National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 140 out of 3,524

Result pages: prev   41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239   next


VAERS ID: 1352351 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: Ceflacor (Ceclor)
Diagnostic Lab Data: N/A - diagnosed by signs and symptoms
CDC Split Type:

Write-up: Shingles - started as super itchy spot on my back later in the day/night of 2nd covid shot. Developed into several spots on my back as shingles does.


VAERS ID: 1352378 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH LOT# ER8735 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Donepezil Hydrochlorothiazide Memantine Vitamin D Mirtazapine
Current Illness: Dementia High BP
Preexisting Conditions: Dementia High BP
Allergies: PCN Lisinopril
Diagnostic Lab Data: Contacted clinic, but Neurologist physician, is on vacation. Nurse there said for me to call PCP and I asked for a referral for a home health nurse to see her, but they said she would have to be seen by Dr, first.
CDC Split Type:

Write-up: It seems that soon after vaccine my daughter who has Dementia got very weak. Legs and arms shaky. I am personally doing exercises with her to try to help with weakness. and build strength


VAERS ID: 1352767 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-14
Onset:2021-05-18
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

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

Write-up: Prolonged menstrual bleeding, unstoppable with blood clods.


VAERS ID: 1353011 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A2114 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Chills, Dizziness, Headache, Injection site haemorrhage, Injection site swelling, Pain, Pharyngeal swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high (The patient does not take any medicines and controls the blood pressure by diet and exercises.); Injection site scar
Preexisting Conditions: Medical History/Concurrent Conditions: Surgery (The Patient underwent many surgeries post traumatic car accident many years ago.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210547044

Write-up: THROAT SWELLING; BODY ACHES; STOMACH ACHES; CHILLS; DIZZY; SEVERE HEADACHE; FEVER; INJECTION SITE BLEEDING; MILD SHOULDER PAIN; INJECTION SITE "BUBBLED UP"; This spontaneous report received from a patient concerned a 59 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included many surgeries post traumatic car accident, and concurrent conditions included a lot of scar tissue on shoulder (at injection site), and high blood pressure.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A2114, and expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced injection site bleeding. On 18-MAY-2021, the subject experienced mild shoulder pain. On 18-MAY-2021, the subject experienced injection site "bubbled up". On 19-MAY-2021, the subject experienced dizzy. On 19-MAY-2021, the subject experienced throat swelling. On 19-MAY-2021, the subject experienced body aches. On 19-MAY-2021, the subject experienced stomach aches. On 19-MAY-2021, the subject experienced chills. On 19-MAY-2021, the subject experienced severe headache. On 19-MAY-2021, the subject experienced fever. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient recovered from injection site bleeding, and injection site "bubbled up" on 18-MAY-2021, and mild shoulder pain, was recovering from severe headache, throat swelling, fever, chills, and body aches, had not recovered from dizzy, and the outcome of stomach aches was not reported. This report was non-serious.


VAERS ID: 1353587 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, Pain, Pyrexia, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchitis; COVID-19; Exercise induced asthma; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562451

Write-up: Body aches; Headache; Nausea; Fever; Dizziness; Injection site pain; This is a spontaneous report from a contactable consumer (patient). A 27-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: unknown), via an unspecified route of administration in the left arm on 17May2021 at 17:30 (at the age of 27-years-old), 2nd dose, single, for COVID-19 immunization. Medical history included bronchitis, COVID-19, penicillin allergy and exercise endured asthma. The patient''s concomitant medications were not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: unknown) administered via an unspecified route of administration on 26Apr2021 at 17:30 (at the age of 27-years-old), 1st dose, single for COVID-19 immunization. Prior to vaccination, the patient was diagnosed with COVID-19 but did not receive other vaccines four weeks prior. The patient was not pregnant at the time of vaccination. The vaccine was administered at a pharmacy or drug store. On 18May2021 at 09:00, the patient experienced body aches, headache, nausea, fever, dizziness, and injection site pain. The events were reported as non-serious. The patient received unspecified over the counter medication and nurse directed to take rest. The patient had not been tested for COVID-19 since vaccination. The outcome of the events was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1353590 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / OT

Administered by: Public       Purchased by: ?
Symptoms: Body temperature, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210518; Test Name: Body temperature; Result Unstructured Data: Test Result:103 degrees
CDC Split Type: USPFIZER INC2021562714

Write-up: Fever - 103 degrees and tired; Fever - 103 degrees and tired; This is a spontaneous report from a contactable consumer (patient). A 12-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0168), intramuscular in left arm on 17May2021 15:00 (at the age of 12-years-old) as first dose, single for COVID-19 immunization. Medical history was none. The patient had no known allergies. Concomitant medication included fexofenadine hydrochloride (ALLEGRA). Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks prior. The patient experienced fever - 103 degrees and tired on 18May2021 12:00. Since the vaccination, patient has not been tested for COVID-19. No treatment was received for the event. Outcome of the event was unknown.


VAERS ID: 1353592 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint range of motion decreased, Pain in extremity
SMQs:, Arthritis (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: USPFIZER INC2021564103

Write-up: Extremely sore arm, can not move it at all without people in pain; Extremely sore arm, can not move it at all without people in pain; This is a spontaneous report from a contactable consumer (patient). A 22-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number was unknown and expiration date was not reported), via an unspecified route of administration, in Left Arm on 17May2021 at 19:00 (at the age of 22-years old) at first dose, single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. The most recent COVID-19 vaccine was administered at Pharmacy or Drug Store. The patient experienced extremely sore arm, can not move it at all without people in pain on 18May2021 after the first dose and did not had any other side effects. The event was reported as non serious. No treatment was received for the event. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1353605 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021569104

Write-up: fever; body pain; This is a spontaneous report from a contactable consumer (patient''s son). A 40-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW0169 and expiration date was reported), via an unspecified route of administration in arm (reported as shoulder), on 18May2021 between 14:00 to 15:00 (at the age of 40 years old) as second dose, single for COVID-19 immunization in the patient''s home. The vaccine was not administered in a military facility. The patient''s medical history and concomitant medications were not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: ER8731 and expiration date was reported), via an unspecified route of administration in shoulder, on 26Apr2021 (at the age of 40 years old) as first dose, single for COVID-19 immunization. No other vaccinations was administered within four weeks prior to the first dose of the COVID-19 vaccine. The patient experienced body pain on the night of 18May2021 and fever on 19May2021. The patient events did not require emergency room (ER)/physician''s office. The outcome of fever was unknown and body pain was not recovered at the time of report. No follow attempts are possible; no further information is expected.


VAERS ID: 1353614 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576083

Write-up: Abdominal pain that comes and goes; This is a spontaneous report from a contactable consumer (patient). A 34-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: FW0182 and expiration date was not reported), via an unspecified route of administration in left arm, on 17May2021 at 11:30 (at the age of 34 year old) as 2nd dose, single for COVID-19 immunization in a Pharmacy or Drug Store. Medical history included penicillin allergy. The patient''s concomitant medications were not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: unknown and expiration date was not reported), via an unspecified route of administration in right arm, on 20Apr2021 at 11:30 (at the age of 34 year old) as 1st dose, single for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was not tested for COVID-19. The patient experienced abdominal pain that comes and goes on 18May2021 at 12:00. The event was considered non-serious. No treatment was received for this event. The outcome of the event was not recovered at the time of report.


VAERS ID: 1353625 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267100001 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma (Seasonal allergies-asthma); Seasonal allergy (Seasonal allergies-asthma); Sulfonamide allergy (known_allergies: Sulfas)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021583416

Write-up: Swollen tongue and metallic taste; Swollen tongue and metallic taste; This is a spontaneous report from a contactable HCP (patient). A 45-year-old female (no pregnant) patient received the first dose of BNT162B2 via an unspecified route of administration on the left arm on 18May2021 at 09:45 (Lot Number: 59267100001) as single dose for COVID-19 immunization. Relevant medical history and concurrent conditions included seasonal allergies-asthma. Known allergies is sulfas. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Concomitant medication included fexofenadine hydrochloride (ALLEGRA). The patient experienced swollen tongue and metallic taste on 18May2021 at 10:45. The adverse event result in doctor or other HCP office/clinic visit. The steroids had been received as treatment for the adverse events. The outcome of events was recovered on an unspecified date. No attempts are possible. No further information is expected.


VAERS ID: 1354104 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-05
Onset:2021-05-18
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test positive, Tonsillar hypertrophy
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Larissa, Celexa
Current Illness: None
Preexisting Conditions: IBS, Anxiety
Allergies: Bactrim
Diagnostic Lab Data: Positive PCR Covid test 5/19/2021
CDC Split Type:

Write-up: Sore throat, swollen glands, swollen tonsils


VAERS ID: 1354158 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arterial catheterisation, COVID-19, Chest X-ray, Chest pain, Computerised tomogram, Echocardiogram, Echocardiogram abnormal, Electrocardiogram, Fatigue, Metabolic function test, Myalgia, Myocarditis, Pain, Pyrexia, SARS-CoV-2 test positive, Troponin increased, Wolff-Parkinson-White syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Conduction defects (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 05/18/21-CT scan, EKG, chest xray, ultrasound, artery catheterization, Troponin blood test, Full metabolic blood panel
CDC Split Type:

Write-up: For the next few days after I received the second dose of the vaccine, I experienced muscle and body aces, fatigue, and a low grade fever. About 3 days after getting the vaccine I woke up at about 2 AM on the 18th with severe chest pain, the other side effects had subsided at this point. I ended up going to the ER after about a half hour of the pain not going away. They ran a Troponin blood test and foinf my levels to be high. They also tested me for Covid which came back positive. They ended up doing an ultrasound of my heart, using a catheter to take a look at my arteries, a chest xray, a CT scan, and an EKG. The final diagnosis was myocarditis of the heart. I had to stay in the hospital for a few days while my heart stabilized. I was given orders to only participate in light exercise and to take it easy for now. I have a follow up visit with the cardiologist in about a week frok now. It was also found out through testing that I may have Wolf Parkinson''s white syndrome.


VAERS ID: 1354230 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Hyperaesthesia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (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: Vicodin, Augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills/skin sensitivity 5/18/21 11:00pm-5/19/21 8:30pm Fever & joint pain (100-102) 5/19/21 8:00am-5/19/21 8:30pm


VAERS ID: 1354250 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

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


VAERS ID: 1354261 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-26
Onset:2021-05-18
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion induced, Amniorrhoea, Exposure during pregnancy, Multigravida, Preterm premature rupture of membranes
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: Nothing
Preexisting Conditions: No
Allergies: Aspirins (G6PD deficiency)
Diagnostic Lab Data: Medical tests all available at birth centre
CDC Split Type:

Write-up: Sudden Pprom and leakage at 23week and made me do a pregnancy termination. Due date was determined sep 11,2021 and no related complication detected at 20 week ultrasound and examination It was my 2nd pregnancy ( 1 st pregnancy in 2017 with no complication , vaginal delivery full term)


VAERS ID: 1354344 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Dizziness after vaccine administration that started resolving by day four after the second dose


VAERS ID: 1354602 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac failure, Echocardiogram, Myocarditis, N-terminal prohormone brain natriuretic peptide increased
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amitriptyline, clonazepam
Current Illness: none noted
Preexisting Conditions: anxiety
Allergies: acetaminophen (chest tightness), oatmeal (rash, swelling)
Diagnostic Lab Data: NT-proBNP 1508 5/24TTE 5/25, cardiac MRI to be completed 5/27
CDC Split Type:

Write-up: myopericarditis, HFrEF. medication therapy ongoing


VAERS ID: 1354632 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Hypotonia, Muscle twitching
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: pt reports "eye twitching" that developed later that night following the vaccine, and then after a couple more days, noticed he had lost muscle tone on one side of face when he tried to drink some water and in was running out of his mouth ; he went to the ER and was diagnosed with Bell''s Palsy; he began treatment with prednisone 20 mg, 3 tablets daily for 7 days


VAERS ID: 1354643 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Asthenia, Blood test, Dizziness, Dysphemia, Dyspnoea, Electrocardiogram, Fatigue, Feeling hot, Movement disorder, Muscle tightness, Neck pain, Pain in jaw, Palpitations, Panic attack, Paraesthesia, Presyncope, Sleep disorder, Speech disorder, Urine analysis
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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: Escitalopram ?LEXAPRO? 5 mg Oral Tab ?Started 10/28/2020? Levothyroxine ?LEVOTHROID/SYNTHROID? 125 mcg Oral Tab ?Started 2/19/2021? Albuterol ?Ventolin HFA? 90 mcg/actuation Inhl HFAA ?Started 7/7/2020? Vitamin B Complex Butterbur with Fev
Current Illness: None known
Preexisting Conditions: ASTHMA ?Noted 11/10/2009? ASTIGMATISM ?EYE CONDITION? ?Noted 4/15/2013? COMMON MIGRAINE ?Noted 9/10/2008? FIBROMYALGIA ?Noted 9/16/2009? GENERALIZED ANXIETY DISORDER ?Noted 2/9/2015? HYPERLIPIDEMIA ?HIGH BLOOD FATS? ?Noted 2/27/2012? HYPOTHYROIDISM ?LOW THYROID? ?Noted 9/10/2008? IRRITABLE BOWEL SYNDROME ?Noted 4/9/2010? KERATOSIS, PILARIS, ACQUIRED ?Noted 4/9/2010? NECK PAIN ?Noted 9/10/2008? OBESITY, BMI 30?34.9, ADULT ?Noted 9/10/2008? PREMENSTRUAL DYSPHORIC DISORDER ?Noted 1/27/2016?
Allergies: Clonazepam Eletriptan Hydrobromide Rizatriptan Sumatriptan Succinate
Diagnostic Lab Data: Urinalysis Blood work EKG all on 05/26/2021 Will have an MRI on 05/28/2021
CDC Split Type:

Write-up: Immediately after receiving the second dose of Pfizer on Tues May 18, I felt prickly sensations throughout my body. After sitting for the recommended 30 minutes (due to known allergies to previous medications), I began to feel dizzy. They monitored me in the tent for several minutes and checked my vitals, which were fine. The nurse thought I may have hyperventilated. I thought I must have just had a mild panic attack. But the attacks did not stop. Rather, the first three days post vaccine, I had several panic attacks a day, even being woken from sleep because of them. It''s not fear or a racing mind but a constant racing heart, weakness, feeling faint. I feel prickly sensations and sensation of heat, which are common in panic attacks. But even after three days, they were not letting up. In addition to the attacks, I felt lightheaded, weak and extremely fatigued, even at rest. There is also constant pain and tightness in my neck and jaws. Thursday evening (May 20), I had an episode where I nearly passed out. Once I got seated, my body froze. I was unable to get my words out clearly. Instead of saying the full sentence in my head, I could only get a word or two out. Instead of being able to lift my arm to eat, I couldn''t move. The episode lasted about 15-20 minutes. I had several of these episodes on Saturday, two on Sunday and one on Monday. Thinking it was purely anxiety, I reached out to my psychiatrist who prescribed Klonopin to ease the symptoms. I took 0.5mg on Friday afternoon (5/21) and 0.5mg on Saturday morning (5/22). Realizing the Klonopin was likely making my symptoms worse, I have not taken any since Saturday morning (05/22). Most of the day I am breathless, weak, feel faint doing nearly nothing. I have an hour or so a couple of times of day where I''m more functional but still have to move very slowly. Otherwise, I''m either like a zombie or unable to speak clearly, stuttering when I speak, and unable to operate without feeling faint.


VAERS ID: 1354813 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-29
Onset:2021-05-18
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad)

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

Write-up: the patient noticed a purple discoloration of the skin but no pain or rash


VAERS ID: 1354876 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH IW0170 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Electric shock sensation, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: brain zapping jolts throughout the day, pins and needles sensation in fingers, hand, toes, and random parts of body


VAERS ID: 1354924 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

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

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

Write-up: Patient mom called in regards to daughter, she stated her daughter got the vaccine on Monday 5/17 around 6pm and the next day in the afternoon she started to itch and notice a rash on her shoulders and then under bra, cheeks, around mask, neck and even on legs. She states the rash is all over body and looks like little bumps. Patient is extremely itchy. Mom applied cortisone on the patients arms and she states it might have helped a little and also gave her Allegra which she states it didn''t work. Patient''s mother gave her daughter Benadryl on 5/25/21 at round 10:30pm and it helped.


VAERS ID: 1354929 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Hyperhidrosis, Influenza like illness, Malaise, Nausea, Oropharyngeal pain, Pain, Pyrexia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 100mg
Current Illness: None
Preexisting Conditions: Hepatitis C
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: flu like symptoms, swollen tongue, fever, sweats, chills, body aches, malaise, sore throat, headache, nausea, loss of appetite, fatigue


VAERS ID: 1354930 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Erythema, Hallucination, Hot flush, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol (PROAIR HFA) 90 mcg/actuation inhaler albuterol 90 mcg/actuation inhaler cholecalciferol (VITAMIN D3) 2,000 unit tablet docusate sodium (COLACE) 100 MG capsule EPINEPHrine (EPIPEN) 0.3 mg/0.3 mL (1:1,000) famotidine (PEPCI
Current Illness: Sickle cell trait Anemia Fibroadenoma of breast Varicose veins of lower extremity Unilateral vocal fold paralysis Moderate persistent asthma with acute exacerbation Moderate persistent asthma Chronic interstitial cystitis Urticaria Other intervertebral disc degeneration, lumbar region Other cervical disc degeneration, unspecified cervical region Chronic interstitial cystitis Arnold-Chiari malformation Dysphonia Submandibular sialolithiasis Migraine with aura and without status migrainosus, not intractable Celiac disease Colitis, indeterminate Gastroesophageal reflux disease Chronic cystitis Hydrosalpinx Dysuria Urinary tract infection Urinary frequency Mastodynia H/O cesarean section Breast lump Encounter for supervision of normal pregnancy in first trimester Multigravida of advanced maternal age in first trimester COVID-19 Depressive disorder Abdominal cramping Pain in thoracic spine Pain in left hip Other bursitis of hip, left hip Rash and other nonspecific skin eruption Headache Throat pain Localized edema LLQ pain Neck pain Uncoded H/O Cyst of breast - 7MM CYST (L) BREAST Uncoded H/O Epidermal inclusion cyst - (L) FACE Closed head injury Dark stools
Preexisting Conditions: Sickle cell trait Anemia Fibroadenoma of breast Varicose veins of lower extremity Unilateral vocal fold paralysis Moderate persistent asthma with acute exacerbation Moderate persistent asthma Chronic interstitial cystitis Urticaria Other intervertebral disc degeneration, lumbar region Other cervical disc degeneration, unspecified cervical region Chronic interstitial cystitis Arnold-Chiari malformation Dysphonia Submandibular sialolithiasis Migraine with aura and without status migrainosus, not intractable Celiac disease Colitis, indeterminate Gastroesophageal reflux disease Chronic cystitis Hydrosalpinx Dysuria Urinary tract infection Urinary frequency Mastodynia H/O cesarean section Breast lump Encounter for supervision of normal pregnancy in first trimester Multigravida of advanced maternal age in first trimester COVID-19 Depressive disorder Abdominal cramping Pain in thoracic spine Pain in left hip Other bursitis of hip, left hip Rash and other nonspecific skin eruption Headache Throat pain Localized edema LLQ pain Neck pain Uncoded H/O Cyst of breast - 7MM CYST (L) BREAST Uncoded H/O Epidermal inclusion cyst - (L) FACE Closed head injury Dark stools
Allergies: mesalamine aspirin cephalexin cephalosporins ciprofloxacin doxycycline latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot flashes, arm swelling and redness, hallucinations, chest pain


VAERS ID: 1354934 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-05-18
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Sinus tachycardia
SMQs:, Supraventricular tachyarrhythmias (narrow), Dehydration (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 10 mg oral tablet, 1 tab(s), Oral, Daily ammonium lactate 12% topical cream, 1 app, TOP, Once a day (at bedtime) Atorvastatin 40mg tablet, 1 tab(s), Oral, Daily digoxin 125 mcg (0.125 mg) oral tablet, 125 mcg= 1 tab(s), Oral, Dai
Current Illness: None reported by pt
Preexisting Conditions: Atrial fibrillation BPH - Benign prostatic hypertrophy Dyslipidemia HTN Thoracic aortic aneurysm
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Persistent Sinus Tachycardia in previously well controlled pt with no new changes in chronic disease course. No new meds, no life changes. At risk of worsening/death as pt has history of thoracic aortic aneurysm, uncontrolled HR can potentially raise pressures and cause rupture.


VAERS ID: 1354987 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client present to a 1st Dose COVID Clinic indicated he missed his 2nd dose appointment, 1st dose was received at a different location. We advised we had Moderna, confirmed clients card stated Moderna, Moderna was given. Upon entering information into IMPACT, Vaccine Registry, we found that previous location documented his first does was Pfizer.


VAERS ID: 1354990 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 RA / IM

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

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

Write-up: RED ITCHY DOTS ON ARM JOINTS AND INJECTION SITE


VAERS ID: 1355096 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Cough decreased, Dysphagia, Loss of consciousness, Pyrexia, Rash
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: robaxin , gabapentin, meloxicam, hydrocodone
Current Illness: none
Preexisting Conditions: back issues
Allergies: suldindac , diclofenac, and potassium
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: patient called saying she had a fever of 102-99 for 4 days. then that friday she blacked out , developed huge rash all over her body and face. had someone look at it, said possible infection at injection site. casued chest pressure,severe cough, and hard to swallow. and increased joint pain


VAERS ID: 1355179 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKDA
Diagnostic Lab Data: VISITED PCP AND SOME PAIN MEDICATIONS WERE GIVEN WHICH HAS NOT PROVIDED RELIEF
CDC Split Type:

Write-up: PATIENT SAYS THAT AFTER VACCINE SHE HAS HAD PAIN IN HER LEFT ARM. SHE DESCRIBES IT AS MOVING TO DIFFERENT PARTS OF HER ARM. SOMETIMES ITS AT THE TOP OF HER ARM NEAR THE JOINT AND SOMETIMES IT GOES DOWN TOWARDS HER FOREARM


VAERS ID: 1355263 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder, Oligomenorrhoea, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Fertility disorders (broad)

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

Write-up: Menstrual cycle started again a week after my normal cycle ended. Abnormal menstrual cycle is still on going (started 18May2021) today is 27May2021, no sign of stopping any time soon. This abnormal menstrual cycle is extremely heavy where it is causing concern. There is a lot of blood clots.


VAERS ID: 1355271 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling jittery
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol 6.25mg twice daily Lisinopril 40mg once daily ( AM) Fluocinolone 0.01% scalp oil prn Betamethasone Valerate 0.1% ointment Fluocinonide 0.05% ointment bid prn Clobetasol 0.05% solution twice weekly for maintenance
Current Illness: none
Preexisting Conditions:
Allergies: Codeine sulfate Hydrochlorothiazide Ibuprofen Prednisone
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient was observed for 30 minutes in the pharmacy due to her concerns. After she went home and had some lunch, she started feeling "jittery or "busy" inside." She was not visibly shaking and she took her BP and it was good. She said she was not visibly shaky or trembling. She took a Tylenol and went to bed and slept, then felt better later. Patient just called in to pharmacy today ( May 27th) to voice concern about receiving 2nd vaccine.


VAERS ID: 1355283 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-04
Onset:2021-05-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Dyspepsia, Dyspnoea, Electrocardiogram, Inflammation, Influenza like illness, Migraine, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine 100mg Alprazolam XR 4mg Green tea
Current Illness: None
Preexisting Conditions: Chronic Insomnia
Allergies: None known
Diagnostic Lab Data: 5/18/2021 -4 EKGs -1 chest X-ray -Blood work for blood clot and PE *Results were not concerning. I was monitored in the ER for 3 hours.
CDC Split Type: J&J 205 A21A

Write-up: -Chest pressure and pains, difficulty breathing, left side tingles in arm and leg -Inflammation -Severe migraine -Indigestion -Began inside 2 weeks of receiving vaccine. -This is after the initial flu-like symptoms I experienced from day 1 to day 6.


VAERS ID: 1355321 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: adderall 15 mg PO daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fevers on 5/18 (1 day after) up to 103 F and resolved on 5/19. Severe chest and affected arm pain on 5/19 resolved on 5/20.


VAERS ID: 1355591 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-15
Onset:2021-05-18
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arterial occlusive disease, Arthralgia, Back pain, Chest pain, Myocardial infarction, Pain, Pain in extremity, Stent placement, Vomiting
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall XR 25MG
Current Illness: 0
Preexisting Conditions: 0
Allergies: 0
Diagnostic Lab Data: Diagnosis: Heart attack. Stent inserted into main artery with 95-99% blockage.
CDC Split Type:

Write-up: night of 5/18 into early morning of 5/19: Pain in right arm, and upper right back, shoulder, and chest. Ultimately Vomiting violently. Could not lie down without the pain returning. 5/19 Day: Had light breakfast and dinner. No vomiting, but could not lie down without same pain. Morning of 5/20: Breakfast of cereal and fruit at 9am. And noon, I experienced pain again, vomiting at noon. Then to Urgent care, then, Emergency Room, then Hospital.


VAERS ID: 1357079 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210551439

Write-up: TRANSIENT NUMBNESS; TINGLING DOWN BOTH ARMS FROM FOREARMS DOWN TO HANDS; CHILLS; FEVER; This spontaneous report received from a pharmacist concerned a 30 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known allergies.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205A21A expiry: 23-JUN-2021) dose was not reported, administered on 17-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced chills. On 18-MAY-2021, the subject experienced fever. On 19-MAY-2021, the subject experienced tingling in both hands. On 20-MAY-2021, the subject experienced transient numbness. The action taken with covid-19 vaccine was not applicable. The patient recovered from chills, and fever on 19-MAY-2021, and had not recovered from transient numbness, and tingling in both hands. This report was non-serious.


VAERS ID: 1357467 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-19
Onset:2021-05-18
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Feeling abnormal, Insomnia, Pruritus, Swelling, Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: symptoms started spreading from the injection site to the whole arm; Worried about the side effects; Red injection site; Itchy injection site; Swollen injection site; It is very itchy, symptoms started spreading from the injection site to the whole arm; she cannot sleep at night; some of the red spot in her right arm, symptoms started spreading from the injection site to the whole arm; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 18-May-2021 and was forwarded to Moderna on 18-May-2021. This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (some of the red spot in her right arm, symptoms started spreading from the injection site to the whole arm) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 19-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-May-2021, the patient experienced ERYTHEMA (some of the red spot in her right arm, symptoms started spreading from the injection site to the whole arm) (seriousness criterion medically significant) and INSOMNIA (she cannot sleep at night). On an unknown date, the patient experienced PRURITUS (It is very itchy, symptoms started spreading from the injection site to the whole arm), SWELLING (symptoms started spreading from the injection site to the whole arm), FEELING ABNORMAL (Worried about the side effects), VACCINATION SITE ERYTHEMA (Red injection site), VACCINATION SITE PRURITUS (Itchy injection site) and VACCINATION SITE SWELLING (Swollen injection site). At the time of the report, ERYTHEMA (some of the red spot in her right arm, symptoms started spreading from the injection site to the whole arm), PRURITUS (It is very itchy, symptoms started spreading from the injection site to the whole arm), INSOMNIA (she cannot sleep at night), SWELLING (symptoms started spreading from the injection site to the whole arm), VACCINATION SITE ERYTHEMA (Red injection site), VACCINATION SITE PRURITUS (Itchy injection site) and VACCINATION SITE SWELLING (Swollen injection site) had not resolved and FEELING ABNORMAL (Worried about the side effects) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route), the reporter did not provide any causality assessments. No concomitant medication information was provided treatment products for the symptoms were Cortisone cream , prednisone tablet ice affected area. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. This case was linked to MOD-2021-141702 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1357903 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill, Prozac
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Passed out/ got chills and sweats after receiving vaccine at the Pharmacy. Proceeding the vaccine she had headaches and still gets them and it?s currently 05/27/2021 which it?s been 9 days since also for 3 days after vaccine was extremely exhausted.


VAERS ID: 1357909 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gingival disorder, Oral herpes, Streptococcus test negative
SMQs:, Oropharyngeal infections (narrow), Gingival disorders (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oral contraceptive
Current Illness: allergic rhinitis
Preexisting Conditions: denied
Allergies: amoxicillin
Diagnostic Lab Data: Rapid strep Negative
CDC Split Type:

Write-up: Cold sores on lip, tongue, throat and " gums feel different"


VAERS ID: 1358127 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN L#205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Malaise, Migraine, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe Migraine for 6 days then reduced to mild headache for 2 more days. Diarrhea for 2 days. Cough for 8 days. Muscle aches for 24 hours. 102 fever for 24 hours. Overall feeling of malise for 3 days.


VAERS ID: 1358270 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blepharospasm, Fatigue, Headache
SMQs:, Dystonia (broad), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Extreme fatigue, tiredness, headaches, lack of energy, twitchy eyes ever since. Could sleep long hours.


VAERS ID: 1358329 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-06
Onset:2021-05-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: miscarriage-Mild, Additional Details: patient had miscarraige


VAERS ID: 1358416 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-27
Onset:2021-05-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood folate normal, Computerised tomogram abdomen normal, Epstein-Barr virus antibody positive, Flow cytometry, Full blood count abnormal, HIV test negative, Haptoglobin normal, Hepatitis viral test negative, Immunoglobulin therapy, Oral blood blister, Petechiae, Platelet count decreased, Platelet transfusion, Rash, Refractory cytopenia with unilineage dysplasia, Vitamin B12 normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Blood premalignant disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Myelodysplastic syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, fenofibrate, multivitamin, omeprazole, probiotic, simvastatin
Current Illness: See chronic illnesses section below.
Preexisting Conditions: Barrett''s esophagus, BPH, lipidoses
Allergies: No known allergies
Diagnostic Lab Data: Initial CBC with platelet count of 12k on 5/20/21. Platelets as low as 1k later on 5/20/21. Platelets 4k on 5/28/21. EBV Abs IgG/IgM 5/26/21 indicating prior infection, likely not active infection. Hepatitis panel negative 5/20/21 Haptoglobin wnl on 5/20/21 HIV negative 5/20/21 Folate and B12 wnl 5/20/21 Flow cytometry negative for any clonal hematology malignancy Normal spleen on CT 5/26/21
CDC Split Type:

Write-up: Patient noted petechial rash on his hands on 5/18/21. On 5/19/21, patient woke up and noted a blood blister on inside of his cheek. On the morning of 5/20/21, patient noted many more additional blisters with more petechial rash on his lower legs and arms. Patient called PCP, who ordered CBC. Patient presented to the hospital in the evening of 5/20/21. Patient remains hospitalized. Received high dose IV corticosteroids, IVIG. Now on oral high dose corticosteroids, received vincristine 2 mg and Nplate 10 mcg/kg/dose 5/27/21. Received multiple platelet transfusions. Refractory, no improvement observed as of 5/28/21.


VAERS ID: 1358476 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)

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

Write-up: Late menstrual cycle (10 days and counting). I''m very regular.


VAERS ID: 1358530 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / SYR

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

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

Write-up: Patient reported to pharmacist that a rash appeared on left side of stomach 1 day after vaccine was administered. The rash has since continued to spread across stomach and appear on top of right thigh. The rash is flat and papular causing pruritis. Patient was advised to take Benadryl daily to twice daily to relieve rash. She will wait one additional week to received dose 2 of vaccine (day 28 instead of day 21).


VAERS ID: 1358652 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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: Celiac
Allergies: Lactose Intolerant Gluten Allergy
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: The day of the vaccine his throat started to feel like it was closing. He was starting to have trouble breathing. His parent gave him some Benadryl and we waited to be observed for an hour before we left. He has not had any other problems since the vaccine and we have been advised to pre-medicate before the next dose.


VAERS ID: 1358761 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Oral herpes, Pain in extremity, Pain of skin, Pruritus
SMQs:, Anaphylactic reaction (broad), Oropharyngeal infections (narrow), Hypersensitivity (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rizatriptan
Current Illness:
Preexisting Conditions: migraine, cold sores (mild and infrequent)
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe outbreak of multiple coldsores, lips and inside nostrils, severe itching and tenderness of scalp only at the back near hairline. these all occurred approximately 3 days after receiving 2nd shot. These effects are in addition to the more common and expected ones, sore arm, mild flu symptoms, etc. coldsore outbreak was unusually painful, and severe. after discovering that many others experienced similar outbreaks after receiving vaccine I thought I should report it. I sought treatment through an online telehealth doctor and received prescription for valocyclovir.


VAERS ID: 1359027 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Neck pain, Neuralgia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Methylphenidate Vitamin D Trimethoprim Topamax Trazadone
Current Illness: Fibromyalgia Celiac Lymphocytic Colitis Gastroparesis Reynauds syndrome
Preexisting Conditions: See above
Allergies: All opiates Ibuprofen Zofran Ortho-tricyclen
Diagnostic Lab Data: On 5/21 went to hospital. Was told there was possible nerve issues due to covid vaccine. I was given gabapentin and a sling. It has not helped.
CDC Split Type:

Write-up: Left upper arm began feeling extreme pain radiating to shoulder neck and down to shoulder blade. After several hours the pain increased to forearm, hand and into fingers. Fingers became tingling and numb. Pain so intense I went to hospital three days later. Was given gabapentin for nerve pain and arm put in a sling. That did nothing to resolve the pain. It is still very intense from the left shoulder blade over my left shoulder down my arm to my hand. It hurts worse when I bend over. I get minor relief when I hold my arm over my head. I cannot deal with this pain much longer. It is too intense.


VAERS ID: 1359053 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Feeling abnormal, Feeling hot, Granulocyte count increased, Headache, Minimum inhibitory concentration, Minimum inhibitory concentration increased, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Dementia (broad), Guillain-Barre 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: Baby Marrows Issues when he was born - his labs were so low when he was 4 years old that he had to get medication to get his white blood cell count to go back up to normal - but for the last two years he hasn''t had any problem
Allergies: no
Diagnostic Lab Data: 20th -facility labs - bloodwork - some numbers were low - white blood count 3.0 - low; MID % - high - 7.0; GRAN - 1.3 (low): MID - low 0.2 - they will check him again in a couple of months.
CDC Split Type: vsafe

Write-up: Weak and tired. He felt like he was numb. Like he couldn''t really move. He slept - didn''t have any fever. Was really hot though. He had a really bad headache and his dad gave him Tylenol. He felt still tired the next day but felt better. The headache was gone. Doctor exam - physical and labs


VAERS ID: 1359239 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-05-18
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient claims to have developed rash at injection site 3 days after injection and complained of erythema and itching. The rash went away after 5 days (which was approx. 8 days after injection), but came back 4 days later on 5/25. Recommended for patient to see primary care physician.


VAERS ID: 1359731 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, aspirin, zoloft, fish oil, descovy
Current Illness: High blood pressure, epelepsy, athsma
Preexisting Conditions:
Allergies: codeine, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed Titinuis in right ear, dizziness


VAERS ID: 1360561 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Pain
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562694

Write-up: headache; body ache; This is a spontaneous report from a contactable consumer (Patient) via Medical Information team. A 57-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number and expiry date not reported), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. The patients medical history and concomitant medications were not reported. On 18May2021, the patient experienced headache, body ache. Reported serious as no, reported that patient had the first dose of the Pfizer COVID vaccine yesterday. He wants to know if he can take Aspirin, Tylenol or Ibuprofen for the pain. Reported that reporter seriousness for Headache and Body Aches was Unspecified. Reported that patient experienced his headache and body aches began this morning. States he does not want to complete a report he wants to be transferred to health facility. Caller declined to complete report. The outcome of events was not recovered. Follow up attempt needed. Additional information has been requested.


VAERS ID: 1360576 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Ear pain, Tinnitus
SMQs:, Hearing impairment (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: TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes); Migraine
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021568143

Write-up: On 05/18/21at 6pm I started hearing a loud hissing noise in both ears, tinnitus; left ear pain on and off; This is a spontaneous report from a contactable consumer (patient). A 59-year-old non-pregnant female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Lot number: ER8732), via an unspecified route of administration, administered in left arm on 11May2021 (age at the vaccination 59-year-old) as first dose single for covid-19 immunisation. Medical history included migraine and COVID-19. Concomitant medication included topiramate (TOPAMAX) taken for an unspecified indication, start and stop date were not reported. Prior to vaccination the patient diagnosed with COVID. Since the vaccination, the patient has not been tested for COVID-19. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Other vaccine same date vaccine location left arm. On 18May2021 at 6pm patient started hearing a loud hissing noise in both ears, tinnitus, it subsided after about 15 minutes but returned at about 9 pm, it subsided after a few minutes, it has continued to come and go since. Also left ear pain on and off since vaccine. Patient did not received treatment for the adverse events. The outcome of the events was not recovered.


VAERS ID: 1360583 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Accidental exposure to product, Haemorrhage, Needle issue, Underdose
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021569058

Write-up: clear fluid was accompanied with some blood thereafter; some of the vaccine leaked out of her arm; some of the vaccine leaked out of her arm; held the needle too long at the arm; This is a spontaneous report from a contactable consumer. This consumer (mother) reported for a 12-year-old female patient (daughter) that. A 12-years-old female patient received first dose bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Batch/Lot Number: EW0185),via an unspecified route of administration, administered in Arm Right on 18May2021 17:00 as 1st dose, single for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 18May2021 the patient experienced clear fluid was accompanied with some blood thereafter, some of the vaccine leaked out of her arm, some of the vaccine leaked out of her arm and held the needle too long at the arm. Caller called for her 12 year old daughter who received her 1st dose of the Pfizer COVID Vaccine yesterday at 5:00pm MST at a Pharmacy. She mentioned that 5 out of 6 of them in the family were over 16 years old and had no problem with their vaccination as they received it at a different Pharmacy branch. She mentioned that the branch she went to yesterday for her daughter was very unorganized. The vaccination was held at a drive-thru in which she noticed that the Pharmacy Technician held the syringe too long on her daughters arm and when he pulled out, some clear fluid flowed out and ran down her arm and she started bleeding. She already went up to the Pharmacist and they mentioned that they will call Pfizer within the week. She is called for herself just to make sure and seeked recommendations for events such as these because she is doubtful that her daughter even got enough of the 1st shot. She is wondered if she should restart the dose, how long should she wait if she restarts, or just proceed with the 2nd dose. Consumer called about Pfizer COVID-19 vaccine who reports her 12 year old daughter supposedly received her first dose yesterday at a pharmacy at 05:00PM MST. Agent reports that caller also mentioned that 5 people in their family above the age of 16 received doses at another pharmacy and had no problems, but her daughter who took her first dose yesterday at a drive thru of a pharmacy had a problem. Agent reported caller said that yesterday the tech who administered the first dose held the needle too long at the arm and when they pulled it out some of the vaccine went out, some clear fluid leaked out of her daughter''s arm, and was accompanied with some blood thereafter. Agent reported that caller was advised to consult their physician and let them know Pfizer Medical Information''s number so they can contact and discuss options. Caller said she would say that she was not very far from her daughter''s arm when it happened since she was sitting next to her. She said she saw a fat drop of clear liquid run down her daughter''s arm, and then after that came down, after it came a drop of blood that leaked down into it, so that it was clear at first then became pinkish. She said the person who gave the injection to her daughter had to grab something to wipe it because it was traveling down her arm. Caller said that there was no treatment done to her daughter''s arm other than when he wiped it off and slapped a band aid on it, and then he didn''t make eye contact with her and didn''t want to talk about it. She understood that things like this can and do happen sometimes. She said she should have taken her daughter to a doctor but she didn''t. Said her daughter did not have any other vaccinations yesterday or any other vaccinations in the last four weeks. The clinical outcome of the events was unknown. Follow up attempts are needed. Further information has been requested.


VAERS ID: 1360599 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: NORETHINDRONE [NORETHISTERONE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021571504

Write-up: The morning after the 2nd shot, I woke up with a rash that looks like a bruise on my chin.; The morning after the 2nd shot, I woke up with a rash that looks like a bruise on my chin.; This is a spontaneous report received from a non-contactable consumer or other non hcp. A 33-year-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: EW0186) via an unspecified route of administration in Arm Left on 17May2021 13:45 (at the age of 33-years-old) as single dose for covid-19 immunisation. Medical history included hypothyroidism from an unknown date and unknown if ongoing. Concomitant medication included norethindrone taken. Prior to vaccination the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the covid vaccination. On 18 May 2021 in morning after the 2nd shot, he woke up with a rash that looks like a bruise on his chin. Outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1360693 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-05-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Chest pain, Malaise, Myocarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fish oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood samples that showed elevated levels of Troponin.
CDC Split Type:

Write-up: Mayocarditis; started as a feeling like I had a very bad viral infection on 5/18. Then 5/20 I started getting intense chest pain and went to Hospital where I was admitted for 5 days. They observed my condition and gave me Ibuprofen, Motrin, and Colchicine. Released on 5/25 once my fever broke.


VAERS ID: 1360832 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Ear congestion, Head discomfort, Hypoaesthesia oral, Lip swelling, Pruritus, Rash, Sinus congestion, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: linsinopril, 10mg, omega-3-acid 1gm, multi vitamin, vitamin C, vitamin D, CQ10, Flaxseed oil
Current Illness: None
Preexisting Conditions: High Blood pressure, high cholesterol
Allergies: Statins Ezetimibe Levofloxacin Codeine Shellfish-Derived Products Sulfa Antibiotics Sulfites Sulfur Clarithromycin Tumeric Iodine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: With in 10 minutes of the injection my thoart closed, my lips swelled and I was having trouble breathing. Benaydyl was given and an Epipen was used, I was taken by ambulance to the local hospital ER where an IV was started, steroid was injected. I was kept several hours for observation and sent home. The following day I had attacks of itching and rashes as well as occasional numbness in my lips, by Thursday evening it was worse, returned to a different hospitals ER at 2am Friday morning, more steroid was given and I was observed, and sent home with an prescription for an epipen as well as steroids. Continued to take Benadryl often taking two with in a half hour, Monday May 24 went to my own docotor, as I had a new reaction of pressure in both ears with pressure in my cheeks and around the back of my head. She give me a prescription for additional steroids and is still monitoring me as I am still reacting.


VAERS ID: 1360888 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Back pain, Body temperature increased, Cold sweat, Decreased appetite, Dizziness, Fatigue, Full blood count, Headache, Heart rate decreased, Heart rate increased, Immediate post-injection reaction, Myalgia, Nasal congestion, Nausea, Pain in extremity, Pallor, Panic attack, Pyrexia, SARS-CoV-2 antibody test negative, Syncope, Thyroid function test normal, Vitamin B12, Vitamin D
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Loratadine 10mg (once nightly), vitamin C, vitamin D, Elderberry
Current Illness: None known. Was potentially exposed to RSV on 5/16/21-5/18/21, but had shown no symptoms.
Preexisting Conditions: None known
Allergies: None known for food, medications, or materials; but some seasonal allergies.
Diagnostic Lab Data: Tested for COVID-19, influenza, and mono on 5/26/21 and was negative on all. Had general bloodwork done (not sure what all tests, but included CBC, thyroid levels, check kidney/liver function, etc.) on 5/26/21 and all levels were normal. Blood pressure, heart rate, and other vital signs were normal as well. Returned to doctor on 5/28/21 and had blood tests for vitamin B12, vitamin D, and testosterone. Results have not returned yet. After going to the ER, that afternoon (5/28/21), had more blood tests, EKG, and chest x-ray. All levels were reportedly normal and was discharged. Other vital signs were normal except for slightly elevated temperature (decreased during stay).
CDC Split Type:

Write-up: Reporting primary symptoms: headache, fever, lightheadedness, elevated heart rate, arm soreness, muscle soreness, back pain, nausea, suppressed appetite, anxiety, and panic attacks. (see below for more information) Initially, felt faint and lightheaded. Stood up and the feeling worsened. Within five minutes, felt nauseated and clammy. Also, appeared pale in the face. Was given instructions to sit, close eyes, and take deep breaths. Applied a cool, wet rag to the face and neck as needed. Was anxious and may have had a panic attack triggered by the experience. Heart rate had elevated, but not to a concerning level. Within 30 minutes of initial vaccine administration, face was no longer pale and heart rate was lowering. Other symptoms mostly subsided within 90 minutes of the vaccine administration. The next morning (5/19/21), woke with a mild headache, low grade fever, some fatigue, slight nasal congestion, and very sore arm. Took Tylenol for fever and it was mostly gone by the next day (5/20/21). Felt well enough Saturday (5/22/21) morning for lots of physical activity (push-mowed lawn in humid conditions) and only had a mild headache and mild fatigue afterward. No notable symptoms on Sunday (5/23/21) morning, but had indigestion, gas pain, and some soreness (back muscle) late that night. Stayed up a little later than normal. Woke a few hours early (around 4:30 am) on Monday (5/24/21) with throbbing low-to-mid, left-side back pain and worsened indigestion and gas pain. Had anxiety that led to a panic attack. Did not feel well and tried stretching, taking Tums, deep breathing, used the bathroom, and walked around. This was helpful enough to return to sleep. Woke up again at 8:45 am and had a mild headache, some soreness in neck/shoulders, and anxiety about the situation. Took a shower, did some deep breathing, and tried to relax. Drank some caffeine at noon, but the headache was not relieved. Appetite was somewhat suppressed and was mildly lightheaded. Stomach became more unsettle by night. Stopped all caffeine intake and NSAID usage (and still no intake/usage at the time of this report). At night, anxiety over the situation worsened, so tried deep breathing, talking to others about the situation, and stretching. Panic attack occurred, but was able to manage with the aforementioned techniques. Woke the next day (5/25/21) with mild headache, muscle soreness in mid-to-upper back, shoulders, and neck, suppressed appetite, and anxiety. Was able to manage most symptoms with breathing, stretching, relaxing, and talking through the situation. No panic attack on 5/25/21. Went to bed earlier than normal (around 9:30 pm) and woke on 5/26/21 around 9:30 am. Had similar symptoms, but appetite was more decreased and worsened anxiety. Decided to see doctor that afternoon (see item 19 for more information on testing from that visit) and was told to give more time to recover from vaccine side effects. Did not give doctor information about anxiety or panic attacks at that time. Had a panic attack (less severe than previous) Wednesday night and managed with the aforementioned techniques. Thursday (5/27/21) morning woke with no headache and no fever, but still some soreness in neck/shoulder area, suppressed appetite, mild fatigue, and mild anxiety about the situation. No panic attack on 5/27/21. Friday (5/28/21) woke with similar symptoms and decided to visit doctor again about anxiety. Was prescribed Buspar and Zoloft. After taking Buspar (first time ever) at 2:30 pm, experienced an increased heart rate up to 160bpm and a low fever up to 100.2F. Experienced another panic attack during this time. Sought medical assistance from local ER around 3:30 pm. Was seen and monitored until discharge at about 11:45 pm. During stay, tests and levels were mostly normal except during a panic attack that was triggered after blood was drawn. Treated with Vistaril around 11:20 pm and monitored for about 20 minutes before being discharged. Anxiety was relieved after deep breathing and relaxing. Did not take Zoloft. Slept and woke on 5/29/21 with mild headache, unsettled stomach, and mild anxiety. Anxiety is more manageable so far and other symptoms were somewhat improved after eating breakfast. Currently, no plans to continue taking Buspar, but will consult doctor.


VAERS ID: 1360932 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-12
Onset:2021-05-18
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Full blood count, Laboratory test abnormal, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Trulicity, Lantus Insulin, Zyrtec, Singulair, Vraylar, simvastatin, colchicine, allopurinol, lamotrigine, lisinopril, furosemide, duloxetine, dexmethylphenidate, clonazepam, carvedilol, meloxicam
Current Illness:
Preexisting Conditions: Type 2 diabetes, celiac disease, obesity, obstructive sleep apnea, primary hypothyroidism, hypertension, depression, gout
Allergies: penicillin, latex
Diagnostic Lab Data: complete blood count and others ordered by hematologist pending at this time
CDC Split Type:

Write-up: The patient had noted increased bruising at her insulin injection sites within weeks after the vaccine. She had routine labs on May 18, 2021 that showed isolated thrombocytopenia with a platelet count of 12 thousand. This was confirmed in hospital with a platelet count of 13 thousand the same day. She was admitted to Hospital and seen by hematology. She was treated with glucocorticoids and discharged when her platelet count rose to around 20 thousand. Thus far, she has not had thrombotic events. None of her medications are new. All are stable. We have prior complete blood counts that showed perfectly normal platelet counts in 2020 and earlier.


VAERS ID: 1360952 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-27
Onset:2021-05-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram normal, Dyskinesia, Electrocardiogram normal, Feeling abnormal, Tachycardia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: claritin, ketotifen
Current Illness: Long covid
Preexisting Conditions: Long covid
Allergies: aspirin, latex
Diagnostic Lab Data: Neural CT (clear), EKG (clear)
CDC Split Type:

Write-up: Tremor, dyskinesia, brain fog, tachycardia


VAERS ID: 1361024 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-02
Onset:2021-05-18
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody positive, Chest X-ray, Computerised tomogram thorax abnormal, Condition aggravated, Disease progression, Double stranded DNA antibody positive, Dyspnoea, Echocardiogram, Ejection fraction normal, Fibrin D dimer, Laboratory test, Oxygen saturation decreased, Rheumatoid factor negative
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Venlafaxine HCL XR 150 mg and 75mg qd, Atorvastatin 40 mg qd, Atenolol 25 mg qd, ASA 81 mg qd, Gabapentin 300mg BID, Tylenol ES 2 daily, Biscadodyl 2 tabs daily, Omeprazole 40 mg qd Supplements: Fish Oil, Vit C, Centrum silver, Vit D3, Mel
Current Illness: No acute illness
Preexisting Conditions: PMH of CAD, Interstitial lung disease on room air and asymptomatic, s/p cardiac stents, and spinal stenosis with radiculopathy, GERD, s/p nephrectomy, HLD
Allergies: NKA
Diagnostic Lab Data: See above----CxR, Chest CT, extensive lab work, D-dimer, cardiac echo, dysphagia eval by speech and rule out for dysphagia Chest CT- chronic ILD with some progression
CDC Split Type:

Write-up: He developed acute dyspnea with a drop in pulse ox to 90. Normally not dsyneic, on room air and sats in a good range. Symptoms progressed and he was seen at the ED and ruled out for a PE, MI and antibiotics stopped based on neg proclaimed, imaging, etc Chest CT read as interval progression of ILD and he was seen in consultation by Pulmonary. Additional cardiac workup with TTE with normal EF. Autoimmune/rheum workup was initiated with result to date unremarkable except for positive ANA and mildly positive dsDNA. He was discharge home on continuous O2, not weanable in hospital with follow up with pulmonary and no clear trigger as of discharge for acute change in pulmonary status from usual baseline.


VAERS ID: 1361201 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-05-18
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster, Herpes zoster meningitis, Herpes zoster reactivation
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Patient # 1 of 3 with reactivation zoster after COVID-19 vaccination, will report other patient in separate report Crohn disease on infliximab Moderna vaccine # 1 on 4/10/2021 Moderna vaccine # 2 on 5/8/2021 Diagnosed with C2 distribution dermatomal zoster complicated by zoster meningitis on 5/18/2021


VAERS ID: 1361213 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia
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:

Write-up: Patient received Moderna vaccine on 5/18/21 in right deltoid and her muscle is still quite sore. She is going to call her doctor Tuesday if it is still hurting


VAERS ID: 1361448 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Epistaxis, Full blood count, Platelet count increased, Prothrombin time
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Gabepentin, Sertraline, Buproprion, Losartin, Amlodipine, Vit B complex,
Current Illness: None
Preexisting Conditions: Hypertension, Depression, neck and low back pain
Allergies: Motrin
Diagnostic Lab Data: CDC and PT/PTT on 19 May 21 were normal except minimally elevated platelet count of 420.
CDC Split Type:

Write-up: Nosebleed that did not stop after several hours of direct pressure. Required visit to Emergency Room and ENT consult. Bleeding identified as anterior nasal and the mucosa appeared friable. Resolved with placement of hydrostatic gel.


VAERS ID: 1361603 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stroke .. blood clot.


VAERS ID: 1361644 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2038218 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Fatigue, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NA
CDC Split Type:

Write-up: Chills, upset stomach, store leg muscles, vomiting, extreme fatigue


VAERS ID: 1361741 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Diarrhoea, Dizziness, Fatigue, Injection site bruising, Injection site pain, Nausea, Pain, Pain in extremity, Pyrexia, Urine analysis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 1000mg, Lamotrigine 100mg, Gabapentin 200mg
Current Illness: None
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data: 5/23/2021 Blood test, urine test
CDC Split Type:

Write-up: 5/18/21 - 3PM: extreme nausea, dizziness, fatigue 5pm 100 degree fever 6pm - 11pm 102 degree fever, slight arm pain 12pm fever broke 5/19/21 - Entire day: severe arm pain at injection site, nausea, diarrhoea, fatigue, whole body aches 5/20/21 - 5/22/2021extreme fatigue, nausea, watery diarrhoea 5/23/2021 - went to urgent care because I was in a lot of pain, fatigue, nausea, could not eat food without passing watery stool, extreme lower stomach pain, body aches. They ran blood and urine tests which all came out ok. They said my immune response was high which indicated I was still reacting to the vaccine. They prescribed me nausea medication and told me to drink pepto. Sent off a stool sample. 5/30/21 - I still cannot eat without feeling nauseous, stool alternating between extremely hard to watery, the bruise at my injection site is getting worse and it still hurts if I touch it.


VAERS ID: 1361843 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

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

Write-up: Light headed, dizzy (vertigo), vommitting. Lasted 48 hours.


VAERS ID: 1361851 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-16
Onset:2021-05-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Erythema, Eye irritation, Gait disturbance, Hypersensitivity, Lymphadenopathy, Pain in extremity, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Corneal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: diphenhydramine 25 mg every 4 hours, except when sleeping (aka Benadryl)
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Between 24-48 hours began have reactions not expected. Pain in LEFT foot and toes. Severe pain in LEFT hand, fingers, wrist, and forearm. Then pain in BOTH wrists, hands, feet, and then lower back pain. The pain moved from scary levels to dull pain over the 2 weeks post-vaccination. I expect the pain will go away soon. The use of my hands was affected. Walking was affected. It felt like the lymph nodes around my ears, neck, face, eyes, chest, arms, abdomen, legs were all swollen. Can swollen lymph cause carpal tunnel like symptoms? Foot pain? Lower back pain? Began to have allergic like skin reactions 5 days post-vaccination. Burning eyes, itchy skin. Still experiencing itchy skin with red/warm face 13 days post-vaccine. Antihistamine relieves most symptoms. This vaccine does not seem sustainable for me as a yearly vaccine. (I had red palms after the 1st vaccine within hours. I am not sure if this was a reaction to the vaccine. I began taking antihistamine before the 2nd vaccine and did not get red palms. I have no idea if red palms were an early hint that I would be hyper sensitive to the vaccine.)


VAERS ID: 1361853 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site reaction, Muscle tightness, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

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

Write-up: patient developed pain and swelling in the shoulder that later spread all the way across his back to his other shoulder. It has improved, but it still feels like he has a tight muscle in the shoulder what was injected. i was the one to give his vaccine, and i know for sure that i gave it in the most central, thickest region of the medial deltoid and did not give it too high. I told him that as well, and he confirmed that i gave it in the muscle. he said a long time ago, he received a shot that was too high, and he knew i didn''t give it too high.


VAERS ID: 1361914 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO182 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse 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:
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: torn hamstring ~1 week after


VAERS ID: 1362025 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-28
Onset:2021-05-18
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase normal, Chest pain, Electrocardiogram normal, Fatigue, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: EKG and CPK on may 27th: Both normal results
CDC Split Type:

Write-up: Heart palpitations throughout the day in 2 minute bouts whole week of may 17th, Dull chest pain in left chest consistent throughout the day started weekend of May 18th, Elevated heart rate, fatigue, Random elevated HR and palpitations in middle of the night on morning of may 30th.


VAERS ID: 1362083 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Back pain, Fatigue, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Percocet, Gabapentin, Amlodopine, Lisinopril/HCTZ, Invokana
Current Illness: n/a
Preexisting Conditions: sciatica, hypertension, lower back problems, diabetes
Allergies: iodine
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Woke up with COVID-like symptoms similar to when I had contracted COVID 5 months earlier. Headache, mild loss of taste, body pains all over body, extreme back pains not typical of back problem, fatigue, nausea, vomiting


VAERS ID: 1362117 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood pressure decreased, Confusional state, Dizziness, Heart rate decreased, Hypotension, Injection site pain, Presyncope
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: pt had dizziness, confusio, drop in BP and HR. called 911 and transfered to ER; pt did not receive any medication only monitored; pt had an anxiety attack and vegal reaction per ER staff-Severe, Systemic: Hypotension-Severe, Additional Details: pt had low BP and HR in 50s


VAERS ID: 1362138 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-04
Onset:2021-05-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site rash, Injection site scab
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Proberry:Blueberries, Elderberry, Blackberry, Vit D, VisonAliv
Current Illness:
Preexisting Conditions:
Allergies: Aspirin sensitivity
Diagnostic Lab Data:
CDC Split Type:

Write-up: A couplle af days after shot hard sore lump about a couple inched below injection site occured. Then 2 weeks later a Red rash below injection site about the size of 2"x2" appeared. Sharp pain like porqupine quills. Rash was red dots like broken blood capilaries and very itchy. Lasted a few days. Kind of scabed over. Reminded me of a shingles rash and pain. Very tired for the following month.


VAERS ID: 1362171 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Lethargy, Lip swelling, Lymphadenopathy, Muscle tightness, Nausea, Pain, Tendon pain, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: D-amphetamine salt combo Venlafaxine Plexus supplements
Current Illness: N/A
Preexisting Conditions: Asthma Narcolepsy Sleep apnea
Allergies: Ceclor Sensitivity to gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: ? Sharp shooting pain from injection spot to elbow 5 minutes post injection ? Body aches ? Muscles tensing up ? Tendon pain at joints ? Swollen lymph nodes on neck and by collar bone ? Lethargic ? Headaches ? Nausea ? Vertigo ? Swollen lips (have had filler months prior- maybe the way vaccine reacts to filler?)


VAERS ID: 1362413 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient is having pain in her left arm, left buttock, left leg, and left foot. This pain began 1 day after receiving the initial dose of the Moderna Vaccine.


VAERS ID: 1362528 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (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: Multivitamins Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Asprin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left shoulder sever pain


VAERS ID: 1362541 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21ALCDOH / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Cough, Fatigue, Lung disorder, Mobility decreased, Myalgia, Pain in extremity, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (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: flu shot, age 65
Other Medications: vitamins
Current Illness: none
Preexisting Conditions: arthritis
Allergies: gluten, latex
Diagnostic Lab Data: Never bothered. We were told to expect issues and to date have not seen anything that would indicate that the medical profession could do anything to alleviate the issues.
CDC Split Type:

Write-up: Throat started to close up after 1 hour (took Benadryl which alleviated problem) Cough started next day, lungs still feel a little dry. Biggest problem are my joints, they hurt non stop - my fingers, my toes, my wrists, my knees, my spine - hurt, hurt, hurt. The joints started hurting the day after the shot and have not let up since. Also have muscle pain in my thighs which started at the same time as the joint pain. The pain is affecting my ability to go up and down stairs. Suffered from total exhaustion for about 2 weeks. Still get tired easily but not as bad. Taking acetaminophen which is not working.


VAERS ID: 1362550 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VitamenB,D,zinc, Prilosec, Tylenol, Crestor, Nabumenton, Culturelle
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin, Codene, sulfa drugs, leviquine, dust mites, pollens
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had diarrhea for 16 hours after the injection and loose stools for another 10 days after the injection. My left forearm became itchy a few minutes after receiving the injection in my left arm and I have developed a rash that has not gone away and my forearm remain itchy.


VAERS ID: 1362638 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-09
Onset:2021-05-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Dyspnoea exertional, Fibrin D dimer increased, General symptom, Pleuritic pain, Pulmonary embolism, Scan with contrast abnormal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT Scan with contrast on 5/21/2021 : Filling defect within the distal left pulmonary artery extending in to the left upper lobe branch and left lower lobe with segmental and subsegmental extension. Findings are consistent with PE. DDimer: 2.35 (top normal 0.05)
CDC Split Type:

Write-up: First dose received on 4/18/2021, second dose received 5/9/2021. Admitted to Hospital on 5/21/2021 with large pulmonary embolus and bilateral DVT. Patient became short of breath 3 days prior to admission, and the day of admission developed left sided pleural pain. Physical exam revealed a friction rub in left posterior chest. Patient was initially heparinized, then switched to oral apixaban bid and is being followed up as an outpatient. As of this day 5/31/2021 patient is asymptomatic at rest but still has dyspnea on exertion.


VAERS ID: 1363801 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN A205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Chills, Headache, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210552762

Write-up: SEVERE ABDOMINAL PAIN; SEVERE BLOATING; LEG PAIN; CHILLS; MILD HEADACHE; 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 and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced severe abdominal pain. On 18-MAY-2021, the subject experienced severe bloating. On 18-MAY-2021, the subject experienced leg pain. On 18-MAY-2021, the subject experienced chills. On 18-MAY-2021, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 20-MAY-2021, and had not recovered from severe abdominal pain, severe bloating, mild headache, and leg pain. This report was non-serious.


VAERS ID: 1363863 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN E04AZ1A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had No known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210555278

Write-up: SWOLLEN GLANDS IN JAW; HEADACHE WAS AFFECTING BOTH SIDES OF THE HEAD; FATIGUE; This spontaneous report received from a patient concerned a 53 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: E04AZ1A, expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced swollen glands in jaw. On 18-MAY-2021, the subject experienced headache was affecting both sides of the head. On 18-MAY-2021, the subject experienced fatigue. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache was affecting both sides of the head, fatigue, and swollen glands in jaw. This report was non-serious.


VAERS ID: 1363913 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-18
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Dizziness, Hypoaesthesia, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anxiety
Preexisting Conditions: Comments: No known drug allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210522; Test Name: Blood test; Result Unstructured Data: Normal; Comments: No abnormal results were reported to the patient
CDC Split Type: USJNJFOC20210556594

Write-up: NUMBNESS ON LEFT SIDE OF BODY (LEG, ARM AND FACE); PINS AND NEEDLES THROUGHOUT THE BODY (INTERMITTENTLY); DIZZINESS; VERTIGO; This spontaneous report received from a patient concerned a 42 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included anxiety, and other pre-existing medical conditions included no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAY-2021, the subject experienced dizziness. On 18-MAY-2021, the subject experienced vertigo. On 19-MAY-2021, the subject experienced numbness on left side of body (leg, arm and face). On 19-MAY-2021, the subject experienced pins and needles throughout the body (intermittently). On 22-MAY-2021, Laboratory data included: Blood test (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from dizziness, vertigo, numbness on left side of body (leg, arm and face), and pins and needles throughout the body (intermittently). This report was non-serious.


VAERS ID: 1364490 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Cough, Dizziness, Headache, Hypertension, Influenza like illness, Rhinorrhoea, Sinus headache
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: First day - dizziness, headache, temperature: 37.5 (paracetamol) Second day - flu syndromes, temperature: 40.0, sinus headaches, runny nose (paracetamol, ibuprofen) 3rd-6th day - temperature: 37-38, flu, runny nose, strong sinus headaches, cough (ibuprofen, aspirin - but not together) 7th - 10th day - runny nose, cough, sinus headaches, temperature back to normal (aspirin) 11th day - high blood pressure (160/100), strong sinus headaches 12-14th day - blood pressure 130/90, sinus headaches


VAERS ID: 1364678 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-15
Onset:2021-05-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Injection site pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (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: none
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: initial soreness at injection site (Left Shoulder) A couple days after the shot that soreness subsided but started experiencing tightness in left chest/heart area. Will experience the tightness for a period of time then it will go away. More prevalent with activity, and is accompanied with shortness of breath as well.


VAERS ID: 1364787 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-11
Onset:2021-05-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: 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: topiramate, amitriptyline, famotidine, cetirizine
Current Illness: none
Preexisting Conditions: migraine
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient complaining of lower leg pain specifically to a particular vein in left lower leg.


VAERS ID: 1364802 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Endometrial cancer
SMQs:, Uterine and fallopian tube malignant tumours (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized within 6 weeks of receiving COVID vaccination with endometrial cancer.


VAERS ID: 1364936 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Children''s Multivitamin;she has an inhaler - but she hasn''t taken it in over a year
Current Illness: no
Preexisting Conditions: Eczema; she was diagnosed with asthma but hasn''t used an inhaler for over a year.
Allergies: skin sensitivity: scented soaps or laundry soaps
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: She had a rash after school - she noticed it about 2:00 - she started getting a headache and around 03:00 - she noticed a rash (red marks - no bumps) on her knees and upper and thighs. About 3:20 - her right arm and a little bit on her left arm were almost like hives (bumps) - they were a little bit itchy off and on. The next morning, could still the bumps but not as bad, but on 19th after school it was back just like the day before. We gave Benadryl to see if that would help. In the morning it goes away - on her arms, she can see a little a bit of where the lumps are - not as bad; on legs it''s just almost completely gone, and by afternoon it''s back to full scale of where it had been the night before. Could see where the bumps were in her arm but it is not as bad as it was. Today, as far as I know from the last time I asked her, she said there are still some on her arms but not on legs.


VAERS ID: 1364956 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-24
Onset:2021-05-18
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Cardiac failure, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Fatigue, Heparin-induced thrombocytopenia test, Intensive care, Myocardial strain, Platelet count decreased, Pulmonary embolism, Respiratory failure, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ascorbic Acid
Current Illness: None reported
Preexisting Conditions: No chronic health conditions reported
Allergies: Non known allergies
Diagnostic Lab Data: 5/17/21: CT angiogram Chest - Central pulmonary emboli with large clot burden and evidence of right heart strain 5/20/21: LE duplex - Acute occlusive and nonocclusive DVT of the right lower extremity, Acute nonocclusive DVT of the left popliteal vein 5/28/21: CT angiogram Chest - Extensive and largely unchanged pulmonary emboli most evident in the right middle and right lower lobes with much less involvement in the lingula and left lower lobe. Once again, there is marked enlargement of right-sided cardiac chambers with dilatation of the IVC and hepatic veins. 5/26/21: Heparin platelet antibodies OD = 0.333; Serotonin release assay = negative
CDC Split Type:

Write-up: Patient admitted to referring hospital on 5/18/2021 for fatigue and SOB, found to have pulmonary embolism (CT with central pulmonary emboli with right heart strain), alteplase was given at referring hospital and was admitted to ICU for continued monitoring. Venous duplex done also revealed bilateral DVTs. Patient was doing well after fibrinolytic with heparin anticoagulation, but had sudden decompensation on 5/21 (hypotension and respiratory failure requiring intubation). Transferred to current institution for ECMO evaluation due to severe cardiopulmonary compromise. Patient deemed not ECMO candidate based on co-morbid conditions based on CT findings. He underwent mechanical thrombectomy with improvement. He was continued on heparin infusion, then had sudden decrease in platelet on 5/25 with worsening cardiopulmonary status. HITT was suspected and heparin was transitioned to argatroban. Results of heparin induced platelet antibodies (PF4 ELISA assay) and Serotonin Release assay was negative. Repeat imaging revealed increase clot burden and therefore patient underwent catheter directed thrombolysis followed by aspiration suction thrombectomy. Due to high clinical suspicion of HITT, repeat heparin induced platelet and SRA sent and pending at the time of report. Of note, patient still in hospital at the time of this report


VAERS ID: 1365044 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

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

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

Write-up: At approximately 4:15 pm, the patient became dizzy after after receiving the Pfizer vaccine. EMS evaluated the patient and determined that his vitals were normal and no further medial attend was needed.


VAERS ID: 1365050 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

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

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

Write-up: Under age administration of Pfizer COVID-19 vaccine. Recipient is under the age of 12. Recipient''s parents did sign consent form. They will be notified that recipient should not return for second dose.


VAERS ID: 1365078 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-10
Onset:2021-05-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Hypoaesthesia, Pain in extremity, Ultrasound Doppler normal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ultrasound of left leg showed no blood clot
CDC Split Type:

Write-up: numbness in left arm, shooting pain in left leg, dizziness, headache


VAERS ID: 1365113 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: Nausea/Vomitting, fever for approximately 24 hours


VAERS ID: 1365153 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Fatigue, Hypoaesthesia, Pain, Pain in extremity, Paraesthesia, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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: Otezla 30mg BID, vitamin D, Vitamin B12, Omega 3, Claritin 10mg, Magnesium,
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: Avelox, Gabapentin, Abreva, Eggs, Banana, Latex, Phenergan, Bees & bees wax,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 2 minutes of receiving shot had pain numbness and tingling in the right arm. By 415 that afternoon broke out in hives and felt itchy all over, felt very tired and achy and had a heaviness in my chest and started having episodes of dizziness that are on and off


VAERS ID: 1365366 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-05-18
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / SYR

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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.


VAERS ID: 1365438 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort, Albuterol, Centrum Silver, Vitamin D
Current Illness: Gastroesophageal Reflux Disease
Preexisting Conditions: COPD
Allergies: Penicillin,
Diagnostic Lab Data:
CDC Split Type:

Write-up: generalized urticaria, intense itching, fatigue, shortness of breath


VAERS ID: 1365745 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-19
Onset:2021-05-18
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding
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: Albuterol, as needed
Current Illness: Asthma, very controlled
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data: I''ll see a doctor on Thursday
CDC Split Type:

Write-up: I''ve had my period for 15 days straight with no end in sight! I always have it 4-5 days, mostly light after 1 heavy day. With this period it was heavy days 1-8, lighter on days 9-14, and now on Day 15 it''s started over with horrific cramps. The longest periods I''ve ever had before were for 8 days as a teenager. This is far outside of anything I''ve ever experienced before. Also I previously submitted a record of me getting diagnosed with Guillain-Barr? Syndrome, so I continue to experience terrible side effects of this vaccine.


VAERS ID: 1365944 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-02-01
Onset:2021-05-18
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Menstruation irregular, Ultrasound pelvis
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cotalopram Levothyroxin Vitamin D supplement
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: An ultrasound of my uterus, both external and transvaginal.
CDC Split Type:

Write-up: I started having a menstrual period. It lasted 4 1/2 days.


VAERS ID: 1366322 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, C-reactive protein increased, Headache, Immunology test, Influenza like illness, Mononucleosis heterophile test negative, Nausea, Pain, Pain in extremity, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, Tenderness
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Advair inhaler
Current Illness: n/a
Preexisting Conditions: Breathing issues since having covid September 2020
Allergies: Shellfish
Diagnostic Lab Data: Blood work full panel including lyme and 2 mono tests 5/28/21 - all negative, except elevated C reactive Protein. Rapid covid test 6/1/21 - negative
CDC Split Type:

Write-up: Flu like symptoms and arm soreness started the next day. Never really subsided. Transitioned to headache, stronger body aches to the point of hurting when touched. Started a fever on 5/27. Today is 6/1 and she still has intermittent fever, aches, nausea, congestion. Started on Zithormycin by doctor. Now on day 3 with no alleviation of the symptoms. Lyme, mono, covid - negative. Bloodwork all normal except for C reactive protein which was elevated at 20.


VAERS ID: 1366324 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Burning sensation, Herpes zoster, Paraesthesia, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Vyvanse Verapamil Multi vitamin Vitamin C Vitamin D
Current Illness: None
Preexisting Conditions: Migraines High BP Acid reflux
Allergies: Sulfa Keflex Augmentum Penicillin
Diagnostic Lab Data: No tests or labs were done
CDC Split Type:

Write-up: Few hours after having 1st dose I started having Severe burning pain in my upper right side of my back 3 days later I went to urgent care and qas told that I have shingles was prescribed valacyclovir a few days later pain was pretty much gone. About a week later I then started having the pain again in my back and had a small rash on my left side of my back. Extremely itchy, tingling, burning sensation and painful went to urgent care and was.told the rash is fading and the pain should subside


Result pages: prev   41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=140&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166