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

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



Case Details (Reverse Sorted by Onset Date)

This is page 145 out of 6,867

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VAERS ID: 1582864 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-05
Onset:2021-08-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939676 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hypoaesthesia, Induration, Injection site hypoaesthesia, Injection site rash, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: H1N1 caccine
Other Medications: Zyrtec daily, flonase, Apri birth control
Current Illness:
Preexisting Conditions: Gerd
Allergies: Lobster
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day #1 headache, numbness to face and injection site. Chills 1hr after injection. Day 2-5 posterior occipital headache, day 7 rash to injection site worsening, day 15 rash, red, raised hard, itchy, bulls eye in appearance.


VAERS ID: 1582885 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyzal, Patanese, Nasonex, Nikki (generic birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: Seasonal Allergies, allergic to dye for MRIs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headaches/Migraines, Fatigue/Tired, Extended Pain at Shot Site (Left Deltoid), Shot Site (area around Left Deltoid) red, hot and swollen...also itching, Pain in armpit and tricep radiating down the under side of the shot arm. I have been using muscle cream and Advil and ensuring hydrated.


VAERS ID: 1582906 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (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: PROAIR HFA INHALER AND BENZAC 10% GEL
Current Illness: NONE
Preexisting Conditions: ASTHMA
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: ON 8/14/21 he was seen by the RN c/o hives and stated that his throat felt like it was closing during the night. Pt was noted to have hives to anterior and posterior trunk, neck, and face. No difficulty breathing noted. Pt was treated with benadryl 50mg IM. and scheduled for provider follow up. On 8/16/2021 Pt was seen by NP and stated he was feeling better. He was noted to have hives to bilateral thighs and hives with swelling to palms of both hands. Pt was given Adrenain 1 mg IM and prednisone 10mg one tab every morning for 5 days. On 8/18/2021 Pt seen by NP. He reported he felt better, all hives were gone.


VAERS ID: 1582909 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Injection site pain, Lymphoedema, Rash, Rash erythematous, Rash papular, Skin weeping
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Losartan Potassium; Metformin; extra strength Acetaminophen; Latanoprost; Lansoprazole; MSM; Cephalexin; Centrum Senior Multivitamins; Iron Bisglycinate 25 mg for Anemia.
Current Illness: Lymphedema.
Preexisting Conditions: Lymphedema.
Allergies: Severe Allergy to red wine; some food preservatives.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red bumpy rash on tops of both feet, oozing.like hives Arm shot site sore 4 days + Made my chronic Lymphedema worse! New site of red skin and lymphedema on left knee


VAERS ID: 1582910 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-11
Onset:2021-08-13
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Fatigue, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol, vitamin D3, (VITAMIN D3 ORAL) clopidogreL (PLAVIX) 75 mg tablet doxycycline (DORYX) 100 mg EC tablet DULoxetine (CYMBALTA) 30 mg capsule furosemide (LASIX) 40 mg tablet glucosamine/chondr su A sod (OSTEO BI-FLEX ORAL) levot
Current Illness:
Preexisting Conditions: Nervous Chronic back pain greater than 3 months duration Bilateral leg pain Chronic pain of right knee Atypical chest pain Respiratory Shortness of breath Asthma Asthma, persistent not controlled Snoring Circulatory CAD in native artery Essential hypertension Ischemic cardiomyopathy Venous insufficiency Peripheral venous insufficiency Digestive Gastroesophageal reflux disease Obesity (BMI 30-39.9) Moderate protein-calorie malnutrition Musculoskeletal Arthritis Primary osteoarthritis of right knee Sacroiliitis Bilateral sacroiliitis Lumbar facet arthropathy Benign skin lesion of forearm Endocrine/Metabolic Mixed hyperlipidemia Hypothyroidism Disorder of thyroid Other History of cardiac catheterization Situational anxiety Generalized edema Edema History of coronary artery bypass graft x 2 Hypersomnia Suspected sleep apnea Positive methacholine challenge
Allergies: Bupropion HclItching Statins-hmg-coa Reductase InhibitorsMyalgia / Muscle Pain Adhesive Tape-siliconesOther (document details in comments)
Diagnostic Lab Data:
CDC Split Type:

Write-up: generalized malaise, fatigue, intermittent abdominal pain, nausea, vomiting, diarrhea. Her GI symptoms happen occasionally.


VAERS ID: 1582918 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Facial spasm, Injection site pain, Lymphadenopathy, Pain in jaw, Trismus
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (narrow), Extravasation events (injections, infusions and implants) (broad), Conjunctival disorders (narrow), Osteonecrosis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Aleve
Diagnostic Lab Data: Did not seek medical attention for these symptoms
CDC Split Type:

Write-up: Sore/tender injection site - onset 8/13 through 8/17 Swollen lymph node at left arm pit and left side of neck - onset 8/14 through 8/16 Left jaw sore and could not open until I used hot compresses and massaged jaw - onset 8/16 in the AM and lasted 2 hours (not sure when it started, as I did not notice until I woke up that morning. Popped blood vessel in my left eye and nerve spasms on the outside of my left eye - onset 8/16 and still ongoing. Spasms are frequent throughout the day (guesstimate of about 2-3 times per hour) and also occur when my eyes are closed at bedtime.


VAERS ID: 1582922 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-08-13
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Illness, Impaired work ability, Infusion, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril, hydrochlorothiazide, metformin, fluoxetine, statin
Current Illness: November 2020, UTI
Preexisting Conditions: DM Type 2, Obesity, HTN
Allergies: fluconazole
Diagnostic Lab Data: Covid PCR tests. Mono- infusion
CDC Split Type:

Write-up: 12/20/2020 Covid Pfizer 01/20/2021 Covid Pfizer 8/13/21 Covid exposure to son 8/13/21 ill Neg Covid PCR 8/16/21 + Covid PCR 8/24/21 Potential to RTW


VAERS ID: 1582952 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril-HCTZ
Current Illness:
Preexisting Conditions: Diabetic, high high blood pressure and asthma
Allergies: Atenenol, tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, Fatigue, Chills


VAERS ID: 1582954 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

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

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

Write-up: Abnormal period. Period started when it wasn''t supposed to and now won''t stop.


VAERS ID: 1582986 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-27
Onset:2021-08-13
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: clotrimazole-betamethasone (LOTRISONE) cream PNV22-iron cb,gl-folic-dss-dha (PNV OB+DHA) 27-1-50-250 mg combo pack
Current Illness:
Preexisting Conditions:
Allergies: Metoclopramide HclShortness of breath / Dyspnea, Welts, Swelling
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Headache New loss of taste or smell Congestion or running nose


VAERS ID: 1582988 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-03
Onset:2021-08-13
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

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

Life Threatening? Yes
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: unknown
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: SARS COV 2 PCR Positive on 8/17
CDC Split Type:

Write-up: Pt experienced dry cough, occasional fever, episodic Diarrhea starting 8/13/2021, and is now admitted to hospital for treatment since 8/17/2021


VAERS ID: 1583007 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-03-10
Onset:2021-08-13
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / -

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

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

Write-up: Hospitalization with Covid after being fully vaccinated


VAERS ID: 1583093 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-23
Onset:2021-08-13
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Diarrhoea, Fatigue, Headache, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Tested positive for COVID-19, symptoms included muscle aches, headache, fatigue, cough, and diarrhea


VAERS ID: 1583107 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: A week after the initial vaccination I developed a red, itchy rash on and about the injection site. It was about 2" in diameter. The following day the rash area felt very hard and thick to the touch. The hardness subsided that evening but was replaced by heat. I began to ice the area a couple times a day. That Sunday a large oval, red "ring" appeared on my upper arm. The shape was distorted and was the color of a new sunburn. The heat dissipated after a few days but the rash and outside ring are still visible after 5 days.


VAERS ID: 1583112 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-08-13
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ascorbate calcium 500 mg tablet calcium-D3-K-FA-B12-C-minerals 500 mg calcium- 400 unit-15 mcg tablet cholecalciferol, vitamin D3, 400 unit tablet naproxen (NAPROSYN) 500 mg tablet
Current Illness:
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Tested positive for COVID-19


VAERS ID: 1583126 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Employee received first dose of COVID19 vaccine on 8/12/2021. Employee states that on 8/13/2021 at about 7:00 am, she started having severe headache, numbness from her left shoulder to her left foot and lower back pain of which she took Tylenol but it did not help her. She then took Advil and felt a little better.


VAERS ID: 1583181 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: Pt received first dose on 7/29/21, and 2nd dose should have been scheduled for 8/19/21. However, pt received vaccine 6 days before recommeneded 2nd dose on 8/13/21. Pt was recommended to receive a booster sometime in September pending CDC''s recommendations for non-immunocompromised pts.


VAERS ID: 1583183 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-08
Onset:2021-08-13
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Hypophagia, Malaise, Nausea, Pollakiuria, Productive cough, Pyrexia, SARS-CoV-2 test, Treatment noncompliance, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, Levemir, Tramadol, Omeprazole, Trulicity, Paroxetime,
Current Illness: Unknown
Preexisting Conditions: HTN, HLD, Insulin Dependent DM, Hypothyroidism, Depression, Afib; Cardizem CD, Klor-Con, Losartan, Xarelto, Meclizine, Topiramate, Albuterol, Azithromycin, Zofran
Allergies: Cefzil, Glyburide, Levaquin, Lexapro, Providone iodine, Sucralfate, Sulfadiazine
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/13/2021
CDC Split Type:

Write-up: The patient presents with Patient is 80-year-old female with history hypertension, hyperlipidemia, diabetes, not feeling well for the past week. Patient states she had symptoms of fever, productive cough. Patient called her primary care doctor, who started her on steroids, cough medication, but not improved. Soon after, patient began having nausea, vomiting, and unable to tolerate anything p.o.. Patient also describes worsening general weakness. Increased urination. Patient states she has not been taking her diabetes medication. No diarrhea, hematuria, dysuria, chest pain, shortness of breath, leg swelling. Patient got both her Pfizer vaccines earlier this year.


VAERS ID: 1583186 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 RA / SYR

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

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

Write-up: On 8/13/2021 two days after covid vaccine I woke up experiencing what I could only describe as vertigo , whirling spinning feeling . It is now 8/18/2021 and symptoms still persist.


VAERS ID: 1583188 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-26
Onset:2021-08-13
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Tested (+) after being fully vaccinated


VAERS ID: 1583393 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. T034630 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: adderall, hydroxychloroquine, zoloft
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: none specified by patient
CDC Split Type:

Write-up: Patient returned to pharmacy on 8/17 to pick up a medication and informed the pharmacy that after she received her vaccinations on 8/13 she developed a rash on her arm that then became swollen on her arm. She stated she researched it on the internet and said she read about "covid arm." She thought that is what she had. She stated she iced the area, took ibuprofen, and took only one benedryl. She stated that her arm was getting better after a couple of days since the vaccination.


VAERS ID: 1583817 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Heart rate increased, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Bad fever, severe chills, nausea and vomiting, diarrhea, dizziness, fatigue, rapid heartbeat, and ongoing diarrhea since the vaccine.


VAERS ID: 1584002 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zetia
Current Illness: None
Preexisting Conditions: High Cholesterol
Allergies: None Known
Diagnostic Lab Data: None from a medical facility. Self tests: Blood oxygen 97%, resting pulse 62, BP 133/81. All are in ranges consistent with pre-vaccine tests.
CDC Split Type:

Write-up: Tinnitus - It started within 2 hours of receiving the vaccine. It still continues (now 5 days later) and has not diminished.


VAERS ID: 1584198 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Cold sweat, Dyspnoea, Gait inability, Heart rate increased, Migraine, Mobility decreased, Sensory disturbance, Sleep disorder, Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: No immediate results until roughly 6 hours after the shot. Was not able to go to sleep after the 6 hour mark. Shortly began to get cold sweats/chills alternating through the night. Became extremely weak and was no longer able to walk or use my arms from ~midnight until 8 AM the next day. I also was experiencing huge migraines that entire time. The migraines occurred from the 6 hour mark until ~48 hours later. Became slightly difficult to breath and it felt slightly weird when breathing(somewhat like a tickle in throat/feeling when you breath air that is too cold and it doesn''t feel like its working). This was from approximately that 6 hour mark until the ~48 hour mark. My already high (~100 bpm typically despite being 22) heart rate increased significantly as well. This was from the same 6 hour mark till the 48 hour mark Overall I had a significantly worse reaction to the shot than I did to my case of Covid itself.


VAERS ID: 1584202 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Autoimmune disorder, Burning sensation, Complex regional pain syndrome, Condition aggravated, Herpes zoster, Lymphadenopathy, Musculoskeletal chest pain, Rash vesicular
SMQs:, Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Measle vaccine 1979
Other Medications: Duragesic fentanyl patch, vitinans: C, B12, D3 and probiotics. Allegra
Current Illness: Reflex sympathetic dystrophy Ketamine infusions for the RSD
Preexisting Conditions: RSD, reflex sympathetic dystrophy
Allergies: Sulfa drugs, penicillin, codeine, ivp dye, dermocette, demoral, E-mycin, Linconsin, darvon, surgical tape, ultram, Foods: chocolate, pork, Lima beans, grapefruit Insect stings, Measle vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen glands Friday night had blister rash on rib cage with pain and burning. Monday went to clinic, diagnosed with Shingles. Reflex sympathetic dystrophy is considered an autoimmune disorder.


VAERS ID: 1586322 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Loss of consciousness, Pallor, Syncope, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: twice passed out while at pharmacy-Medium, Additional Details: similar happen with first shot, this time passed out twice with second shot, was pale as ghost for 30''


VAERS ID: 1586356 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Nausea, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Mild


VAERS ID: 1586571 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Palpitations, Sleep disorder, Tinnitus
SMQs:, Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states 15 mins after Moderna vaccine was given, patient had metallic taste in his mouth that lasted for 1 1/2 days. He also complains of palpitations that were so bad it woke him up - he still has some palpitations but not as bad. He also has tinnitus that is very intense that started a 5 days after his vaccine.


VAERS ID: 1586581 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-08-13
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Myalgia, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), 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: busPIRone (BUSPAR) 10 mg tablet clindamycin (CLEOCIN T) 1 % lotion escitalopram (LEXAPRO) 20 mg tablet levonorgestrel (SKYLA) 14 mcg/24 hour (3 years) intrauterine device melatonin 3 mg tablet sulfacetamide sodium-sulfur 8-4 % suspension tr
Current Illness:
Preexisting Conditions: Musculoskeletal Cystic acne Other Anxiety Depression
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: Fever or Chills Muscle or body aches Congestion or running nose


VAERS ID: 1586622 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Antiphospholipid antibodies, Chest pain, Coagulation factor V level, Coagulation test, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Electrocardiogram ST-T segment abnormal, Gene sequencing, Myocardial strain, Palpitations, Pleuritic pain, Pregnancy test negative, Protein C, Protein S, Pulmonary embolism, Right ventricular dysfunction, Right ventricular systolic pressure, SARS-CoV-2 test negative, Ultrasound Doppler abnormal, Venous thrombosis limb
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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 (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Infective pneumonia (broad), COVID-19 (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol/amitriptyline/Aimovig/Nexplanon/omeprazole/Valtrex
Current Illness: None
Preexisting Conditions: Migraines/obesity/GERD. - Left ankle fracture July 6, finished cast ~8/9 (not immobile though)
Allergies: None
Diagnostic Lab Data: 8/17/21 - CT chest with moderate burden bilateral PE; COVID negative, ultrasound left leg with small clot peroneal vein (no above knee clots), troponin I 0.2, negative pregnancy,
CDC Split Type:

Write-up: On 8/13 (2 days after injection), became short of breath with pleuritic chest pains and palpitations. Workup 8/17 showed bilateral PE with moderate clot burden and right heart strain. Admitted to hospital for initial treatment and monitoring cardiac status. She is on no estrogens, does have small distal DVT in left leg (but I am not convinced that would lead to moderate burden of bilateral PE). No family history of VTE


VAERS ID: 1586653 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-08-13
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Alveolar lung disease, Asthenia, Blood creatinine increased, Blood pressure abnormal, COVID-19, Chest X-ray abnormal, Cough, Exposure to SARS-CoV-2, Haemoglobin decreased, Lymphopenia, Pyrexia, SARS-CoV-2 test positive, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 MG tablet apixaban (ELIQUIS) 5 MG tablet aspirin 81 MG tablet B Complex Vitamins (VITAMIN B COMPLEX PO) benzonatate (TESSALON) 200 MG capsule carvedilol (COREG) 3.125 MG tablet dexamethasone (DECADRON) 6 MG tablet iso
Current Illness: Respiratory OSA (obstructive sleep apnea) CPAP/BiPAP dependent Circulatory CAD (coronary artery disease) PAD (peripheral artery disease) (HCC) Essential hypertension with goal blood pressure less than 130/85 Femoral-popliteal bypass graft occlusion, left, initial encounter (HCC) Infectious/Inflammatory COVID-19 Genitourinary Stage 3a chronic kidney disease Endocrine/Metabolic Mixed hyperlipidemia Other Current use of long term anticoagulation
Preexisting Conditions: Respiratory OSA (obstructive sleep apnea) CPAP/BiPAP dependent Circulatory CAD (coronary artery disease) PAD (peripheral artery disease) (HCC) Essential hypertension with goal blood pressure less than 130/85 Femoral-popliteal bypass graft occlusion, left, initial encounter (HCC) Infectious/Inflammatory COVID-19 Genitourinary Stage 3a chronic kidney disease Endocrine/Metabolic Mixed hyperlipidemia Other Current use of long term anticoagulation
Allergies: N/A
Diagnostic Lab Data: COVID19 PCR-Positive 8/13/2019
CDC Split Type:

Write-up: Very pleasant, 83 y.o. maler CAD s/p stent and CABG, PVD s/p fem-pop bypass, HTN, CKD, OSA on CPAP who presented to te ED with complaints of cough, weakness and fever snoted 8/5. He states that he had a known Covid exposure the last weekend of July from his daughter. He notes that she had a positive Covid test a few days after him and his wife saw her. Upon arrival to the ED, patient BP was soft but other vitals were stable. Baseline blood work was obtained showing WBC 12 with lymphopenia, hgb 12.7, Cr 1.57. Covid test was positive. CXR was obtained showing bibasilar airspace disease. He was given a dose of decadron.ED O2 at 78 % RA. Then bounced back to the 90s. After starting on decadron felt much better and was on room air for 2 days. He is eating, walking and his O2 sat walking was normal. He was offered Oxygen at home despite normal O2 sat but refused. Seen and examined 8/15/2021 .Will prescribe 7 more days of decadron to complete 10 day course.


VAERS ID: 1586706 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Staring, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra
Current Illness: Lupus, Hx of seizures
Preexisting Conditions: Lupus, Hx of seizures
Allergies: Latex
Diagnostic Lab Data: Vitals were taken and EMS was called
CDC Split Type: SC202144

Write-up: After the vaccination in the observation area the patient could not follow commands. She had a blank stare. She was breathing but not responding. Her grandmother, who was with her, said she has a history of seizures, and she always makes sure that her granddaughter takes her meds. Vitals were taken and EMS was called.


VAERS ID: 1586721 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site rash, Injection site warmth
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: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID ARM. RASH, ITCHY, HOT TO TOUCH, SENISTIVE TO TOUCH. THE SYMPTOMS STARTED ON DAY 3. PATIENT HAS BEEN TAKING BENARYL. AS OF 08/17/2021 SHE STILL HAS SYMPTOMS BUT IT DOES SEEM TO BE IMPROVING.


VAERS ID: 1586726 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-20
Onset:2021-08-13
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clozapin, Cogentin, Abilify, Tylenol, Docusate Sodium, and Miralax
Current Illness: Unknown
Preexisting Conditions: CKD, chronic anemia, OCD, learning disability, schizoaffective disorder-bipolar type, tremor/shaking since age 21 related to meds.
Allergies: Lithium
Diagnostic Lab Data: Covid 19 nasopharyngeal swab
CDC Split Type:

Write-up: Per chart notes patient was asyptomatic.


VAERS ID: 1586755 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-16
Onset:2021-08-13
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 1 AR / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 AR / SYR

Administered by: Work       Purchased by: ?
Symptoms: Lymphadenopathy, Odynophagia, Oropharyngeal pain, SARS-CoV-2 test negative, Streptococcus test negative, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Flonase
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data: Negative covid test and negative strep test, both 8/16/21
CDC Split Type:

Write-up: Woke up with a mild throat irritation on the left side on 8/13, it resolved quickly. 8/14, woke up with a minor sore throat, again only on the left side. By 8/15, it was a severe sore throat such that it hurt to swallow, but still only on the left side. 8/16, it had worsened to where there was a sharp pain on the left side of my throat when I swallowed or talked. Saw doctor, negative strep & covid tests. Swollen lymph nodes on left side of neck. 8/17, the throat was so painful, it hurt even when not swallowing or talking. Started antibiotics. By 8/19, still hurts to swallow and talk, but the pain isn?t as sharp or as intense.


VAERS ID: 1586809 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

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

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

Write-up: Client had a Moderna on 3-11-21. When she filled out her paper for the vaccine she checked that she had not received a previous dose of vaccine and indicated she wanted Janssen vaccine. Before giving vaccination reviewed with client that she was getting a Janssen vaccine and she acknowledged this. Janssen was given instead of a booster of Moderna.


VAERS ID: 1586814 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-01-28
Onset:2021-08-13
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oxygen saturation decreased, Pneumonia
SMQs:, Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PUI is hospitalized at hospital, he was diagnosed with pneumonia and low oxygen level.


VAERS ID: 1586865 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Dyspnoea, Paraesthesia oral, Rash
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (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? Yes
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: Does not remember the name of the vaccine
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: eczema, seasonal allergies, Type 2 Diabetes
Allergies: Sulfa, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Employee Developed an Anaphlatic reaction to the Pfizer COVID Vaccine 45 minutes after receiving her first dose. Employee first developed a rash on her face, then tingling on her lips, progressing to not being able to breathe. epinephrine given and sent to the ER.


VAERS ID: 1587001 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin 800mg
Current Illness:
Preexisting Conditions:
Allergies: Penicilin; Skin Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache everday!!! I''ve had a headache for a whole week


VAERS ID: 1587027 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Immediate post-injection reaction, Joint contracture, Syncope, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Additional Details: Immediately after pt received vaccine, he stated he needed to lay down. His head/eyes rolled back, clinched hands in a fist and crossed hands then passed out/fainted. He came to and even though he said he was fine, still needed to lay down. Entire episode lasted 10-15 seconds. 911 called and paramedics took over.


VAERS ID: 1587048 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-13
Onset:2021-08-13
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine adverse event report completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/2o Lot#EK9231 2nd dose01/13/21 ,lot#EL3248 Diagnosed covid positive:08/13/21 Symptom onset:08/13/21 Exposure:Community Symptoms:Fatigue, runny nose.


VAERS ID: 1587051 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Decreased appetite, Exposure to SARS-CoV-2, Feeling abnormal, Homeless, Malaise, Nausea, Pain in extremity, Paraesthesia, Rash, Rash erythematous, Somnolence, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (narrow)

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

Write-up: Patient called Sunday 8/15/21 to ask about some side effects he thought may be a result of the Pfizer 2nd dose (lot fa7485 exp 10/31/21) he received on Tuesday 8/10/21 (he received his first dose in April). He stated a few days after the shot, he had no energy, was nauseas, vomited once (Friday 8/13/21), was sleepy all the time, had no appetite, and felt bad overall (malaise). What prompted his call on Sunday was that he noticed "red freckles" all over his arm of the arm he was given the vaccine in. They were not raised, not itchy, and stayed red with pressure (non-blanching, although I''m not sure if this was accurate as he may not have understood what I was describing exactly). He stated his fingertips and fingers hurt, and that his arm overall felt somewhat tingly. I explained that while some of these symptoms sound vaccine-related, several seem very atypical from my understanding. I recommended he call his doctor or seek urgent care that day so that he could be evaluated. He understood. He did have a recent COVID exposure from his adult child''s family that he was living with. In addition, while he was living with them temporarily, his child has told us in the past that he is homeless. He did say on the phone with me that he is currently living in his truck. That being said, he did not act like access to healthcare would be a barrier to getting this looked at and said he would do so right away. I called him today, Thursday 8/19/21 to follow up to make sure he was doing okay and to see what the doctor said, but I could not reach him and he did not have a voicemail that had been set up. I will attempt to reach out again tomorrow.


VAERS ID: 1587169 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-08
Onset:2021-08-13
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Headache, Myalgia, Oropharyngeal pain, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/11/21Lot#012L20A 2nd dose 02/08/21,lot#012M20A Diagnosed covid positive:08/15/21 Symptom onset:08/13/21 Exposure: Symptoms:SOB, muscle aches,sore throat,loss of smell/taste,cough ,runny nose, headache.


VAERS ID: 1587174 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-10
Onset:2021-08-13
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/202/21Lot#ER8727 2nd dose 04/10/21 ,lot#EW0150 Diagnosed covid positive:08/13/21 Symptom onset: Exposure:Travel Symptoms:Asymptomatic


VAERS ID: 1587183 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-11
Onset:2021-08-13
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Nasopharyngitis, Pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: Exzema,
Allergies: Augmentin Cedar Dust
Diagnostic Lab Data: 8.13.2021 Covid-19 tested positive. type unknown
CDC Split Type:

Write-up: 8.13.2021 3 days of cough, cold congestion with body aches and chills.


VAERS ID: 1587216 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2020-12-18
Onset:2021-08-13
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oropharyngeal pain, Paranasal sinus discomfort, Productive cough, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: no known allergies
Diagnostic Lab Data: Covid 19 positive from referral hospital
CDC Split Type:

Write-up: 8.13.2021 sore throat, productive cough, and sinus pressure around


VAERS ID: 1587226 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-07
Onset:2021-08-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: It was identified by pharmacy staff that patient had previously received Moderna COVID vaccine on 4/27/21 but did not get 2nd follow up dose. Came into pharmacy on 8/14/21 and received Janssen vaccine. Patient did not report any adverse reactions.


VAERS ID: 1587323 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-21
Onset:2021-08-13
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Blood lactate dehydrogenase, Blood uric acid normal, Computerised tomogram normal, Delivery, Electroencephalogram normal, Exposure during pregnancy, Full blood count normal, Laboratory test normal, Live birth, Magnetic resonance imaging normal, Urine protein/creatinine ratio, Venogram normal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 8/17/21-complete obstetric hypertension panel (pih chem panel, cbc, LD, LDH, uric acid, protein/creatine ratio) , CT, MRI-all normal 8/19/21-EEG, MRA, MRV-all normal
CDC Split Type:

Write-up: 1st dose 6/30/21 2nd dose 7/21/21 delivered term infant 7/28/21-normal vaginal delivery, uncomplicated pregnancy


VAERS ID: 1587389 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Cystitis interstitial, Diarrhoea, Epistaxis, Fatigue, Headache, Pain in extremity, Paranasal sinus discomfort
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BHRT, Thyroid medication, antihistamine, various vitamins and supplements (B12, D, calcium, zinc, probiotic)
Current Illness: None
Preexisting Conditions: Mild Asthma, Allergies, Interstitial Cystitis,
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1 - sore arm and thumb, fatigue, headache, diarrhea Day 2 - same as day 1 Day 3 - IC flare, fatigue, sinus pressure Day 4 - same as Day 3 Day 5 - same as Day 4, add in nose bleed Day 6 - starting to improve Day 7 - still improving


VAERS ID: 1587475 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-08-13
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan, fluticasone, furosemide, metformin, tamsulosin,
Current Illness:
Preexisting Conditions: Hypertention,Type 2 Diabetes, COPD, Adenocarcinoma of the Bladder,Former Smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 01/07/2021- 1ST DOSE OF MODERNA COVID 19 VACCINE 02/03/2021- 2ND DOSE OF MODERNA COVID 19 VACCINE 08/06/2021 - SYMPTOM ONSET OF COVID. SYMPTOMS: HEADACHE, CHILLS, AND NASAL DISCHARGE. 08/13/2021 - PT TESTED POSITIVE FOR COVID-19 via RAPID PCR TEST.


VAERS ID: 1588537 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-03
Onset:2021-08-13
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 02/03/2021- 1ST DOSE MODERNA 03/03/2021 - 2ND DOSE MODERNA 08/13/2021- PT TESTED POSITIVE FOR COVID19 VIA PCR TEST. PT WAS ASYMPTOMACTIC AT TIME OF TESTING.


VAERS ID: 1588553 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Rash, Skin irritation
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: I was taking Cephalexin in early July for a spider/insect bite. This bite was causing severe itching on my upper thigh the symptoms subsided but didn''t go away completely. After i received the Pfizer shot I was fine with no immediate
Current Illness: Nothing
Preexisting Conditions: None, in perfect health I''m very concerned about getting the 2nd shot on Monday the 23rd I have taken pictures of the rashes and irritation
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: see prior page


VAERS ID: 1589074 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lutera birth control, omega 3 fish oil, biotin, daily probiotic.
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I received my first dose of the Pfizer vaccine on 8/11. I ended my period on 8/9, and have been experiencing some spotting since the 13th. I usually never spot after completing the ''period pills'' in my BC regimen.


VAERS ID: 1589087 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO172 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chest pain, Spinal pain
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Very focused chest pain and pain in back in exact same area (heart) also pain along spine. I have a pretty high pain tolerance and needed Advil to get comfortable. I decided not to report to Dr. unless it went past 3 days post vaccine. On the 4th day it subsided. It came back for short periods. No treatment besides Advil and hot baths.


VAERS ID: 1589713 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

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

Write-up: On 7 June 2021, member received the first dose of Pfizer. On 7 August 2021, member presented to Air Base COVID-19 Vaccination Line to receive a dose of Janssen. Member documented that no prior doses of COVID-19 vaccine was received during patient screening. Upon record reviews conducted on 20 August 2021, it was revealed that member received a dose of Pfizer prior to 13 August.


VAERS ID: 1589714 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

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

Write-up: On 7 June 2021, member received an initial dose of Pfizer. On 13 August 2021, member presented to COVID-19 Vaccination Line to receive a dose of Janssen. Member document that he did not receive prior doses of any COVID-19 vaccine during patient screening. Upon record reviews on 20 August 2021, it was revealed that member did receive an initial dose of Pfizer.


VAERS ID: 1589716 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Myositis
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CK-16k
CDC Split Type:

Write-up: Myositis


VAERS ID: 1590893 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-23
Onset:2021-08-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

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

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

Write-up: Site: Pain at Injection Site-Medium.


VAERS ID: 1590979 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-30
Onset:2021-08-13
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 RA / IM

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

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

Write-up: This patPient received 3 vaccine doses. Pfizer on 6/30 and 7/21. He received Moderna on 8/13


VAERS ID: 1591250 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arrhythmia, Electrocardiogram, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Unithroid, Busbirone, Bupropian, Adderal, Atomoxetine, trazedone, Pantaprozole, Sporanox, Naltrexone 1.5mg, Multivitamins, Probiotics, Zinc, Vit D, B vita, Vit C, Vit E, Macu-Health supplement for eyes.
Current Illness: CIRS, no thyroid, Osteoarthritis
Preexisting Conditions: Thyroid, CIRS & now heart arrythmias
Allergies: Wheat, gluten, morphine, Augmentin
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Heart tachycardia out of rhythm. Given: Eliquis 2X/day; Multaq 400mg 2X/day; and Metropolol 1/2 tab (12.5mg) 2X/day


VAERS ID: 1591266 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Adenovirus test, Arthralgia, Blood culture negative, C-reactive protein, Chest discomfort, Chlamydia test, Coronavirus test, Dizziness, Dyspnoea, Echocardiogram normal, Enterovirus test, Epstein-Barr virus test negative, Fatigue, Headache, Human metapneumovirus test, Human rhinovirus test, Hypotension, Inflammatory marker increased, Influenza A virus test, Influenza B virus test, Malaise, Myalgia, Mycoplasma test, Nausea, Pain, Pyrexia, Respiratory syncytial virus test, Respirovirus test, SARS-CoV-2 test, Sports injury
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CRP , PCT Blood culture negative EBV PCR negative Negative - Metapneumovirus, Human Rhinovirus/Enterovirus, Coronavirus, SARS-CoV-2 (COVID-19), Influenza A virus, Influenza A Subtype H1, Influenza A, Subtype H3, Influenza A subtype 2009 H1N1, Influenza B virus, RSV A, RSV B,Adenovirus, Parainfluenza 1, Parainfluenza 2, Parainfluenza 3 and Parainfluenza 4 and Chlamydia pneumoniae and Mycoplasma pneumoniae. TTE unremarkable
CDC Split Type:

Write-up: Patient is an immunized previously healthy 12yo male, who presented from a hospital with hypotension unresponsive to fluid in the setting of receiving 2nd COVID vaccine one day prior to presentation. Per parents, patient was in his usual state of health until yesterday (8/13) evening, when he woke-up from a nap feeling unwell. He complained of nausea, dizziness, headache, myalgias, abdominal pain, lightheadedness, fatigue, chest tightness and some difficulty breathing with deep breaths. He had gotten his vaccine that day at 12 pm. He was found to be febrile to 103F so he went to another Hospital where he was febrile to 102.5 on arrival. No emesis, diarrhea, or medications taken at home for symptoms. Mom reports he had a similar reaction to his first COVID vaccine, but did not require hospitalization. No known sick contacts and no known COVID exposures. Has pain localized to the left knee after "playing sports.", but no trauma. Patient was never tested for COVID or symptomatic, but Mom suspects that he could have had COVID previously given she had it previously. He had no hives, wheezing or tachycardia but presented with clear hypotension. He received IM epi, and then was placed on epinephrine infusion. He required 2 days of vasopressor infusion, had mild increases in his inflammatory markers and received an empiric course of antibiotics. He had no evidence of LV dysfunction or coronary artery ectasia/dilation. He had no conjunctivitis, rash, lymphadenopathy. His inflammatory markers downtrended and he was discharged home.


VAERS ID: 1591320 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-08-13
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PCR test on 8/14/2021 @ medical facility
CDC Split Type:

Write-up: Employee was fully vaccinated on 1/26/2021 and 1/28/2021 with Pfizer, and on 8/13/2021 became ill and tested positive for COVID


VAERS ID: 1591321 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not applicable. Dose administered too soon and medications at time of vaccination not necessary.
Current Illness: Not applicable. Dose administered too soon.
Preexisting Conditions: Not applicable. Dose administered too soon.
Allergies: Not applicable. Dose administered too soon and previous ADRs do not add to assessment
Diagnostic Lab Data: Not applicable ? dose given too soon therefore no medical tests/lab results indicated
CDC Split Type:

Write-up: For unknown reason (not documented in chart) patient received the first Moderna COVID-19 Vaccine dose on 7/23/21 and the second dose of Pfizer COVID-19 Vaccine on 8/13/21 which is earlier than 28 days and outside of the 4-day grace period. There were no adverse events associated with administration of the vaccine. Per CDC guidance, doses inadvertently administered earlier than the grace period should not be repeated.


VAERS ID: 1591323 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / UN

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest discomfort, Chest pain, Chills, Dyspnoea, Echocardiogram normal, Ejection fraction, Ejection fraction normal, Nausea, Pain in extremity, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Troponin increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None on file.
Current Illness: None
Preexisting Conditions: Moderate asthma
Allergies: None of file.
Diagnostic Lab Data: Troponin: 8/15 6743 ng/L, 8/16 3247 ng/L ESR 8/15: 621 U/L CRP 8/14: 4.6 mg/dL TTE 8/16: o Normal left ventricular ejection fraction estimated at 55-65%. Simpson''s biplane EF is 59%. o Normal left ventricular diastolic function. o Normal RV systolic function. o Mild mitral valve regurgitation. o No previous study for comparison.
CDC Split Type:

Write-up: 23 yom with pmh of moderate asthma presents to the hospital on 8/15 complaining of chest discomfort transferred from outside hospital. Reports he was in his normal state of health when 2 days prior to admission he had his second dose of modern vaccine. The subsequent day he had a normal side effect of fevers chills and he and his girlfriend felt diffuse chest pressure throughout the chest. His girlfriend got better the next day, however the patient started complaining of sharp chest pain in the mid to left chest area that improved after he laid down and took deep breaths. Subsequently he decided to wait until 48 hours after the second vaccine dose and if continues to have problems with go to the hospital for assessment. On the day of admission, on awakening from sleep the patient felt severe left arm soreness and then upon standing up felt severe sharp pain in his left chest and therefore decided to go to the hospital for assessment. He also reported nausea and vomiting since 1 day prior to admission. Reports episodes of chills and shortness of breath as well. He was tested for COVID-19 at the outside hospital which was negative. Had positive troponin, elevated CRP and ESR upon presentation. Cardiology was consulted and recommended continuing telemetry monitoring, an echocardiogram, and empiric ibuprofen 600 mg every 8 hours in the absence of hemodynamic compromise. He was given 2 doses of PRN nitroglycerin for chest pain during his hospitalization without relief, which was then followed with an IM dose of toradol. He does have a strong family history of heart disease; however, the patient''s symptoms did not suggest an ischemic syndrome per cardiology notes. On the day of discharge (8/16), patient was chest pain-free, had no shortness of breath, and echocardiogram was negative for any wall motion abnormalities and showed a normal EF. Patient was discharged in stable condition home with plan to follow-up outpatient with cardiology in 1-2 weeks and to obtain a cardiac MRI as an outpatient.


VAERS ID: 1591385 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-24
Onset:2021-08-13
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, norvasc, tessalon, hygrotron, vit. D, fish oil, synthroid, lisinopril, loratadine, prilosec, zocor, flomax
Current Illness:
Preexisting Conditions: ASHD, HTN, MI, RBBB, diastolic CHF, hypothyroidism, COPD,
Allergies:
Diagnostic Lab Data: Swabbed positive upon admission 8/13/2021
CDC Split Type:

Write-up: Shortness of breath


VAERS ID: 1591424 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: C/O chest tightness. Pt breath sounds clear, pulse ox. 99% on room air. BP 110/72, pulse 72, good capillary refill. Pt. took 2 puffs of her personal albutrerol inhaler used for asthma. Pt. monitored for additional 20 minutes. stated feels better and remains stable.


VAERS ID: 1591537 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0108 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Feeling abnormal, Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: tingling sensation in my lower leg - in the shin area about 5/6 inches up from the where the leg forms into the foot. It is predominantly my left leg but impacts both legs. Severe headaches, some dizziness not able to focus on a image. general brain fog.


VAERS ID: 1591659 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Chills, Fatigue, Headache, Hyperhidrosis, Injection site pain, Injection site swelling, Musculoskeletal stiffness, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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: Metropolol Succenate, 50mg Nexium OTC
Current Illness: High Blood Pressure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site swelling, pain. Sweating, chills, chest pain, extreme fatigue, stiff neck, headache, neck and back pain.


VAERS ID: 1591685 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Dyspnoea, Heart rate increased, Pruritus, Sensitive skin, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No tests have been done. This is my HONEST personal journey after the covid Pfizer vaccine dose 1.
CDC Split Type: Pfizer FA7485

Write-up: That same night I was very itchy all over my legs. My legs felt bumpy but it was dark so I just went to sleep. 08/13/2021 the next morning I was still itchy and AFTER I scratched my legs I broke out in hives all over where I scratched. After that my legs were normal again and no more hives. I have very sensitive skin so I assumed I would have some type of skin reaction as a symptom. Not horrible. 08/15/2021 I have started to feel quick flashes of pain in my middle chest area and even my stomach area. Today is 08/20/2021 and I still get the flashes of pain. Its a 3 on a scale of 1 to 10. I felt shortness of breath one time and my heart beat really fast at the same exact time I had shortness of breath. Im nervous to take my second dose now. I havent noticed other symptoms at all so far.


VAERS ID: 1591724 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-18
Onset:2021-08-13
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04421A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, C-reactive protein normal, COVID-19, COVID-19 pneumonia, Fall, Fibrin D dimer normal, Intensive care, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Home Medications Taking? Ascorbic Acid (Vitamin C) 500 mg Oral Tab Takes Regularly Sig: Take 1 tablet by mouth daily Atorvastatin (LIPITOR) 40 mg Oral Tab Takes Regularly Sig: Take 1 tablet by mouth daily to prevent heart attacks
Current Illness: Severe headache, seizure, COVID +
Preexisting Conditions: h/o dementia (baseline A&Ox2), HTN, HLD, DM2, history of subarchnoid hemorrhage due to ruptured right middle cerebal artery distribution aneurysm (7/2010, s/p craniotomy complicated by encephalomalacia, seizure disorder and hydrocephalus s/p ventriculoperitoneal shunt (10/29/2010)
Allergies: Percocet [Oxycodone-acetaminophen] Not Specified 9/21/2010 Past Updates... Agitation, aggressive behaivor, hallucinations
Diagnostic Lab Data: Ref. Range 8/14/2021 05:35 8/15/2021 05:30 8/17/2021 06:25 8/18/2021 06:51 8/19/2021 06:01 CRP, SER QL Latest Ref Range: <=0.9 mg/dL 16.2 (H) 8.6 (H) 2.6 (H) 1.9 (H) 1.4 (H) Ref. Range 8/17/2021 06:25 8/18/2021 06:51 8/19/2021 06:01 D-DIMER Latest Ref Range: <=0.49 ug/mL FEU 3.86 (H) $g4.00 (H) 3.19 (H)
CDC Split Type:

Write-up: 67M with dementia, HTN, HLD, DM2, subarchnoid hemorrhage due to ruptured right middle cerebal artery distribution aneurysm s/p craniotomy complicated by encephalomalacia, seizure disorder and hydrocephalus s/p ventriculoperitoneal shunt 2010, vaccinated w/ Moderna 3/18, seen in ED for seizure 8/4, tested covid + (asymptomatic), presented on 8/13 with generalized weakness, found on the floor at home Methylpredniolone 125 BID, iNO (8/13-8/15) Decadron 10mg BID (8/16- Completed 5 days remdesivir today (8/14-8/18) FiO2 35L, 90% Covid pneumonia/acute respiratory failure - received tocilizumab in ED. Admitted to ICU and treated with methylpredniolone 125 BID, iNO (8/13-8/15) and HFNC. FiO2 req is variable. He is more alert today -cont HFNC and wean as tolerated -cont decadron 10mg BID 8/16- -cont to trend inflammatory markers


VAERS ID: 1591802 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest pain, Computerised tomogram thorax normal, Dyspnoea, Fatigue, Fibrin D dimer increased, Headache, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the vaccine at 3:30 pm, at my job. I went home and later that event around 8:30 pm, I became severely fatigued, weak, tingling in both my legs and a severe headache. Those symptoms have lasted since receiving the vaccination. I developed chest pain and shortness of breath on the 18th of August. I was seen in the emergency room on the 19th and had blood work done. D-dimer test came back elevated and a Ct scan was done on my chest only. No pulmonary clots were been found. Symptoms are still present. I take Tylenol for the headache which offers temporary relief.


VAERS ID: 1591815 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-21
Onset:2021-08-13
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Blood glucose normal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Computerised tomogram thorax normal, Continuous positive airway pressure, Cough, Dyspnoea, Fibrin D dimer increased, Hyperhidrosis, Inflammatory marker test, Insomnia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: h/o obesity (BMI 39.5), no diagnosis of OSA, h/o HLD, pre-DM (Hba1c 6.2), Due to culture (declines blood products), OA of both knees, s/p knee arthroplasty,
Allergies: nka
Diagnostic Lab Data: Ref. Range 8/13/2021 15:07 8/14/2021 04:21 8/15/2021 05:51 8/16/2021 06:06 8/17/2021 05:46 8/18/2021 06:07 8/19/2021 05:35 CRP, SER QL Latest Ref Range: <=0.9 mg/dL 22.5 (H) 23.6 (H) 10.8 (H) 3.7 (H) 2.2 (H) 1.5 (H) 0.9 Results for (MRN 110005209342) as of 8/19/2021 07:33 Ref. Range 8/13/2021 15:07 8/14/2021 04:21 8/15/2021 05:51 8/16/2021 06:06 8/17/2021 05:46 8/18/2021 06:07 8/19/2021 05:35 D-DIMER Latest Ref Range: <=0.49 ug/mL FEU $g4.00 (H) $g4.00 (H) $g4.00 (H) $g4.00 (H) $g4.00 (H) $g4.00 (H)
CDC Split Type:

Write-up: 58M with HLD, PreDM, Due to culture (declines blood products), OA of both knees s/p knee arthroplasty who presented with cough, fever, sweats, and SOB. COVID Pneumonia/Acute hypoxemic Respiratory failure - symptom onset on 8/6. COVID positive on 8/9/21. Last fever 8/13/21 in ED. Received J&J vaccine 3/21/21. D-dimer remains $g4. CRP improving. Chest CT on 8/13 negative for PE. - FiO2 down to 1L NC, cont to wean as tolerated - cont decadron 6mg daily for up to 10 days (8/13 - ) or until no longer hypoxic - completed 5 day course of remdesivir (8/13 - 17) - cont pepcid for GI prophylaxis - cont to trend inflammatory markers - continue isolation in hospital Insomnia - slept well - cont melatonin 9 mg QHS - cont trazodone 25mg qHS OSA (?) - - cont CPAP q HS as tolerated - will need sleep study outpatient PreDM - BS''s Ok will dc ISS


VAERS ID: 1591919 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Sleepiness. Can sleep for two sessions in a row most days. Feel fatigued every day, most of the day, if not all day.


VAERS ID: 1591970 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins and PRN Migraine pill (butalbital-acetaminophen-caffeine)
Current Illness: None
Preexisting Conditions: Occasional migraine
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a Pfizer 2nd dose on 8/13/2021 after receiving a Moderna 1st dose on 7/16/2021. The mistake was due to miscommunication among the clinical team.


VAERS ID: 1592753 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction, Seizure, Skin abrasion
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Generalised convulsive seizures following immunisation (narrow), 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: Tylenol
Current Illness: Cad. High blood pressure, copd. Low heart attack.
Preexisting Conditions: Blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 22 hours later. I had a heart attack. Several seizures. Already had a low heart rate. Abrasion


VAERS ID: 1592785 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206AZ1A / UNK LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Numbness and tingling in bilateral legs and right hand and sometimes the tongue and lower lip. No treatment given yet. Was watching it to see if it would resolve on its own.


VAERS ID: 1593177 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-04
Onset:2021-08-13
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Heart rate increased
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:
CDC Split Type:

Write-up: Sudden chest pain, heart rate 172 went to hospital sent home and still have slight chest pain


VAERS ID: 1594334 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Dizziness, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Body temperature; Result Unstructured Data: 103.5
CDC Split Type: USJNJFOC20210830322

Write-up: FEELING DIZZY; CHILLS; MUSCLE ACHES; NAUSEA; FEVER OF 103.5; SEVERE HEADACHE; This spontaneous report received from a consumer concerned a 23 year old female. 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, intramuscular, and batch number: 1808982 expiry: UNKNOWN) dose was not reported, administered on 13-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-AUG-2021, the patient experienced feeling dizzy. On 13-AUG-2021, the patient experienced chills. On 13-AUG-2021, the patient experienced muscle aches. On 13-AUG-2021, the patient experienced nausea. On 13-AUG-2021, the patient experienced fever of 103.5. On 13-AUG-2021, the patient experienced severe headache. Laboratory data included: Body temperature (NR: not provided) 103.5. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle aches, nausea, fever of 103.5, chills, feeling dizzy, and severe headache. This report was non-serious.


VAERS ID: 1594348 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Dizziness, Fatigue, Headache, Myalgia, Pain assessment, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 100.4 F; Test Date: 20210814; Test Name: Pain scale; Result Unstructured Data: 4/10; Test Date: 20210814; Test Name: Body temperature; Result Unstructured Data: 99.5 F; Comments: At 4:45 and 10:45 pm
CDC Split Type: USJNJFOC20210832341

Write-up: FEVER WITH TEMPERATURE OF 100.4 DEGREE FAHRENHEIT; SLIGHT DIZZINESS; CHILLS; HEADACHE; MUSCLE ACHES; FATIGUE; This spontaneous report received from a patient concerned a 19 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 13-AUG-2021 10:15 for prophylactic vaccination. No concomitant medications were reported. On 13-AUG-2021, the patient experienced slight dizziness. On 13-AUG-2021, the patient experienced chills. On 13-AUG-2021, the patient experienced headache. On 13-AUG-2021, the patient experienced muscle aches. On 13-AUG-2021, the patient experienced fatigue. Treatment medications included: ibuprofen, and paracetamol. On 14-AUG-2021, the patient experienced fever with temperature of 100.4 degree fahrenheit. Laboratory data included: Body temperature (NR: not provided) 100.4 F, 99.5 F, and Pain scale (NR: not provided) 4/10. Treatment medications included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever with temperature of 100.4 degree fahrenheit on 15-AUG-2021, and was recovering from headache, chills, muscle aches, slight dizziness, and fatigue. This report was non-serious.


VAERS ID: 1594455 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Coronary stent placement (The patient has 1 or 2 coronary stents); Non-smoker.
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Body temperature; Result Unstructured Data: 100-102 F; Test Date: 20210817; Test Name: COVID-19 virus test; Result Unstructured Data: Positive; Comments: Not certain on the type of test performed.
CDC Split Type: USJNJFOC20210837634

Write-up: SUSPECTED CLINICAL VACCINE FAILURE; SUSPECTED COVID-19 INFECTION; NO APPETITE; NOT ABLE TO EAT; This spontaneous report received from a health care professional concerned a 48 year old male of white race and unknown ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: 1 or 2 coronary stents, non-alcohol user, non-smoker and the patient had no known allergies. The patient did not have any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-AUG-2021, the patient began having symptoms of aching, congestion, generalized malaise, temperature ranging from 100-102 Fahrenheit, no appetite and not able to eat and also experienced the event of suspected clinical vaccine failure. Laboratory data included: Body temperature (NR: not provided) 100-102 Fahrenheit. On 17-AUG-2021, after receiving vaccine about 2-3 months ago, the patient was found positive to covid-19 infection (suspected covid-19 infection), however reporter was not certain on the type of test performed (nasal or throat swab, or PCR vs rapid). The reporter stated that the patient''s health care professional was aware of the symptoms and positive test result. The patient''s symptoms abated when the patient was given a steroid injection and anti-emetic, and that the patient commented that nausea he was experiencing (date of onset unknown) had improved and was able to eat solid food and drink soup and green tea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from no appetite, and not able to eat, and had not recovered from suspected covid-19 infection, and suspected clinical vaccine failure. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000190135.; Sender''s Comments: V0: 20210837634-Covid-19 vaccine ad26.cov2.s-suspected clinical vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1595979 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Dyspnoea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe


VAERS ID: 1595985 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Lethargy, Pruritus
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Exhaustion / Lethargy-Severe


VAERS ID: 1602617 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Erythema, Fatigue, Pain in extremity, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: I take sertraline at night time no mornings.
Current Illness: None
Preexisting Conditions: none
Allergies: I am allergic to tree nuts such as walnuts, Almonds and pecans I get an allergic reaction nothing serve. I am allergic to buspirone anti depress drug that gives redness and itchness on my vagina area and messes with my anxiety and as well as my depression. Fruit I cant nnot have certain fruit such as apples my ears and tongue get very itchy, watermelon, some melons I cannot have as well get an allergic reaction as well.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: symptoms I had when I first got the first shot on 8/13/2021 felt pain in my arm and felt a little bit tired the next day I was very tired and fatigue. I was very anxious throughout the time I gotten getting it. Now today on 8/21/2021 I am getting a red itchy and swallon arm which under my skin not on the outside of it and suffering with anxiety along with it as well. I called up the Phamacry to see what they thought of it and they told me its normal.


VAERS ID: 1602620 (history)  
Form: Version 2.0  
Age: 0.08  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-18
Onset:2021-08-13
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENG201 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Chest X-ray, Dizziness, Ear discomfort, Fatigue, Headache, Nasal discomfort, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test, Sinus congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate, benlysta (belimumab), levothyroxine, Atorvastatin, hydroxychloaquine, pantoprazole, metoprolol, FOLIC ACID, vitamins D3, losartan, cyclobenzaprine
Current Illness:
Preexisting Conditions: LUPUS, SYSTEMIC SCLEROSIS, SYNDROME, HASHIMOTOS THYROIDITIS (hypo)
Allergies: Imuran, penicillin, erythromycin, Flagyl, peanuts, pollen, formaldehyde
Diagnostic Lab Data: Exam, Chest xray, covid19 test
CDC Split Type:

Write-up: Fatigue, 99.3 temp, sore throat, chest and sinus congestion, left earplugged, dizziness, sores in nostrils, headache


VAERS ID: 1602635 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Pain in extremity
SMQs:, Anticholinergic 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: N/a
Diagnostic Lab Data: n/a
CDC Split Type: vsafe

Write-up: We went and sat down right after the shot and shortly later he was complaining that his head was hurting. Then he said my head feels funny and my arm is throbbing and I said to give it a couple more minutes, then we talked to the nurse because he was really light headed. The nurse there at the site monitored him, he drank water and ate some crackers and checked his BP. Monitored all his vitals basically. He said he was able to get up and walk after about thirty minutes so we left after that.


VAERS ID: 1602870 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 300mg welbutrin
Current Illness: No
Preexisting Conditions: Psoriasis
Allergies: Nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain the following morning, followed by 3 days of fevers ranging from 99-103 chills, body aches, skin was painful to touch. Responded somewhat to rotating Tylenol and ibuprofen


VAERS ID: 1602972 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dizziness, Facial pain, Fatigue, Injection site pain, Loss of personal independence in daily activities, Lymphadenopathy, Malaise, Neuralgia, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No Prescriptions, No OTCs Vitamin Supplements usually taken in the morning (Lutein, Beta Carotene, Calcium/Magnesium, Vitamin C and Minerals) - None were taken on the morning of the day I received the vaccine out of concerns I had over p
Current Illness: None
Preexisting Conditions:
Allergies: Lactose Intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Excessive swelling in armpit that extended to shoulder blade. Swelling lasted a few days (5-6), pain at injection site. Extreme/abnormal fatigue, unusually extreme feeling of malaise, intermittent dizziness affecting normal activity, Also, higher level of pain in lower back, nerve pain in legs and feet still ongoing and requiring use of OTC (Tylenol), however the pain is still present, sometimes constant and sometimes intermittent. Patient feels the vaccine caused increased pain sensations in back, legs and feet.


VAERS ID: 1603815 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Headache, Nausea, Polymenorrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Preexisting Conditions: Fibromyalgia, vertigo, chronic tachycardia
Allergies: Dyclophinac
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Severe lingering headache, shoulder and back pain, abdominal pain, nausea, early menstrual period. Started 8/13/2021. All symptoms except for headache subsided by 8/17/2021. Dull headache and back pain still persistent. Took ibuprofen and calcium carbonate, frequent fluid intake, and rest.


VAERS ID: 1605762 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-29
Onset:2021-08-13
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Lymphadenopathy, Myalgia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: Tested negative for Covid 19 on 08/19/2021
CDC Split Type:

Write-up: Tiredness, headache, muscle pain, chills, joint pain, swollen lymph nodes. Possible leukocytosis.


VAERS ID: 1609047 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Myalgia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Very low BP. Syncope. Muscle pain.


VAERS ID: 1617410 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Fatigue, Feeling abnormal, Headache, Malaise, Muscular weakness, Rash, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Vyvanse 70mg daily Adderal 10mg daily Lo estron daily
Current Illness: No
Preexisting Conditions: ADHD
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash all over face, skin was hot, extreme fatigue, headache, muscles weak, brain fog, malaise, stomach cramps


VAERS ID: 1617457 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-08-13
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Infection, Pyrexia, SARS-CoV-2 test positive, Sneezing, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data: Positive covid-19 results
CDC Split Type:

Write-up: Breakthrough covid-19 infection. Fever, chills, cough, sneezing, shortness of breath, vomiting


VAERS ID: 1617461 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-08-13
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Asthenia, COVID-19, Decreased appetite, Diarrhoea, Malaise, SARS-CoV-2 test positive, Tachycardia, Tearfulness, Vaccine breakthrough infection, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol (ProAir HFA) 108 (90 Base) MCG/ACT Inhalation Aerosol Solution Inhale 2 puffs every 6 hours as needed for wheezing or shortness of breath. 6/7/21 amoxicillin (AMOXIL) 500 MG Oral Tablet Take 2 tablets by mouth 2 times daily f
Current Illness:
Preexisting Conditions: Acute non intractable tension-type headache 6/12/2017 ? Candidal esophagitis 7/1/2021 ? CHF (congestive heart failure) ? COPD (chronic obstructive pulmonary disease) ? COPD exacerbation ? Hypertension ? Lumbago 1/9/2013 Description: Lower Back Pain ? Personal history of noncompliance with medical treatment, presenting hazards to health ? Respiratory distress ? SOB (shortness of breath)
Allergies: HCTZ, Lisinopril
Diagnostic Lab Data: SARS-COV-2, Detected: 08/14/21.
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. She received J&J vaccine on 03/19/21. Hospitalized from 08/13/21 - 08/19/21. Below is copied from discharge summary: Says diarrhea with 3 loose BMs today; I see a small formed stool in bedside commode but resting tachycardia 100s PT advise home with intermittent supervision sats 95% with exertion on her home 3 l NC, pt v relucatnt to go home saying son is out of town, also a big component of her base line anxiety too Maintain COVID isolation for 20 days 8/13-9/2 8/16- 99% on home 3 lmp NC; refuses to let go of unneeded O2 " i''ve been on it for 2 yrs" 8/15- 100% on home 3lmp NC- dips to 97% on RA 8/14- 94% on RA with good wave - however says 3 lpm NC home O2 dependant x 2 yrs and gets v tearful when I remove O2 Now says was told at hospital a day before this ER visit for couple of days of gen wkness, poor appetite, vomiting and not feeling well and was told to have COVID dispo - clinical improvement in diarrhea, then STR who accepts COVID


VAERS ID: 1617512 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-04
Onset:2021-08-13
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Dizziness (vertigo) and tinnitus (ringing in ears) have been substantial and noticeable since about a week to 10 days after the vaccine


VAERS ID: 1617638 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, armour thyroid, benazepril,
Current Illness: None
Preexisting Conditions: Migraine
Allergies: Dust, mold, dogs, cats, grass
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very sore arm for 4 days following vaccine and then on day 9 redness and itching the size of a quarter?not known yet how long this will last.


VAERS ID: 1620502 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: Broke out into rash and welts all over stomach, back, chest, and spreading to underarms and pelvis area.


VAERS ID: 1623063 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Fatigue, Insomnia, Lethargy, Pain, Tachycardia
SMQs:, Anaphylactic reaction (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Joint Pain-Severe, Systemic: Tachycardia-Severe, Systemic: Unable to Sleep-Severe


VAERS ID: 1623287 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Private       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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No known adverse events. Patient received dose of Pfizer Covid vaccine when had previously received Janssen Covid vaccine 3/30/21.


VAERS ID: 1623290 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1069 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Eyelid ptosis
SMQs:, Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)

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

Write-up: Client called health department on 8/20/21 to report "several hours" after receiving his first dose of COVID-19 vaccine (Pfizer), he noticed drooping of his right eye. On 8/20/21 he reported the drooping has persisted. Denies drooping of mouth/cheek. Denies any other side effects of the vaccine. Client stated he called his doctor (client''s PCP) and he was going to see the Dr. for a steroid injection that should improve symptoms.


VAERS ID: 1623337 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: LOW GRADE HEADACHE THAT PATIENT DESCRIBED AS "BOTHERSOME, BUT NOT SEVERE"


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