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

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



Case Details (Reverse Sorted by Onset Date)

This is page 146 out of 3,524

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VAERS ID: 1343425 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Fluid retention, Muscular weakness, Weight increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Propanolol, Hydroxyzine, Creon, Vit C, Magnesium, Quercetin
Current Illness:
Preexisting Conditions: POTS, EDS (ehlers-danlos Syndrome)
Allergies: Codeine, milk
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extreme fatigue, muscle weakness, brain fog, and significant weight gain/water retention


VAERS ID: 1343520 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Erythema, Eye movement disorder, Fall, Loss of consciousness, Pain in extremity, Pallor, Visual impairment, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received her first dose of the Covid vaccine without a problem. She was reading a magazine in a chair while waiting for me (her mother) to have the second dose in the same room. About 5 to 10 minutes has passed since patient had received her injection. I looked over at patient, her eyes had rolled back and she had slumped in her chair. I ran over to her - her face was very red and she did not appear to be breathing. Her eyes were open but were not focused. I sat her up as straight as I could while the technician who administered the vaccine ran for the pharmacist. This took a few minutes. By the time the pharmacist arrived patient was gaining consciousness but began throwing up (although mainly dry retching). Her face had gone pale. The pharmacist was very helpful - she gave patient some Coke to drink and took her blood pressure, which was low. After 30 minutes of observation we were allowed to leave. The event was very frightening. Patient was very pale for the rest of the day. She had a severe pain in her left arm (and leg) which gradually improved over the next three days. We are very worried about her taking the second dose of the vaccine.


VAERS ID: 1343535 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Chest pain, Chills, Muscle rigidity, Myocarditis, Pericarditis, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Parkinson-like events (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data: More tests needed but blood work came back on Friday 05/21/21 with troponin levels at 9.5 ng/ml and normal levels are 0-0.04 ng/ml
CDC Split Type:

Write-up: I had chills for 2 nights that cause my body to be feel rigid. Then on Thursday I had chest pain on 2 occasions that lasted around an hour each time and on Friday I had to go to the ER. I was released on Saturday and I either have myocarditis or pericarditis. I need more tests to be done


VAERS ID: 1343601 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Ordered CBC, CMP, pt did not complete
CDC Split Type:

Write-up: Extensive urticarial rash, pruritis


VAERS ID: 1343638 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Electrocardiogram normal, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: ECG (NORMAL) 5/17/2021
CDC Split Type:

Write-up: 39yr old patient with unknown PMH presented for first dose of COVID-19 vaccine on 5/17. Patient was administered COVID-19 Pfizer vaccine (LOT # EW0179), IM in patient''s left deltoid. While walking away to waiting area, patient with dizziness. Patient tachycardic with HR 120s-130s and BP 157/95. Patient placed in reclining chair and monitored. Other symptoms denied. Reporter notes symptoms resolved within 15min but then prior to discharge, patient tachycardic again (HR 130s) and BP increased back to 137/85 with new feelings of dizziness and feeling faint. EMS contacted and transferred patient to ED. At 1542, BP 134/69 and HR 69. No interventions given in ED. At 1903, CMA documented "patient leaving ED". ecg 5/17/2021 NORMAL SINUS RHYTHM.


VAERS ID: 1343649 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-05-17
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Brain stem thrombosis, Cerebrovascular accident, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan and mri on 5/17/21
CDC Split Type:

Write-up: Stroke due to blood clot in artery at the base of the brain


VAERS ID: 1343740 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Echocardiogram normal, Electrocardiogram normal, Troponin
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID+ 4/22/21
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG 5/17 normal sinus rhythm ECHO 5/18 normal troponin 5/17 2043 0.175 troponin 5/17 2227 0.179 troponin 5/18 0510 0.07
CDC Split Type:

Write-up: Patient developed chest tightness during soccer tournament the day after receiving first dose of COVID vaccine and then subsequently developed abdominal pain with several episodes of hematochezia which self resolved. Upon arrival to the ED pt had elevated troponin which downtrended. EKG and ECHO were normal and symptoms resolved without intervention.


VAERS ID: 1343752 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Muscle tightness
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad)

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

Write-up: severe back pain, severe muscle tightness


VAERS ID: 1343792 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Disorientation, Fall, Feeling abnormal, Head injury, Malaise, Nausea, Pallor, Somnolence, Syncope, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mother reported he takes medication for ADHD and anxiety
Current Illness:
Preexisting Conditions: ADHD and anxiety
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient (14 years old) fainted in the observation area receiving the first dose of the Pfizer vaccine. Patient fell from chair and had some scratches to right temporal region. Patient was accompanied by his mother. Patient was assisted to chair and appeared very pale and disoriented to time and place. EMS was called at 1138. Patient also stated his vision was blurred, reported nausea (emesis x1), and reported feeling very weak and ?really weird?. Patient also reported he was very sleepy and wanted to go to sleep. Patient was kept awake. Mother stated patient had history of ADHD and anxiety but no other past medical history. Paramedics arrived at 1145 and assessed patient. Blood glucose and VS were normal. Patient continued to report feeling unwell and wanted to go to the hospital but also wanted to ?stop for food?. Patient?s mother reported that patient was starting to sound like his normal self and that his color was returning. Patient?s mother agreed for the paramedics to transfer patient to ED for further evaluation. Patient left in ambulance at 1157.


VAERS ID: 1343837 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / IM

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

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

Write-up: No adverse event.


VAERS ID: 1343883 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-02
Onset:2021-05-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Back pain, Blood test, Chest pain, Computerised tomogram abnormal, Cough, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer increased, Musculoskeletal chest pain, Pulmonary embolism, SARS-CoV-2 test negative, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications: Metformin Azurette
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: All tests below were done on 5/18 in the Emergency room. X-rays EKG D-Dimer Test CT Scan (this is what confirmed the Pulmonary Embolism diagnosis) Blood Tests Covid Test (negative)
CDC Split Type:

Write-up: Adverse Events: I went to the emergency room on 5/18 after experiencing major back pain, sharp pain in ribs, chest pains, difficulty breathing, shortness of breath and chronic coughing. Outcome: After x-rays, EKG, D-Dimer Test and a CT scan the doctor determined that I have Pulmonary Embolism (blood clots in my lungs). I''ve never had any symptoms prior to receiving the covid vaccine. Today is 5/24 and I am still experiencing most of the same symptoms despite taking my medications as prescribed. The worst symptoms are difficulty breathing and chronic coughing. Treatment: -No longer taking birth control (Azurette) since that can cause blood cots -Xarelto (to treat and prevent blood clots) -Gabapentin 100MG 3x Day (for pain) -Benzonatate 200MG 3x Day (for cough) -Tizanidine 2MG 1X day (for pain) -Albuterol Inhaler Every 4 hours


VAERS ID: 1343910 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Fatigue, Feeling cold, Muscle spasms, Muscle tightness, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: The first night, in addition to chills and joint pain (my joints were on fire ), I had extreme pain and cramping in my calves from 9pm to 3am. Throughout the next seven days, the lower leg pain and overall fatigue has continued. Each day, between mid to late day, I have to lay in bed and take my foot and massage the opposing calf due to tightness and uncomfortable pain. Each night, the calf pain worsened when compared to the day. I prop my pillow under my knee.


VAERS ID: 1343950 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Herpes zoster, Paraesthesia, Peripheral swelling, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Latanaprost .005% w/v eye drop solution Topamax 25 mg tablet Junel FE 1/20 Claritin D
Current Illness: n/a
Preexisting Conditions: Sinusitis
Allergies: KNA
Diagnostic Lab Data: May 21st shingles
CDC Split Type:

Write-up: There were not adverse events at the time the shot was administered. I started displaying symptoms on or around May 10th with tingling in fingertips that I couldn''t pin point and joint pain in my left hand below my knuckles (palm side). Around May 17th, I got swelling in my feet (I took photos) and May 18th, I started to feel itching on the back of my left thigh with no symptoms of a rash. I woke up on May 19th with what looked like ant bites but by the 20th, I couldn''t touch it. I went to urgent care on May 21st and was diagnosed with shingles.


VAERS ID: 1343988 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 RA / IM

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

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

Write-up: Patients mother stated he experienced a full body rash from head to toe


VAERS ID: 1344050 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-05-17
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonazepam 1mg BID Fluoxetine 80mg Daily Fluticasone Nasal 50mcg/inh nasal spray BID Metoprolol Tartrate 50mg BID Sildenafil 100mg Daily PRN
Current Illness: Prostate issues - feeling of incomplete emptying
Preexisting Conditions: Bipolar II disorder
Allergies: Penicillins Tongue Swelling
Diagnostic Lab Data: COVID-19 PCR test
CDC Split Type:

Write-up: Symptoms of Cough, runny nose, Headache, fatigue, muscle aches, fever, sore throat - diagnosed as COVID. Symptom onset 5/17/2021.


VAERS ID: 1344103 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Orbital swelling, Pruritus, Swelling face, 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: MVI. Vitamin C, Excedren ES, Nitro subling, Miralax, diclofenac gel, ambien, mag-ox, lantus, cyclobenzaprine, tricor, losartan, metformin, amlodipine, atorvastatin, Vitamin D, celebrex, amitriptyline, endocet, vaginal cream, xanax
Current Illness: None
Preexisting Conditions: DM type II, Gerd, coronary arteriosclerosis, HTN, chronic pain, vitamin d deficiency, insomnia, hypomagnesemia, diabetic neuropathy with proteinuria.
Allergies: codeine, gabapentin, ibuprofen, pantoprazole, sutures
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient initially called on May 21st with complaints of an itching sensation 3 days following vaccine. No visible hives or swelling at that time. Was given instructions for topical cream to relieve symptoms. Patient was then seen on May 24th with itchy hives of the lower abdomen and vagina areas along with facial and orbital swelling. Was started on a Medrol Dose Pack


VAERS ID: 1344153 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Oral mucosal blistering, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headaches, fever and mouth blisters.


VAERS ID: 1344621 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Between 6-7 hours after receiving the vaccination I started to feel increasingly cold. After putting on a sweater and trying to stay warm I also started to get sore. Around 8-9 hours after vaccination I decided to go to sleep to hopefully sleep of the symptoms. I was extremely cold and sore, but attempted to sleep. Around 12 hours after the shot the fever broke and I was sweating. After that I slept much better and woke up the next morning feeling fine. No further issues.


VAERS ID: 1344878 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: 14 year old, accompanied by parents, got his first Pfizer vaccine. After 15 minute observation, the parents and child left the site. The parents returned within minutes from leaving and requested the child be checked out by EMS. The child was feeling numbness in the let arm, face, and neck. EMS responded and his vital were normal, but parents insisted EMS transport him to the hospital.


VAERS ID: 1345270 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Laboratory test abnormal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCOS
Allergies: Citrus
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left side numbness. Tests pointed to possible blood clot. Still don?t have feeling in left arm. Having to continue to see neurologist.


VAERS ID: 1345796 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-17
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545085

Write-up: INJECTION SITE VERY WARM TO TOUCH; BODY ACHING; CHILLS; FEVER; HEADACHE; INJECTION SITE RED; INJECTION SITE SWOLLEN; This spontaneous report received from a patient concerned a 36 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A, and batch number: 204A21A expiry: UNKNOWN) dose was not reported, administered on 17-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-MAY-2021, the subject experienced injection site very warm to touch. On 17-MAY-2021, the subject experienced body aching. On 17-MAY-2021, the subject experienced chills. On 17-MAY-2021, the subject experienced fever. On 17-MAY-2021, the subject experienced headache. On 17-MAY-2021, the subject experienced injection site red. On 17-MAY-2021, the subject experienced injection site swollen. The action taken with covid-19 vaccine was not applicable. The patient recovered from body aching, chills, fever, and headache on 19-MAY-2021, and had not recovered from injection site red, injection site swollen, and injection site very warm to touch. This report was non-serious.


VAERS ID: 1345997 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-30
Onset:2021-05-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Electrocardiogram, Infection, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, chest x ray, and other tests
CDC Split Type:

Write-up: Myocarditis. I had to go to the ER on last Monday after having chest pains. After doing EKG, chest x ray, and other tests, they determined it was myocarditis due to an infection. Pain level was an 8/10


VAERS ID: 1346383 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Pruritus, Skin exfoliation, Skin warm
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: after first shot i notice sunburn and blistering on the top shoulder of injection site arm. second dose i received in the opposite arm. a few hours after injection my entire face turned red and itchy. it has been a week and i am less red but my face is still itchy. my right cheek had gotten very hot and red and now the skin is peeling like it was burned.


VAERS ID: 1346512 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Eye movement disorder, Mobility decreased, Musculoskeletal stiffness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none none
Preexisting Conditions: none noted
Allergies: None none
Diagnostic Lab Data: patient was taken to hospial
CDC Split Type:

Write-up: patient received vaccine , looked at his arm , and started to freeze up, almost passing out , eyes rolled back and we got him to the floor and he came around saying he could move his arms (both) and his fingers were seizing up, we got ice packs, hewas clammy, but breathing fine , and hew was speaking and complaining about his inability to move. no issues breathing , we called 911


VAERS ID: 1346567 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

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

Write-up: Metallic taste in mouth 12 min after vaccine. Lasting on and off until that same night. I did not have any further metallic taste after it resolved that night


VAERS ID: 1346594 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Unknown  
Location: Arkansas  
Vaccinated:1961-03-19
Onset:2021-05-17
   Days after vaccination:21974
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: Vaccine was given outside 6 hour window and it was given 40 minutes afterwards. I tried to call patient several times but he never returned my call. I called Janssen on 05/17/2021


VAERS ID: 1346612 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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. c/o "a little dizziness". Pt had blood drawn in the morning and did not eat. Snack and water provided. Pt. also reports he has anxiety and this feels similar. Pt. waited additional 15 minutes and reports symptoms resolved. Pt. dc'' d home.


VAERS ID: 1346656 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-05-17
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: no
CDC Split Type:

Write-up: I gave the vaccine 50 minutes outside the 6 hour window. I called patient and told her if she wanted another one we could give her one. She said it was fine and that she was not interested in getting a second one


VAERS ID: 1346687 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Biopsy skin, Burning sensation, COVID-19, Cheilitis, Dry eye, Dry mouth, Fatigue, Fibrin D dimer increased, Headache, Hypoaesthesia, Injection site rash, Livedo reticularis, Neoplasm skin, Paraesthesia, Petechiae, Rash, Rash vesicular, Red blood cell sedimentation rate increased, Sleep disorder, Ultrasound scan normal, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Skin tumours of unspecified malignancy (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological tumours of unspecified malignancy (narrow), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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? No
Previous Vaccinations:
Other Medications: Vyvanse
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Elevated D-Dimer panel, elevated SED rate. US on legs- Normal. Skin biopsy - Awaiting results
CDC Split Type:

Write-up: Burning/blistering rash developed abruptly on left arm, chest, lower legs and right arm that has continued to spread to entire body including lips and inside of nose. Numbness in hands and feet. Notes from all medical visits below. 5/17/2021 Walk-In. Patient present with a worsening rash x today. She received her second Pfizer COVID vaccine on 5/14. Patient reports a small rash at the vaccine site that evening. No worsening of rash over the weekend. Patient denies fevers, HA, ST, dyspnea. She reports a history of skin sensitivities. No new soaps, lotions or detergents. No new medications or supplements. No itching or pain from rash. She reports that her symptoms started with small, clear, "bubbles", then turn into flat, excoriated erythema. 5/19/2021 SMHC ER. 32 y.o. woman presenting with a rash. Patient had her second COVID-19 vaccine on 5-14. On 5-17 started developing a rash over her left arm at the site of the vaccine. Started with clear bubbles, that then look excoriated. She reports that they feel like they are burning. They have since spread to her chest and her back, her legs, her arms. She has put a little bit of antibiotic ointment on some of them, but this has not helped. No painful urination. Does report her eyes and her mouth feel dry. 5/19/2021 Dermatology Pt arrived from the ER admitting to significant fatigue. The burning in her skin has an abrupt onset which wakes her from sleep. She notes that starting Saturday 5/15 she has had intermittent pins and needles in her hands and feet. As of today her right foot is becoming more numb. She also notes the onset of burning at the left inside of her mouth. 5/20/2021 Dermatology. Assessment and Plan: 1. Neoplasm of uncertain behavior of skin. 32F with vesicular - petechial eruption with secondary crusting at trunk and extremities s/p 2nd Pfizer COVID-19 Vaccine on 5/14/21. Vasculitis vs DIC vs Stevens Johnson syndrome/ TENS in pt with symptoms consistent with coronavirus infection despite vaccination. SURGICAL PATHOLOGY TISSUE SPECIMEN; pending. Skin biopsies sent urgently on 5/19/21 for H&E and DIF. Prednisone started 5/19/2021 in ER: 60mg x3 d, 50mg x 3 d, 40mg x3 d, 30mg x3 d, 20mg x3 d, 10mg x 3 d (18 day taper). Out of concern for possible vasculitis compromise of the pt''s kidneys I prescribed bleach baths and topical mupirocin oint rather than add systemic antibiotics for secondary infection of lesions. Given the worrisome and worsening presentation, the pt and her husband agree to present to the E.R. They declined transport by ambulance and will go to the E.R. now. Number and Complexity of Problems Addressed. 1 acute or chronic illness or injury that poses a threat to life or bodily function. Mild headache last evening, no blurry vision. Extreme fatigue with effort of getting up and getting dressed Interrupted sleep with persistent burning pains at LEs, pins and needles at hands and feet and worsening blue discoloration at LEs and numbness at 2nd & 3rd rt toes. Has been able to hydrate; urine light yellow. Appetite maintained but no stool since 5/17. Pt removed IV from rt antecubital which had been left by E.R. 5/20/2021 ER. This is a 32 y.o. female with a rash that initially developed over her injection site from her second COVID vaccine received 6 days ago. The rash begins as bubbles and then appears excoriated. Described as burning and have since spread to her chest, back, legs and arms. She was evaluated yesterday at SMHC ED and Dermatology. Placed on 60 mg Prednisone and admits that the pain has not really improved. Sent here today for concern of DIC/Vasculitis/SJS. Patient well appearing, VSS. Will repeat labs, provide 1 L NACL and Oxycodone for pain. Had today''s dose of Prednisone. Does have decreased DP pulses, foot mottling and decreased capillary refill. Will obtain bilateral arterial US. Discussed with Dr. who also evaluated the patient and is in agreement. Labs improved from yesterday, only mild elevation of D-dimer. Some protein in her urine. Repeat evaluation after keeping her legs covered reveals normal cap refill less than 2 seconds. Still mottled and unable to palpate DP pulses bilaterally. 5/21/2021 Assessment. Prescribed Ondansetron Hydrochloride 4 mg For nausea.


VAERS ID: 1346698 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-06
Onset:2021-05-17
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 UN / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 UN / UN

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

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

Write-up: Patient received COVID vaccines on 02/06/2021 and 03/06/2021. Developed COVID symptoms; tested positive for COVID on 05/17/2021


VAERS ID: 1346718 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-05-17
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / UN

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

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

Write-up: Patient received Johnson & Johnson COVID vaccine on 04/02/2021. Developed COVID symptoms; tested positive for COVID on 05/17/2021


VAERS ID: 1346720 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, vitamin E, magnesium, and folic acid
Current Illness: None
Preexisting Conditions: Just obesity
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am nine days out from getting the vaccine and I still have a half dollar size red itchy patch on my injection site.


VAERS ID: 1346734 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-12
Onset:2021-05-17
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 received Pfizer COVID vaccines on 02/19/2021 and 03/12/2021. Pt tested positive for COVID on 04/20/2021 and 05/17/2021.


VAERS ID: 1346767 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 AR / SC

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Catheter directed thrombolysis, Dyspnoea, Electrocardiogram ST-T segment abnormal, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, Multivitamin, Vitamin D 3, Flax Seed, Potassium Gluconate
Current Illness: None
Preexisting Conditions: Obesity
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presents with 7 day history of shortness of breath. Ct angiogram showed multiple pulmonary emoblism with ventricular strain. Patient required EKOS procedure for clot dissolution and bridging from Lovenox to warfarin.


VAERS ID: 1346812 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-11
Onset:2021-05-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Laboratory test, Nausea, Vertigo positional, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), 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: Vitamin C Vitamin D Quercitin Zinc
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Basic tests ruled out heart and blood pressure events on 5/19. Physical therapy tests revealed issue in left ear on 5/22.
CDC Split Type:

Write-up: A week following my second Moderna shot. I was dizzy, nauseous, and had some blurred vision. I was diagnosed with BPPV, a type of Vertigo. I did physical therapy to move the inner ear crystals back to where they belong. Prescribed AntiVert for dizziness and Nausea symptoms. More physical therapy to follow.


VAERS ID: 1346882 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-20
Onset:2021-05-17
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Pt. believes the shot gave her shingles. Breakout below waist, back/bend of L knee, bottom of L foot. Went to Doctor on 05-21-2021. RX prescribed: Famciclodir 500mg, Hydrocodone 5/325mg


VAERS ID: 1346917 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Janssen COVID vaccine was given to this patient when she is 17 years old. Her year date of birth was 2003 and it was not realized that she had not yet turned 18 because her birthday is in December.


VAERS ID: 1346990 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-11
Onset:2021-05-17
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Positive test: SARS-CoV-2 RNA Resp Ql NAA+probe, specimen collection date 5/19/2021
CDC Split Type:

Write-up: Symptomatic infection with covid-19 after being fully immunized.


VAERS ID: 1347028 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lethargy, Mononucleosis heterophile test, Oropharyngeal pain, Rash, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid-19 (5/18/21 negative) Strep ((5/18/21 negative) Mononucleosis (5/24/21 results not back yet)
CDC Split Type:

Write-up: Very sore throat, rash on body, extreme lethargy


VAERS ID: 1347109 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Ocular discomfort, Paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (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:
Current Illness:
Preexisting Conditions: Celiac''s Disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAG6258

Write-up: Tingling left side of body, blurry vision, pressure behind left eye, foggy, dizzy, fatigued, hard time catching breath.


VAERS ID: 1347207 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Fatigue
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: Diphenhydramine
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within (12) hours of injection: Fatigue set in which is still occurring (9) days later. Within (5) days of injection: Left arm is showing a lot of discoloration & numerous black & blue within 6? of vaccination site.


VAERS ID: 1347218 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 RA / IM

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

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

Write-up: Patient fainted after receiving 2nd dose of covid vaccine while being under 15 minute post vaccine observation. Patient fainted in arms of clinical observer. She did not fall or hit her head. She was aroused after her episode (about 30 seconds in duration). She then drank some juice. She continued to be diaphoretic, pale and felt as though she were going to faint again. Since her symptoms did not seem to be resolving we called an ambulance. EMS arrived within 5 minutes and took patient to the hospital.


VAERS ID: 1347238 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiocardiogram, Angiogram abnormal, Back pain, Cardiac imaging procedure abnormal, Chest pain, Coronary artery dissection, Magnetic resonance imaging heart, Myocarditis, Pain, Troponin increased
SMQs:, Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: He took Claritin on 5/12 & 13/ 2021
Current Illness: None besides seasonal allergies.
Preexisting Conditions: None
Allergies: No food or drug allergies. Only seasonal allergies- "Claritin for 2 days after mowing the lawn."
Diagnostic Lab Data: 5/19/21- Troponin peaked to 1945 5/19/21- Cardiac CTA LM and RCA SCAD 5/20/21- cMRI- myocarditis
CDC Split Type:

Write-up: Pt developed upper body pain 5/17, then back and chest pain 5/18. + Troponin. CT showed LMCA and RCA SCAD. Cardiac MRI showed active myocarditis.


VAERS ID: 1347309 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Injection site pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), 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-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Patient stated she felt weird.-Mild, Systemic: Headache-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Per the father, patient reported arm pain/soreness on 5/17/21, body aches on 5/18/21, and on 5/19/21 patient reported waking up with a mild headache and mild tingling of leg.


VAERS ID: 1347315 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough
SMQs:, Anaphylactic reaction (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: Pt received 2nd dose Pfizer at clinic. Pt sat in observation room after vaccine administration. Pt began to cough. RN brought water and asked if pt was chocking on saliva. RN assessed pt''s tongue and mouth. No swelling noted. Pt continued to cough. RN called charge RN. Charge RN came to assess. No visible swelling noted. Pt denies any history of allergic reactions. At 1556 Epi 0.3mg given IM in R thigh. Pt tolerated well. Vitals collected at 1600: Bp- 189/114, RR-18, O2-96% , HR-97. Pt reported feeling much better after EPI administration and coughing ceased. Charge RN called 911 per emergency protocol.


VAERS ID: 1347317 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-15
Onset:2021-05-17
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR positive for COVID-19 on 05/17/2021
CDC Split Type:

Write-up: Hospitalized due to COVID-19 after being fully vaccinated.


VAERS ID: 1347424 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Discomfort, Erythema, Pallor, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None; uses an inhaler for exercise-induced asthma when needed, but had not taken it since being vaccinated.
Current Illness: Not ill at time of vaccination; unknown status one month prior
Preexisting Conditions: Exercise-induced asthma
Allergies: No known allergies to medications, food, or other products
Diagnostic Lab Data: Tests were not performed.
CDC Split Type:

Write-up: 05/17/21; Patient attended school, orthodontist, baseball training and practice. Mother picked patient up from baseball practice at approximately 07:30pm and both of patients legs were a pale pink color and developed into a deep red over the next hour. Patient started developing hives that were itchy, red, and uncomfortable, "all over body" per Mother. Mother states hives were mostly on his trunk, both legs down to calf/shin area, thighs, both arms (notably more irritated on the same arm where patient received injection). Mother took patient to the Emergency Room between 9:30-10pm. Patient was seen by ER Physician, who stated rash did not appear to be poison ivy, mother denied any recent changes in laundry detergent, soap, lotion, etc. ER Physician informed mother and patient that he thought the reaction was to the COVID-19 vaccine and advised against receiving the 2nd dose. Patient was prescribed 40mg Prednisone for 8 days, and mother is giving patient Benadryl as needed.


VAERS ID: 1347574 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-03
Onset:2021-05-17
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 RA / IM

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

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

Write-up: Tested positive for COVID after full vaccination. Test on 5/17/21 by PCR.


VAERS ID: 1347582 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027AZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute sinusitis, Chest X-ray, Computerised tomogram, Electrocardiogram, Upper respiratory tract infection
SMQs:

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

Write-up: uri, acute sinusitis


VAERS ID: 1347894 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone, gabapentin, celecoxib, tramadol
Current Illness: None
Preexisting Conditions: Avascular Necrosis
Allergies: Blood products
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have had hives since Monday may 17th. They get really itch but then some of the bumps stay for a day or two after it pops up.


VAERS ID: 1348817 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-24
Onset:2021-05-17
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest pain, Computerised tomogram thorax, Electrocardiogram normal, Fibrin D dimer increased, Troponin
SMQs:, Haemorrhage laboratory terms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Nexplanon Ibuprofen prn History of Paxil Prenatal vitamin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, strawberries (=hives) Sulfa (unknown rxn)
Diagnostic Lab Data: o BP=128/80, HR=75, RR=16, HT=67in, Wt=86.2kg, SpO2=99% o EKG=normal sinus rhythm, no acute ST or T wave segments concerning for ischemia, no evidence of arrhythmia o CT pulmonary angiogram = negative o Troponin negative (less than 3 ng/L) o D-dimer slightly elevated at 1.04
CDC Split Type:

Write-up: This is a 21 year old female who reported to the emergency department on 5/17/21 at 0917 with complaints of intermittent chest pain since the previous Tuesday (5/11/21). She described it as light in pressure, pain 4/10, in the right upper chest/right breast area. The patient believed her chronic anxiety may be playing a role since she has recently started a new job that involves public speaking and she had stopped her paxil due to adverse effects. No pleuritic pain described, no pain on exertion described. Differential diagnosis included low risk for ACS, PE given oral contraceptives, anxiety. Given no evidence of abnormality in labs/work-up, the patient was discharged home with instructions to follow-up with PCP for any ongoing symptoms/anxiety.


VAERS ID: 1348833 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cardiac monitoring, Chest discomfort, Dizziness, Electrocardiogram, Heart rate increased, Heart rate irregular, Hypertension, Immediate post-injection reaction
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood pressure monitor, heart rate monitor, ambulance ride to the ER with EKG in the ambulance and at the ER. After waiting almost 5 hours decided to leave the ER as nobody would help me. It was crowded. I felt good enough to stand up and walk out. In the last week this has occurred one other time and I could not get my heart rate to slow to normal. Some chest tightness. HR was elevated most of the day.
CDC Split Type:

Write-up: Less than one minute upon receiving the injection my heart rate was elevated and continue to rise. Upon resting it remained at 120 bpm. My normal resting heart rate is 50. I could not get it to slow down with deep breathing. I was quickly monitored in my blood pressure was 157/90. My normal is 115/75. After 10 minutes it decreased to around 85 bpm at rest and 134/90 BP. I waited and it begin to rise again after five minutes. I felt dizzy and was monitored again and placed in a declined position. At this point my blood pressure was discovered to be high again and heart rate back up and they felt an irregular heartbeat. They recommended I go to the ER.


VAERS ID: 1349012 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Nevada  
Vaccinated:0000-00-00
Onset:2021-05-17
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210537316

Write-up: SORE THROAT MORE ON THE LEFT SIDE OF THROAT; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805018, expiry: 25-MAY-2021) dose was not reported, administered on 06-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-MAY-2021, the subject experienced sore throat more on the left side of throat. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from sore throat more on the left side of throat. This report was non-serious.


VAERS ID: 1349679 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO0182 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Off label use, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021556676

Write-up: current_age: 12; Sore arm; This is a spontaneous report from a contactable 12-year-old male consumer reported for himself that he received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Lot number: EWO0182), via an unspecified route of administration in the right arm on 17-MAY-2021 15:45 as 1 ST DOSE SINGLE for covid-19 immunization. The patient was diagnosed with COVID-19 prior to vaccination. Since the vaccination the patient has not been tested positive for covid-19. The patient''s medical history and concomitant medications were not reported. On 17May2021 at 04:00pm, the patient experienced sore arm. Since the patient was 12-Year-old Off label use in unapproved age group was added as an additional event. The outcome of the event was recovered.


VAERS ID: 1349709 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Erythema, Headache, Lip blister, Lip pain, Lip swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Guillain-Barre syndrome (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: The patient takes no daily medications, supplements, or herbals.
Current Illness: N/A
Preexisting Conditions: No past medical history which is chronic.
Allergies: NKDA, no known food, or other allergies.
Diagnostic Lab Data: No tests or lab studies were performed.
CDC Split Type:

Write-up: 21yo Active Duty female Navy Sailor currently deployed to UAE reports to Fujairah Detachment medical clinic with c/o bottom lip swelling x 96hrs, which began about 24 hours post receiving the J&J vaccine on 16May21 in Jebel Ali, UAE. Pt denies any pain, tingling, or numbness but does report a throbbing sensation in the lip. Pt denies any dyspnea, SOB, dysphagia, or difficulty eating/drinking. Pt states there is also a blister like red spot on the middle of the lip. Pt denies any fever, body aches, fatigue, n/v, or other skin lesions. Pt denies any history of cold sores/herpes labialis. Pt denies having anything like this from a vaccine in the past. No history of medication, food, or environmental allergies. Pt also reported HA, stomach ache, and feeling weak for 24 hours after vaccination then resolved, but lip then swelling began and persisted prompting medical evaluation. Provider prescribed 25mg Benadryl which significantly decreased the lip swelling over the following 6-8 hours.


VAERS ID: 1350317 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Injection site erythema, Injection site pain, Nausea, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Medium, Additional Details: Patient was sitting in chair after vaccination and <5 minutes later, he started shaking, then faceplanted on the ground. He regained consciousness within 30 seconds. I elevated his feet and laid him on his back/gave water bottle. Observed for total of 30 minutes before allowing him to leave. he denied emergency services.


VAERS ID: 1350361 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Error: Wrong Dose of Vaccine - Too Low


VAERS ID: 1350442 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood albumin decreased, Blood calcium increased, Blood chloride decreased, Blood sodium decreased, Blood urea increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax, Fibrin D dimer increased, Full blood count abnormal, Haematocrit decreased, Haemoglobin increased, Hilar lymphadenopathy, Immature granulocyte count, Lung infiltration, Lung opacity, Lymphocyte count increased, Mean cell haemoglobin decreased, Mean cell volume decreased, Metabolic function test, Protein total decreased, White blood cell count increased
SMQs:, Acute renal failure (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: vitamin D, vitamin B12
Current Illness:
Preexisting Conditions: History of chronic lymphocytic leukemia, age-related osteoporosis, history of breast cancer
Allergies: Penicillins
Diagnostic Lab Data: 5/21 chest x-ray positive for bilateral diffuse infiltrates consistent with COVID pneumonia, CMP significant for sodium 128, chloride 95, BUN 22, calcium 8.0, albumin 2.9, and total protein 5.7. CBC significant for hemoglobin 11.7, hematocrit 34.5, MCV 78.9, MCH 26.8, immature granulocytes 0.8, lymphocytes 59.9. 5/22 CT angio thorax significant for bilateral multifocal groundglass opacities and reactive hilar lymphadenopathy, CMP sodium 131, chloride 96, BUN 26, Calcium 8.5. 5/23 CMP significant sodium 132, chloride 96, BUN 26, calcium 8.0. 5/24 CMP significant sodium 128, chloride 94, BUN 22, calcium 8.0; d-dimer 470. 5/25 CMP significant chloride 95; CRP 26.2; CBC significant WBC 29.38, MCH 26.6
CDC Split Type:

Write-up: Pt received vaccine on 4/8/2021. Pt was diagnosed with COVID-19 on 5/17/2021. Pt was admitted to the hospital on 5/21/2021 for pneumonia secondary to COVID-19.


VAERS ID: 1350448 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Chills, Fatigue, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had a fever, aches, chills, fatigue for approximately 24 hours. In addition, I had sharp pain (only when walking) in my right lower abdomen and in the second toe on my left foot.


VAERS ID: 1350543 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO172 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Hypoaesthesia, Injection site pain, Lymph node pain, Lymphadenopathy, Mobility decreased, Paraesthesia, Peripheral swelling, Skin mass, Skin swelling, Sleep disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: smallpox vaccine, infant, tetanus, 17 years old
Other Medications: calcium, magnesium, bioflavonoids, B12, biotin, kelp, vitamin D, probiotic
Current Illness:
Preexisting Conditions: autoimmune issues
Allergies: erythromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right arm swelled up within 5 minutes after shot, hard to move fingers with the swelling. Tingling, numbness. Next day intense pain at injection site, but swelling had gone down. Trouble sleeping first 3 nights after vaccine. Pain at injection site lasted until 4 days later when right shoulder joint began to hurt causing limited mobility. 7 days after vaccine lymph nodes very swollen and tender in left armpit and large swollen nodule next to right ear on scalp appeared. 9 days after vaccine still having pain and mobility issues with right shoulder. Have been generally fatigued, harder to exercise in the days after the vaccine.


VAERS ID: 1350576 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Grip strength decreased, Hyperhidrosis, Hypoacusis, Pallor, Presyncope, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), 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: Daily Marijuana user, Mirena implant birth control
Current Illness: None
Preexisting Conditions: Mild asthma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 2 mins of receiving injection, I experienced full body sweats, deadening of sound, blackness in eyes, lightheaded, unable to hold things in my hands, uneasy stomach, very pale all over, especially face. Talked/deep breathed my way out of fainting. Within 10 minutes all the above symptoms started to lessen. 15 minutes after receiving the injection, the near fainting experience was over and I was comfortable leaving and driving. But the 10 minutes were terrible and I came very close to passing out. My husband experienced the exact same symptoms 2 days later. I will be reporting that immediately following this submission.


VAERS ID: 1350591 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-30
Onset:2021-05-17
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, COVID-19, Cerebral small vessel ischaemic disease, Chest X-ray abnormal, Computerised tomogram head abnormal, Confusional state, Neurological examination normal, Pneumonia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CALCIUM PO take by mouth once daily. CRANBERRY PO take by mouth once daily. furosemide (LASIX) 40 MG PO Tab take 1 Tab by mouth see instructions. One tablet for 3 days then as needed for swelling Qty: 90 Tab, Refills: 3 Multiple Vit
Current Illness:
Preexisting Conditions: Patient is a 91 year old female who presented with a chief complaint of aphasia. Patient with increasing frequency in confusion episodes over the past few months. Patient presented in no acute distress, normal neurologic exam. Vitals stable, afebrile. Asymptomatic. CT Head without acute findings, but chronic microvascular disease consistent with age which may explain patient''s symptoms. TIAs cannot be ruled out however at this time. Recommend patient be evaluated by neurology. Discussed with patient who is in agreement with plan. Incidentally, patient with CXR findings consistent with pneumonia. Patient treated with antibiotics for CAP in case this is contributing to symptoms. COVID is positive but patient states that she tested positive in March and has received both vaccines. SpO2 94% on RA.
Allergies: none
Diagnostic Lab Data: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19) by NAA, Micro Not Detected DetectedAbnormal Narrative The SARS-CoV-2 (COVID-19) by NAA test is for in vitro diagnostic use under the FDA Emergency Use Authorization (EUA) for US laboratories certified under CLIA to perform high complexity testing. This test has not been FDA cleared or approved. Methodology: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (PCR). Specimen Collected: 05/17/21 6:56 PM Last Resu
CDC Split Type:

Write-up: Patient is a 91 year old female who presented with a chief complaint of aphasia. Patient with increasing frequency in confusion episodes over the past few months. Patient presented in no acute distress, normal neurologic exam. Vitals stable, afebrile. Asymptomatic. CT Head without acute findings, but chronic microvascular disease consistent with age which may explain patient''s symptoms. TIAs cannot be ruled out however at this time. Recommend patient be evaluated by neurology. Discussed with patient who is in agreement with plan. Incidentally, patient with CXR findings consistent with pneumonia. Patient treated with antibiotics for CAP in case this is contributing to symptoms. COVID is positive but patient states that she tested positive in March and has received both vaccines. SpO2 94% on RA.


VAERS ID: 1350634 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Gardasil (HPV) - 12/13/17 13 yrs near fainting, vomiting
Other Medications: escitlopram, iron
Current Illness: Covid March 10
Preexisting Conditions: depression
Allergies: none
Diagnostic Lab Data: Blood pressure
CDC Split Type:

Write-up: Patient sat about 2 minutes after getting vaccine and started to walk away to sit in our designated area. She immediately turned around to sit down again. She then proceeded to start falling to her right and passed out. I was able to catch her and then she started shaking as if having a seizure. This lasted about 5 seconds . She stopped and then it happened again for about 5 seconds. When she came to, she tried to walk away again and had to return to sitting. Then she vomited twice. Upon checking her blood pressure after about 30 minutes, it was 97/66. She sat for a total of about an hour before feeling good enough to leave. She was nauseous for the remainder of the day and the next day as well.


VAERS ID: 1350671 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Insomnia, Memory impairment, Paranoia, Psychotic disorder, Speech disorder
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (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: Not sure if this is a coincidence or not as mental health issues run in the family. Since receiving the Pfizer first dose, the patient has had a case of psychosis and has been admitted to inpatient as of 5/25/21 for psychological evaluation. First symptoms I personally noticed were about 24 hours after she received the shot. Speaking and getting stuck in loops, making up stories that never occurred, forgetting what ?reality? she is in, paranoia, not able to sleep are symptoms she is exhibiting.


VAERS ID: 1350731 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-05-17
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Dysstasia, Gait disturbance, Limb discomfort, Muscle twitching, Muscular weakness, Musculoskeletal discomfort, Pain in extremity, Paraesthesia, Sensory loss
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament 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? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal Multivitamins with Folic Acid 0.8 mg oral tablet, 0.8 mg= 1 tab, Oral, Daily
Current Illness: none known
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: 32-year-old female without any known past medical history presents with an acute onset of bilateral arm weakness and pain. She reports around 10 PM she was caring for her children when she suddenly started having acute onset upper back and shoulder discomfort which radiated into the arms resulting in significant distal arm weakness bilaterally. She has some paresthesias and loss of sensation associated with such. Subsequently she also noticed that her symptoms radiating into her legs and she had difficulty ambulating and standing. She reported some twitching of her legs during a CT scan that was performed as well. Patient is otherwise healthy does not take any medications for any chronic medical issues. She has had gestational diabetes with her pregnancy in 2011, without any subsequent diagnosis of diabetes. She also had a traumatic motor vehicle collision in November 2020 with some residual chronic low back pain is resolved.


VAERS ID: 1350841 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-16
Onset:2021-05-17
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Fatigue, Nasal congestion, Oropharyngeal pain, Rhinorrhoea, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: buPROPion XL (WELLBUTRIN XL) 150 mg 24 hr tablet loratadine (CLARITIN) 10 mg tablet meloxicam (MOBIC) 7.5 mg tablet montelukast (SINGULAIR) 10 mg tablet MULTIVITAMIN (DAILY VITAMIN ORAL)
Current Illness:
Preexisting Conditions: Nervous Chronic arthralgias of knees and hips Rib pain on left side Sore throat Respiratory Allergic rhinitis Asthma, moderate persistent Genitourinary Irregular menstrual cycle Other Depression Overweight(278.02) Breast microcalcification, mammographic Carcinoma in situ of female breast, left H/O tamoxifen therapy Panic attacks Major depressive disorder, recurrent episode, moderate (CMS/HCC) Anxiety disorder, unspecified type
Allergies: NKA
Diagnostic Lab Data: 05/20/21 2333 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/20/21 1146 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Fatigue Sore throat Congestion or running nose Care Coordination Progress Note COVID 19 Navigator Initial Patient Assessment Ordering Prescriber has completed required FDA EUA elements. COVID-19 Positive Result Date (and on chart/file): 05/20/2021 Start of Symptoms Date: 05/17/2021 Meets Criteria: ANY AGE: ? Body mass index (BMI) ?35 ? Chronic kidney disease ? Diabetes ? Immunosuppressive disease AGE SPECIFIC: ? ? 65 years of age ? ?55 years of age AND had Cardiovascular Disease OR Hypertension OR COPD/other chronic respiratory disease


VAERS ID: 1350872 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nodule, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient reports swollen knot in arm that is tender and Fatigue greater that 1 week.


VAERS ID: 1350891 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain, Electrocardiogram ambulatory
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler PRN
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Amoxacillin
Diagnostic Lab Data: 30 day Holter Monitor
CDC Split Type:

Write-up: The evening after the client received his first dose of Pfizer, he reported chest pain and fluttering in his chest while playing basketball. This event lasted approximately 5 seconds and resolved without intervention. The client is being followed by his pediatrician. Per his parent, these events have happened before, but this was the most severe.


VAERS ID: 1350916 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose increased, Dizziness
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pt received care in emergency room for dizziness.
CDC Split Type:

Write-up: Pt reports dizziness started and increasing blood sugars after receiving second dose. Pt had ER visit related to dizziness


VAERS ID: 1350924 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-06
Onset:2021-05-17
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atelectasis, Breath sounds abnormal, COVID-19, Chest X-ray, Chest pain, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Nausea, Paranasal sinus discomfort, Pneumonia, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline (ELAVIL) 10 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 10 mg tablet buPROPion XL (WELLBUTRIN XL) 300 mg 24 hr tablet butalbital-acetaminophen-caff (FIORICET, ESGIC) 50-325-40 mg per tablet CHANTIX CONTINUING MONTH B
Current Illness:
Preexisting Conditions: Nervous Supraorbital neuralgia Severe headache Pelvic pain Migraine without aura Low back pain Breast pain in female Nicotine dependence Polyarthralgia Myalgia Chronic neck pain Paresthesia and pain of both upper extremities Intermittent paresthesia of hand and foot Respiratory Shortness of breath at rest Obstructive sleep apnea hypopnea, severe Circulatory Palpitations Hypertension Digestive Obesity Esophageal reflux Genitourinary Vaginal dryness Vaginal discharge Urinary incontinence Urinary frequency Urethral hypermobility Stress incontinence, female Perimenopausal Ovarian cyst Musculoskeletal Edema extremities Costochondritis Rash Mixed connective tissue disease (CMS/HCC) Rosacea Primary osteoarthritis involving multiple joints Interphalangeal osteoarthritis Endocrine/Metabolic Solitary thyroid nodule Hyperglycemia Type 2 diabetes mellitus (CMS/HCC) Other Depression Breast asymmetry Bilateral nipple discharge Anxiety Positive ANA (antinuclear antibody) Long-term use of Plaquenil Sicca complex (CMS/HCC) Primary insomnia
Allergies: Vicodin [Hydrocodone-acetaminophen]Hives / Urticaria, Rash, Nausea and Vomiting Pyridium Plus [Phenazopyridine-butabarb-hyosc] BenazeprilRash MetforminDiarrhea OxycodoneRash, Nausea and Vomiting Oxycodone-acetaminophenNausea Only
Diagnostic Lab Data: 05/19/21 2140 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/19/21 0851 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical procedure Component Value Ref Range Date/Time X-ray chest 1 view - Portable [3284183108] Resulted: 05/20/21 1458 Order Status: Completed Updated: 05/20/21 1458 Narrative: XR CHEST 1 VW PORT IMPRESSION: Opacity at the lung bases, atelectasis versus pneumonia. END OF IMPRESSION: INDICATION: SOB. TECHNIQUE: AP portable chest. COMPARISON: 9/28/2020 FINDINGS: No focal consolidation. Mild opacity at the lung bases, atelectasis versus pneumonia. No pneumothorax or pleural effusion. Heart size and pulmonary vasculature appear within normal limits. No acute bony abnormalities. Chronic left rib fractures noted.
CDC Split Type:

Write-up: 51-year-old female who presents today with complaint of Covid, apparently diagnosed with Covid about 1 day prior to presentation and has been having symptoms for about 3 days now. Sent in by PCP after being found to have heart rate of 140 and pulse ox of 79% from home pulse ox. On exam at this time, vitals stable, patient making complete sentences, does have some decreased breath sounds however likely consistent with her smoking history and possible COPD. Patient would prefer to return home at this time which I think is reasonable given her presentation, will provide patient with symptomatic relief, as long as she is able to demonstrate appropriate ambulation anticipate that she can likely be discharged home. History of Present Illness 51 y.o. yo female presenting to the ED with shortness of breath. Diagnosed with Covid yesterday, has been having symptoms for about 3 to 4 days now, primarily consisting of cough, decreased appetite, nausea, and diarrhea as well as sinus pressure. Yesterday she has she developed some chest pain and shortness of breath with exertion, scheduled a PCP televisit today during which she used a home pulse oximeter and was found to have a pulse ox of 79% and a heart rate of over 140 after ambulation at that time was instructed to present to the emergency department for evaluation. Currently she states that while at rest she does not feel so symptomatic however she feels significantly symptomatic with walking. She states that she has been able to eat some food however significantly decreased appetite. She does endorse a smoking history, denies a productive cough. Has not noticed any increased swelling in her lower extremities, not experiencing any chest pain today, this is primarily after having prolonged coughing fits. Has no other complaints at this time. She has a history of lupus for which she takes Plaquenil, does not take steroids. She has been taking some Tylenol on and off, and did not notice that she had a fever of 103.5 yesterday. Clinical Support RN (Registered Nurse) ? ? Encounter Date: 5/21/2021 ? ? Signed Patient is here for MAB Infusion Consent for infusion prior to this visit reviewed and verified. O2 sats $g or = 90% Signs of potential reaction reviewed with patient. Tolerated IV start and MAB infusion without complication. Pt has access to pulse oximeter and thermometer for home monitoring Provided fact sheet for patients, parents and caregivers- Emergency Use Authorization of BAM for Coronovirus Disease 2019 for pt to review. Discharge instructions reviewed. Patient denies any questions


VAERS ID: 1350989 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-05-17
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 mg tablet atorvastatin (LIPITOR) 40 mg tablet cholecalciferol, vitamin D3, (VITAMIN D3) 2,000 unit tablet clopidogreL (PLAVIX) 75 mg tablet docusate sodium (COLACE) 100 mg capsule ELIQUIS 5 mg tablet latanoprost (XALA
Current Illness:
Preexisting Conditions: Nervous Stable angina Circulatory CAD (coronary artery disease) AVNRT (AV nodal re-entry tachycardia) Hypertension TIA (transient ischemic attack) Hypertensive heart and kidney disease with chronic kidney disease Sinus node dysfunction Pre-syncope Acute pulmonary embolism without acute cor pulmonale Genitourinary Anemia associated with stage 3 chronic renal failure Enlarged prostate without lower urinary tract symptoms (luts) Prostate cancer Renal lithiasis Hypertensive kidney disease with chronic kidney disease stage III Stage 3b chronic kidney disease Endocrine/Metabolic Hyperlipidemia Impaired fasting blood sugar Infectious/Inflammatory COVID-19 Other Long-term (current) use of anticoagulants Pacemaker Hospital discharge follow-up
Allergies: Folic AcidDiarrhea
Diagnostic Lab Data: 05/18/21 0006 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/17/21 2300 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 12/02/20 1603 COVID-19/Flu/RSV PCR - Asymptomatic screening for admission Collected: 12/02/20 1438 | Final result | Specimen: Swab from Nasopharynx Influenza A Not Detected Respiratory Synctial Virus Not Detected Influenza B Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Patient does have chronically positive COVID-19. He has remained asymptomatic throughout this hospital stay. ED to Hosp-Admission Discharged 5/17/2021 - 5/22/2021 (5 days) Hospital MD Last attending ? Treatment team Stable angina Principal problem


VAERS ID: 1350993 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-05-17
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan of chest VL lower ext venous duplex scan
CDC Split Type:

Write-up: left leg DVT Left lower lobe PE


VAERS ID: 1351065 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-30
Onset:2021-05-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac disorder, Myocarditis, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was in the hospital for 3 days with a heart condition. My cardiologist thinks it was either pericarditis or myocarditis.


VAERS ID: 1351137 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-05-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

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

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

Write-up: Client tested positive for COVID-19 on 11/07/2020. She received Pfizer COVID-19 vaccine on 03/18/2021 and 04/08/2021. She then tested positive for COVID-19 again on 05/17/2021. She was hospitalized from 05/17/2021-05/21/2021. She has a history of gastric bypass surgery. She was short of breath at the time of her positive COVID test on 05/17/2021. She was found to have an obstructed gastric outlet at the time of her hospitalization. When I spoke with her on the phone on 05/25/ 2021, she reported that her medical provider felt that her shortness of breath was related to her gastric issues. She is no longer short of breath and will be having further surgery in June 2021.


VAERS ID: 1351246 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: 05/17/21 1438 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/17/21 1033 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Contact with and (suspected) exposure to covid-19


VAERS ID: 1351336 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood electrolytes normal, Muscle spasms, Pain in extremity, Ultrasound scan normal
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: blood circulation issues
Other Medications: Metoprolol Succinate ER 50 mg Potassium Cit 10MEQ Multivitamins Omega - 3
Current Illness: none
Preexisting Conditions: High Blood Pressure Chronic Pain issues Autoimmune disorder (thyroid)
Allergies: Shellfish
Diagnostic Lab Data: ER visit to hospital. Ultrasound test showed no blood clots in legs. Blood test showed normal electrolytes. Diagnosis was blood circulation issues, muscle spasms and prolonged sitting . Given prescription for Acetaminophen (Tylenol Extra Strength) 500mg.
CDC Split Type:

Write-up: Severe pain in feet on May 17, 2021. Severe cramping in feet after both shots. Severe blood circulation issues. I believe these issues stem from the vaccine as I didn''t have these issues prior to the shots being given.


VAERS ID: 1351390 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-05-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rhinorrhoea, Sinus congestion, Sinusitis
SMQs:

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

Write-up: Developed severe sinus infection with yellow mucus, runny nose, and sinus congestion within 2 days after receiving the vaccine. Symptoms lasted 2-3 days and resolved without medication.


VAERS ID: 1351565 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-11
Onset:2021-05-17
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Blood gases abnormal, Bronchitis, C-reactive protein increased, COVID-19 pneumonia, Chest discomfort, Computerised tomogram thorax abnormal, Confusional state, Cough, Procalcitonin increased, Pulmonary congestion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Lactic acidosis (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), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin 40 mg QD, Bee pollen 2 Caps QD, Carbidopa/Levodopa 62.5 mg/250 mg QID, Cetirizine 10 mg QD, Clonazepam 0.25 mg QD, ferrous sulfate 325 mg MWF only, Glucosamine/Chondroitin QD, Hydrocodone/Acetaminophen 5mg/325mg 1-2 Q6H prn pai
Current Illness:
Preexisting Conditions: Back pain, Coronary artery disease, diverticulitis, GERD, Hyperlipidemia, Hypothyroidism, Parkinson''s, Postural hypotension, Obstructive sleep apnea, Type 2 diabetes mellitus
Allergies: Horse Serum (anaphylaxis), Morphine (Bradycard Tramadol (jitters), Pregabalin (Swelling), Solfenacin (Photosensitivity), Codeine, Tetanus immune globulin
Diagnostic Lab Data: COVID Positive - Detected SARS-CoV-2
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA: Case of COVID-19 that resulted in Hospitalization post vaccination. Patient received Moderna COVID Vaccinations on January 14, and February 11, 2021. On May 17th patient requested a Telemedicine visit for chest congestion, painful cough, tightness in chest since May 14th - diagnosed with acute bronchitis and provided prescriptions for prednisone BID, Doxycycline BID, and Benzonatate Q6H prn cough. On May 18th the patient presented to the ED for evaluation of confusion upon waking. Upon arrival patient was febrile (102), CRP was 224. Evaluation was significant for acute respiratory failure with hypoxia secondary to COVID pneumonia. CT scan demonstrated multifocal pneumonia consistent with COVID. He was started on 2L oxygen via NC, dextamethasone, remdesivir (2 doses given), & Duo Neb treatments. He initially did well on 2L. On the 20th, he began to decompensate. He went from 2L to Airvo 55L 70% at 11am. Procalcitonin went from 0.26 to 0.96. Ceftriaxone & doxycycline was initiated. He maintained saturations on the Airvo, & was even weaned down to 55%. On May 21st, he has decompensated further, with saturations quickly dropping to the upper 80''s with minimal activity. RR has been 28-32. Airvo settings were increased to 60L/95%. Saturations are now 88-93%. ABG was 7.45-38-60-27-92%. He was given an additional IV dextamethasone. Patient will be transferred to Medical center for a higher level of care. Patient was treated with tocilizumab on May 21st.


VAERS ID: 1351579 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-05-17
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time prolonged, Anticoagulant therapy, Atrial thrombosis, Computerised tomogram thorax abnormal, Myocardial ischaemia, Pulmonary embolism, Scan with contrast abnormal, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norg-ee .18-0.215/0.35 tablet
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: 5/21/21 Mobile filling defect attached to the inferior wall of the right atrium adjacement to the inferior vena cava, which demonstrates low signal intensity and no evidence of enhancement after administration of contrast, consistent with right atrium thrombus. 5/19/21 Chest CT PE Protocol w Con
CDC Split Type:

Write-up: Adverse event: Acute pulmonary embolism, Demand Ischemia, Prolonged Ptt, Thrombocytopenia. Treatment: Eliquis 6 months with follow up with hematology, pulmonolist, and cardiologist


VAERS ID: 1351715 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 RA / IM

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

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

Write-up: Fever (100.2) chills, aches, vomiting, SHINGLES over left scalp forehead, nose and LEFT EYE. diagnosed 5/18 ------ON GOING as of 5/26 Treatment: VALACYCLOVIR, PREDNISOLONE DROPS, COMBIGAN DROPS


VAERS ID: 1351908 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Anxiety, Chest pain, Chills, Dyspnoea, Pleurisy
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: UNK
Current Illness: N/A
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: ROS HEENT: no runny nose, no eye pain, no ear pain CV: POSITIVE chest pain, no palpitations Resp: POSITIVE shortness of breath, no cough, POSITIVE pleurisy Abd: no abdominal pain, no, ROS HEENT: no runny nose, no eye pain, no ear pain, CV: POSITIVE chest pain, no palpitations, Resp: POSITIVE shortness of breath, no cough, POSITIVE pleurisy, Abd: no abdominal pain, no N/V/D, no hematuria/dysuria, MSK: no joint pain, no joint swelling, no back pain PE Gen: A&Ox4, NAD, speaking in full sentences HEENT: EOMI with conjugate gaze, no facial trauma, no AOM/OE/Ludwig''s, no cervical adenopathy, CV: S1/S2 RRR no MRG, Pulm: CTA all fields, no dyspnea, unlabored respirations, GI: no focal TTP, no peritoneal signs,MSK: moving all extremities equally 5/5 strength, no deformities, no joint effusions, Neuro: CN 2-12 and cerebellar grossly intact Labs: CBC: unremarkable CMP: unremarkable TROP: neg DIMER: positive LIPASE: neg Rad: CXR: EXAMINATION: CHEST, PA AND LATERAL COMPARISON: None . Findings: PA and lateral views of the chest were performed. The costophrenic angles are sharp. The heart and mediastinum are normal. The lungs are clear. Mild pectus excavatum with no acute bony abnormality. Impression: No acute cardiopulmonary process. Transcribed Date and Time: 05/17/2021 13:11:00 Dictated and Signed by: DR. CHEST CTA WITH CONTRAST; 5/17/2021 14:02 GMT+9:00 TECHNIQUE: CT images from the lung apices through the upper abdomen were obtained per standard department protocol with intravenous contrast. COMPARISON: Chest radiograph dated 5/17/2021 FINDINGS: Tubes and lines: None. Pulmonary arteries: There is adequate opacification of the pulmonary arteries to the sub-segmental level. There are no filling defects in the pulmonary arteries to suggest pulmonary embolus. The main pulmonary artery is normal in diameter. Lungs and Airways: The lungs are clear. The central airways are patent. Pleura: There are no pleural effusions. There is no pneumothorax. Heart and Mediastinum: The cardiac chambers are normal. There is no significant pericardial effusion. There is no mediastinal or hilar lymphadenopathy. The visualized thyroid is unremarkable. Upper Abdomen: There are no focal abnormalities in the visualized liver, spleen, pancreas or kidneys. The visualized adrenal glands are normal. Soft tissues: Incidental note is made of bilateral gynecomastia. The soft tissues are otherwise normal. Bones: There are no concerning lytic or blastic osseous lesions. IMPRESSION: No evidence of pulmonary embolism. Transcribed Date and Time: 05/17/2021 13:58:00 Dictated and Signed by: DR. MDM: Pt is stable, with unremarkable CTPA-- PE unlikely. Trop negative with normal EKG-- ACS unlikely. No evidence of pneumonia or pneumothorax. F/u and return precautions discussed. Pt stable for DC.
CDC Split Type:

Write-up: 22y/o AD male c/o Chest Pain since 4am today, Mid-sternal radiates to back. PT states Shivers/chills and anxious. PT is in Quarantine right now recieved J&J vaccine last night at 2300.


VAERS ID: 1352371 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia
SMQs:, Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diflucan, once per week for 10 months.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Penicillin, Macrolides, Goose Down.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Complete loss of smell & taste. No treatment sought. To this date, still no smell or taste.


VAERS ID: 1352375 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Fatigue, Memory impairment, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Persistent Skin discoloration/rash on various parts of body, unable to focus, struggle to remember simple things, persistent fatigue.


VAERS ID: 1353588 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Irritability
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (known_allergies: Shrimp)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562507

Write-up: I''m really weak and grouchy; I''m really weak and grouchy; This is a spontaneous report from a contactable consumer (patient). An 18-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number and expiry date not reported), via an unspecified route of administration in left arm on 17May2021 at 14:00 (at the age of 18-years-old) as 1st dose, single for COVID-19 immunization. Medical history included shrimp allergy. Concomitant medication included Ibuprofen. The patient was vaccinated at Hospital. No other vaccine was given in four weeks. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination has not been tested for COVID-19. The patient reported that he was really weak and grouchy on 17May2021 17:00. The events were reported as non-serious. The patient did not receive any treatment for the events. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1353603 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Body temperature, Headache, Hyperhidrosis, Lymph node pain, Lymphadenopathy, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: NEXIUM; CELEXA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210517; Test Name: Temperature; Result Unstructured Data: Test Result:102 Fahrenheit; Comments: high fever; Test Date: 20210416; Test Name: nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021568186

Write-up: high fever - 102 F; very swollen and painful lymph nodes in left armpit and right but not as bad sweaty feet; very swollen and painful lymph nodes in left armpit and right but not as bad sweaty feet; very swollen and painful lymph nodes in left armpit and right but not as bad sweaty feet; abnormal horrific headache; This is a spontaneous report from a contactable consumer (patient). A 40-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW0179 and expiration date was not reported), via an unspecified route of administration in left arm, on 17May2021 at 14:30 (at the age of 40 years old) as second dose, single for COVID-19 immunization in a Public Health Clinic/Veterans Administration facility. The patient''s medical history was not reported. The patient previously took prochlorperazine maleate (COMPAZINE) and experienced drug allergy. Concomitant medications included esomeprazole sodium (NEXIUM) and celecoxib (CELEXA). Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW0172 and expiration date was not reported), via an unspecified route of administration in left arm, on Apr2021 at 10:30 (at the age of 40 years old) as first dose, single for COVID-19 immunization. The patient was not pregnant at the time of vaccination and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, it was unknown if the patient diagnosed with COVID-19 and post-vaccination, the patient was tested for COVID-19 with nasal swab and the result was negative on 16Apr2021. The patient experienced high fever with a temperature of 102 F, very swollen and painful lymph nodes in left armpit and right but not as bad sweaty feet and abnormal horrific headache on 17May2021 at 14:30. This case was considered as non-serious and no treatment was given to the patient for these events. The outcome of these events was recovering at the time of report.


VAERS ID: 1353617 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Gluten intolerance
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021576192

Write-up: Nausea; vomiting; This is a spontaneous report from a contactable physician. A 14-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0182), dose 1 via an unspecified route of administration on 14May2021 (at the age of 14-years-old ) as first dose, singe for COVID-19 immunization. Medical history included gluten allergy. The patient''s concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks and was not pregnant. The patient experienced nausea and vomiting on 17May2021 11:00. Since the vaccination, patient has not been tested for COVID-19. The events resulted in physician or other healthcare professional office/clinic visit and was treated with oral Ondansetron. Outcome of the events were resolved.


VAERS ID: 1354163 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Unknown  
Location: Wisconsin  
Vaccinated:2021-02-07
Onset:2021-05-17
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test ordered was 2019 NOVEL CORONAVIRUS (SARS-COV-2), specifically SARS-CoV-2 RNA Resp Ql NAA+probe.
CDC Split Type:

Write-up: Positive COVID-19 test after full vaccination. Immunizations given 01/10/2021 and 02/07/2021.


VAERS ID: 1354292 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025CZIA / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Tylenol
Current Illness: No.
Preexisting Conditions: No.
Allergies: Latex, Ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm. Red itchy raised painful patch at sight of injection.


VAERS ID: 1354316 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1354331 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-17
Onset:2021-05-17
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Diarrhoea, Headache, Nausea, Pain, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (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: None
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data: COVID-19 PCR test positive for COVID
CDC Split Type:

Write-up: Patient developed symptoms of diarrhea, nausea, vomiting, headaches on 05/05/2021. Seen in the clinic on 05/12/2021 declined COVID testing. 05/17/2021 reported chills and bodyaches, positive for COVID.


VAERS ID: 1354488 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Headache, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Muscle twitching
SMQs:, Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take several supplements. One daily Women''s Multivitamin, psyllium husk fiber, vitamin E, probiotic, zinc, B-Complex, vitamin D, vitamin A, folic acid, ginger root, ginkgo biloba, selenium, tumeric curcumin. I have been taking these supp
Current Illness: No
Preexisting Conditions: No
Allergies: I have a family history of severe anaphylactic reaction to codeine including death. Synthetic codeine is okay but not real codeine. I am choosing to avoid it. Otherwise no known allergies.
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Mild headache, soreness at site of injection, redness about the size of a quarter at site of injection, swelling at site of injection equivalent to about a quarter of a golf ball sliced long ways , hotness at site of injection, lower back pain, slight muscle twitching in upper arm - all relatively mild.


VAERS ID: 1354585 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: Prescriptions: Metoprolol Tartrate 100 mg 2X day; Lisinopril 40 mg 1X day; Nifedipine Er 60 mg 1X day; Metformin Er 500 mg 1 X day; Omeprazole Dr 40 mg 2X day. Vitamins/Supplements: Fish Oil 700 mg Omega 3 2 ea 1X day; Calcium 600 mg 1
Current Illness: No other illnesses.
Preexisting Conditions: Type 2 diabetes, back pain and knee pain, lymphedema,
Allergies: Statins , have had rash or hives to other drugs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had almost continual muscle twitches on the left side of my abdomen below my chest and to the pelvic region. I am not sure of exact time it began, but a few hours after appointment. This continued regularly on Day 1 and 2, then less on Day 3, and ended on Day 4. I contacted pharmacist on Day 4, who advised me only to contact if it persisted over next few days. I was trying to find out if this could be related to the vaccine.


VAERS ID: 1354669 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-16
Onset:2021-05-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Fibrin D dimer increased, Lymph node pain, Lymphadenopathy, Nausea, Platelet count increased, Pyrexia, Skin warm
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone only birth control pills, 2.5 mg of melatonin nightly, Zyrtec, trazodone
Current Illness:
Preexisting Conditions: Obesity
Allergies: Bees,
Diagnostic Lab Data: D dimer first results were 555 second results were 513 Platelets remained in the normal range
CDC Split Type:

Write-up: Low grade fever for 5 days. Extreme nausea for 24 hours. Diarrhea for 72 hours. 24 hours after the injection the lymph node under my left arm swelled up to about the size of a baseball, it was extremely hot and painful. It stayed that size for 4 days, and then finally started getting a little smaller each day. It''s officially been 10 days and I would say that lymph node is about golf ball sized now. I did see my doctor and she said it can be a normal side effect and as long as it''s going down not to worry. I also was having pain in my back and the doctor suspected a possible pe, my d-dimer test came back positive twice but my platelets remained in the normal range. The second d-dimer was only 513 and considered barely out of range so we assume whatever clot I had dissolved on its own.


VAERS ID: 1354717 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-13
Onset:2021-05-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt reported increased heart rate, pt states she is on a heart rate monitor


VAERS ID: 1354733 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-05-17
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray abnormal, Computerised tomogram, Dyspnoea, Musculoskeletal chest pain, Pneumonia, Pulmonary thrombosis, Pyrexia, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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 (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: omeprazole 40mg, allopurinol 200mg,
Current Illness:
Preexisting Conditions: GOUT GERD
Allergies:
Diagnostic Lab Data: CT Doppler Chest X-ray blood work
CDC Split Type:

Write-up: on 5/17/2021 pt developed a fever, pain in the left side of his ribs and had SOB. He was brought to Hospital ER. Pt had Chest x-ray, blood work, Doppler on both legs, and CT. His DX was pneumonia, blood clot in left lung and bilateral blood clot in legs. He was admitted and stayed for 5 days.


VAERS ID: 1355157 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-01-20
Onset:2021-05-17
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for COVID-19 on 17May21 via nasal swab.
CDC Split Type:

Write-up: Patient received 2nd dose of Pfizer COVID-19 vaccine on 20Jan21 and tested positive for COVID-19 on 17May21 via nasal swab.


VAERS ID: 1355214 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-10
Onset:2021-05-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Attention deficit hyperactivity disorder, Oedema peripheral, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loxapine, quetiapine, vitamin D, Thera-M, albuterol, propranolol, docusate, vitamin b, alendronate, loratadine
Current Illness:
Preexisting Conditions: schizophrenia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had his Covid vaccine 5/10/21 upper left arm, then a week later he presented with puffy left arm. Staff attempted x 2 to assess his left arm. Patient refused both times. Staff observed that patient did have full range of motion with no complaints of pain or discomfort. Appt was set up to assess his left arm edema. Both times patient refused. Dr was made aware that patient still has some edema and that staff was unable to measure related to uncooperative nature of patient. Dr. feels it is an adverse reaction to his Covid-19 (Adenovirus) Vaccine. This is now listed on his Allergy list. Dr feels this edema will resolve itself.


VAERS ID: 1355222 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-25
Onset:2021-05-17
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Inflammation
SMQs:

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: Amoxicillin
Diagnostic Lab Data: Heart inflammation
CDC Split Type:

Write-up: Had extreme heart inflammation for a couple of days.


VAERS ID: 1355257 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: hives all over


VAERS ID: 1355269 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-30
Onset:2021-05-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Nephrolithiasis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 3mm kidney stone confirmed by CT Scan
CDC Split Type:

Write-up: Kidney Stone


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