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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 138 out of 6,867

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VAERS ID: 1591535 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Fear, Gait inability, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I?ll be having a follow up CBC on Monday but all my medical testing is current and recent
CDC Split Type:

Write-up: The evening after 2nd dose I had horrible body aches to where I could not walk, fever102, unbearable headache , nausea, profuse sweating. As of now over a week later, my fever is down to 99 but I still experiencing debilitating body aches and fatigue along with uncontrollable sweating. I?m very scared


VAERS ID: 1591580 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Palpitations
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

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

Write-up: Began feeling heart pounding and what felt like mild shock waves traveling down neck. Persisted for about 5 or 10 minutes, subsided temporarily, but has reoccurred approximately twice each day since then (about 1 week). Usually occurs around 9:00 am and around 5:00 pm, and while resting or light physical activity. I also feel my heart begin to pound heavily at other times throughout the day (frequently, usually lasting for 5 or 10 minutes). These more frequent occurrences are not accompanied by the sensation of electric shock waves. I can still breathe normally. I have not had this experience prior to the Covid vaccine.


VAERS ID: 1591584 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-15
Onset:2021-08-14
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Respiratory tract congestion, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)

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

Write-up: Runny Nose, Congestion, and Sneezing


VAERS ID: 1591585 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Diarrhoea, Dizziness, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizzy, lightheaded, diarrhea, no appetite, fever, chills, coughing


VAERS ID: 1591876 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-29
Onset:2021-08-14
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 UN / IM

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

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

Write-up: Tested positive for Covid 19 on 08/16/2021


VAERS ID: 1591900 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-30
Onset:2021-08-14
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Cough, Decreased appetite, Dyspnoea, Laboratory test, Nausea, Oxygen saturation decreased, Pneumonia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prior to Admission Medications Outpatient Home Medications Taking? Carboxymethylcellulose-Glycerin (REFRESH OPTIVE) 0.5-0.9 % Opht Drop Takes Occasionally Sig: Instill 1 drop in both eyes 2-4 times a day or as needed for dry eyes Glucose-Ke
Current Illness: CORN (primary encounter diagnosis) Note: 1 lesion was pared down today without difficulty. Corn care instructions were given. GERD (GASTROESOPHAGEAL REFLUX DISEASE) Note: Stable. No change in therapy at this time. Monitor for any changes. DM 1 W ERECTILE DYSFUNCTION Note: Stable. No change in therapy at this time. Monitor for any changes. ULCERATIVE COLITIS OF UNSPECIFIED SITE Note: The patient is currently asymptomatic
Preexisting Conditions: IDDM on insulin pump (Tandom insulin pump with continuous glucose monitoring), hypothyroidism, ulcerative colitis who was became symptomatic on 8/7. COVID positive on 8/10
Allergies: nka
Diagnostic Lab Data: Ref. Range 8/14/2021 09:20 8/14/2021 18:25 8/15/2021 07:14 8/16/2021 07:23 8/17/2021 06:55 CRP, SER QL Latest Ref Range: <=0.9 mg/dL 7.2 (H) 6.9 (H) 1.1 (H) 0.7 TP Latest Ref Range: 6.0 - 7.7 g/dL 5.8 (L) Ref. Range 8/14/2021 09:20 8/14/2021 18:25 8/15/2021 07:14 8/16/2021 07:23 8/17/2021 06:55 CRP, SER QL Latest Ref Range: <=0.9 mg/dL 7.2 (H) 6.9 (H) 1.1 (H) 0.7
CDC Split Type:

Write-up: 53M with hypothyroidism, ulcerative colitis s/p remote colectomy, DM1 (on insulin pump), and GERD who presents with fever, poor appetite, nausea, cough and worsening SOB beginning on 8/7. Tested covid + on 8/10. Received pfizer vaccine series in march. Seen in ED 8/13 and given levaquin for CAP. After discharge he noted his O2 sats reading 84-89%. COVID Pneumonia/Acute hypoxemic respiratory failure - he was treated with decadron 6mg daily for 4 days and remdesivir for 5 days. Supplemental O2 was successfully weaned from 2lpm to room air. In case he would require tocilizumab, screening labs were sent and returned negative except cocci which is pending. Primary Procedures: None Secondary Procedures: None Reason for Hospital Admission (Admitting Diagnosis): covid pneumonia


VAERS ID: 1591952 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyskinesia, Muscle twitching
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalopathy/delirium (broad)

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

Write-up: Pt came in to our office on 8/18/21 after dealing with involuntary muscle twitching all over since 8/16/21 that was worsening


VAERS ID: 1591971 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-03
Onset:2021-08-14
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, Atrial fibrillation, Benign prostatic hyperplasia, Coronary artery disease, Dyspnoea, Hyperlipidaemia, Hypertension, Productive cough, Pulmonary amyloidosis, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Lipodystrophy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: CIPRO MACROBID IODINE BACTRIM
Diagnostic Lab Data: 8/14/21 SARS COV2 LAB = POSITIVE AT MEDICAL CENTER
CDC Split Type:

Write-up: COVID VACCINATIONS 1/6/21 MODERNA LOT # 032H20A GIVEN AT HEALTH DEPT SECOND DOSE NOTED ABOVE. PATIENT SEEN AT ER. TRANSFERRED TO MEDICAL CENTER FOR HIGHER LEVEL OF CAE. PATIENT NOTED TO HAVE FEVERS 101, PRODUCTIVE COUGH, SHORTNESS OF BREATH. REQUIRED 3L OF O2.PATIENT DID NOT USE HOME O2 PRIOR . NOW O2 UP TO 6 L. DX; PNA, ACUTE RENAL FAILURE, ATRIAL FEB, CAD, HYPERTENSION, HYPERLIIDEMIA, BPH.PATIENT TREATED ON STEP DOWN MEDICAL UNIT. DISCHARGED 8/18/21 TO HOME WITH HOME HEALTH NURSING AND THERAPY.


VAERS ID: 1591983 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-08-14
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Blood alkaline phosphatase, Blood bilirubin, Blood gases, Blood lactic acid, Blood thyroid stimulating hormone, Chest X-ray, Chest pain, Computerised tomogram thorax, Differential white blood cell count, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer, Full blood count, Heart rate increased, Human chorionic gonadotropin, Laboratory test, Lipase, SARS-CoV-2 test negative, Sinus tachycardia, Troponin I
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Latex, Dairy Products, Sulfa
Diagnostic Lab Data: August 16th: EKG showed Sinus Tachycardia my resting BPM was 147 The emergency room ran White Blood cell differential, CBC with differential, HCG, D-Dimer, Troponin I, Lipase, Alkaline Phosphatase, Total Bilirubin, Alanine Aminotransferase (ALT), AST, Chemistry Panel, XR Chest, PA and Lateral, EKG 12, Lactic Acid, TSH, CT CHEST SCAN, Venous Blood Gas
CDC Split Type:

Write-up: Elevated heart rate and chest pain, shortness of breath and difficulty breathing. Ended up in the Emergency Room on 08/16/2021 and now have follow up appointments and blood work to be completed on 08/23/2021. No treatments or outcomes have been found. COVID test was taken to rule out symptom but it came back NEGATIVE.


VAERS ID: 1591989 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-03
Onset:2021-08-14
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Aphasia, COVID-19, COVID-19 pneumonia, Chest discomfort, Cough, Dizziness, Dyspnoea, Fatigue, Feeding disorder, Fibrin D dimer increased, Headache, Myalgia, Oropharyngeal pain, Pulmonary congestion, Sputum increased, Tachypnoea, Trismus, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Dystonia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Home Medications Taking? Albuterol (PROAIR/PROVENTIL/VENTOLIN) 90 mcg/actuation Inhl HFAA Takes Occasionally Sig: Inhale 2 puffs by mouth one-half hour before sports or exercise to prevent cough or wheezing. May repeat every 4 ho
Current Illness: none
Preexisting Conditions: h/o GERD, myotonic dystrophy (adult onset muscular dystrophy dx age early 40s, now with bilateral hand and leg weakness, difficulty with balance, fecal incontinence, last neuro note from 1/20/21), ?tachyarrhythmias followed by cardiology (last in 3/2020), right knee OA, who presents with increasing shortness of breath. Pt started having headache, sore throat, cough, myalgias on 8/2.
Allergies: nka
Diagnostic Lab Data: Results for patient as of 8/20/2021 13:57 8/14/2021 19:15 D-DIMER: $g4.00 (H) 8/16/2021 07:11 D-DIMER: 3.00 (H)
CDC Split Type:

Write-up: 61 Y male with h/o GERD, myotonic dystrophy (adult onset muscular dystrophy dx age early 40s, now with bilateral hand and leg weakness, difficulty with balance, fecal incontinence, last neuro note from 1/20/21), ?tachyarrhythmias followed by cardiology (last in 3/2020), right knee OA, who presents with increasing shortness of breath. Pt started having headache, sore throat, cough, myalgias on 8/2. He had a positive covid test on 8/11/21. He was vaccinated with pfizer on 4/12/21, 5/3/21. The last two days he has been feeling much worse. He has shortness of breath, wheezing, cough, chest congestion, fatigue, more sputum production. He has had chest discomfort across both sides of his chest. He had a VAV today and was referred to ED for evaluation. Per ED Dr "Pt placed on o2 by nursing as sats were at 90% on ra. I had him do squats in the room off o2. His oxygen levels initially dropped into the high 80''s, but then became very dyspneic/tachypenic and felt like he was going to syncopize. His o2 levels rebounded quickly with rest and his increased respiratory rate, but pt did not feel comfortable going home." Regarding his myotonic dystrophy, he reports that his weakness has been steadily worsening monthly. He is still able to eat and swallow normal texture foods. Last night he was able to eat steak and mashed potatoes. No choking episodes. However, sometimes his jaw "catches" and he is unable to chew or speak temporarily. His hands and legs are weak. On ROS, he denies fever, abd pain, nausea, vomiting, dysuria, hematochezia, melena. He has a walker but does not use it. He still drives; his car is in our parking lot. He takes an occasional antiacid for GERD but it is mostly controlled by diet and lifestyle modification. " 1) COVID Pneumonia, Acute hypoxemic Respiratory failure - Symptom onset on 8/2/2021. Patient found to be COVID positive on 8/11/2021. Patient was on nasal Cannula at 2Lpm and now on RA. Goal SpO2 $g92%. Consider ICU evaluation if requiring $g40LPM and 60% FiO2 for SpO2 $g/= 90% - Self-proning as tolerated for O2 req $g3L - Decadron 6mg IV or PO qday for up to 10 days (started 8/14/2021) or until no longer hypoxic. - Remdesivir 200mg IV x1, followed by 100mg IV daily until clinical improvement or 5 days (started 8/14/2021), last dose 8/18/21. - Daily LFTs. Hold Remdesivir if ALT $g10xULN or CrCl<30 - Pecid for GI prophylaxis - trend inflammatory markers - Lovenox 40mg SQ daily and hold for Plt <25k, Fibrinogen <100, active bleeding - continue isolation in hospital per Regional/Local ID guidance. -Plan to increase activity levels in room and check 02 sats on RA tomorrow. Modified IMPROVE VTE SCORE (for discharge) Age more than 60 years. - 1 POINTS Total Points: 1 o Consider anticoagulation if IMPROVE VTE score greater or equal to 4 OR IMPROVE VTE score is 2 or more, and the D-dimer is greater than 2x ULN on discharge. o Anticoagulate with Rivaroxaban 10mg orally daily for 30 days total post-discharge or Enoxaparin 40mg SC q24 hours


VAERS ID: 1592029 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-02-13
Onset:2021-08-14
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Dizziness when lying down/getting up. Right shoulder pain going down to elbow


VAERS ID: 1592083 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-22
Onset:2021-08-14
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest pain, Chills, Cough, Decreased appetite, Diarrhoea, Fatigue, Myalgia, Nausea, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes, Parkinson''s Disease, Hypothyroid
Allergies: Unknown
Diagnostic Lab Data: Case tested positive for COVID-19 with an antigen test on 8/14/21.
CDC Split Type:

Write-up: On 8/14/2021, case was hospitalized. Released 8/19/21. Symptoms: Fever, cough, sore throat, runny nose, congestion, poor appetite, nausea, vomiting, diarrhea, chest pain, wheezing, fatigue, muscle aches, chills.


VAERS ID: 1592118 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone 5mg Dicyclomine 10mg
Current Illness:
Preexisting Conditions: IBS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching over entire body


VAERS ID: 1592122 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-10
Onset:2021-08-14
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID-19 test 8/14/21 - completed Pfizer series on 3/10/21
CDC Split Type:

Write-up: Pt admitted to hospital 8/18/21 due to acute hypoxic respiratory failure. Per H&P, tested positive at drive-up testing site on 8/14/21


VAERS ID: 1592339 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: redness and swelling at injection site


VAERS ID: 1592560 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness unilateral, Ear discomfort, Ear pain, Tinnitus, Viral infection
SMQs:, Hearing impairment (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: TriSprintec Hair skin and nails vitamins
Current Illness:
Preexisting Conditions: Anxiety
Allergies:
Diagnostic Lab Data: Hearing tests.
CDC Split Type:

Write-up: After two days of receiving first dose I woke up Saturday morning with ringing in right ear and was muffled with some hearing loss. Test proved some hearing loss in right ear due to viral infection. (I was not sick before the vaccine.) Went to ENT and prescribed me steroids. Taking them for two weeks. Hopefully pain and ringing subsides!


VAERS ID: 1594341 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Headache, 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: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 100.8 F; Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 99.5 F
CDC Split Type: USJNJFOC20210832272

Write-up: CHILLS; LOW GRADE TEMPERATURE (99.5F AND 100.8F); HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a 21 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 13-AUG-2021 18:00 for prophylactic vaccination. No concomitant medications were reported. On 14-AUG-2021, the patient experienced chills. On 14-AUG-2021, the patient experienced low grade temperature (99.5f and 100.8f). On 14-AUG-2021, the patient experienced headache. On 14-AUG-2021, the patient experienced fatigue. Laboratory data included: Body temperature (NR: not provided) 99.5 F, 100.8 F. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, low grade temperature, headache, and fatigue on 15-AUG-2021. This report was non-serious.


VAERS ID: 1594347 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Chills, Dizziness, Dyspnoea, Gingival swelling, Injection site induration, Injection site pain, Injection site pruritus, Injection site swelling, Movement disorder, Nausea, Paraesthesia, Pyrexia, Rash pruritic, Taste disorder, Tinnitus, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NEXPLANON
Current Illness: Abstains from alcohol; Adhesive tape allergy; Contraceptive implant (implanted on the left arm.); Food allergy; Non-smoker; Penicillin allergy
Preexisting Conditions: Comments: Patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832336

Write-up: DIZZINESS AND LIGHT HEADNESS; LEG LOCK; BLURRED VISION; SLIGHT TO MEDIUM DIFFICULTY BREATHING; CHEMICAL AND METALLIC TASTE WITH FOOD AND DRINKS; INJECTION SITE ITCHING; HARDENING OF THE INJECTION SITE; CHEST PAIN; MODERATE SWELLING OF THE BOTTOM ROW OF GUMS WHICH WAS INFLAMED AND BRIGHT RED; CHILLS; RINGING OF THE RIGHT EAR; TEMPORARY ITCHY RASH ON FACE AND NECK; TINGLY SENSATIONS IN THE FACE (TEMPORARY LASTED ABOUT 3 HOURS); SWELLING AT INJECTION SITE (LEFT DELTOID AREA); PAIN AT INJECTION SITE (LEFT DELTOID AREA); WEAKNESS; NAUSEA; FEVER; This spontaneous report received from a patient concerned a 26 year old female. The patient''s weight was 236 pounds, and height was 67 inches. The patient''s concurrent conditions included: penicillin allergy, tegaderm allergy, red onions allergy, no alcohol use, non-smoker, and birth control implant, and other pre-existing medical conditions included: Patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: 21-SEP-2021) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. Concomitant medications included etonogestrel for birth control. On 14-AUG-2021, the patient experienced dizziness and light headness. On 14-AUG-2021, the patient experienced leg lock. On 14-AUG-2021, the patient experienced blurred vision. On 14-AUG-2021, the patient experienced slight to medium difficulty breathing. On 14-AUG-2021, the patient experienced chemical and metallic taste with food and drinks. On 14-AUG-2021, the patient experienced injection site itching. On 14-AUG-2021, the patient experienced hardening of the injection site. On 14-AUG-2021, the patient experienced chest pain. On 14-AUG-2021, the patient experienced moderate swelling of the bottom row of gums which was inflamed and bright red. On 14-AUG-2021, the patient experienced chills. On 14-AUG-2021, the patient experienced ringing of the right ear. On 14-AUG-2021, the patient experienced temporary itchy rash on face and neck. On 14-AUG-2021, the patient experienced tingly sensations in the face (temporary lasted about 3 hours). On 14-AUG-2021, the patient experienced swelling at injection site (left deltoid area). On 14-AUG-2021, the patient experienced pain at injection site (left deltoid area). On 14-AUG-2021, the patient experienced weakness. On 14-AUG-2021, the patient experienced nausea. On 14-AUG-2021, the patient experienced fever. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from leg lock, chest pain, and tingly sensations in the face (temporary lasted about 3 hours) on 14-AUG-2021, and blurred vision, chemical and metallic taste with food and drinks, and temporary itchy rash on face and neck on 15-AUG-2021, and had not recovered from dizziness and light headness, ringing of the right ear, weakness, nausea, slight to medium difficulty breathing, injection site itching, hardening of the injection site, fever, moderate swelling of the bottom row of gums which was inflamed and bright red, swelling at injection site (left deltoid area), pain at injection site (left deltoid area), and chills. This report was non-serious.


VAERS ID: 1594392 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Cancer; Heart disorder
Preexisting Conditions: Medical History/Concurrent Conditions: Breast operation
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Antibody test; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210834896

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 77 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included breast surgery in right side, and concurrent conditions included heart issue, cancer, and asthma. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: Unknown) dose was not reported, 1 total, administered on 08-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 07-AUG-2021 and, on 11-AUG-2021 the patient was exposed to life covid-19 cases and hence on 14-AUG-2021 her doctor ordered her to take titer test (antibody test) to check for protection and the result came out to be negative (confirmed immunological vaccine failure). The patent said that she did not know the type of test that the doctor ordered her to take and what she knew was that they drew blood from her in the doctor''s office. The patient said that she feels she was not protected. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210834896-covid-19 vaccine ad26.cov2.s- Confirmed immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1594446 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot
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:
Current Illness:
Preexisting Conditions: Comments: The patient have no change in colour or swelling.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210837494

Write-up: FEET/ANKLES FEEL LIKE STUCK THEM IN A HOT BUCKET OF WATER; This spontaneous report received from a patient concerned a 64 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient have no change in colour or swelling. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-AUG-2021, the patient experienced feet/ankles feel like stuck them in a hot bucket of water. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feet/ankles feel like stuck them in a hot bucket of water. This report was non-serious.


VAERS ID: 1594465 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Myalgia, Sinusitis
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210838047

Write-up: SYMPTOMS OF SINUSITIS HEADACHE SINUS PRESSURE; FATIGUE; MUSCLE ACHES; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 14-AUG-2021, the subject experienced symptoms of sinusitis headache sinus pressure. On 14-AUG-2021, the subject experienced fatigue. On 14-AUG-2021, the subject experienced muscle aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from symptoms of sinusitis headache sinus pressure, fatigue, and muscle aches. This report was non-serious.


VAERS ID: 1594679 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: Moderna #1 on 7/22/2021
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: No reaction occurred. The patient received the dose 8 days prior to the 4 weeks.


VAERS ID: 1595977 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: Patient says she was dizzy. Was given some crakers and lots of ventilation. She appeared to be getting better and was given some crakers. After a few mins, she felt she was getting worse and that her throat was tightening. Was then given EPIPEN and felt better after a few mins.


VAERS ID: 1602590 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fall, Headache, Pain, Petechiae, Tinnitus
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

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

Write-up: She states that on day one she had a headache, dizziness that lead to falling down, ears buzzing, body aches. This went on for three days. On fourth day bilateral petechial rash to lower extremities that remains present.


VAERS ID: 1602684 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-27
Onset:2021-08-14
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK LA / IM

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

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

Write-up: COVID 19


VAERS ID: 1602729 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-24
Onset:2021-08-14
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium 20mg Vitamin D3 50mcg Losartan 100mg Magnesium 250mg Amlodipine 5mg Atorvastatin 20mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Saw doctor August 19, 2021 He diagnosed it.
CDC Split Type:

Write-up: Bells Palsy Put on steroid by primary care doctor Affected right side of face


VAERS ID: 1602758 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Cough, Fatigue, Feeling abnormal, Injection site bruising, Injection site pain, Malaise, Pain, Pyrexia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Retinal 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: On no medications
Current Illness: No illnesses. Always healthy.
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fever, body aches, foggy vision, foggy brain, extreme pain in injection site with giant bruise, coughing, exhaustion Took Tylenol and Aleve The symptoms started less than 12 hours after the 2nd shot with the arm pain being immediate Took 5 days for the fever to break and still suffering with brain fog and exhaustion. I went from being healthy to feel sick. I never get sick. My whole family got covid and I''m the only one who didn''t catch it living in the house with them. I never go to the doctor because I don''t get sick. I''m not even set up with a primary care doctor since I had my last child 34 years ago because I don''t get sick. I very much regret getting this vaccine. I hope to return to myself soon. I have no energy and it''s been 8 days since my 2nd dose of moderna.


VAERS ID: 1602927 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol Cymbalta Omneprazole Gabapentin
Current Illness:
Preexisting Conditions: High Blood Pressure PVC
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives from night after vac to present


VAERS ID: 1603061 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, vitamin C, Calcium w/ D
Current Illness: None
Preexisting Conditions: None
Allergies: Lactose intolerance
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I was awoken at 6:00am with a pain in my left armpit and extreme numbness along the outside of my upper left arm from the shoulder to the elbow. I had been sleeping on my back and my arm was not pinched or compressed in any way. I got up and walked around while moving my arm in circular motions. The numbness turned to pain that went down the outside of my left forearm. I used a 2 lb weight to do some exercises with my left arm. After about 15 minutes I took 2 Advil and kept rotating my left arm and massaging it. After one half hour the numbness and pain went away. Then at 8:45pm the same day while sitting upright, the same symptoms as described above began again, only this time more intense. I took 2 Advil right away and massaged my left arm and rotated it around. After 45 minutes, the pain and numbness subsided. So far these symptoms have not returned again.


VAERS ID: 1603078 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Erythema, Fatigue, Injected limb mobility decreased, Injection site pain, Injection site swelling, Muscle discomfort, Pain, Pain in extremity, Peripheral swelling, Pruritus, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness:
Preexisting Conditions: asthma, acid reflux, lower back pain, seasonal allergies, face rosacea, anxiety, depression, panic attacks, vertigo, arthritis, right side neck muscle spasms
Allergies: lamisil, minocycline, fruit''s skin, vegetable skin, fragrances
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna Covid-19 Vaccine EUA On the day of the vaccine my arm (where the vaccine was injected) started to hurt in the evening. That night I was laying in bed and when I moved it felt as if the muscle was hanging off my arm. The next day the pain was worse and my arm was very swollen and looked like a ball where they injected the vaccine. My arm was also red and felt hot. My joints hurt and I felt tired. Throughout the day the redness began to travel down my arm to my elbow. I couldn''t move my arm or do anything with it due to the pain. I took 1K miligrams of Tylenol with breakfast that day and felt a relief in joint pain and I didn''t feel tired anymore. That Monday my arm began to itch sometimes. The pain, redness, and swelling was still there. On Thursday there was less swelling and less redness. To this day my arm is still itchy sometimes and still a bit red.


VAERS ID: 1605741 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-06
Onset:2021-08-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins C & D
Current Illness: No
Preexisting Conditions: I have Rheumatoid Arthritis but haven''t had any flare ups.
Allergies: Drugs containing Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My arm was sore from that Fri. night until Sunday 8/8. The following week 8/15 I awoke to itching/scratching my neck. Followed my other upper parts of my body chest and arms up. As I scratched bumps would appear. I been taking Benadryl and it seems to be getting better(leaving) . I have scratched less today.


VAERS ID: 1617435 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cold sweat, Dizziness, Dysstasia, Fatigue, Feeling cold, Hyperhidrosis, Pain, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Within a minute of receiving the shot, I became extremely weak, dizzy, and couldn''t stand up. Whole-body felt cold and clammy, hot to the touch, and underarms and neck became very sweaty. Had to lie down on the floor and elevate my feet on a chair for 20 minutes until I could stand up safely again. Four hours after receiving the shot, I felt extreme fatigue and soreness all over my body. This lasted for three days.


VAERS ID: 1617458 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Glossodynia, Headache, Influenza like illness, Oral pain, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Only birth control
Current Illness: no
Preexisting Conditions: no
Allergies: only to nail polish
Diagnostic Lab Data: The doctors thought that my symptoms were not from the vaccine, they thought it was covid. I took the exam on tuesday 08/17/2021 and it was negative.
CDC Split Type:

Write-up: The next day after the vaccine I was fine for most of the day, later i started with headaches and body aches and maybe a fever, expected side effects. Sunday 08/15/2021, I woke up with body aches, a sore throat and a runny nose, feeling like i had the flu. Monday 08/16/2021 I was still with these same symptoms. Tuesday 08/17/2021 I started to get a little worse, I woke up with a dry cough and sneezing attacks and mouth sores appeared on the tongue. Wednesday 08/18/2021 it was the same, but the sores started to get worse. Thursday I started to get better.


VAERS ID: 1617601 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Approximately 36 hours after the first Moderna shot my left arm began to swell and itch, with a 5 inch by 2 inch red blotch. It is now day 9 with no improvement.


VAERS ID: 1617626 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH Z17533 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Talz, Levothyroxine, Valtrex, Estradiol, Methylprogesterone
Current Illness: no
Preexisting Conditions: I have psoriatic arthritis (past 50 years)
Allergies: no
Diagnostic Lab Data: no
CDC Split Type:

Write-up: I experienced chest pains for 3 days - left side, heart area. They were not severe enough for me to go to the hospital and would subside. There were about 3 episodes in a given day. I was concerned but not panicked about it. Then, after 3 days they stopped. The only other side effect I had was a very sore arm the day after receiving the vaccine.


VAERS ID: 1617649 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Awaiting follow up with GYN, no tests ordered yet
CDC Split Type:

Write-up: Persistent vaginal bleeding for 9 days and counting, started within 24 hours. Heavy flow, only subsided a little so far. Prior to vaccine, had not had a period in 3 months due to Mirena IUD. Typical flow is moderate to light prior to IUD. Not pregnant. Waiting for follow-up with GYN.


VAERS ID: 1617688 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU0196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Aphasia, Asthenia, Disorientation, Dysarthria, Hypoaesthesia, Incoherent, Memory impairment, Muscle fatigue
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: discussed symptoms with Dr office midday on 8/16 went to hospital on monday 8/16 as per recommendation of Dr office to check for blood clots and/or possible stroke.
CDC Split Type:

Write-up: - numbness in elbow and through to the fingers - short term memory loss - slight slurring of words - slightly incoherent....trouble putting all words of sentence together/forgetting words to use in a sentence - trouble recalling relevant information - briefly forgot sons name - disoriented for several days - muscle fatigue and low energy


VAERS ID: 1617822 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Feeling hot, Pallor, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fainting/fear of needles
Other Medications:
Current Illness:
Preexisting Conditions: muscular dystrophy (as verbalized by his aunt who was present during the vaccine)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was waiting for the required 15-minutes in store. He was feeling hot, so he sat down in the pharmacy lobby. He started to have a seizure and his aunt yelled to me that he was having a seizure. I called 911, but the seizure lasted less than a minute. The patient''s eyes were darting back and forth and he was white and gripping the sides of the chair while seizing. I got his legs elevated and got him a wet paper towel. His aunt (who said she is a nurse) said that he has muscular dystrophy but has never had a seizure before, although he does currently see a neurologist. She asked him if he knew where he was, and he did--he said he didnt know what happened (or that he had a seizure, but he knew he had gotten a vaccine and was at Pharmacy). The EMT''s came, he was able to get up and go with them to get checked out.


VAERS ID: 1619165 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: None stated.


VAERS ID: 1620334 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-08-14
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Confusional state, Dizziness, Feeling abnormal, Headache, Hypersomnia, Nausea, Paraesthesia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular 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: ESTROGENON ESTRADIOL; MEDROXY PROGESTERONE; LEVOTHYROXINE; L-THYRONINE; ADDERALL
Current Illness:
Preexisting Conditions: Comments: The patient was not pregnant at the time of vaccination.
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 102 F; Test Date: 20210816; Test Name: Body temperature; Result Unstructured Data: 99 F
CDC Split Type: USJNJFOC20210841282

Write-up: TINGLING OF FACE (CHEEKS AND MOUTH) AND BOTH HANDS AND ARMS; BAD POUNDING HEADACHE (FELT LIKE BRAIN WANTED TO COME OUT OF MY HEAD); FEVER; NAUSEA (FELT LIKE PREGNANT AND SMELLS WERE BOTHERING); CONFUSED; FEELING SPACED OUT/ FEELING WEIRD; SLEPT FOR 2 DAYS STRAIGHT; DIZZY BUT NOT UNBALANCE; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient was not pregnant at the time of vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: 21-SEP-2021) dose was not reported, administered on 14-AUG-2021 for prophylactic vaccination. Concomitant medications included amfetamine aspartate/amfetamine sulfate/dexamfetamine saccharate/dexamfetamine sulfate for drug used for unknown indication, estrogens conjugated for drug used for unknown indication, levothyroxine for drug used for unknown indication, liothyronine sodium for drug used for unknown indication, and progesterone for drug used for unknown indication. On 14-AUG-2021, the patient experienced confused. On 14-AUG-2021, the patient experienced feeling spaced out/ feeling weird. On 14-AUG-2021, the patient experienced slept for 2 days straight. On 14-AUG-2021, the patient experienced dizzy but not unbalance. On 14-AUG-2021, the patient experienced nausea (felt like pregnant and smells were bothering). On 14-AUG-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 102 F. On 16-AUG-2021, Laboratory data included: Body temperature (NR: not provided) 99 F. On 18-AUG-2021, the patient experienced bad pounding headache (felt like brain wanted to come out of my head). On 18-AUG-2021 21:10, treatment medications included: paracetamol. On 19-AUG-2021, the patient experienced tingling of face (cheeks and mouth) and both hands and arms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 16-AUG-2021, was recovering from bad pounding headache (felt like brain wanted to come out of my head), had not recovered from confused, tingling of face (cheeks and mouth) and both hands and arms, nausea (felt like pregnant and smells were bothering), and feeling spaced out/ feeling weird, and the outcome of slept for 2 days straight and dizzy but not unbalance was not reported. This report was non-serious.


VAERS ID: 1620499 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Hypophagia, Migraine, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Gabapentin, lexapro, atorvastatin
Current Illness: No
Preexisting Conditions: Fibromyalgia, high cholesterol, depression
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme migraine on right side of head, vomiting/ dry heaving, unable to even keep down water, diarrhea, unable to do anything but try to sleep for 3 days.


VAERS ID: 1623067 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium


VAERS ID: 1623346 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-31
Onset:2021-08-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Fluid retention, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Chronic kidney disease (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: not taking any medications prior to vaccination
Current Illness: no known illness
Preexisting Conditions: no prior chronic conditions
Allergies: NKDA
Diagnostic Lab Data: Patient was diagnosed with pericarditis and hospitalized.
CDC Split Type:

Write-up: Approximately 2 weeks after vaccine administration patient started developing shortness of breath, fluid retention, lightheadedness with movement, and chest pain. Patient was seen for their symptoms diagnosed with pericarditis and hospitalized. Patient is now on isosorbide and metoprolol suc for maintenece treatment.


VAERS ID: 1623383 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-12
Onset:2021-08-14
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / UN

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

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

Write-up: Tested positive after fully vaccinated (outcome was full recovery with few symptoms)


VAERS ID: 1623393 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Fatigue, Hypersomnia, Impaired work ability, Loss of personal independence in daily activities, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: depression, anxiety
Allergies: Augmentin and bactrim- hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got my first dose of the vaccine (Pfizer) on 8/13/21 and have been having side effects ever since; they began 8/14/21. I had the extreme fatigue and nausea. The nausea subsided for a while but the fatigue has not gone away. I already had more than normal fatigue as an ongoing side effect of covid (had covid in March 2021 but it was very mild. My symptoms were the loss of smell/taste, mild coughing (I do have asthma), and fatigue), but that was starting to get a bit better, however it has gotten much worse since getting the vaccine. This past Saturday 8/21/21 (which was 8 days after my first dose) I slept about 23 hours, with waking up 2-3 times for the bathroom. Sunday 8/22/21 I slept another 18ish hours. I''ve also had some nausea returning today. It is making it very difficult for me to function at my job, let alone basic daily functions such as showering. I know my body and I know this is not normal for myself. The last time I threw up was at least 10 years ago, and I''ve thrown up twice since my first dose. I''ve dealt with fatigue off and on before and this is much worse than anything I''ve had and it was only after this vaccine that it got worse. Very, very rarely have I ever experienced side effects from a medication or vaccine, including the flu shot. I have messaged my primary care provider informing him of these side effects.


VAERS ID: 1623454 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache
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: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mild Intermittent Throbbing headache that started 45mn after shot. Subside the morning of the next day, but came back in the afternoon 5pm. It''s been progressively worsen over the course of the week


VAERS ID: 1623524 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-31
Onset:2021-08-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / UNK UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prilosec, she takes a couple other meds I will need to update here when I have the information,
Current Illness: none This happened after the 2nd Shot. 1st shot was on 07/02/21 2nd shot was on 07/31/2021
Preexisting Conditions: COPD
Allergies: penicillin
Diagnostic Lab Data: She had a massive heart attack, she is still fighting for her life at hospital.
CDC Split Type:

Write-up: She had a massive heart attack, she is still fighting for her life at hospital.


VAERS ID: 1623527 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Myocardial infarction, Pulmonary embolism
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: DVT, PE, MI diagnosed on 08/14/21.


VAERS ID: 1623694 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-20
Onset:2021-08-14
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Write-up: Covid19


VAERS ID: 1623709 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-20
Onset:2021-08-14
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID 19
CDC Split Type:

Write-up: COVID19


VAERS ID: 1623884 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cognitive disorder, Depressed level of consciousness, Feeling abnormal, Impaired driving ability, Impaired work ability, Insomnia, Lethargy, Sedation, Sleep inertia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Men''s multi vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: on-going
CDC Split Type:

Write-up: - In bed since the event and unable to operate car or go to work - Brain fog unable to process surroundings and/or make decisions - unable to get deep sleep, and constant sleep inertia (vivid dreaming) - feels semi conscious and/or sedated - almost immediately felt lethargic and foggy, pharmacy kept for 30 minutes - Called pharmacy the next day and told they are normal side effects - after a few more days called doctors office and made appointment for check-up however unable to get in until 8/23/2021. Visited urgent care clinic on Friday 8/20/2021 after no improvement for vital check and inner ear evaluation.


VAERS ID: 1623927 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-01
Onset:2021-08-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache
SMQs:, Dementia (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: I didn?t take anything at the time/day of vaccination for fear of bad reaction.
Current Illness: None
Preexisting Conditions: You?re trying to blame my past medical history on this, but I feel like something has definitely changed within my body and mind. Mctd, hypothyroidism, migraine, adhd, asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Having severe daily headaches, thought it was my migraines at first but now realize it?s different. Feels different. I feel that I?m even spacing out for lack of better description. Unsure what a doctor will do at this point other than tell me it my migraines or stress because I?m a women. In my experience women are dismissed when sharing their symptoms.


VAERS ID: 1623960 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acupuncture, Autoimmune disorder, Eczema, Fungal infection, Lip swelling, Pruritus, Rash, Skin weeping, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Auto immune issues including cheilitis, eczema, and allergies
Allergies: Ibuprofen, inhalants
Diagnostic Lab Data: I have been receiving acupuncture for the elimination of allergies and to treat my autoimmune conditions.
CDC Split Type:

Write-up: 36 hours following injection, all of my autoimmune issues flared. My lips became swollen and were oozing pus, my eczema flared and kept me up through the night with itching, I developed a rash under my left armpit, and I also developed a yeast infection which I do not believe was a coincidence.


VAERS ID: 1623969 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-05
Onset:2021-08-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Migraleif, multi vitamin, cyproheptadine, vit d
Current Illness: N/a
Preexisting Conditions: Migraines, VP shunt for hydrocephalus at 1 month old
Allergies: Pcn, cephalosporins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started with a rash, on same arm as injection was given. Then he started having pain in that arm. We took him to local urgent care and he was suspicious for shingles, and was started on valacyclovir 1gm tid for 7 days


VAERS ID: 1623984 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chromaturia, Fatigue, Jaundice, Malaise, Muscle spasms, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations: Flu shot ~ 10-15 years ago
Other Medications: Metoprolol succ 50 mg daily and Valsartan 160 mg PO daily
Current Illness: None
Preexisting Conditions: Hypertension and obesity
Allergies: NKDA
Diagnostic Lab Data: Patient will be sent to ER due to jaundice.
CDC Split Type:

Write-up: Patient reports waking up the following morning with leg cramps, malaise, fatigue, feverish (subjective). Patient noted darker urine and abdominal pain starting on 8/18/21.


VAERS ID: 1624057 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram, Metabolic function test, Palpitations, Red blood cell sedimentation rate, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: magnesium, feverfew, b2, coq10, Adderall
Current Illness: none
Preexisting Conditions: migraines, adhd- nothing major, pretty healthy
Allergies: amoxicillin
Diagnostic Lab Data: I was seen for a visit on 8/18. I had EKG, cmp, sed rate, esr at this appt
CDC Split Type:

Write-up: palpations, SOB, chest pain, tachycardia that started on 8/15 and got progressively worse.


VAERS ID: 1624133 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Flank pain, Gait disturbance, Impaired work ability, Pain, Pain in extremity, Sciatica
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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: Advil as needed.
Current Illness: No illnesses. I had some very minor low back pain a few days prior, but nothing more than minor aches from possibly playing with grandkids, or vacuuming house.
Preexisting Conditions: None.
Allergies: No known allergies. Codeine type pain killers have made me nauseous.
Diagnostic Lab Data: I plan on going to see some sort of specialist to determine if I have any issues still going on that need to be treated or what I can do to make sure I never experience this again.
CDC Split Type:

Write-up: I received my first shot around 9am of 8/14/21. I ran a few errands and went home. Some time around 1-2pm that same afternoon, I was hit with excruciating pain in my left flank area that totally encompassed my upper thigh. This was the worse pain I have ever experienced, ever. I have had children, surgeries, etc. and have not had this severity of pain. I was outside in my yard when the pain started. I tried walking around some to see if that would help, but the pain became so unbearable, it was all I could to to walk into my house and lie on the floor. I did everything I could to try and relieve the pain but nothing helped. And what made it so unbearable was that the pain was nonstop; it would not let up no matter what I did. I tried different positions, etc. I finally half walked and half crawled to our extra bedroom to lie down on the bed. Again I tried multiple positions to try and help. I was in bed in horrible pain from Saturday afternoon until Tuesday. At some point late Monday or early Tuesday, the pain started radiating down into my lower right leg and foot and toes. I was alternating aleve and tylenol (normally I take Advil for any pain but the nurse that gave me the shot that morning specifically told me not to take any Advil because there are studies or something that indicate Advil may affect the effectiveness of the shot so I specifically had my husband go get aleve and tylenol). After much online searching and discussions with my daughter and husband, we came to the conclusion that I most likely was having severe sciatica. I have never had this before, never had back pain that was so relentless to never let up. I have had minor aches and pains, but again, nothing this debilitating. Finally by Wednesday morning, I was able to walk and sit just enough through the pain to go see Dr., my internal medical family practitioner. I explained my symptoms and I did tell her that I had the shot Saturday morning around 9 and my pain started 4-5 hours after the shot. She told me she believed what I have is classic sciatica and she prescribed prednisone. I was able to start doing the child pose almost all day off and on for the next several days and taking the prednisone. Initially, the child pose was the only thing I could do to help alleviate some of the pain. And I was only able to feel well enough to do that on Wednesday. I am on day 5 of the prednisone and am almost finishing it up by tapering off. My pain is much better now. I was able to return to work this week. I was out of work the entire last week.


VAERS ID: 1624282 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Injection site rash, Pain, Pyrexia, Rash pruritic, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: Bupropion Levothyroxine
Current Illness: NA
Preexisting Conditions: Depression
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke up out of a sound sleep aprox 12 hours after injection with high fever, chills, body aches, vomiting, extreme headache, dizziness and almost fainted. I ran a fever until after 54 hours. Developed an itchy rash, around the injection site on day 9.


VAERS ID: 1624565 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Levothyroxine, Trazadone, Sertraline, and Bupropion.
Current Illness: None.
Preexisting Conditions: Asthma, hypothyroidism, and depression (surrounding death of parent).
Allergies: Sulfa.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Severe itching and hives only on the back of my leg and on the back of my right arm which lasted approximately three days. Treated with a steroid dose pack and Zyrtec.


VAERS ID: 1624580 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness transient, Ischaemia, Muscle twitching, Ophthalmological examination
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Dyskinesia (broad), Dystonia (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: migraines
Allergies: none known
Diagnostic Lab Data: eye exam, Dr said unknow if vaccine was related to event.
CDC Split Type:

Write-up: ischemic event causing temporary blindness in rt eye. Days leading up to event twitch above rt eye.


VAERS ID: 1624587 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: Latanaprost, tacrolimus
Current Illness: Had COVID 2 weeks prior to vaccination
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Office visit. No tests or labs at this time.
CDC Split Type:

Write-up: Tinnitus- ringing in both ears. Started ear drops( carbamide peroxide 6.5%) after 8/18/2021 appointment with Dr.


VAERS ID: 1627719 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Lethargy, Pain, Paranasal sinus discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: SINUS PRESSURE-Severe


VAERS ID: 1627986 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-12
Onset:2021-08-14
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for SOB, COVID19 8/14/21-8/17/21


VAERS ID: 1627996 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Florida  
Vaccinated:2020-12-30
Onset:2021-08-14
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ685 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalization for hypoxic respiratory failure, COVID pneumonia. Treated with dexamethasone 6 mg IV twice daily


VAERS ID: 1628031 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-09
Onset:2021-08-14
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalization for COVID pneumonia; hypoxemia. Treated with dexamethasone 6 mg IV daily; Remdesivir for 5 days.


VAERS ID: 1628113 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-08-14
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 AR / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 AR / 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: COPD OBESITY HTN DM
Preexisting Conditions: SEE ABOVE
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID


VAERS ID: 1628182 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold type haemolytic anaemia, Cough, Cyanosis, Dyspnoea, Extra dose administered, Headache, Influenza like illness, Pain, Pain in extremity, Peripheral coldness, Rhinorrhoea, Sneezing
SMQs:, Haemolytic disorders (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazapam, Oxycodone, Tamsulosin, aspirin, ibuprofen, magnesium, milk thistle, flax oil, fish oil, vitamin-d, gamma e complex, alpha lipoic acid, dihydromyricetin, choline & Inositol Ginkgo Biloba
Current Illness: none
Preexisting Conditions: Polycemia vera, Multiple Myeoloma, spinal cord damage, possible MS
Allergies: None
Diagnostic Lab Data: None since the vaccination
CDC Split Type:

Write-up: Sore arm and aches for 2 days, then flu like symptoms, sneezing, coughing, running nose, breathing issues, headaches and body aches, Then yesterday, my left pinky finger turned blue and cold. It appears to be cold agglutinin disease which i did not have until the 3rd vaccination. The first 2 vaccinations only resulted in sore arm for 2 days.


VAERS ID: 1628205 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dizziness, Heart rate increased, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Chest pain, left hand fingers tingling and numbness, dizzy after elevated heart rate


VAERS ID: 1628543 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-04
Onset:2021-08-14
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 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: T2DM, anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized with (+) COVID on 8/14/2021


VAERS ID: 1628586 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-01
Onset:2021-08-14
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received 2-dose COVID-19 vaccine (unsure if Moderna or Pfizer) received second dose in February.


VAERS ID: 1628685 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Asthenia, Chills, Electrocardiogram normal, Headache, Interchange of vaccine products, Nausea, Pain, Palpitations, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, levothyroxine
Current Illness: Not illness, however, breastfeeding
Preexisting Conditions:
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was given the Pfizer vaccine as my first dose. 25 days later I returned to the same Doctor''s office for my second dose. Later to find out, I was given the Moderna for the second dose, rather than the Pfizer. About 12 hours later, I had the chills so badly, I was shaking uncontrollably. I had a fever of 102. Pounding headache, I was nautious, achey, and so weak, I could not lift my 3 month old baby. Symptoms lasted about 60 hours. About 72 hours later, my heart began to race and pound hard. This lasted about 4 or 5 days. Unsure if the heart racing was related, I went to urgent care, who did an EKG and found nothing wrong. Labeled it as anxiety. I. Aware fever, etc are considered a normal immune response to the vaccine. However, I am reporting die to my unique situation, which is I was given the wrong vaccine to complete my series.


VAERS ID: 1628695 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-06
Onset:2021-08-14
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Cough, Dyspnoea, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin (AMOXIL) 500 mg capsule aspirin (ADULT LOW DOSE ASPIRIN) 81 mg tablet benzonatate (TESSALON) 100 mg capsule calcium carbonate (CALCIUM 500 ORAL) calcium carbonate (TUMS ORAL) cholecalciferol, vitamin D3, (VITAMIN D3 ORAL)
Current Illness:
Preexisting Conditions: Nervous Cerumen in auditory canal on examination Eustachian tube dysfunction, right Primary cough headache Respiratory Acute non-recurrent maxillary sinusitis Cough in adult patient Circulatory PVC''s (premature ventricular contractions) Palpitations Digestive Class 1 obesity due to excess calories without serious comorbidity with body mass index (BMI) of 32.0 to 32.9 in adult Gastroesophageal reflux disease without esophagitis Vitamin D deficiency Genitourinary Hypercalciuria Musculoskeletal Postmenopausal osteoporosis DDD (degenerative disc disease), cervical Irritant contact dermatitis due to other agents Tick bite of head, subsequent encounter Primary osteoarthritis of right knee Endocrine/Metabolic Impaired fasting glucose Hematologic Thrombocytosis Infectious/Inflammatory COVID-19 virus infection Other Long term current use of diuretic Other fatigue
Allergies: Sulfamethoxazole-trimethoprimHives / Urticaria Bee Venom Protein (Honey Bee) Chloroquine Phosphate
Diagnostic Lab Data: 08/16/21 1823 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/16/21 1317 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Fever or Chills Cough Headache WEAKNESS ED Discharged 8/22/2021 (2 hours) Hospital ED Last attending ? Treatment team COVID-19 +1 more Clinical impression Shortness of Breath


VAERS ID: 1628700 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-08-14
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Taxol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fully Vaccinated patient hospitalized for COVID-19.


VAERS ID: 1628710 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-04
Onset:2021-08-14
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Oxaprozin, Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fully Vaccinated patient hospitalized with COVID-19.


VAERS ID: 1628756 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #FC3180 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash, Myalgia, Rash papular
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 60mg. Vyvanse
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Muscle pain occurred from the time of vaccination for 2 days. Rash appeared days following the injection, 2 weeks later and it hasn''t changed at all. Red bumps, around the area where shot was given.


VAERS ID: 1628773 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Cardiac monitoring, Chest X-ray normal, Dizziness, Electrocardiogram abnormal, Head discomfort, Heart rate increased, Lymphocyte count decreased, Orthostatic heart rate response increased, Orthostatic hypertension, Palpitations, Sinus tachycardia, Tachycardia, Troponin normal, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None, n/a
Current Illness: None, n/a
Preexisting Conditions: None, n/a
Allergies: Penicillin
Diagnostic Lab Data: ER visit 8/14 - troponins negative, abs lymphocytes low (0.8 when lower reference range was 1.0), chest x-ray negative. EKG with sinus tachycardia. ER visit 8/16 - troponins negative, abs lymphocytes remain low (0.8), WBCs now also low (3.2 when the lower reference range is 4.0). These CBC changes were never present prior to the COVID-19 vaccine. CTA was normal. Pericarditis was ruled out. EKG with sinus tachycardia. Orthostasis test revealed highly orthostatic. PCP visit 8/17 - EKG with sinus tachycardia and other changes Cardiologist visit 8/18 - EKG with sinus rhythm, however borderline PR interval
CDC Split Type:

Write-up: 12 hours after receiving the Pfizer-BioNTech COVID-19 Vaccine EUA, the patient experienced heart pounding and palpitations. Went back to sleep and in the morning (~11am) his heart rate was 120-135 bpm at rest. On rising it elevated to 153. The advice nurse advised us to go to the ER 8/14. Blood work in the ER was negative for troponins and chest x-ray negative (myocarditis appeared to be ruled out), but tachycardia persisted after receiving 2 L IVF and he was discharged as such. Symptoms worsened over the next 3 days and a virtual MD visit advised us to return to the ER on 8/16. His heart rate would elevate 30-40 bpm on rising and would be mildly tachycardic while at rest. Despite 3 L IVF in the ER, he was very orthostatic. He was discharged home still with tachycardia which is only relieved by laying flat. He is currently wearing a heart monitor provided by a cardiologist following the ER visit and is being worked up for postural orthostatic tachycardia syndrome secondary to the first vaccine. It has been 11 days and the symptoms have not improved. Heart rate elevates to 145-151 on standing. Dizziness and head pressure when sitting. This vaccine has completely altered his health, which was perfect prior to receiving this initial dose.


VAERS ID: 1628790 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-21
Onset:2021-08-14
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Atelectasis, COVID-19, COVID-19 pneumonia, Continuous positive airway pressure, Cough, Dyspnoea, Dyspnoea exertional, Fibrin D dimer increased, Headache, Lung infiltration, Oropharyngeal pain, Oxygen saturation decreased, Posture abnormal, Pulse abnormal, SARS-CoV-2 test positive, Scan with contrast, Use of accessory respiratory muscles, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler amoxicillin (AMOXIL) 500 mg capsule ASPIRIN ORAL atorvastatin (LIPITOR) 40 mg tablet clopidogreL (PLAVIX) 75 mg tablet fluticasone (FLONASE) 5
Current Illness:
Preexisting Conditions: Nervous Coronary artery disease involving native coronary artery of native heart with angina pectoris (CMS/HCC) Numbness and tingling in left hand Chronic low back pain Chronic pain syndrome Unstable angina (CMS/HCC) Respiratory COPD (chronic obstructive pulmonary disease) (CMS/HCC) OSA (obstructive sleep apnea) Circulatory Essential hypertension Pulmonary HTN (CMS/HCC) Digestive GERD (gastroesophageal reflux disease) Morbid obesity (CMS/HCC) Musculoskeletal Restless legs syndrome Endocrine/Metabolic Hyperlipidemia Controlled type 2 diabetes mellitus without complication, without long-term current use of insulin (CMS/HCC) Other Anxiety S/P TKR (total knee replacement) S/P CABG x 3
Allergies: NKA
Diagnostic Lab Data: 08/19/21 0244 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/18/21 1552 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 0244 COVID-19 PCR Collected: 08/18/21 1552 | Final result | Specimen: Swab from Nasopharynx Imaging Results Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast [3299362384] Resulted: 08/24/21 1442 Order Status: Completed Updated: 08/24/21 1442 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: 1. There are patchy, bilateral peripheral infiltrates with underlying centrilobular emphysema. Areas of basilar subsegmental atelectasis/infiltrate and scarring are also present. 2. Commonly-reported imaging features of COVID-19 pneumonia are present. Other processes that can cause a similar imaging pattern include but are not limited to: Atypical infections (such as influenza virus, adenovirus, or organizing pneumonias) or noninfectious etiologies (such as drug-induced lung toxicity or connective-tissue disease.) 3. There are no findings for pulmonary thromboemboli, aortic dissection, or aneurysmal dilation. 4. Additional findings and lesser details are as described below. END OF IMPRESSION: INDICATION: COVID-19 positive, shortness of breath, chest pain, dyspnea, hypoxia, positive for COVID-19, high D-dimer. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CTA scan of the chest was performed from the lung apices to below the diaphragm, including the pulmonary artery. 2 mm axial reconstruction with MPR coronal, oblique, and sagittal images were created. 3D post processing imaging were obtained and stored. CONTRAST: 100 mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUSLY. Quality of contrast opacification was adequate. COMPARISON: None. CT CHEST PULMONARY ANGIOGRAPHIC FINDINGS: There are no findings for aortic dissection or aneurysmal dilation. Post-operative sequelae of median sternotomy and open heart surgery are present. Coronary arterial calcifications are present. No pulmonary thromboemboli are identified. Paratracheal, paracarinal, and prominent right hilar lymph nodes are present and likely of reactive etiology. A right hilar lymph node measures 30 x 19 mm. There are patchy, bilateral peripheral infiltrates with underlying centrilobular emphysema. Areas of basilar subsegmental atelectasis and scarring are also present. Protocol included aspects of the superior abdominal viscera demonstrate decreased hepatic density likely representing steatosis. Calcified hepatic and splenic granulomata are present. There is fatty infiltration of the pancreas. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.
CDC Split Type:

Write-up: headache ? Sore Throat ? Fatigue ? Shortness of Breath ? Cough RN 8/24/21 8:42 AM Note Wife reporting that patient tested + for covid; having hard time with o2_ 88-89%. Patient is having DOE while walking. Pt reporting that his P/O was low this morning when he woke up despite being on cpap at night. (88%) Pt with + wheezing that can be heard across the room while on the phone. Denies any chest pain. + mild sob while up and moving and is winded very quickly while ambulating. Advised ER, verbalized understanding and will take over for treatment. Verbalized understanding to call back if condition worsens. Reason for Disposition ? Wheezing can be heard across the room Answer Assessment - Initial Assessment Questions 1. RESPIRATORY STATUS: "Describe your breathing?" (e.g., wheezing, shortness of breath, unable to speak, severe coughing) Wheezing, sob, doe, sever coughing 2. ONSET: "When did this breathing problem begin?" 2 days ago 3. PATTERN "Does the difficult breathing come and go, or has it been constant since it started?" constant 4. SEVERITY: "How bad is your breathing?" (e.g., mild, moderate, severe) - MILD: No SOB at rest, mild SOB with walking, speaks normally in sentences, can lay down, no retractions, pulse < 100. - MODERATE: SOB at rest, SOB with minimal exertion and prefers to sit, cannot lie down flat, speaks in phrases, mild retractions, audible wheezing, pulse 100-120. - SEVERE: Very SOB at rest, speaks in single words, struggling to breathe, sitting hunched forward, retractions, pulse $g 120 modertae 5. RECURRENT SYMPTOM: "Have you had difficulty breathing before?" If so, ask: "When was the last time?" and "What happened that time?" "not like this" 6. CARDIAC HISTORY: "Do you have any history of heart disease?" (e.g., heart attack, angina, bypass surgery, angioplasty) Open heart 7. LUNG HISTORY: "Do you have any history of lung disease?" (e.g., pulmonary embolus, asthma, emphysema) copd 8. CAUSE: "What do you think is causing the breathing problem?" covid 9. OTHER SYMPTOMS: "Do you have any other symptoms? (e.g., dizziness, runny nose, cough, chest pain, fever) cough Protocols used: BREATHING DIFFICULTY ED Discharged 8/24/2021 (6 hours) Hospital ER MD Last attending ? Treatment team Pneumonia due to COVID-19 virus Clinical impression Shortness of Breath Chief complaint


VAERS ID: 1629082 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol tart 25mg keppra 500mg alprazolam 0.5mg clopidogrel albuterol hfa hydroxyzine 10mg
Current Illness: n/a
Preexisting Conditions: Hypertension Asthma
Allergies: penicillins
Diagnostic Lab Data: unsure
CDC Split Type:

Write-up: Patient states that she had redness and pain in her left arm, the day following the vaccination. Patient states that she has gone to urgent care/ER and was diagnosed with cellulitis. Not sure of the course of time, however as of today Aug 24th, the patient states that she is seeking additional medical help as the antibiotic she took, has not resolved the cellulitis. Her symptoms were soreness, redness, heat, at the site and fever.


VAERS ID: 1629280 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Blood creatinine normal, Chronic sinusitis, Condition aggravated, Facial asymmetry, Glomerular filtration rate decreased, Hypoaesthesia, Magnetic resonance imaging head normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril-hydrochlorothiazide
Current Illness: None
Preexisting Conditions: Hypertension, chronic sinusistis, polycythemia, obesity, gout
Allergies: None
Diagnostic Lab Data: 8/17/21 obtained eGFR and Cr, eGFR 57, Cr WNL 8/19/21 MRI brain wo contrast; showed possible fluid collection versus mass 8/23 CT sinus wo contrast for further evaluation of abnormality above, suggestive of chronic sinusitis 8/24/21 MRI brain w contrast obtained for abnormality above, suggestive chronic sinusitis
CDC Split Type:

Write-up: Developed gradually progressive facial asymmetry with facial numbness 24-36 hours after immunization. Seen in clinic the following week. MRI obtained and negative for CVA and started on prednisone for presumed Bell''s Palsy. Slight improvement in facial asymmetry 1 week later


VAERS ID: 1629309 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, Basophil count decreased, Basophil percentage decreased, Bilirubin urine, Blood albumin decreased, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium increased, Blood phosphorus normal, Blood potassium normal, Blood sodium decreased, Blood urea normal, Blood urine present, C-reactive protein increased, Carbon dioxide increased, Creatinine urine, Eosinophil count decreased, Eosinophil percentage decreased, Glucose urine absent, Haematocrit increased, Haemoglobin normal, Haemoglobin urine present, Human chorionic gonadotropin negative, Immature granulocyte count, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin, Mean cell haemoglobin concentration normal, Mean cell volume normal, Mean platelet volume increased, Monocyte percentage, Neutrophil count normal, Neutrophil percentage increased, Nitrite urine absent, Nucleated red cells, Periorbital oedema, Peripheral swelling, Platelet count normal, Pregnancy test negative, Protein urine present, Red blood cell count normal, Red blood cell sedimentation rate increased, Red blood cells urine, Red cell distribution width normal, SARS-CoV-2 test negative, Specific gravity urine normal, Ultrasound Doppler normal, Urinary sediment present, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine decreased, White blood cell count normal, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (broad), Haemolytic disorders (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of nephrotic syndrome first diagnosed on 8/29/17, no flares in 6 months prior to vaccination.
Allergies: penicillin
Diagnostic Lab Data: 08/23/21 18:45 White Blood Cell Count 7.1 (Ref. Range 5.0 - 11.0) Red Blood Cell Count 5.33 (Ref. Range 4.10 - 5.10) Hemoglobin 15.4 (Ref. Range 12.0 - 16.0) Hematocrit 44.7 (Ref. Range 36.0 - 46.0) Mean Corpuscular Volume 84 (Ref. Range 78 - 98) Mean Corpuscular Hemoglobin 28.9 (Ref. Range 25.0 - 35.0) Mean Corpuscular Hemoglobin Conc 34.5 (Ref. Range 31.0 - 37.0) Red Cell Distribution Width 11.4 (Ref. Range 11.0 - 14.5) Platelet Count 305 (Ref. Range 150 - 450) Mean Platelet Volume 11.0 (Ref. Range 8.9 - 13.1) NRBC (%) (Auto) 0.0 (Ref. Range 0.0 - 0.0) NRBC # (Auto) 0.00 (Ref. Range 0.00 - 0.01) Neutrophils (%) (Auto) 73 (Ref. Range 30 - 70) Lymphocytes (%) (Auto) 21 (Ref. Range 20 - 40) Monocytes (%) (Auto) 6 (Ref. Range 0 - 10) Eosinophils (%) (Auto) 0 (Ref. Range 0 - 4) Basophils (%) (Auto) 0 (Ref. Range 0 - 1) Immature Granulocyte (%) (Auto) 0.3 (Ref. Range 0.0 - 0.7) Neutrophils # (Auto) 5.2 (Ref. Range 1.5 - 7.0) Lymphocytes # (Auto) 1.5 (Ref. Range 1.1 - 4.5) Monocytes # (Auto) 0.4 (Ref. Range 0.0 - 0.9) Eosinophils # (Auto) 0.00 (Ref. Range 0.00 - 0.20) Basophils # (Auto) 0.01 (Ref. Range 0.00 - 0.04) Immature Granulocyte # (Auto) 0.02 (Ref. Range 0.00 - 0.05) Erythrocyte Sedimentation Rate 39 (Ref. Range 0 - 20) Sodium, Serum 132 (Ref. Range 133 - 143) Potassium Level 4.4 (Ref. Range 3.6 - 5.0) Chloride Level 102 (Ref. Range 98 - 107) Carbon Dioxide Level 29 (Ref. Range 22 - 30) Blood Urea Nitrogen 8 (Ref. Range 7 - 17) Random Glucose * 106 (Ref. Range 60 - 115) Creatinine 0.4 (Ref. Range 0.6 - 0.9) Calcium Level 8.6 (Ref. Range 8.4 - 10.2) Anion Gap Calculation 1 (Ref. Range 5 - 15) Albumin 3.1 (Ref. Range 3.8 - 5.4) Phosphorus Level 5.3 (Ref. Range 2.5 - 4.5) Magnesium Level 2.1 (Ref. Range 1.6 - 2.3) C-Reactive Protein <5.0 (Ref. Range 0.0 - 10.0) Urine Beta Human Chorionic Gonadotropin Negative (Ref. Range Negative - ) 08/23/21 18:54 Urine Color Colorless (Ref. Range Yellow - ) Urine Clarity Clear (Ref. Range Clear - ) Urine Specific Gravity 1.009 (Ref. Range 1.005 - 1.030) Urine pH 7.0 (Ref. Range 5.0 - 8.5) Urine Protein 100 (Ref. Range - <=30) Urine Glucose (UA) Negative (Ref. Range Negative - ) Urine Ketones Negative (Ref. Range Negative - ) Urine Bilirubin Negative (Ref. Range Negative - ) Urine Nitrite Negative (Ref. Range Negative - ) Urine Urobilinogen <2.0 (Ref. Range - <=2.0) Urine Leukocyte Esterase Negative (Ref. Range Negative - ) Urine Hemoglobin Free 2+ (Ref. Range Negative - ) Urine RBC <4 (Ref. Range - <=4) Urine WBC <4 (Ref. Range - <=6) Urine Squamous Epithelial Cells <4 (Ref. Range - <=6) Urine Random Total Protein 173 (Ref. Range - <=12) Urine Creatinine 36.9 08/23/21 19:07 (UA) Yellow (Ref. Range Yellow - ) Clarity- (UA) Clear (Ref. Range Clear - ) Glucose-(UA) Negative (Ref. Range Normal - ) Bilirubin-(UA) Negative (Ref. Range Negative - ) Ketones-(UA) Negative (Ref. Range Negative - ) Specific Gravity-(UA) 1.020 (Ref. Range 1.001 - 1.035) Blood- (UA) Moderate (Ref. Range Negative - ) pH-(UA) 7.0 (Ref. Range 5 - 9 units) Protein-(UA) $g=300 (Ref. Range Negative - ) Urobilinogen-(UA) 0.2 (Ref. Range Normal - ) Nitrite- (UA) Negative (Ref. Range Negative - ) Leukocytes-(UA) Negative (Ref. Range Negative - ) 08/23/21 19:09 POC Pregnancy Results Negative 08/23/21 20:09 SARS-CoV-2 RTPCR Source NP swab SARS-CoV-2 RTPCR (COVID-19) * Negative (Ref. Range Negative - )
CDC Split Type:

Write-up: Patient woke up on 8/14 with bilateral lower extremity swelling and periorbital edema, 7 days after her COVID-19 vaccine (dose #1). Had 3+ protein via urine dipstick on 8/14 and 4+ protein via urine dipstick on 8/16. Symptoms continued despite starting on prednisone 20 mg. Presented to Hospital ED on 8/23. Nephrology consulted on admission and recommended albumin infusion followed by lasix x2. Patient tolerated her 2 albumin infusions and lasix well. US LE were obtained to assess for DVT and were negative. Patient remained hemodynamically stable on room air throughout admission. At time of discharge, patient on room air and sent home with plan for follow up with nephrology in 3 weeks with 60 mg of prednisone per day. Pt informed by nephrology that she should get her second covid vaccine approx 1 week after originally scheduled date.


VAERS ID: 1629857 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-14
Onset:2021-08-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood culture, Dysstasia, Fatigue, Hypotension, Leukocytosis, Presyncope, Somnolence, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hydralazine 100 mg 3 x daily, isosorbide mononitrate 60 mg Er 1 x daily, lithium carbonate 300 mg morning, lithium carbonate 600 mg night, metoprolol succinate 100 mg 1 x daily , prazosin 2 mg 2 x daily.
Current Illness: Nothing
Preexisting Conditions: Copd, asthma, bipolar, hypertension, aniemia
Allergies: Penicillin, moraphine, methadone, bees, latex amoxocillin. And sulfa
Diagnostic Lab Data: Serum separator tube sst, culture blood 1, culture blood 2 8/16/21
CDC Split Type:

Write-up: About 6 p.m. the night of the shot I started getting tired and weak and really groggy and continued through Sunday by Monday morning I couldn''t hardly stand I was dizzy every time I stood up I go blind and almost pass out my husband help me to the bathroom where I could not hold my head or talk or anything my body just kind of convulsed my husband called the ambulance my blood pressure bottom number was 40 and extremely low the ambulance suggested taking me to the hospital I was admitted to the hospital blood pressure bottom number was 40 they pumped a bunch of Iv in me and kept me for the night I was diagnosed with hypotension and near syncope, and neutrophilic leukocytosis adverse reaction to Covid 19 vaccine


VAERS ID: 1631953 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Hypoaesthesia, Injection site pain, Injection site pruritus, Injection site rash
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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? 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: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Systemic: Described as electrical feeling in left side of brain-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Second day after receiving vaccination, pt stated having a localized rash and itching at injection site area. On day 3, pt stated electrical feeling in left side of brain, was instructed to follow up with md to assess


VAERS ID: 1632013 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-03
Onset:2021-08-14
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, Olfactory nerve disorder, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: NONE
Allergies: Unknown
Diagnostic Lab Data: Covid 19 Rapid Antigen = positive on 8/19/21
CDC Split Type:

Write-up: As of disease investigation date of 8/24/21 case reported symptom onset of 8/14/21 which included sore throat, new olfactory disorders, headache and cough which resolved 8/21/21.


VAERS ID: 1632032 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-08-14
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Fatigue, Olfactory nerve disorder, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes, Hypertension
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR = Positive on 8/17/21
CDC Split Type:

Write-up: As of disease investigation on 8/23/21 case reported symptom onset of 8/14/21 which included fever, chills, runny nose, new olfactory disorders, fatigue and cough. Still symptomatic.


VAERS ID: 1632203 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-17
Onset:2021-08-14
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes, Hypertension, Ashtma, Smoker, Depression and Previous bladder surgery
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR = Positive on 8/17/21
CDC Split Type:

Write-up: Upon disease investigation of 8/20/21 case reported onset of symptoms as 8/14/21 which included fever, subjective fever, chills, rigors, muscle aches, runny nose, sore throat, new olfactory disorders, headache, fatigue, cough, wheezing, shortness of breath, chest pain, nausea, abdominal pain, diarrhea, loss of appetite and ear pain.


VAERS ID: 1632410 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-29
Onset:2021-08-14
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 10 mg tablet desoximetasone (TOPICORT) 0.25 % cream doxazosin (CARDURA) 4 mg tablet multiple vitamins (HEXAVITAMIN) tablet tablet ustekinumab (STELARA) injection
Current Illness:
Preexisting Conditions: Nervous Bell''s palsy Carpal tunnel syndrome, bilateral upper limbs Hearing loss Peripheral neuropathy Essential tremor Circulatory Murmur Digestive Adenomatous colon polyp Diverticulosis Duodenal ulcer Chronic diarrhea Genitourinary Benign prostatic hyperplasia with urinary hesitancy Musculoskeletal Mass of finger of left hand Trigger finger of left thumb Trigger finger of right thumb Endocrine/Metabolic Hypercholesterolemia Impaired fasting glucose Immune Psoriasis Other Overweight(278.02) Male erectile disorder of organic origin S/P carpal tunnel release
Allergies: NKA
Diagnostic Lab Data: 08/17/21 2135 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/17/21 1349 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/17/21 2135 COVID-19 PCR Collected: 08/17/21 1349 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: FEVER, COUGH, Fatigue, Muscle or body aches, Congestion or runny nose, and Diarrhea


VAERS ID: 1632430 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204 A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Cough, Dysphonia, Fatigue, Myalgia, SARS-CoV-2 test negative, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu vaccine last year _ same type of reaction - other info unknown
Other Medications: Vit B-12, Vit D3, Levothyroxine, Topamax, Carbamazepine, Metoprolol ER, Minivelle Patch, Progesterone Cap, Omeprazole, Symbicort, Proair, Azithromycin PRN, and Entyvio infusions every 8 weeks
Current Illness: Ulcerative Colitis,
Preexisting Conditions: Migraines, Ulcerative Colitis, Elevated BP, Hypothyroid, Trigeminal Neuralgia, Asthma, Arthritis in Lower back
Allergies: Tetnus, Quinalones, Chamomille,
Diagnostic Lab Data: No test required
CDC Split Type:

Write-up: After a day or so started with coughing, then wheezing, with cough increasing, hoarse voice, weak tired, muscle aches Started to need to use inhaler this increased for several days over weekend, went to work on Monday, they sent me home, made me get Covid tested, This was negative. Still unable to return to work on Tuesday, some better on Wednesday with inhalers and had visit with MD to let her know what had been going on. She agreed with treatment of Symbicort Inhaler and Proair, Continue with Vitamins. Started to feel better about a week after vaccine. Still on 08/25/21 have some residual cough and using inhaler.


VAERS ID: 1632437 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-30
Onset:2021-08-14
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Adenovirus test, Atelectasis, Bordetella test negative, COVID-19, Chest X-ray abnormal, Chlamydia test negative, Condition aggravated, Cough, Dyspnoea, Enterovirus test negative, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lung opacity, Malaise, Mycoplasma test negative, Pleural calcification, Pulmonary fibrosis, Pyrexia, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Sepsis, Viral test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 10 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet cefuroxime (CEFTIN) 500 mg tablet dexAMETHasone (DECADRON) 2 mg tablet folic acid/multivit-min/lutein (CENTRUM SILVER ORAL) hydrALAZINE (APRESO
Current Illness:
Preexisting Conditions: Respiratory Shortness of breath Community acquired bacterial pneumonia Circulatory Coronary atherosclerosis Essential hypertension Paroxysmal atrial fibrillation Coronary artery disease Atrial fibrillation Genitourinary Chronic renal insufficiency, stage III (moderate) Endocrine/Metabolic Mixed hyperlipidemia Hematologic Iron deficiency anemia Thrombocytopenia Infectious/Inflammatory COVID-19 Other History of prostate cancer Long term current use of anticoagulant therapy Long term current use of aspirin Vertigo Elevated troponin
Allergies: NKA
Diagnostic Lab Data: 08/16/21 2224 Respiratory virus detection panel Collected: 08/16/21 2032 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected ED to Hosp-Admission Discharged 8/16/2021 Surg Nursing Imaging Results Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable Resulted: 08/16/21 2152 Order Status: Completed Updated: 08/16/21 2152 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 8/16/2021 8:48 PM Age: 79 years old Clinical indication: Shortness of breath; Additional info: Suspected sepsis. Suspected sepsis TECHNIQUE: Imaging protocol: XR of the chest. Views: 1 view. COMPARISON: DX RAD CHEST PORTABLE 9/22/2017 11:23 AM FINDINGS: Lungs: Left mid and lower lung pleural calcification is again demonstrated. Patchy left mid and lower lung opacification may be related to chronic scarring and/or atelectasis. Superimposed infection is possible. Pleural spaces: See "Lungs" finding. Heart/Mediastinum: Unremarkable. No cardiomegaly. Diaphragm: There is mild elevation of the left hemidiaphragm. Bones/joints: Unremarkable. IMPRESSION: Left mid and lower lung pleural calcification and probable scarring and/or atelectasis. Superimposed infection is possible.
CDC Split Type:

Write-up: fever, cough, not feeling well, vomiting ED to Hosp-Admission Discharged 8/16/2021 - 8/21/2021 (5 days) Hospital MD Last attending Treatment team Shortness of breath Principal problem Care Coordination Progress Note LPN (Licensed Nurse) referral received for Covid today. Called ato screen patient. Reached patient in hospital room, but patient states he is HOH over phone and requests I call wife. She was educated on the program and its benefits. He is appropriate and agreeable to the program. Kit to be delivered to their home by delivery service. She was advised to go ahead and open up the kit when when it arrives to their home unpack the tablet and charger, charge the tablet, and then turn on the tablet which will walk her through an instructional video to explain how to obtain his first set of vitals. Patient was also given our contact information. One of the RNs, with the program will call her after receiving the first set of vitals to further explain the program. patient verbalized understanding. Patient reports having the following equipment Scale, Blood pressure cuff and monitor and thermometer. Kit direct shipped to patient''s home. Program referral re entered in EMR. Original did not populate into computer program. After several attempts referral still did not populate into computer. Profile entered manually.kit assigned


VAERS ID: 1632482 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Patient called complaining about a severely sore arm that start a day after his 2nd Covid shot and the soreness has continued to the current date of 8/25/21. The soreness prevents the patient from using his left arm and he has to rest his arm continually due to the soreness. The soreness has not gone away.


VAERS ID: 1632607 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / SYR

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

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

Write-up: The next day I was experiencing severe itching all over my body and then the day after that I experienced rashes on my arms and swelling


VAERS ID: 1632814 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / -

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

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

Write-up: Tested positive for Covid.


VAERS ID: 1632825 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-16
Onset:2021-08-14
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Lethargy, Nausea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (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: unknown
Current Illness: unknown
Preexisting Conditions: diabetes type 2, hypertension, gout
Allergies: nkma
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chief Complaint pt brought to ED via EMS for diarrhea, SOB, weakness, and lethargy. tested positiver for covid last thursday History of Present Illness Patient is a 79-year-old male with past medical history significant for diabetes type 2, hypertension, gout presenting to the emergency department today with profound shortness of breath and increased fatigue and weakness after recently being infected with COVID-19. Patient was diagnosed on Thursday with COVID-19. Patient had 2 days of symptoms prior to this. Patient had positive sick contact of his daughter who also had Covid. Patient notes that he was vaccinated against COVID-19. Patient was obtunded on scene for EMS and perked up after 700 mL of normal saline. Patient admits nausea associated with symptoms. Patient has had persistent diarrhea associated with the symptoms.


VAERS ID: 1633109 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-15
Onset:2021-08-14
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Fatigue, Headache, SARS-CoV-2 test negative
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pulmicort, diltiazemCD,Prilosec,topiramate,furosemide,potassiu
Current Illness: none
Preexisting Conditions: hypertension, aortic aneurysm, asthma, GERD. Also taking vitamins and Claritin for allergies
Allergies: cow milk, fragrances, e.mycin, penicillin, trees & ragweed
Diagnostic Lab Data: CPT test Saturday, 8/14 was negative; follow-up rapid test Wednesday 8/18 was negative.
CDC Split Type:

Write-up: On the morning of Saturday, August 14, 2021, I lost my sense of taste and smell, was tired and had a headache. I went to the walk-in clinic and saw a Dr, who believed I probably had COVID-19. He called later that afternoon with a negative CPT test result but prescribed azithromycin anyway which I took for 10 days as directed. He also told me to get a follow-up test. My symptoms gradually went away and were gone by Friday, August 20.


VAERS ID: 1633143 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-13
Onset:2021-08-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Tinnitus
SMQs:, Hearing impairment (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 shots, very ill / flu symptoms for a number of days after vaccination
Other Medications: None Mentioned
Current Illness: NA
Preexisting Conditions: None
Allergies: Sulfa Antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began having ringing in her ears and a headache the day after vaccination, continuing constantly through today


VAERS ID: 1633810 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-06
Onset:2021-08-14
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Positive COVID result on admission despite full vaccination Feb 2021


VAERS ID: 1633991 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-04
Onset:2021-08-14
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Pneumonia
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted for CVA/pneumonia


VAERS ID: 1635572 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-06
Onset:2021-08-14
   Days after vaccination:100
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Fever Headaches


VAERS ID: 1636406 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-31
Onset:2021-08-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dysmenorrhoea, Fatigue, Feeling abnormal, Heavy menstrual bleeding, Immediate post-injection reaction, Injection site pain, Injection site swelling, Insomnia, Lymphadenopathy, Pain, Pain in extremity, Polymenorrhoea, Suicidal ideation
SMQs:, Acute pancreatitis (broad), Suicide/self-injury (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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: Venlafaxine ER 150 Gabapentin 100mg 2x/day Vitamin D 1000 IU Magnesium 75mg
Current Illness:
Preexisting Conditions: Depression, IBS, Scoliosis of Lower Back Chronic debilitating pain throughout muscles and joints, particularly in back/shoulders, cause unknown.
Allergies: Paradoxical Reaction to Benzodiazepines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after getting the vaccine, slight soreness in arm, slight increase in fatigue, slight increase in body aches About 10 hours later, huge increase in body aches/pains. Inability to sleep. Felt suicidal due to pain. Considered going to ER, decided against. Following day, Horrible stomach pains and nonsolid poops. Period began 1.5 weeks early. Very heavy, bad cramps, worst I''ve had in adult life, lasted 2 days longer than usual (7 days total). Using the bathroom miserable experience. Lymph nodes swollen, pain (minimal) and swelling at injection site. Body aches reduce to ''mostly bearable, able to sleep. 1 week later, Lymph nodes reduce in size, injection site pain/swelling resolved To current day, 1 month later: existing pain, fatigue, and brain fog worse than pre-shot. 10% of poops are solid. Stomach pain comes and goes. I don''t know what is wrong with me but whatever it is has has gotten worse since the shot. I have very little healthcare access.


VAERS ID: 1636520 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-21
Onset:2021-08-14
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Respiratory tract 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: amLODIPine (NORVASC) 5 mg tablet
Current Illness:
Preexisting Conditions: Nervous Left ankle pain Circulatory Hypertension, essential Heart palpitations Digestive Severe obesity (BMI $g= 40) (CMS/HCC) Endocrine/Metabolic Dyslipidemia IFG (impaired fasting glucose) Prediabetes Other Umbilical hernia
Allergies: Oxycodone-acetaminophenOther (document details in comments)
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: respiratory illness Cough congestion


VAERS ID: 1636536 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-21
Onset:2021-08-14
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Malaise, Pneumonia, Respiratory symptom, SARS-CoV-2 test
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL EXTRA STRENGTH) 500 mg tablet amLODIPine (NORVASC) 10 mg tablet amoxicillin (AMOXIL) 500 mg capsule aspirin 81 mg tablet atenoloL (TENORMIN) 25 mg tablet atorvastatin (LIPITOR) 80 mg tablet azithromycin (ZITHROM
Current Illness:
Preexisting Conditions: Circulatory Essential hypertension Coronary artery disease involving native coronary artery of native heart without angina pectoris Digestive Adenomatous polyp of colon Musculoskeletal Primary osteoarthritis of right shoulder Endocrine/Metabolic Dyslipidemia (high LDL; low HDL) Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin (CMS/HCC) Other Neoplasm of bone, soft tissue, and skin Status post placement of stent in right coronary artery Status post hip replacement
Allergies: LansoprazoleRash
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: URI symptoms malaise pneumonia of left lower lobe of lung


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