358 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-19
Onset:2021-08-14
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Nasal congestion, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (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: irbesartan (AVAPRO) 150 mg tablet levothyroxine (SYNTHROID) 50 mcg tablet lisinopriL (ZESTRIL) 10 mg tablet multiple vitamins (DAILY MULTI-VITAMIN) tablet tablet omeprazole (PriLOSEC) 20 mg capsule simvastatin (ZOCOR) 20 mg tablet SUMAtript
Current Illness: None
Preexisting Conditions: Nervous Migraine Circulatory Benign essential hypertension Musculoskeletal Erosive osteoarthritis Endocrine/Metabolic Hyperlipidemia Hypothyroidism Other Sicca syndrome
Allergies: Bacitracin Mycinette [Cetylpyridinium-benzocaine] Neomycin Sulfate Polymyxin B AmlodipineRash
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Nasal Congestion Headache


VAERS ID: 1574360 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Pea sized lump at injection site.


VAERS ID: 1574413 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: MODERATE RASH, ITCHING REPROTED AROUND VACCINATION SIGHT. COVID ARM


VAERS ID: 1574416 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 RA / IM

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

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

Write-up: 3x3 induration with redness on site injection (Right arm)


VAERS ID: 1574465 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-08-14
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04821A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Odefsey 1 tablet , Prednisone 5 mg, Aspirin 325mg, Lisinopril 20mg, Atorvastatin 10mg, Humalog 5 units, Lantus 70units, Amlodipine 5mg, Ferrous Sulfate 325mg
Current Illness:
Preexisting Conditions: Diabetes mellites, Anemia, asthma, Brain Tumor, HIV, Hypertension,
Allergies: Codeine, Morphine, Vicodin
Diagnostic Lab Data: SARS COV2 Codid-19 PCR positive
CDC Split Type:

Write-up: Fully vaccinated patient with Severe symptoms of Covid-19


VAERS ID: 1574486 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

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

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

Write-up: Pt advised and completed consent to get 2nd pfizer. After completion of injection, and inputting information into data base pt received Moderna as first dose on 06/29/2021 and not pfizer.


VAERS ID: 1574507 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-15
Onset:2021-08-14
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 RA / IM

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

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

Write-up: Patient had a positive COVID test on 8/14/2021


VAERS ID: 1574519 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 RA / IM

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

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

Write-up: The patient reported that her arm is red and swollen and warm on 8/16/21. She received her vaccine on 8/13. It was originally hard to the touch near the injection site, which has lessened.


VAERS ID: 1574543 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: No adverse reaction - The patient presented to a Community Vaccine Event with a consent form signed by a guardian. The date of birth placed on the form by the guardian was (12). When I went to enter information in MIIX, I discovered the Date of Birth of the patient was (11) which is not able to receive the vaccination.


VAERS ID: 1574550 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

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

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

Write-up: Patient received Moderna COVID 19 vaccine for 1st dose in series on 07/19/2021. He was mistakenly given a Pfizer shot for the second dose on 08/14/2021. He did not report any adverse events or adverse reactions as of 08/16/2021.


VAERS ID: 1574552 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Inflammation, Pain in extremity, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, birth control, allergy nose spray
Current Illness: None
Preexisting Conditions: None
Allergies: Advil and seasonal allergies
Diagnostic Lab Data: None yet. Monitoring through end of week in hopes that symptoms resolve themselves.
CDC Split Type:

Write-up: Injection given up in the shoulder joint. Pain from shoulder blade down to finger tips. Spoke with doctor who wants to monitor for potential rotator cuff injury, but suspects tendon inflammation from injecting too high in the shoulder and not in the deltoid muscle.


VAERS ID: 1574564 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Caused abnormal menstruation. Period came 2 weeks early and was so extremely heavy, I nearly went to the ER for fear of bleeding out. Period is always regular and normally somewhat light.


VAERS ID: 1574573 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: COVID-19 within past month
Preexisting Conditions: N/A
Allergies: Rocephin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Diffuse urticaria, mild bilateral finger and toe swelling that developed the day after receiving the vaccine. Seen in the ED 2 days post vaccine for persistent symptoms that did not resolve prior to discharge.


VAERS ID: 1574597 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: chest pain, difficulty breathing, accelerated heart rate, chest compression.


VAERS ID: 1574600 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3818 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Impaired work ability, Limb operation, Lymph node pain, Lymphadenopathy, Pain in extremity, Vaccination complication
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient stated a few hours after vaccine she started to feel bad. She had a lot of pain in her right arm. Her right arm has been surgical repaired. The lymnnodes under her arm was so painful that she could not bring her arm down. Dr. Said that she is having a reaction to the vaccine. Every Lympnode on her body is swollen. Dr has also taken her off work.


VAERS ID: 1574603 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Administration site pain, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Paraesthesia, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after receiving the shot, I felt a burning sensation and a then a few sharp pains in my arm below where the shot had been administered. Over the next few hours, the random prickling sensations continued in a downward fashion, to my elbow, wrist and hand (there was even pricking sensations underneath my fingernails), and I also began experienced generalized tingling and numbness throughout my affected arm and hand. I am continuing to experience these sensations in my arm, wrist and hand after 48 hours. I also experienced tenderness at the site of the injection (and just below it), starting about 5 hours after receiving the shot. However this is separate from the tingling and numbness, and is all but gone, now.


VAERS ID: 1574619 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-29
Onset:2021-08-14
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

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

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

Write-up: COVID PCR positive on 8/14/2021


VAERS ID: 1574644 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Arthritis (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: none. pt talked to dr.
CDC Split Type:

Write-up: pt felt joint pain on day 1 and lung tightness that resolved quickly on day 3


VAERS ID: 1574859 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-07
Onset:2021-08-14
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Gait disturbance, Mobility decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: baby aspirin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Medical test are scheduled for Sept 2.
CDC Split Type:

Write-up: I cannot say for sure this was connected to the vaccine....but about a week afterwards both upper arm musles became sore as well as upper leg muscles, but it was tolerable. My brother who had the shot at same time had the same reaction but to a lesser degree. I waited to see if it would go away but it stayed. I then received my second dose on March 12 2021 and as the days went on it got worse to the point where I cannot get up and down from a chair without pushing my self up with my arms. WALKIBG BECAME MORE DIFFICULY, ESPECIALLY REGARDING STAIRS. i CONTINUED WAITING TO SEE IF IT WOULD FINALLY GO AWAY BUT AS IT REMAINED i FINALLY CONTACTED MY DOCTOR IN jULY AND TODAY i HAD A CONSULTATION WITH A NEUOROLOGIST AND HE WILL BE CONDUCTING A COUPLE OF PROCEDURES SOON REGARDING NERVES AND MUSCLES. (sorry for capital letters ... I pushed the wrong key) .. Again, I cannot be positive this was a reaction to the vaccine, but as I did not have this problem beforehand and as my brother had the same reaction to a much lesser degree, I thought I would report this as a friend encouraged me to. I am curious as to if any others that had the moderna vaccine have had this same experience. Thank you.


VAERS ID: 1574863 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Diarrhoea, Feeling abnormal, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Syraquill 200 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever was up to 103. Aches. Diarrhea. Cold sweats 3 days after. Strange pain in different areas in my legs.


VAERS ID: 1574886 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Allergic reaction - Urticaria. Treating with short-course PO prednisone


VAERS ID: 1575059 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Laboratory test abnormal, Red blood cell count decreased
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Was taken to the ER with low red blood severe stomach pain. , abnormal labs.


VAERS ID: 1575071 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient states at 9:00AM 8/13/2021 dry, scratchy cough all day with shortness of breath and difficulty breathing. Throat was swollen which was physically visible and noticeable with touch Saturday. Swelling was the same as of 8/16/2021 4:10pm. Patient also had diarrhea Saturday-Monday. Patient went to the ER, was prescribed Prednisone 20mg, 40mg daily for 5 days that was started 8/16/2021.


VAERS ID: 1575076 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-18
Onset:2021-08-14
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Imaging procedure abnormal, Portal vein thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknonwn
Preexisting Conditions: hypothyroidism endometriosis
Allergies: erythromycin, lamotrigine, bupropion
Diagnostic Lab Data: 8/14/21 finding of thrombosis of main portal vein and right portal vein thrombosis on imaging for abdominal pain
CDC Split Type:

Write-up: portal vein thrombosis


VAERS ID: 1575077 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-08-14
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Senior Living       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Cough, runny nose, loss of taste and smell


VAERS ID: 1575082 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: PATIENT BROKE OUT IN HIVES 2-30 HOURS AFTER VACCINE ADMINISTRATION. WENT TO URGENT CARE AND RECEIVED AN STEROID INJECTION WHICH HELPED ALLEVIATE THE SYMPTONS. HOWEVER, THE NEXT DAY THE HIVES CAME BACK IN DIFFERENT PARTS OF THE BODY. DR PRESCRIBED A STEROID DOSE PARK


VAERS ID: 1575096 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Injection site erythema, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Arthritis (broad)

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

Write-up: Patient experienced redness and swelling at site of injection. In addition, patient had body aches and her bones/joints were hurting all over.


VAERS ID: 1575255 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Fatigue, Headache
SMQs:, Arthritis (broad), 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: bursitis like pain in right hip 24 hours after Covid second injection 3/21
Other Medications: Acebutolol Dexilant Pravastatin Bupropion Amitriptyline. Celebrex held 2 days before and after vaccine
Current Illness: none
Preexisting Conditions: bronchiectasis Breast cancer Left ventricular hypertrophy. Apical cardiomyopathy
Allergies: Levaquin. muscle leg aching fentanyl migraine like headache
Diagnostic Lab Data: nane
CDC Split Type:

Write-up: Developed fatigue, joint pain and severe headache 8-10 hours after injection. Symptoms became worse from 10 to 35 hours after.


VAERS ID: 1575262 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Pain, Tongue discolouration, Tonsillar erythema, Tonsillar hypertrophy
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Metformin, IVIG, Victoza, Vit D, Prenatal
Current Illness: NA
Preexisting Conditions: Hypogammaglobulinemia, Type two diabetic
Allergies: Benadryl, Morphine
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: MY right tonsil swelled for 2 hours and became red, my tongue turned white for a while, became fatigued. very bad vivid dreams. Headache since the injection and it has been 3 days. body aches and pain for 2 days.


VAERS ID: 1575468 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: -
Current Illness: -see below
Preexisting Conditions: IBS, rosacea, fibromyalgia, breast fibroadenoma
Allergies: no allergies; several food intolerances; hypersensitivity to radiation, alcohol, fragrance
Diagnostic Lab Data: none so far, i will see a doctor if it gets worse
CDC Split Type:

Write-up: Four hours after the vaccine, the arm in which it was injected started to feel very sore (it lasted for about a day and a half). The following day I had a very bad headache and brain fog the entire day. The next day (today) I woke up with a macular rash all over my chest, which is now spreading.


VAERS ID: 1575617 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Lip swelling, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid Vitamin D Vitamin B12 Vitamin C Glutathione CoQ10 Probiotic Aspirin 81mg Iron L-lysine
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 9pm on August 14, 2021, I started to run a fever and felt a heaviness in my chest. I assumed these were just a sign of the vaccine kicking in. I went to bed to try and sleep it off around 11pm. When I awoke the next morning (August 15th) around 8 am, I saw that my face and lips were swollen and my chest was still heavy feeling. I placed a call to my healthcare provider on their emergency line to let her know what was going on. It was recommend that I take a steroid and Benadryl or antihistamine to alleviate the symptoms. I was told to go to ER if symptoms got worse or to follow up in the office on Monday if it wasn''t emergent. I took a dose of Dexamethasone around 9:45am. I then followed that around 11 am with a Zyrtec. I took Benadryl around 10pm on August 15th. By the time I awoke on Monday, August 16th, my symptoms had subsided.


VAERS ID: 1575621 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD9448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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: Ibuprofen
Current Illness: Not
Preexisting Conditions: No
Allergies: Not at all
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vascular marks in the legs. It?s seems like trombocitopenia


VAERS ID: 1575623 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness: None
Preexisting Conditions: None
Allergies: I have had an allergy to a generic medication for an infection
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received my second dose of the vaccine and the following day I noticed my arm was red around the injection site. The redness grew a bit and was raised off my skin. It was slightly itchy, painful and I noticed it was warm. I did take the spots tempature out of curiosity and it was 100.7 but has since dropped to 99.7. I also noticed on day 3 that it spread a bit further on my arm.


VAERS ID: 1575637 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Northern Mariana Islands  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram normal, Painful respiration, Pyrexia, Troponin I increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: An EKG was normal. DATE TIME SPECIMEN TEST VALUE Ref ranges ------------------------------------------------------------------------------- 08/15/2021 03:03 BLOOD TROP-I: 0.098 ng/mL .04 - 1.5 08/15/2021 00:42 BLOOD TROP-I: 0.139 ng/mL .04 - 1.5
CDC Split Type:

Write-up: Patient developed sudden onset fever, feeling of pressure on the chest, worse with inspiration, worse when laying down, better when standing up. The patient was given hyocyamine, famotidine, and tylenol and the fever and pain resolved. Three days later it has not recurred.


VAERS ID: 1577530 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: It was unknown if the patient had drug abuse or illicit drug usage, consume alcohol and smoke.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830316

Write-up: CHILLS; FEVER; NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: It was unknown if the patient had drug abuse or illicit drug usage, consume alcohol and smoke. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 14-AUG-2021, the patient experienced chills. On 14-AUG-2021, the patient experienced fever. On 14-AUG-2021, the patient experienced nausea. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from fever, chills, and nausea. This report was non-serious.


VAERS ID: 1577623 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Seizure-Severe, Additional Details: Woman with the patient stated he reported not feeling well. She stated his skin tone turned white and he went limp. She called out to pharmacy staff stating he was having a seizure. Patient regained consciousness about 30 seconds later.


VAERS ID: 1577859 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen, Pristiq
Current Illness: None
Preexisting Conditions: Just completed chemotherapy for breast cancer in the last few months. Still being treated but no cancer is present now.
Allergies: Erythromycin, Percocet, Scopolamine, Chlorhexidine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Inability sleep. Sleeplessness began the night of the vaccine. I have been unable to sleep more than 30 minutes at a time without waking up. Still happening 4 days later.


VAERS ID: 1577876 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-15
Onset:2021-08-14
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 RA / IM

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

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

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


VAERS ID: 1577888 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-08-14
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray, Cough, Electrocardiogram, Fatigue, Gastrointestinal disorder, Laboratory test, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Known lung disease/moderate tobacco
Allergies: penicilian
Diagnostic Lab Data: No Covid testing, Chest xray 8/14/1md 8/15/2021 Labs ECG
CDC Split Type:

Write-up: J&J vaccine for C19 per pt 4/2021 w/o actual date knowledge 8/8/2021- onset symptoms- GI and fever at home 8/14/2021- came to ED and admit same day- pt came in with body aches, cough, fatigue, progressive weakness, 8/10/2021- had C19 testing at pharmacy and reported as Covid positive


VAERS ID: 1577911 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-27
Onset:2021-08-14
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily gummy vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Was seen on August 16 by Nurse Practitioner for evaluation. Blood pressure was 114/68, temperature 99F, pulse was 64. Noted by NP of neck muscle spasms.
CDC Split Type:

Write-up: Beginning August 14, involuntary neck spasms started and continued throughout the day. They have continued and grown in frequency.


VAERS ID: 1577931 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Swelling, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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

Write-up: chest was swollen and couldn''t breath good, vomiting, went to ER and was given an anti-inflammatory


VAERS ID: 1577963 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: embolization of maxillary artery just over 2 weeks ago...
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: extremely painful and swollen lymph nodes in armpit.... opposite arm of where the shot was administered. I would say the swelling is almost size of golf ball in my right armpit. This was Moderna first vaccine...


VAERS ID: 1577975 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088DZIA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Diarrhoea, Gastrointestinal disorder
SMQs:, Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Cyclophorine, cefaclor, red dye
Diagnostic Lab Data: Have not sought medical treatment yet
CDC Split Type:

Write-up: Next morning, left eye started to twitch and has not stopped since- it is now 5 days later. Also have had severe gastrointestinal issues (diarrhea) since having the shot.


VAERS ID: 1577999 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Incorrect dose administered, Pain, Pain in extremity, Product preparation error
SMQs:, Tendinopathies and ligament disorders (broad), 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: Entire undiluted vial inadvertently administered. Error immediately identified. Patient immediately made aware 24 hours later, patient had expected post-vaccine response with sore arm, body ache, chills. Self-limited.


VAERS ID: 1578030 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-29
Onset:2021-08-14
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001CZIA / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017CZIA / 2 - / SYR

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

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

Write-up: diagnosed COVID + on 08/15/2021


VAERS ID: 1578043 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

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

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

Write-up: Developed rash the next day to torso that spread to thighs and arms and has been taking OTC of Benadryl without improvement.


VAERS ID: 1578052 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Fall, Feeling hot, Head injury, Loss of consciousness, Malaise, Nausea, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Glucose of 93
CDC Split Type:

Write-up: Client was observed by nurse to be pale and not doing well. Nurse went to check on client and client leaned to his left falling out of his chair, losing consciousness, and hitting his head. Client regained consciousness shortly after and was alert and oriented x4. Client stated he felt dizzy, hot, and nauseous. EMS was called and client was transported by them to local hospital.


VAERS ID: 1578088 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vestibular neuronitis
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: Fluoxetine 40mg daily Gabapentin 1200mg daily
Current Illness: none
Preexisting Conditions: anxiety and depression
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vestibular neuritis


VAERS ID: 1578114 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-10
Onset:2021-08-14
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: COPD, type 2 diabetes
Allergies:
Diagnostic Lab Data: Positive CPVID -19 PCR test
CDC Split Type:

Write-up: Hospitalization with positive COVID test


VAERS ID: 1578120 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-09
Onset:2021-08-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Electrocardiogram ST segment abnormal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sirolimus 3 mg daily.
Current Illness: NA.
Preexisting Conditions: Liver transplant recipient for biliary atresia (surgery at 5 months of age).
Allergies: NA.
Diagnostic Lab Data: Troponin 3329 down to 1802 on day of discharge. ECG with global ST segment changes.
CDC Split Type:

Write-up: Myopericarditis - elevated troponins and CKMB, global ST segment changes on ECG


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