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

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



Case Details (Reverse Sorted by Onset Date)

This is page 146 out of 6,867

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VAERS ID: 1623371 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

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

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

Write-up: No adverse event. Mixed dose series. Patient had received J & J Covid Vaccine on 3/6/21.


VAERS ID: 1623397 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Electric shock sensation, Insomnia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine: 50mcg every other day. 25mcg every other day Cytomel: 5 micrograms daily
Current Illness: Hashimoto?s Thyroiditis Possible Meniere?s Iron deficiency
Preexisting Conditions: Hashimoto?s Thyroiditis Possible Meniere''s
Allergies: Prednisone
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Have been experiencing insomnia since August 13 along with brain zaps/shivers that keep jolting me awake upon falling asleep. Also experiencing body tremors or vibrations that can be felt by me but are not seen by others. It is still ongoing.


VAERS ID: 1623420 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059EZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Grip strength decreased, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Sexual dysfunction (broad)

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

Write-up: My left hand went numb immediately after the injection. Since then, I have regained feeling, but my hand is weak and my grip strength has weakened. It now hurts to hold things like a hair brush or broom for more than a few seconds.


VAERS ID: 1623432 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-11
Onset:2021-08-13
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia, Skin warm
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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:
Other Medications: lasenoprol, metfarmin, cartia, metropolol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: right hand sore, hot to touch, beginning to tingle, progressed to left hand, hands aching


VAERS ID: 1623437 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Muscle spasms, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Dystonia (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: Synthroid 100 mcg daily
Current Illness: None
Preexisting Conditions: Hashimoto''s
Allergies: Keflex, Cipro, Bactrim, Latex (rash)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports hives, muscle spasms, fatigue, and "brain fog" beginning 8/13/21. Symptoms had not resolved by 8/17/21, so she was seen by her PCP on 8/17/21. Currently on Prednisone (unsure of dosage) and Flexiril prescribed by PCP. Has follow up appointment 8/23/21


VAERS ID: 1623498 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Pain, Postural orthostatic tachycardia syndrome, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I was diagnosed with POTS a week after first dose
CDC Split Type:

Write-up: I was nauseous ,fatigue, bodyaches ,vomiting


VAERS ID: 1623525 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Dizziness, Malaise, Presyncope, Regurgitation, Tinnitus, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Percocet - headache, nausea, vomiting, severe malaise.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient began feeling weak and slight malaise within 45 minutes of receiving the vaccine. The feeling of near faintness, weakness and dizziness progressed. Ringing ears and vomiting followed after. The patient reported feeling unsteady throughout. Water nor food could be consumed without violent regurgitating. Symptoms resolved after approximately 8 hours.


VAERS ID: 1623592 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-08-13
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 AR / IM

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

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

Write-up: COVID POSITIVE


VAERS ID: 1623803 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Computerised tomogram, Dehydration, Diarrhoea, Dizziness, Fatigue, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Dehydration (narrow)

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

Write-up: Blood in stool, diarrhea, dehydration, dizziness, chills, fatigue


VAERS ID: 1623834 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-18
Onset:2021-08-13
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: positive covid test. Minimal symptoms reported.


VAERS ID: 1623942 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK UN / IM

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

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

Write-up: It was determined that the recipient was administered too much Pfizer vaccine in error. Upon the discovery, the recipient was notified and given care instructions by the school''s physician. Upon follow-up the next day by the nurse, recipient complained of nausea, headaches and being tired. Continious monitoring and follow-up will be made on the recipient''s condition and care.


VAERS ID: 1623946 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

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

Write-up: It was determined that the recipient was administered too much Pfizer vaccine in error. Upon the discovery, the recipient was notified and given care instructions by the school''s physician. Upon follow-up the next day by the nurse, recipient complained feeling tired and some swelling in arm. Continoius monitoring and follow-up will be made on the recipient''s condition and care.


VAERS ID: 1624109 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Immediate post-injection reaction, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

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

Write-up: Pt. became light headed immediately after receiving vaccine. Pt reports feeling medicine go through her and immediately becoming lightheaded for just a minute. Vitals reviewed and pt. reports feeling fine a minute later. Pt. dc ''d home after waiting 30 minutes with precautions given.


VAERS ID: 1624254 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-29
Onset:2021-08-13
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / 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: PATIENT WAS GIVEN BOTH DOSES OF COVID-19 PFIZER VACCINE AND TESTED POSITIVE TO COVID ON 8/19/21.


VAERS ID: 1624277 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Acne, Exposure during pregnancy, Pruritus, Rash, Rash erythematous, Rash papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Prenatal vitamins, 4-5x per week.
Current Illness: None
Preexisting Conditions: None
Allergies: Allergies: Latex, amoxicillin, clarithromycin, soybean, sesame, hazelnut, carrots, clams, goats milk, green beans, lima beans.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was 13 weeks pregnant when receiving my dose of J&J Covid vaccine. I informed the facility that I have a history of allergic reactions and they told me I shouldn?t worry, that if it was severe I should go to a hospital. Otherwise, no other advise was given. 2 days following the injection, I developed a rash along a section of my right back, towards the center. As days progressed, the rash got larger. They almost appeared as raised, red bumps. They resembled a cross between a hive and a pimple. I did not change any topical products I use in my household, nor have I changed anything else with my daily events. The rash progressively spread throughout my entire back from top to bottom as well as along my both shoulders and upper arms. I applied a prescription allergy cream which my allergist has prescribed me recently when I went for a routine allergy test this past June. The cream provided some relief in the sense that new marks didn?t appear as often, but the rash has not went away completely and it?s been nearly 2 weeks. Most recently, I developed a patch of severely itchy skin on my right elbow a few days ago. The allergy cream is not providing any relief. It almost appears as a hive patch, but difficult to tell since it?s on the crease of my elbow.


VAERS ID: 1624573 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-08
Onset:2021-08-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrial fibrillation, Blood creatine increased, Blood test abnormal, Cardiac disorder, Cardiac stress test abnormal, Catheterisation cardiac, Echocardiogram, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Contact for list as I cannot make use of the continuation page
Current Illness: NONE
Preexisting Conditions: CAD ;Sleep Apnea; Obese
Allergies: Niacin
Diagnostic Lab Data: See Above.
CDC Split Type:

Write-up: A-fib was in a range from 57 upto130 up and down over 3 days. blood work showed heart distress; Testing = EKG; Echo cardiograhm, Catherization to heart; daily blood work; chemcial stress test which indicated heart distress. The a-fib was under control after 3 1/2 days but blood work showed high creatine for 24 hours after dye from stress test which then normalized Added to Medications for treatment was Xaretto 20 MG 1x; Bisoprolol fumarte 5 MG 2x


VAERS ID: 1624844 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dyspnoea, Peripheral swelling, Pyrexia, Tendon pain, Throat tightness, Vocal cord disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (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: unknown
Preexisting Conditions: arthritis, hypertension
Allergies: none reported on vaccine consent form
Diagnostic Lab Data: unknown. her doctor could provide these.
CDC Split Type:

Write-up: Before receiving the vaccine, the patient was worried she would have a severe reaction, even though she had no reported history of vaccine allergy or reaction. To ease her mind, we observed her for 30 minutes after vaccine administration. She felt fine and went home after the 30 minutes. The patient reports that when she got home her throat closed up, she had trouble breathing, her blood pressure rose to 173, her tendons became sore, her feet swelled up, and she developed a fever. She says she did not call 911 as advised, but rather drank vinegar to help her throat open up. She later called her doctor, who concurred that it was a severe reaction and prescribed a Zpak, steroids, Benadryl, an inhaler, and cough medication. She reports she is still having vocal cord issues and trouble with elevated blood pressure 10 days after vaccination.


VAERS ID: 1627960 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Pruritus, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None.
Allergies: Dairy products, corn, amoxicillin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Burning sensation in back, itching over the body, stabbing feeling in the body.


VAERS ID: 1627987 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Decreased appetite, Fatigue, Feeling cold, Muscular weakness, Myalgia, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Intense fever and chills the night of vaccination. On going fever since that that 8/13. Fever everyday since the date of vaccination as well as intense fatigue, muscle weakness, lack of appetite, sleepiness, pain in back and other muscle aches, chills and cold. It is now 8/24 and I feel worst.


VAERS ID: 1628217 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Other       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: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Latex, Neosporin, Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on earlobes, face , chest and upper arms


VAERS ID: 1628230 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema
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: Synthroid
Current Illness: None
Preexisting Conditions: None
Allergies: Bactrim
Diagnostic Lab Data: Yesterday I had the antibody infusion and then the next day the injection site became red again
CDC Split Type:

Write-up: The injection site has a big red circle around it. It goes away and then comes back, three time so far


VAERS ID: 1628431 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

Write-up: Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild


VAERS ID: 1628466 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-11
Onset:2021-08-13
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 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: Resolution of Symptoms: Covid-19 Vaccine Yes/No: Y Date of last dose: 1/11/21 Notes: No initial incident created. Patient tested positive on 8/13/21. After her isolation period was cleared for 8/23/21. Advised to update mgmt. 8/16/21: Informed that patient tested positive for COVID-19, specimen collected 8/13 (TYPE OF TEST); Patient works as a Pharmacist. Patient was vaccinated on 12/21/20 1/11/21 (Pfizer). Last day of work was 8/13. Patient reported that she had a headache on Saturday. Patient did not have any other symptoms to report at this time. This patient reports that she has not attended any large gatherings and has mainly interacted with close relatives- parents and sibling who do not report any symptoms. Significant other, who is a household contact, became symptomatic on Friday- sore throat, cough and is going to be tested today. He does not work in healthcare. At work, Patient does wear a mask and eye protection for all patient encounters. Patient does not recall being in contact with any COVID+ patients but did work with the recently positive pharmacy student in the department. Patient reports eating alone.


VAERS ID: 1628512 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Fall, Injection site cellulitis, Magnetic resonance imaging, Mental disorder, Nervous system disorder, Pyrexia, Scan with contrast, Skin laceration, Tremor, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Gabapentin, hydrocodone; tramadol; cymbalta; prozac; tizanadi
Current Illness: N/A
Preexisting Conditions: chronic back pain
Allergies: N/A
Diagnostic Lab Data: CT; CT with contrast; MRI; X-ray; blood work
CDC Split Type:

Write-up: Neurological breakdown; extreme tremors; ED visit and hospitalization over 72 hours following vaccine. Tremors caused fall which resulted in facial cuts; neurological event caused inability to identify date and age, fever of 103* and cellulitis at injection site


VAERS ID: 1628562 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Disorientation, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Anxiety, light headedness, disorientation


VAERS ID: 1628632 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-01
Onset:2021-08-13
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/13/2021, COVID-19 (NAA, Liat), DETECTED
CDC Split Type:

Write-up: Vaccine documented as given on 1/1/2021 and 1/22/2021. On 8/13/21 this person presented to the emergency room and was admitted for COVID-19, this event requires VAERS reporting.


VAERS ID: 1628738 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-05
Onset:2021-08-13
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, Cough, Dyspnoea, Intensive care, Oxygen saturation decreased, Polymerase chain reaction positive, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: Dementia, Hypercholesterolemia, Hypertension, History of Cerebral infarction
Allergies: Amlodipine Besylate, Atorvastatin, Crestor, Lipitor, Omeprazole
Diagnostic Lab Data: 8/13/21 SARS-CoV-2 Antigen Positive (Long Term Care Facility) 8/24/21 RT-PCR Positive (Hospital) No other tests or laboratory results were reported.
CDC Split Type:

Write-up: Admission to Hospital on 8/23/21 for cough, decreased oxygen saturation, and acute respiratory failure. Reported by hospital that she has cough, SOB, difficulty breathing. At this time, it is reported that she has not been admitted to the ICU and has not required mechanical ventilation.


VAERS ID: 1629308 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Liver function test, 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:
Current Illness:
Preexisting Conditions: DRESS syndrome
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported getting a rash around the neck area the day after receiving the vaccine. She self treated with a cold compress and cool water. She contacted her prescriber when the rash began to spread to her face, ears and arms. The prescriber gave a script for Prednisone. Prescriber is also doing blood work to check liver function due to Dress Syndrome.


VAERS ID: 1629517 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: A flu vaccine in 2010
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Hashimotos hypothyroidism
Allergies: None.
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Swollen lymph node on collarbone lasting longer than a week with 6/10 pain. Low grade fever lasting one day.


VAERS ID: 1629876 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Extra dose 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine administration error: Pfizer covid-19 vaccine administered to patient was more than 6 hours old. It was drawn up the previous day, and should be considered expired. There is no evidence that the dose was mishandled in any way, but it was not discarded within the appropriate timeframe. Since it was administered approximately 20 hours after the puncture and mixing of the vial, the dose was determined to be expired, and I (as the pharmacist in charge at the time of discovery) determined that the patient should be revaccinated in order to ensure efficacy. The patient was notified of the error as quickly as possible, and asked to return to the pharmacy to receive a replacement dose. The repeat dose dose was administered approximately 7 hours after the expired dose.


VAERS ID: 1629879 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine administration error: Pfizer covid-19 vaccine administered to patient was more than 6 hours old. It was drawn up the previous day, and should be considered expired. There is no evidence that the dose was mishandled in any way, but it was not discarded within the appropriate timeframe. Since it was administered approximately 20 hours after the puncture and mixing of the vial, the dose was determined to be expired, and I (as the pharmacist in charge at the time of discovery) determined that the patient should be revaccinated in order to ensure efficacy. The patient was notified of the error as quickly as possible, and asked to return to the pharmacy to receive a replacement dose. The repeat dose dose was administered approximately 7 hours after the expired dose.


VAERS ID: 1631916 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Injection site pain, Injection site swelling, Oral discomfort, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic migraine; Contrast media allergy (generalized delayed rash); Drug allergy (codeine (suicidal ideation)); Post concussion syndrome; Premature atrial contraction; Tendinitis (around right ankle)
Preexisting Conditions: Medical History/Concurrent Conditions: Topical adhesive allergy (rash)
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001173

Write-up: Tingling lips; Burning lips; Swelling of injection site; Tenderness of injection site; Burning sensation; This spontaneous case was reported by an other health care professional and describes the occurrence of BURNING SENSATION (Burning sensation), PARAESTHESIA ORAL (Tingling lips), ORAL DISCOMFORT (Burning lips), INJECTION SITE SWELLING (Swelling of injection site) and INJECTION SITE PAIN (Tenderness of injection site) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. Concurrent medical conditions included Premature atrial contraction, Post concussion syndrome, Chronic migraine, Tendinitis (around right ankle), Drug allergy (codeine (suicidal ideation)), Topical adhesive allergy (rash) and Contrast media allergy (generalized delayed rash). On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced BURNING SENSATION (Burning sensation), ORAL DISCOMFORT (Burning lips), INJECTION SITE SWELLING (Swelling of injection site) and INJECTION SITE PAIN (Tenderness of injection site). On an unknown date, the patient experienced PARAESTHESIA ORAL (Tingling lips). At the time of the report, BURNING SENSATION (Burning sensation), PARAESTHESIA ORAL (Tingling lips) and ORAL DISCOMFORT (Burning lips) was resolving and INJECTION SITE SWELLING (Swelling of injection site) and INJECTION SITE PAIN (Tenderness of injection site) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1632019 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Fatigue, Headache, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin (AMOXIL) 500 mg capsule apixaban (ELIQUIS) 5 mg tablet atorvastatin (LIPITOR) 20 mg tablet calcium carbonate-vitamin D3 (OYSTER SHELL CALCIUM-VIT D3) 1250 mg (500 mg calcium)-200 unit per tablet coenzyme Q10 200 mg capsule
Current Illness:
Preexisting Conditions: Nervous Pain in joint involving ankle and foot Circulatory Paroxysmal atrial fibrillation Essential hypertension Genitourinary Atrophic vaginitis Musculoskeletal Closed fracture of lateral malleolus Endocrine/Metabolic Hypothyroidism Hyperlipemia Infectious/Inflammatory Herpetic gingivostomatitis Other
Allergies: Erythromycin Shortness of breath / Dyspnea OtherThroat Swelling PravastatinMyalgia / Muscle Pain Codeine Compazine [Prochlorperazine]Other (document details in comments) Crestor [Rosuvastatin]Itching, Insomnia Paxil [Paroxetine Hcl]Itching Sertraline Nausea Only
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: severe headache fever severe diarrhea dizziness fatigue


VAERS ID: 1632022 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-03
Onset:2021-08-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Eye pain, Injection site pain, Photophobia, Swelling, Uveitis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Ocular infections (broad), Hypersensitivity (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? 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: uveitis-Severe, Additional Details: Patient has uveitis of the eye and still experiencing swelling and redness as of today. vaccinated 8/3/21, symptoms started 8/13, pain in eye, light sensitivity and redness, diagnoses by opthamologist


VAERS ID: 1632191 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-08-13
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L201 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Cough, Dyspnoea, Fatigue, Headache, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: NONE
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR = Positive on 8/16/21
CDC Split Type:

Write-up: Upon disease investigation of 8/21/21 case reported symptom onset of 8/13/21 which included runny nose, headache, fatigue, cough, shortness of breath, chest pain and congestion.


VAERS ID: 1632224 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-15
Onset:2021-08-13
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E13248, EL9267 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Hypertension, DM, RA, COPD, Depression.
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, SOB for the last week., hospitalization.


VAERS ID: 1632289 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-11
Onset:2021-08-13
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam (XANAX) buspirone (BUSPAR) Fluoxetine (PROzac) valacyclovir (VALTREX)
Current Illness:
Preexisting Conditions: Musculoskeletal Onychomycosis Infectious/Inflammatory HSV-2 infection Other Moderate episode of recurrent major depressive disorder (CMS/HCC) Atypical mole Situational anxiety
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: sore throat congestion cough


VAERS ID: 1632292 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049EZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthropod bite, Burning sensation, Dysgeusia, Injected limb mobility decreased, Pain in extremity, Urine odour abnormal
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Left arm extremely sore very hard to lift, (which I know is common), strong iron smell in urine , metal taste,( lasted a few hours) and now mosquitos are biting me. I never got bit by mosquitos and now they bite me and I don''t feel it until later when the bite marks start burning.


VAERS ID: 1632376 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Tic, Tourette's disorder
SMQs:, Congenital, familial and genetic disorders (narrow), Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: had half a kidney removed
Allergies: peanuts, fish, beans
Diagnostic Lab Data: Trying to get help now.
CDC Split Type:

Write-up: Severe Tics resembling Tourettes. He 10-30 tics per minute. He did not have these symptoms at all before the vaccine.


VAERS ID: 1632454 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-14
Onset:2021-08-13
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 2042 KERN ST, / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fall, Gait inability, Loss of personal independence in daily activities, Mobility decreased, Neurological symptom
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg, vitamin C 500mg, folic acid 400mcg, mulivitamin, nitroglycerin 0.4mg, potassium chloride 10mEq, vitamin D3 50mcg (2,000 unit)
Current Illness: CAD, dental caries, hearing loss, refractive error, vitamin D deficiency, hypokalemia, folic acid deficiency
Preexisting Conditions: CAD, cognitive impairment, Hx CVA
Allergies: NKA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Per mom, the affected individual received a second dose of the covid vaccine on 8/13/2021 . On 8/21/2021, mom said the individual was unable to get up, walk, or do his normal activities of daily living. He fell three times within one night, at 8pm, 9pm, and 2am. He had to be bathe and taken care of by the family. Per mom, they called the ambulance and paramedics advised them not to take him to the hospital due to having signs and symptoms of a minor stroke only. Therefore, the individual was not taken to the hospital and instead, taken to city where his wife and sons reside.


VAERS ID: 1632463 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-03
Onset:2021-08-13
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Respiratory tract congestion, 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: aspirin 81 mg tablet sildenafiL (VIAGRA) 50 mg tablet
Current Illness:
Preexisting Conditions: Respiratory Seasonal allergic rhinitis due to pollen Coin lesion of lung Panlobular emphysema (CMS/HCC) Digestive Adenomatous polyp of colon Genitourinary Enlarged prostate without lower urinary tract symptoms (luts) Nodular prostate Endocrine/Metabolic Glucose intolerance (impaired glucose tolerance) Other Living will in place Erectile dysfunction Elevated BP without diagnosis of hypertension
Allergies: NKA
Diagnostic Lab Data: 08/21/21 1658 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/21/21 0722 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/21/21 1658 COVID-19 PCR Collected: 08/21/21 0722 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: exposed to a COVID congestion


VAERS ID: 1632469 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-03
Onset:2021-08-13
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine (SYNTHROID) 50 mcg tablet triamcinolone (KENALOG) 0.5 % ointment
Current Illness:
Preexisting Conditions: Nervous Benign neoplasm of pituitary gland (CMS/HCC) Digestive Diverticulosis of colon Musculoskeletal CMC arthritis Endocrine/Metabolic Acquired hypothyroidism Mixed hyperlipidemia Other Screening mammogram, encounter for Encounter for Medicare annual wellness exam Need for influenza vaccination Status post transsphenoidal pituitary resection (CMS/HCC) Elevated blood pressure reading in office without diagnosis of hypertension
Allergies: LatexOther (document details in comments) PenicillinsOther (document details in comments)
Diagnostic Lab Data: Updated Procedure 08/21/21 1658 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/21/21 0732 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/21/21 1658 COVID-19 PCR Collected: 08/21/21 0732 | Final result | Specimen: Swab from Nares
CDC Split Type:

Write-up: close exposure to COVID-19 virus ASYMPTOMATIC


VAERS ID: 1632592 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-08-13
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / UNK - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / UNK - / IM

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

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

Write-up: Developed Covid 8/13/21


VAERS ID: 1632608 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-01-12
Onset:2021-08-13
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive COVID 19 Antigen test on 8/15/2021 Positive COVID 19 PCR on 8/16/2021
CDC Split Type:

Write-up: Symptomatic on 8/14/2021, Positive COVID 19 antigen test on 8/15/2021


VAERS ID: 1632685 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-08-13
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray normal, Chest discomfort, Computerised tomogram normal, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Feeling abnormal, Gastric disorder, Headache, Hyperventilation, Pain in extremity, Respiration abnormal, Tinnitus, Vision blurred, Visual field defect
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C , multi vitamins, adderall, sodium, potassium, sage drops and vitamin, tramadol as needed and collagen
Current Illness: None
Preexisting Conditions: Left food pain, arthritis in left foot and hands, hypertension, hyperhydrosis
Allergies: None
Diagnostic Lab Data: EKG, chest X-ray, cat scan
CDC Split Type:

Write-up: 61 yr old female I took the Moderna vaccine July 28th and day 1 sore arm. Day 2 sore arm extremely tired. Day 3 still had sore arm and a few dizzy spells. Fast froward to day 13 woke up extremely dizzy. I?d get up to walk I would feel very faint. Black spot would start at my peripheral vision and move inward. Then I couldn?t catch my breath chest felt tight and my vision seem to go out of focus. Oh and I had this wom wom wom feeling in my head and sounds of crickets. I went to urgent care and heart and lungs okay. They gave me anti dizzy meds. This lasted four days on the fifth day only 3 dizzy spells but still taking meds. Still tired and weak and breathing heavy even though my O2 is at 99%. Can?t wait to get back to myself. Now it?s day 9 all problems back also with gastric problem. Day 13 of dizziness and hyperventilating and all the other symptoms someone said to talk Benadryl at this point I would try anything. Within 18 hours my hyperventilating and dizziness went away. I still have headache and fatigue hopefully they will go away soon. None of the healthcare providers would believe me. I went on a lot of forums about side effects. I printed out about a hundred comments but there are thousands. Unfortunately no one believes us. You are the CDC an agency made to look after us the people. Please look into mine and others like me. Maybe if we knew that we b were. Having an allergic reaction to the vaccine I wouldn?t have suffered so long and now wondering if there will be long term problems in fact I had three dizzy spells today August 25, 2021 but no heavy breathing.if they continue how am I supposed to drive and all the other activities I do?


VAERS ID: 1632739 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Heart rate decreased, Sensation of foreign body, Throat irritation
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Hydrochlorothiazide 12.5mg; Arnuity Ellipta POW 200 mcg; Albuterol inhaler 90 mcg;
Current Illness: None
Preexisting Conditions: Asthma, Chronic Anemia, Boarderline Hypertension
Allergies: Sulfa allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchy/ scratching of the throat; lump/restricting of airway in the throat, heart rate dropping.


VAERS ID: 1632793 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-14
Onset:2021-08-13
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Endotracheal intubation, Intensive care, Interstitial lung disease, Lung opacity, SARS-CoV-2 test positive, Sedation
SMQs:, Angioedema (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydrochlorothiazide, aspirin 81mg, carvedilol, Lasix, trulicity, lopid, hydrodiuril, levothyroxine, lisinopril, anaprox, niacin
Current Illness: Hypotension, ARDS, AKI, Hyperkalemia
Preexisting Conditions: HTN, OSA, DM2, OA, HLD, Obesity
Allergies: Atorvastatin, Ibuprofen, Vancomycin
Diagnostic Lab Data: COVID PCR Positive 8/11/21 Chest X-ray 8/22/21- Patchy peripheral interstitial and airspace opacities scattered throughout the bilateral lungs, compatible with COVID 19 pneumonia
CDC Split Type:

Write-up: Pt. transferred to reporting hospital received second dose of Moderna COVID-19 on 4/14/21. Pt was admitted to reporting hospital on 8/22/21 with an admitting diagnosis of Worsening ARDS 2/2 COVID. Pt arrived intubated and sedated. Patient has been in outside hospital ICU since 8/13/21 with COVID pneumonia and has been intubated since 8/15/21.


VAERS ID: 1632850 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Abdominal discomfort, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 1000 mg 2 times a day Linisipril 20 mg paraxitine 20 mg before work
Current Illness: None
Preexisting Conditions: Dietbetes2
Allergies: Just latex skin irrations
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Stomach is not feeling right feeling nauseous


VAERS ID: 1632882 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-22
Onset:2021-08-13
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stoke like symptoms per the EUA we have to report when the patient is admitted to hospital after vaccination. The patient was COVID-19 positive


VAERS ID: 1632893 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-02
Onset:2021-08-13
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: per the EUA we have to report when the patient is admitted to hospital after vaccination. The patient was COVID-19 positive on 7/31/21


VAERS ID: 1632907 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-08-13
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 RA / IM

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

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

Write-up: per the EUA we have to report when the patient is admitted to hospital after vaccination. The patient was COVID-19 positive ON 8/12/21


VAERS ID: 1633041 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Heart rate increased, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fosinopril 20mg Sertraline 50mg
Current Illness: High blood pressure Obesity
Preexisting Conditions: High blood pressure Obesity
Allergies: Relenza - inhalant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, body aches, fever of 99.5, pounding heart, fast heart rate.


VAERS ID: 1633090 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

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

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

Write-up: Hives and itching worse after time


VAERS ID: 1633328 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Headache, Peripheral swelling, Urticaria, Vision blurred
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Codeine, Rose Hips
Diagnostic Lab Data:
CDC Split Type:

Write-up: Head ache, severe chest pain, hives, swollen feet, blurred vision.


VAERS ID: 1633784 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Alabama  
Vaccinated:2020-12-14
Onset:2021-08-13
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, famotidine
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: PCR positive
CDC Split Type:

Write-up: Breakthrough infection


VAERS ID: 1633790 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: spironolactone 100mg, Allopurinol 100mg, Metformin 1000mg, levothyroxine 100 mcg, Calcium Citrate, Vitamin D3, Multivitamin with minerals tablet
Current Illness: Knee replacement Oct 2020- still having pain post replacement with swelling and inflammation. The physician removed some fluid from the knee and sent it in to see if there is an infection. On Aug 12 he said there is no infection - I may have other issues like rheumatoid arthritis and he might need to remove the synovial fluid or synovium around the knee joint - So when he said I did not have an infection I went and got the vaccine as it is being mandated and I don''t want to lose my job. I also have thyroid issue, I have gout issues,, I have PCOS, I am borderline diabetic and I have gout
Preexisting Conditions: PCOS, Gout, Thyroid, boderline diabetic, osteoarthritis
Allergies: Black Pepper, Red Snapper - Dairy must be Lactose Free, Amoxicillin, Cephalexin, Nystatin, Naproxen, Nickel, Clindamycin, Latex
Diagnostic Lab Data: I am seeing employee health nurse practitioner tomorrow. The orthopedic doctor is going to run a complete rhuematoid panel to see if I have this.
CDC Split Type:

Write-up: I developed a rash under my chin and noticed it the next morning when I went to work - Friday Aug 13, 2021. I felt sick all weekend and noticed this rash was now going into my ear and on Sunday it was very painful - somewhat itchy, but very painful. Noticed it on my right side of face. I called my doctor Monday morning immediately and they wanted me to come into the office. She stated the rash looked like shingles and started me on valacyclovir 1000mg tablet and hydrocortisone cream 2.5 % cream. The rash finally went down towards the end of the week -friday, Saturday. I did notice a couple little spots show up on my right arm on Friday - but not sure it was related. My doctor said if it was to get worse to go to Urgent Care. I did also speak to a doctor from employee health today from the hospital and he said that my primary care doctor needs to send in a form stating I had an adverse reaction from the vaccination. My doctor is on a leave of absence right now so I am scheduled to see the Nurse Practitioner from Employee Health tomorrow - Aug 26. I figured this should be reported as I read an article from April 21, 2021 and the title was "Rash Horror Shingles could be new but rare side effect of Covid vaccine, docs discover."


VAERS ID: 1634221 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Computerised tomogram head, Feeling abnormal, Full blood count normal, Headache, International normalised ratio, Laboratory test
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Head Ct, normal CBC, chemistry, pt/PTT/INR?need to get copies of lab results from medical records?
CDC Split Type:

Write-up: On 08/11/21 at approx 10 pm patient started having a 104.0 temp. Thursday and Friday . Friday night 08/13/21 he started feeling what he describes as ?brain fog?. Patient continues to complain of ?brain fog,? and ?I feel like my head is in the clouds,? that has not resolved since receiving his second covid vaccine dose. Was having headaches shortly after for a few days and I took him to the emergency department on 08/192021. He had a brain CT and had basic labs drawn. We doctor dc?d him home with a diagnosis of headache, and told us to follow up with his pediatrician. We are waiting to schedule that appointment this week. The ?brain fog,? has not gone away since 08/13/2021?


VAERS ID: 1636116 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-08
Onset:2021-08-13
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler fexofenadine (ALLEGRA) 180 mg tablet HEATHER 0.35 mg tablet multivitamin-minerals (THERAGRAN M) 9 mg iron-400 mcg tablet SPRINTEC, 28, 0.25-35 mg-mcg per tablet
Current Illness:
Preexisting Conditions: Respiratory Asthma Other Seasonal allergies
Allergies: Contrast [Iodinated Contrast Media]Hives / Urticaria ClarithromycinDizziness / Lightheaded, Nausea and Vomiting Oxycodone-acetaminophenNausea Only
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Headaches Sore throat


VAERS ID: 1636484 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-08-13
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026821A / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Dialysis, Dyspnoea, Hypotension, Intensive care, Oxygen saturation abnormal, SARS-CoV-2 test positive
SMQs:, Acute renal failure (narrow), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, allopurinol, aspirin, clopidogrel, ezetimibefluticasone-umeclidin-vilant inhaler, multivitamin, insulin glargine, insulin regular, lactobacillus, levothyroxine, lutein, magnesium oxide, pantoprazole, pramipexole, predniso
Current Illness:
Preexisting Conditions: Afib, ESRD, Heart failure with reduced ejection fraction, COPD, OSA, pulmonary hypertension, non alcoholic steatohepatitis cirrhosis, DM type 2, CLL with hypogammaglobulinemia.
Allergies: Iodinated diagnostic agents, magnesium hydroxide, NSAIDS, Sodium Phosphate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received both doses of the Moderna COVID-19 vaccine (on 3/5/2021 and 4/1/2021). Tested positive for COVID on 8/13/2021 Admitted to an outside hospital around 8/17/2021 with cough and shortness of breath, hypotension during dialysis. Found to have COVID pneumonia in that ER. Transferred to another Hospital on 8/20/2021 due to worsening oxygenation, afib, and RVR. Currently in ICU.


VAERS ID: 1636752 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-25
Onset:2021-08-13
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: I26.99 - Pulmonary embolism.


VAERS ID: 1636772 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-26
Onset:2021-08-13
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Amphetamines negative, Anion gap, Aspartate aminotransferase normal, Ataxia, Barbiturates negative, Basophil count decreased, Basophil percentage, Benzodiazepine drug level, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood cannabinoids, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone decreased, Blood urea normal, Blood urine absent, C-reactive protein normal, Carbon dioxide normal, Computerised tomogram head normal, Cytomegalovirus test negative, Dizziness, Drug screen negative, Dysmetria, Enterovirus test negative, Eosinophil count decreased, Eosinophil percentage, Epstein-Barr virus test, Full blood count normal, Gait disturbance, Glomerular filtration rate, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Head discomfort, Herpes simplex test negative, Human herpes virus 6 serology negative, Immunoglobulin therapy, Influenza virus test negative, Lumbar puncture, Lymphocyte count, Lymphocyte percentage, Magnetic resonance imaging head normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Metabolic function test, Metabolic function test normal, Methaemoglobin urine absent, Monocyte count decreased, Monocyte percentage, Neisseria test, Neurological examination normal, Neutrophil count, Neutrophil percentage, Nitrite urine absent, Platelet count normal, Protein total normal, Protein urine absent, Red blood cell count increased, Red blood cell sedimentation rate normal, Red cell distribution width, SARS-CoV-2 test negative, Specific gravity urine normal, Speech disorder, Streptococcus test negative, Urine analysis normal, Urine ketone body absent, Urine leukocyte esterase, Varicella zoster virus infection, Viral infection, Vitamin B12 increased, Vitamin D decreased, Weight decreased, White blood cell count decreased, pH urine
SMQs:, Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: He had an acute diarrheal illness from 8/11-8/13 with no associated fever, vomiting, or nausea.
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: CT head (8/18/2021) - negative for intracranial pathology 8/18/2021 5:57 PM - CBC Component Value Flag Ref Range Units Status Lab Hemoglobin 15.1 13.3 - 16.9 g/dL Final HNL1 Hematocrit 43.1 38.0 - 47.0 % Final HNL1 WBC 4.7 3.8 - 10.4 thou/cmm Final HNL1 RBC 5.21 4.30 - 5.70 mill/cmm Final HNL1 Platelet Count 164 139 - 320 thou/cmm Final HNL1 MPV 9.0 7.5 - 11.3 fL Final HNL1 MCV 83 83 - 98 fL Final HNL1 MCH 29.0 26.3 - 31.7 pg Final HNL1 MCHC 35.1 32.5 - 35.2 g/dL Final HNL1 RDW 13.0 11.4 - 13.5 % Final HNL1 Differential Type AUTO Final HNL1 Absolute Neutrophils 3.0 1.4 - 6.1 thou/cmm Final HNL1 Absolute Lymphocytes 1.1 1.0 - 3.2 thou/cmm Final HNL1 Absolute Monocytes 0.4 0.2 - 0.8 thou/cmm Final HNL1 Absolute Eosinophils 0.2 0.1 - 0.2 thou/cmm Final HNL1 Absolute Basophils 0.0 0.0 - 0.1 thou/cmm Final HNL1 Neutrophils 63 % Final HNL1 Lymphocytes 24 % Final HNL1 Monocytes 8 % Final HNL1 Eosinophils 4 % Final HNL1 Basophils 1 % Final HNL1 8/18/2021 6:12 PM - CMP Component Value Flag Ref Range Units Status Lab Glucose 121 High 70 - 100 mg/dL Final HNL10 BUN 12 7 - 25 mg/dL Final HNL10 Creatinine 0.95 0.70 - 1.30 mg/dL Final HNL10 Sodium 138 136 - 145 mmol/L Final HNL10 Potassium 4.5 3.5 - 5.1 mmol/L Final HNL10 Chloride 102 100 - 108 mmol/L Final HNL10 Carbon Dioxide 29 21 - 31 mmol/L Final HNL10 Calcium 9.9 8.6 - 10.2 mg/dL Final HNL10 Alkaline Phosphatase 137 High 34 - 104 U/L Final HNL10 Albumin 4.8 3.5 - 5.7 g/dL Final HNL10 Bilirubin, Total 0.7 0.2 - 1.1 mg/dL Final HNL10 Protein, Total 7.7 6.4 - 8.9 g/dL Final HNL10 AST 12 Low 13 - 39 U/L Final HNL10 ALT 7 7 - 52 U/L Final HNL10 Anion Gap 7 4 - 18 Final HNL10 eGFR, Final HNL10 Not performed on patients less than 18 years of age or greater than 97 years of age eGFR, Final HNL10 Not performed on patients less than 18 years of age or greater than 97 years of age eGFR Comment Not applicable Final HNL10 8/18/2021 6:12 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Magnesium 2.1 1.6 - 2.3 mg/dL Final HNL10 8/19/2021 5:09 AM - Interface, Lab Medicine Results In Specimen Information: Nasopharynx (LAB); Separate Accession Component Value Flag Ref Range Units Status Lab SARS Coronavirus 2 PCR Not Detected Not Detected Final HNL1 8/18/2021 6:38 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Specific Gravity, Urine 1.020 1.003 - 1.030 Final HNL10 pH, Urine 6 4.5 - 8.0 Final HNL10 Protein, Urine Negative Negative mg/dL Final HNL10 Glucose, Urine Negative Negative mg/dL Final HNL10 Ketone, Urine Negative Negative mg/dL Final HNL10 Blood, Urine Negative Negative mg/dL Final HNL10 Leukocytes Esterase Negative Negative /uL Final HNL10 Nitrite, Urine Negative Negative Final HNL10 Comment SEE NOTES Final HNL10 Comment: Microscopic analysis not performed on urine with negative contributing biochemical results for Protein, Blood, Leukocyte Esterase, or Nitrates. 8/18/2021 6:50 PM - Interface, Lab Medicine Results In Component Lab Amphetamines, Urine HNL10 Negative Comment: Detection limit: 500 ng/mL Cannabinoids, Urine HNL10 Negative Comment: Detection limit: 50 ng/mL Cocaine, Urine HNL10 Negative Comment: Detection limit: 150 ng/mL Opiates, Urine HNL10 Negative Comment: Detection limit: 300 ng/mL Phencyclidine, Urine HNL10 Negative Comment: Detection limit: 25 ng/mL Barbiturates, Urine HNL10 Negative Comment: Detection limit: 200 ng/mL Benzodiazepine, Urine HNL10 Negative Comment: Detection limit: 200 ng/mL Methadone, Urine HNL10 Negative Comment: Detection limit: 300 ng/mL Oxycodone, Urine HNL10 Negative Comment: Detection limit: 100 ng/mL 8/23/2021 1:36 AM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Hemoglobin 14.6 13.3 - 16.9 g/dL Final HNL10 Hematocrit 42.7 38.0 - 47.0 % Final HNL10 WBC 6.3 3.8 - 10.4 thou/cmm Final HNL10 RBC 5.11 4.30 - 5.70 mill/cmm Final HNL10 Platelet Count 193 139 - 320 thou/cmm Final HNL10 MPV 9.4 7.5 - 11.3 fL Final HNL10 MCV 84 83 - 98 fL Final HNL10 MCH 28.5 26.3 - 31.7 pg Final HNL10 MCHC 34.2 32.5 - 35.2 g/dL Final HNL10 RDW 13.1 11.4 - 13.5 % Final HNL10 Differential Type AUTO Final HNL10 Absolute Neutrophils 3.2 1.4 - 6.1 thou/cmm Final HNL10 Absolute Lymphocytes 2.3 1.0 - 3.2 thou/cmm Final HNL10 Absolute Monocytes 0.3 0.2 - 0.8 thou/cmm Final HNL10 Absolute Eosinophils 0.4 High 0.1 - 0.2 thou/cmm Final HNL10 Absolute Basophils 0.0 0.0 - 0.1 thou/cmm Final HNL10 Neutrophils 51 % Final HNL10 Lymphocytes 37 % Final HNL10 Monocytes 5 % Final HNL10 Eosinophils 6 % Final HNL10 Basophils 1 % Final HNL10 8/23/2021 1:55 AM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Glucose 98 70 - 100 mg/dL Final HNL10 BUN 15 7 - 25 mg/dL Final HNL10 Creatinine 0.96 0.70 - 1.30 mg/dL Final HNL10 Sodium 138 136 - 145 mmol/L Final HNL10 Potassium 4.0 3.5 - 5.1 mmol/L Final HNL10 Chloride 102 100 - 108 mmol/L Final HNL10 Carbon Dioxide 29 21 - 31 mmol/L Final HNL10 Calcium 9.6 8.6 - 10.2 mg/dL Final HNL10 Alkaline Phosphatase 137 High 34 - 104 U/L Final HNL10 Albumin 4.6 3.5 - 5.7 g/dL Final HNL10 Bilirubin, Total 0.5 0.2 - 1.1 mg/dL Final HNL10 Protein, Total 7.5 6.4 - 8.9 g/dL Final HNL10 AST 10 Low 13 - 39 U/L Final HNL10 ALT 7 7 - 52 U/L Final HNL10 Anion Gap 7 4 - 18 Final HNL10 eGFR, Final HNL10 Not performed on patients less than 18 years of age or greater than 97 years of age eGFR, Final HNL10 Not performed on patients less than 18 years of age or greater than 97 years of age eGFR Comment Not applicable Final HNL10 8/23/2021 1:44 AM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Sed Rate 2 0 - 15 mm/hr Final HNL10 8/23/2021 9:40 AM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab C-Reactive Protein <3.0 <7.0 mg/L Final HNL1 8/24/2021 11:09 AM - Interface, Lab Medicine Results In Specimen Information: Serum (LAB); Blood Component Value Flag Ref Range Units Status Lab Lyme Ab (IgG + IgM) 0.67 <0.91 Index Final HNL1 Comment: ELISA screen negative for total (IgG+IgM) antibodies to Borrelia burgdorferi, the causative agent of Lyme disease. Lyme IgM Ab 0.44 <0.91 Index Final HNL1 Comment: ELISA screen negative for IgM antibodies to Borrelia burgdorferi, the causative agent of Lyme disease. No evidence of acute Lyme disease at this time. Comment SEE NOTES Final HNL1 Comment: Reference Range Negative <0.91 Indeterminate/Equivocal 0.91-1.09 Positive $g1.10 MRI /MRA/MRV brain (8/23/2021) - non-diagnostic due to artifact from patient''s braces Dental consult (8/24/2021) - inpatient brace removal MRI brain/C-spine/T-spine/L-spine (8/24/2021) - negative for pathology Lumbar puncture of spine (8/25/2021) 8/25/2021 3:24 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Glucose, CSF 59 40 - 70 mg/dL Final HNL2 Testing Performed By Lab - Abbreviation Name Director Address Valid Date Range 210036619-HNL2 (HNL2) MD 08/19/19 1828-Present 8/25/2021 3:24 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Protein, Total, CSF 42 15 - 45 mg/dL Final HNL2 8/26/2021 11:44 AM - Interface, Lab Medicine Results In Specimen Information: CSF, cerebrospinal fluid (LAB, NGYN) Component Lab Special Requests HNL1 NONE Direct Exam HNL1 No Neutrophils noted Direct Exam HNL1 No organisms observed Culture Results HNL1 NO GROWTH <24 HOURS 8/25/2021 3:21 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Tube Counted 3 Final HNL2 Volume, Tube Counted 2.0 mL Final HNL2 Appear Pre-Centrifugation Clear Final HNL2 Color Pre-Centrifugation Colorless Final HNL2 Color Post-Centrifugation Final HNL2 Supernatent is colorless RBC 41 High 0 - 5 /cmm Final HNL2 WBC 0 0 - 7 /cmm Final HNL2 Neutrophils 0 - 2 % Final HNL2 Test cancelled: test not warranted. Lymphocytes 63 - 99 % Final HNL2 Test cancelled: test not warranted. Monocytes 3 - 37 % Final HNL2 Test cancelled: test not warranted. Other Cells % Final HNL2 Test cancelled: test not warranted. Reactive Lymphocytes % Final HNL2 Test cancelled: test not warranted. Histiocytes % Final HNL2 Test cancelled: test not warranted. 8/25/2021 6:24 PM - Interface, Lab Medicine Results In Specimen Information: CSF, cerebrospinal fluid (LAB, NGYN) Component Value Flag Ref Range Units Status Lab E. coli K1 Not Detected Not Detected Final HNL1 H. influenzae Not Detected Not Detected Final HNL1 L. monocytogenes Not Detected Not Detected Final HNL1 N. meningitidis Not Detected Not Detected Final HNL1 S. agalactiae Not Detected Not Detected Final HNL1 S. pneumoniae Not Detected Not Detected Final HNL1 Cytomegalovirus Not Detected Not Detected Final HNL1 Enterovirus Not Detected Not Detected Final HNL1 H. simplex 1 Not Detected Not Detected Final HNL1 H. simplex 2 Not Detected Not Detected Final HNL1 Herpes virus 6 Not Detected Not Detected Final HNL1 Parechovirus Not Detected Not Detected Final HNL1 V. zoster Not Detected Not Detected Final HNL1 C. neoformans/gattii Not Detected Not Detected Final HNL1 8/26/2021 1:04 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Antinuclear Abs Absent Absent Final HNL1 Comment: 8/25/2021 8:25 PM - Interface, Lab Medicine Results In Specimen Information: Serum (LAB); Blood Component Value Flag Ref Range Units Status Lab EBV VCA IgM Ab <10.0 <36.0 U/mL Final HNL1 Comment: Interpretation Negative <36.0 Equivocal 36.0-43.9 Positive $g43.9 EBV VCA IgG Ab 42.8 High <18.0 U/mL Final HNL1 Comment: Interpretation Negative <18.0 Equivocal 18.0-21.9 Positive $g21.9 EBV EA Ab <5.0 <9.0 U/mL Final HNL1 Comment: Interpretation Negative <9.0 Equivocal 9.0-10.9 Positive $g10.9 EBV EBNA Ab 7.8 <18.0 U/mL Final HNL1 Comment: Interpretation Negative <18.0 Equivocal 18.0-21.9 Positive $g21.9 Interpretation SEE NOTES Final HNL1 Comment: Serological results compatible with recent EBV infection. 8/25/2021 6:03 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Vitamin B12 1,044 $g211 pg/mL Final HNL1 8/25/2021 5:06 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Thyroid Stimulating Hormone 1.17 0.46 - 3.98 uIU/mL Final HNL1 8/26/2021 12:39 PM - Interface, Lab Medicine Results In Component Value Flag Ref Range Units Status Lab Vitamin D, 25-OH 24 Low 30 - 100 ng/mL Final HNL1 Comment: Interpretive information: Total Vitamin D, 25-Hydroxy This assay quantifies the sum of vitamin D3, 25-hydroxy and vitamin D2, 25-hydroxy. <10 ng/mL Deficiency 10-30 ng/mL Insufficiency 30-100 ng/mL Sufficiency $g100 ng/mL Toxicity Added on CSF EBV PCR
CDC Split Type:

Write-up: Patient is a 15 yo M with no significant past medical history who presented with a two week history of worsening ataxia associated with "heaviness" of the head and 15 lb weight loss. Symptoms started on 8/13. Patient received pfizer COVID19 vaccine on 7/26/2021 and 8/16/2021. Initially presented to OSH ED on 8/18 for symptoms where a workup was negative including CBC, CMP, Magnesium, UA, COVID, UDS. CT Head showed no mass effect, hemorrhage or infarction. Was diagnosed with Viral Syndrome and discharged. Two days later (8/20/2021) instability while walking continued as patient could hardly walk. Yesterday evening continued ataxic gait with lightheadedness only on ambulation. No fevers, chills, chest pain, shortness of breath, abdominal pain, nausea, vomiting, vertigo. Of note father states that speech has changed in terms of fluency. Went back to ER on 8/23/2021 where CBC, CMP, ESR, CRP were all negative. Transferred to hospital for further evaluation and workup. In the hospital he has had unchanged ataxia, workup has been negative thus far. Has normal neurologic exam other than dysmetria on finger-to-nose testing, heel-to shin. Has ataxia falling to left side. Still hospitalized but starting on IVIG empirically.


VAERS ID: 1636780 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Hypotension, Paraesthesia, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR, age 24, recovered after 6 months
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Acetamenophine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 10 minutes, dizziness, low blood pressure, tingling in both arms Within 24 hours, tingling intensified in left arm, numbness from elbow to finger tips Within 72 hours, tingling in right arm and tongue Issue not resolved, follow up planned with primary and neurology care


VAERS ID: 1636877 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Mild facial swelling, rash on chest/face and weakness


VAERS ID: 1636980 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Dizziness, Headache, Paranoia, Psychotic disorder, Suicidal ideation
SMQs:, Suicide/self-injury (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (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: flue vaccine about 8 yrs ago - very sick immediately follwinng.
Other Medications: no prescriptions. herbs - glutathione, vit c, antihistamine (diphendydramine), hawthorne berry and leaves, Yarrow leaves, bromelain and Quercitin
Current Illness: I have had lingering reactions to Lyme disease for last 5 years
Preexisting Conditions: Lyme
Allergies: none except nickel
Diagnostic Lab Data: none. I will see my doctor on 9/8/21 for a checkup, so I am waiting until then.
CDC Split Type:

Write-up: headache, dizziness, confusion, forgetfullness and increasing paranoia. The parahnoia increased over the following several days to almost psychotic ideations (that i was the chosen savior), fears of dying, visions of the world ending, and extreme suicidal ideation. I myself am a psychotherapist so I forced myself to do meditations, talk to colleagues and attempt to calm myself. The paranoia has subsided today (8-26-21). although dull headache continues, with some memory problems.


VAERS ID: 1637040 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-08
Onset:2021-08-13
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/11/21 2nd dose02/08/21 Diagnosed covid positive:08/17/21 Symptom onset:08/13/21 Exposure: Symptoms:oss of smell/taste, runny nose,


VAERS ID: 1637207 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-08-13
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Headache, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:08/20/21 Symptom onset:08/13/21 Exposure: Symptoms:SOB,fatigue,COUGH, loss of smell/taste, runny nose,HA


VAERS ID: 1637403 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Headache, Pain of skin, Rash, Rash erythematous, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: reports hx of flu shot (containing thimerosal) reactions and tetanus reactions
Other Medications: vitamin D thyroid compounded medication progestin injections
Current Illness:
Preexisting Conditions: previous endometrial cancer hypothyroid
Allergies: thimerosal tetanus
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt presented to clinic for visit in 8/26/2021. reports multiple symptoms developed on the day after the vaccination and have persisted since: persistent fatigue, headaches and lower back and bilateral hip pain. pt reports 6 days post vaccination she developed an erythematous, vesicular tender rash below right axilla and to right breast, which has increased in size and spread.


VAERS ID: 1638042 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, CSF volume increased, Condition aggravated, Dizziness, Head discomfort, Idiopathic intracranial hypertension, Impaired work ability, Lymphadenopathy, Nervous system disorder, Ocular discomfort
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin c, vitamin d, diamox , statin
Current Illness: none
Preexisting Conditions: been in remmision for 4 years from psuedo tumor cerebri
Allergies: none
Diagnostic Lab Data: Getting an Mri next week, checking eyes for optic nerve swelling, lymph nodes in neck are severely swollen. blood labs being processed. spinal fluid build up in brain. Taken off work.
CDC Split Type:

Write-up: 2 hours after moderna vaccine I started to feel pressure in my whole head and behind my eyes. Same symptoms I had 4 years ago with psuedo tumor cerebri. i had a massive flare up, dizzy, swollen lymph nodes. set my neurological system under attack with the head pressure.


VAERS ID: 1638251 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Malaise, Pruritus, Skin swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: hives all over the body, very itchy and generally unwell. The urticaria has lasted 14 days and persists despite medications. hives appear as redness and swelling of the skin.


VAERS ID: 1640948 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dizziness, Dyspnoea, Herpes virus test abnormal, Oral herpes, Oral pain, Palpitations, Pyrexia, Rash, Stomatitis, Throat tightness, Vertigo
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bisoprolol; soft gel saw palmetto; progesterone; CLA; Slim Vance
Current Illness: UTI; in hospital gave me medicine I''m allergic to cephalexin on July 1.
Preexisting Conditions: Asthma; kidney stones; cystic breast; sinus nodule in right cavity
Allergies: Penicillin; vancomycin; cephalexin; lidocaine; latex; IV tape; nuts; alcohol
Diagnostic Lab Data: Blood clinic, swabbed the sores on my mouth
CDC Split Type: vsafe

Write-up: I felt like a bolt shooting up, and I felt like my throat was closing and top of my mouth was painful and 3 days later I got a sore on my mouth. I started having fever and chills. I had a rash on my stomach my husband took pictures it would come and go. I was having hard time breathing, and strong palpitations, I couldn''t take my heart medication because it would give me a strong headache and it would lower my BP. I went to clinic, they gave me antibiotic, they tested my sore in my mouth it was positive for herpes. I have had dizziness and vertigo. I still difficulty breathing and taking my heart medication. My concern still about my heart palpitations and vertigo.


VAERS ID: 1641008 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-05-27
Onset:2021-08-13
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Nausea, SARS-CoV-2 test negative, Stool analysis normal, Vomiting, X-ray gastrointestinal tract normal
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 2xday; Optic 1xweek; Overtid Staten
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin
Diagnostic Lab Data: blood work stomach x-ray stull sample COVID-19 test
CDC Split Type: vsafe

Write-up: I was nausea with vomiting. I went to see the doctor about this. They did blood work, stomach x-ray, and stool sample, all came out normal. They also did a COVID-19 test, which came out negative.


VAERS ID: 1641144 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Discomfort, Disorientation, Feeling abnormal, Gait disturbance, Hypoaesthesia, Inflammation, Joint stiffness, Muscle tightness, Muscular weakness, Palpitations, Paraesthesia, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: 2 stents in my heart
Allergies: Penacillin, Levaquin, omxacillin, zoloft, others I don''t remember.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My arm went dead and heart started racing before the needle came out of my arm. The guy said to sit there for 15 minutes. My right neck and back and right kidney felt inflamed a minute or so after shot. Face started getting tingly. Body started feeling heavy, went to sit in the chair from the table and couldn''t really feel the floor. Sat down, my heart calmed down. Guy came back and asked how I was about 15 minutes later. I said my heart started racing and my arm went dead and neck and back got tight. I said my heartbeat seems to be better. He said I can go. Walking felt funny. I got to my car and just sat there for at least an hour. I may have been slightly disoriented but I don''t really remember. I drove home, wasn''t wise, felt weird driving. Kind of numb. I got home, thankfully. Sat down on the floor by the couch. Joints started to stiffen up. My hands felt funny. I took out my guitar to try and play and my hand wasn''t really working. I persisted and about 15 minutes and it started coming back. Most of the side effects went away later that day I think, except for my neck and right side of my back and right kidney pain. It''s two weeks today and my right kidney or right kidney area still feels tight


VAERS ID: 1641225 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-06
Onset:2021-08-13
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pain, 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: atenoloL-chlorthalidone (TENORETIC) 50-25 mg per tablet EPINEPHrine (EPIPEN) 0.3 mg/0.3 mL injection syringe potassium chloride (KLOR-CON) 8 mEq CR tablet simvastatin (ZOCOR) 10 mg tablet
Current Illness:
Preexisting Conditions: Circulatory Hypertension Musculoskeletal Primary osteoarthritis involving multiple joints Endocrine/Metabolic Hyperlipidemia
Allergies: Bee Sting KitAnaphylaxis
Diagnostic Lab Data: Updated Procedure 08/19/21 0803 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/18/21 1623 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/19/21 0803 COVID-19 PCR Collected: 08/18/21 1623 | Final result | Specimen: Swab from Nasopharynx
CDC Split Type:

Write-up: EXPOSURE, BODY ACHES


VAERS ID: 1641232 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-06
Onset:2021-08-13
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Headache, Oropharyngeal pain, 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: amoxicillin (AMOXIL) 875 mg tablet atorvastatin (LIPITOR) 80 mg tablet benazepriL (LOTENSIN) 10 mg tablet (Expired) esomeprazole (NexIUM) 40 mg capsule glucagon, human recombinant, (glucagon) 1 mg kit insulin syringe-needle U-100 0.3 m
Current Illness:
Preexisting Conditions: Nervous Peripheral neuropathy Type 1 diabetes mellitus with diabetic polyneuropathy (CMS/HCC) Acute pain of left knee Polyneuropathy associated with underlying disease (CMS/HCC) Bilateral impacted cerumen Respiratory Tracheobronchitis Allergic rhinitis Circulatory Essential hypertension Arrhythmia Digestive GERD without esophagitis Chronic constipation Genitourinary Stress incontinence of urine Acute renal failure (ARF) Kidney stone Endocrine/Metabolic Hyperlipidemia, mixed Type 1 diabetes mellitus Type 1 diabetes mellitus with hypoglycemia Type 1 diabetes mellitus with proteinuria Multiple thyroid nodules DKA (diabetic ketoacidoses) Diabetic ketosis Other Fitting and adjustment of insulin pump Presence of insulin pump Long-term insulin use Dizziness
Allergies: Myrbetriq [Mirabegron]Dizziness / Lightheaded
Diagnostic Lab Data: 08/20/21 1535 COVID-19 (SARS CoV-2 Molecular Amplification) Collected: 08/20/21 1106 | Final result | Specimen: Swab COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/20/21 1535 COVID-19 PCR Collected: 08/20/21 1106 | Final result | Specimen: Swab
CDC Split Type:

Write-up: EXPOSURE headache, her ears are clogged, throat is sore, cough (no fever or sob)


VAERS ID: 1641344 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-08-13
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test, Sinus headache, Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler alum-mag hydroxide-simeth (MAALOX) 200-200-20 mg/5 mL suspension BIOTIN ORAL busPIRone (BUSPAR) 10 mg tablet cholecalciferol, vitamin D3, 1,000 unit capsule citalopram (CeleXA) 20 mg
Current Illness:
Preexisting Conditions: Nervous Abdominal pain Hearing loss Rectal pain Respiratory Cavitary lesion of lung Chronic obstructive pulmonary disease Metastatic lung cancer (metastasis from lung to other site) Circulatory External hemorrhoids Prolapsed internal hemorrhoids Digestive Benign colonic polyp Atony of colon Outlet dysfunction constipation Failure to thrive in adult Barrett''s esophagus Endocrine/Metabolic Hyperlipidemia Other Bloating Depression
Allergies: Oxycodone-acetaminophenNausea and Vomiting, Hallucinations AdhesiveOther (document details in comments)
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: Runny nose, scratchy throat, cough, fever, and slight burning in upper back sinus headache


VAERS ID: 1641359 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dysstasia, Fatigue, Musculoskeletal stiffness, Neck pain, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sharp shooting pain that started mid body then went out to her extremities, tiredness, and random pains throughout body, severe back, neck and upper shoulder pains, unable to stand due to pain. Upper back, shoulder, and neck are stiff.


VAERS ID: 1641490 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Joint swelling, Peripheral swelling, Rash, Spondylitis, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Rash on chest. Swelling in areas where they also have arthritis (neck, fingers, and knees)


VAERS ID: 1641530 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Gluten, Chicken egg protein
Diagnostic Lab Data: Did not go to Doctor for help with this.
CDC Split Type:

Write-up: Joint pain- especially in wrists, fingers, ankles, and toes, but elsewhere in body as well- lasted until August 27th Dizzy feeling started on the 13th. Turned into vertigo 5 days after receiving the vaccine- around August 17th. Still have vertigo that comes and goes throughout each day (Today is the 27th of August and it has not subsided).


VAERS ID: 1641717 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-08-13
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dizziness, Dyspnoea, Dysstasia, Gait disturbance, Heart rate increased, Oropharyngeal pain, Stomatitis, Vision blurred, Visual impairment, Vital signs measurement
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Dizzy spells started day 3. Developed mild sore throat and had little sores inside mouth on day 5. Day 13 extreme dizziness where it was difficult to stand or walk. Black spots in peripheral vision. Could not catch breath, chest tightness and vision went in and out of focus. Went to Urgent Care facility, all vitals were normal, said that?s all they could do and suggested it was anxiety. Gave a prescription for dizziness. Went 6 more days not being able to breathe properly, symptoms were not improving at al/worsening l and went to emergency room. Hospital ran vitals tests and could find nothing wrong other than elevated heart beat, Prescribed Ativan . An out of state doctor suggested trying benadryl, took 2 and all symptoms cleared within 4 hours.


VAERS ID: 1641763 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Cystitis interstitial, Inflammation, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Evening Primrose Oil, Methocarbamol, Hydroxyzine, Percocet, Lamictal, Ondansetron
Current Illness: N/A
Preexisting Conditions: Endometriosis, interstitial cystitis
Allergies: Tramadol, promethizine, Cefalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Interstitial Cystitis flare, inflammatory response in pelvic area, fully body itchiness.


VAERS ID: 1641791 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NITROFURANTOIN, 100 mg ORAL CAPSULE. BID. METRONIDAZOLE, 500 mg ORAL TAB, 1 EVERY 12 HOURS.
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NO KNOW ALLERGIES
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient received her second dose of COVID-19 Moderna vaccine too early. First dose administered on 26 JUL 21, and second dose administered on 13 AUG 21. both are COVID-19 Moderna vaccines.


VAERS ID: 1642021 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Lip pruritus, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Too many to list
Current Illness: Itchy lips and throat felt swollen on right side for about 15 minutes after injection. Diarrhea 4 hours later.
Preexisting Conditions: Migraines
Allergies: Augmentin, penicillin, cephalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: No treatment need. I am to premediated with Benadryl for my next dose and bring my EpiPen.


VAERS ID: 1642497 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain, Myalgia, Trismus
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: first 48 hours was normal muscle soreness at injection site. Upon waking the 3rd day was unable to open mouth more then 1 inch. As day progressed was able to unlock and open fully. Next day woke again unable to open mouth. Has been seen by neurospecialist / chiropractor in attempt to relax jaw muscles and get mouth to open fully. Day 17 still unable to open enough to bite into cheeseburger. has been using IB, HMP, stretches and exercises to draw mandible forward. Has been to dentist for night guard appliance to assist with passive stretching but unable to open enough to get tray in for imprints.


VAERS ID: 1644184 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylcellulose fiber, Loratadine, Amphetamine Salts
Current Illness:
Preexisting Conditions: Asthma, environmental allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Experienced a thrombosed hemorrhoid which lasted about a week.


VAERS ID: 1644977 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-24
Onset:2021-08-13
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dose omission issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: 1st dose 24Mar2021; no 2nd dose; This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (1st dose 24Mar2021; no 2nd dose) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (1st dose 24Mar2021; no 2nd dose). On 13-Aug-2021, PRODUCT DOSE OMISSION ISSUE (1st dose 24Mar2021; no 2nd dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient had had an antibody test in end of Jun2021 or beginning of Jul2021 with a result of 20 (no units). No concomitant medications were reported. No treatment information were reported.


VAERS ID: 1644987 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK - / OT

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Administering an expired vaccine to a patient; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Administering an expired vaccine to a patient) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Administering an expired vaccine to a patient). On 13-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Administering an expired vaccine to a patient) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information was provided. The vaccine vial was punctured and moved from the refrigerator to room temperature at 11:25 A.M in previous day, 12-Aug-2021, and this vial has been stored in room temperature since then.


VAERS ID: 1644994 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Fatigue
SMQs:, Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Bone pain; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of BONE PAIN (Bone pain) and FATIGUE (Fatigue) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059E21A) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced BONE PAIN (Bone pain) and FATIGUE (Fatigue). At the time of the report, BONE PAIN (Bone pain) and FATIGUE (Fatigue) outcome was unknown. No concomitant medication was provided. No treatment medication was provided. Reporter did not allow further contact


VAERS ID: 1645001 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Chills, Fatigue, Injection site pain, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; ROSUVASTATIN; ASPIRIN [ACETYLSALICYLIC ACID]; FOLIC ACID; FLUOXETINE
Current Illness:
Preexisting Conditions: Comments: No patient history Information was provided.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: not feeling really well; injection site is very sore; Armpit became very sore; Fever; Joint pain; Chills; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (not feeling really well), INJECTION SITE PAIN (injection site is very sore), AXILLARY PAIN (Armpit became very sore), PYREXIA (Fever) and ARTHRALGIA (Joint pain) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No patient history Information was provided. Concomitant products included LEVOTHYROXINE, ROSUVASTATIN, ASPIRIN [ACETYLSALICYLIC ACID], FOLIC ACID and FLUOXETINE for an unknown indication. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced MALAISE (not feeling really well), INJECTION SITE PAIN (injection site is very sore), AXILLARY PAIN (Armpit became very sore), PYREXIA (Fever), ARTHRALGIA (Joint pain), CHILLS (Chills) and FATIGUE (Fatigue). At the time of the report, MALAISE (not feeling really well), INJECTION SITE PAIN (injection site is very sore), AXILLARY PAIN (Armpit became very sore), PYREXIA (Fever), ARTHRALGIA (Joint pain), CHILLS (Chills) and FATIGUE (Fatigue) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Treatment medications were provided. Reporter did not allow further contact


VAERS ID: 1645024 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Dyspnoea, Headache, Malaise, Mobility decreased, Oropharyngeal pain, Paraesthesia, Peripheral swelling, Vaccination site pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (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:
Other Medications: WELLBUTRIN
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data: Test Date: 20210814; Test Name: Blood pressure measurement; Result Unstructured Data: 87/60
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Difficulty breathing; Sore throat; Swelling of the right arm; Tingling in the right fingers; Some loss of movement in the right hand; Headaches; Injection site pain; Dizziness; Malaise; This spontaneous case was reported by an other health care professional and describes the occurrence of DIZZINESS (Dizziness), MALAISE (Malaise), DYSPNOEA (Difficulty breathing), OROPHARYNGEAL PAIN (Sore throat) and PERIPHERAL SWELLING (Swelling of the right arm) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included BUPROPION HYDROCHLORIDE (WELLBUTRIN) for an unknown indication. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced DIZZINESS (Dizziness), MALAISE (Malaise), HEADACHE (Headaches) and VACCINATION SITE PAIN (Injection site pain). On 14-Aug-2021, the patient experienced DYSPNOEA (Difficulty breathing), OROPHARYNGEAL PAIN (Sore throat), PERIPHERAL SWELLING (Swelling of the right arm), PARAESTHESIA (Tingling in the right fingers) and MOBILITY DECREASED (Some loss of movement in the right hand). The patient was treated with IBUPROFEN for Adverse event, at a dose of 1 dosage form; PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 dosage form and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at a dose of 1 dosage form. At the time of the report, DIZZINESS (Dizziness), MALAISE (Malaise), DYSPNOEA (Difficulty breathing), OROPHARYNGEAL PAIN (Sore throat), PERIPHERAL SWELLING (Swelling of the right arm), PARAESTHESIA (Tingling in the right fingers), MOBILITY DECREASED (Some loss of movement in the right hand), HEADACHE (Headaches) and VACCINATION SITE PAIN (Injection site pain) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Aug-2021, Blood pressure measurement: 87/60 (Low) 87/60. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient discontinued Wellbutrin Treatment medication included a steroid injection.


VAERS ID: 1645036 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / OT

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: vaccine administered after it was stored beyond 12 hours at room temperature; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (vaccine administered after it was stored beyond 12 hours at room temperature) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (vaccine administered after it was stored beyond 12 hours at room temperature). At the time of the report, EXPIRED PRODUCT ADMINISTERED (vaccine administered after it was stored beyond 12 hours at room temperature) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were provided by the reporter.


VAERS ID: 1645066 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, Illness, Influenza like illness, Myalgia, Oropharyngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Was very sick; Back ache; Felt like flu; Sore throat; Felt like had covid; Fever; very sore all over/ very sore all over; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Was very sick), BACK PAIN (Back ache), INFLUENZA LIKE ILLNESS (Felt like flu), OROPHARYNGEAL PAIN (Sore throat) and COVID-19 (Felt like had covid) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced ILLNESS (Was very sick), BACK PAIN (Back ache), INFLUENZA LIKE ILLNESS (Felt like flu), OROPHARYNGEAL PAIN (Sore throat), COVID-19 (Felt like had covid), PYREXIA (Fever) and MYALGIA (very sore all over/ very sore all over). At the time of the report, ILLNESS (Was very sick), BACK PAIN (Back ache), INFLUENZA LIKE ILLNESS (Felt like flu), OROPHARYNGEAL PAIN (Sore throat), COVID-19 (Felt like had covid), PYREXIA (Fever) and MYALGIA (very sore all over/ very sore all over) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1645124 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-01
Onset:2021-08-13
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 1 LA / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Mixed series of vaccine; First dose (01-jul-2021) ,Second dose (13-aug-2021); This spontaneous case was reported by a pharmacist and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Mixed series of vaccine) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose (01-jul-2021) ,Second dose (13-aug-2021)) in a 34-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 018B21A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for an unknown indication. No Medical History information was reported. On 01-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient received first dose of TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Mixed series of vaccine) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose (01-jul-2021) ,Second dose (13-aug-2021)). At the time of the report, INTERCHANGE OF VACCINE PRODUCTS (Mixed series of vaccine) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose (01-jul-2021) ,Second dose (13-aug-2021)) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter.


VAERS ID: 1645133 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / UNK LA / OT

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Vaccine administered after it was stored beyond 12 hours at room temperature; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Vaccine administered after it was stored beyond 12 hours at room temperature) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Vaccine administered after it was stored beyond 12 hours at room temperature). On 13-Aug-2021, EXPIRED PRODUCT ADMINISTERED (Vaccine administered after it was stored beyond 12 hours at room temperature) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1645147 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-15
Onset:2021-08-13
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Feeling cold, Rash macular, Tremor, Vaccination site erythema, Vaccination site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: BYSTOLIC
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away; I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away; 24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised; 24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised; 24 hours after the second dose I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away; Below the reaction site there is redness blotchy like it kept getting worse arm is swollen; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (Below the reaction site there is redness blotchy like it kept getting worse arm is swollen), FEELING COLD (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), TREMOR (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), CHILLS (24 hours after the second dose I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away) and VACCINATION SITE SWELLING (24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A and 040C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included NEBIVOLOL HYDROCHLORIDE (BYSTOLIC) for an unknown indication. On 15-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Aug-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Aug-2021, the patient experienced RASH MACULAR (Below the reaction site there is redness blotchy like it kept getting worse arm is swollen), CHILLS (24 hours after the second dose I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away) and VACCINATION SITE ERYTHEMA (24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised). On an unknown date, the patient experienced FEELING COLD (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), TREMOR (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away) and VACCINATION SITE SWELLING (24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised). At the time of the report, RASH MACULAR (Below the reaction site there is redness blotchy like it kept getting worse arm is swollen), FEELING COLD (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), TREMOR (I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), CHILLS (24 hours after the second dose I had chills really bad chills I felt very cold and shaky it lasted overnight and then went away), VACCINATION SITE SWELLING (24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised) and VACCINATION SITE ERYTHEMA (24 hours after getting the second dose the injection site had a 5 centimeter coin shape reaction it was red and raised) outcome was unknown. No treatment medication information was provided.


VAERS ID: 1645149 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Severe pain where the shot was administered/It''s worse than a broken arm; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Severe pain where the shot was administered/It''s worse than a broken arm) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced VACCINATION SITE PAIN (Severe pain where the shot was administered/It''s worse than a broken arm). At the time of the report, VACCINATION SITE PAIN (Severe pain where the shot was administered/It''s worse than a broken arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was provided. No treatment was provided.


VAERS ID: 1645161 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-21
Onset:2021-08-13
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Drug ineffective, Nasal congestion, Nasopharyngitis, SARS-CoV-2 test, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: COVID 19; Test Result: Positive; Result Unstructured Data: POSITIVE.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: He tested positive for Covid-19; Drug ineffective; postnasal drip; general cold symptoms; congestion; cough; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (general cold symptoms), NASAL CONGESTION (congestion), COUGH (cough), COVID-19 (He tested positive for Covid-19) and UPPER-AIRWAY COUGH SYNDROME (postnasal drip) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 013M20A and 012L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 21-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Aug-2021, the patient experienced NASOPHARYNGITIS (general cold symptoms) (seriousness criterion medically significant), NASAL CONGESTION (congestion) (seriousness criterion medically significant), COUGH (cough) (seriousness criterion medically significant) and UPPER-AIRWAY COUGH SYNDROME (postnasal drip) (seriousness criterion medically significant). On 15-Aug-2021, the patient experienced COVID-19 (He tested positive for Covid-19) (seriousness criterion medically significant) and DRUG INEFFECTIVE (Drug ineffective). At the time of the report, NASOPHARYNGITIS (general cold symptoms), NASAL CONGESTION (congestion), COUGH (cough), COVID-19 (He tested positive for Covid-19) and UPPER-AIRWAY COUGH SYNDROME (postnasal drip) outcome was unknown and DRUG INEFFECTIVE (Drug ineffective) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 15-Aug-2021, SARS-CoV-2 test: positive (Positive) POSITIVE. Concomitant product use was not provided by the reporter. No treatment information was provided. Company Comment: This report refers to a case of Drug ineffective for mRNA-1273, lot # 013M20A and # 012L20A. Based on the current available information and temporal association between the use of the product and the Drug ineffective event, a causal relationship cannot be excluded. For the event COVID-19, based on the mechanism of action of mRNA-1273 causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. Based on the reporter''s statement of a breakthrough infection and the compatibility of the events NASOPHARYNGITIS (general cold symptoms), NASAL CONGESTION (congestion), COUGH (cough) and UPPER-AIRWAY COUGH SYNDROME (postnasal drip) with a Covid-19 infection, these events are assessed as unlikely related to mRNA-1273.; Sender''s Comments: This report refers to a case of Drug ineffective for mRNA-1273, lot # 013M20A and # 012L20A. Based on the current available information and temporal association between the use of the product and the Drug ineffective event, a causal relationship cannot be excluded. For the event COVID-19, based on the mechanism of action of mRNA-1273 causal association between the event of COVID-19 infection and mRNA-1273 is assessed as not applicable. Based on the reporter''s statement of a breakthrough infection and the compatibility of the events NASOPHARYNGITIS (general cold symptoms), NASAL CONGESTION (congestion), COUGH (cough) and UPPER-AIRWAY COUGH SYNDROME (postnasal drip) with a Covid-19 infection, these events are assessed as unlikely related to mRNA-1273.


VAERS ID: 1645184 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Puerto Rico  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test positive, 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 Name: antibody test; Test Result: Positive ; Result Unstructured Data: positive antibody test
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Tested positive for COVID19 and received both Moderna doses.; This spontaneous case was reported by a consumer and describes the occurrence of SARS-COV-2 TEST POSITIVE (Tested positive for COVID19 and received both Moderna doses.) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Aug-2021, the patient experienced SARS-COV-2 TEST POSITIVE (Tested positive for COVID19 and received both Moderna doses.). At the time of the report, SARS-COV-2 TEST POSITIVE (Tested positive for COVID19 and received both Moderna doses.) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 antibody test positive: positive (Positive) positive antibody test. No treatment medication provided by reporter. No concomitant medication provided by reporter. Suspect product batch number is unknown. Action taken with mRNA-1273 (Moderna Covid-19 vaccine) was not applicable. Reportedly, the patient was tested positive for COVID 19 after both doses of the vaccine, however, there were no any reported signs or symptoms of COVID-19 disease. The exact dates of the first and the second vaccination were not reported. The company causality for the event SARS-CoV-2 test positive is not applicable having in mind that the mRNA-1273 does not contain a virus capable of causing infection.; Sender''s Comments: Reportedly, the patient was tested positve for COVID 19 after both doses of the vaccine, however, there were no any reported signs or symptoms of COVID-19 disease. The exact dates of the first and the second vaccination were not reported. The company causality for the event SARS-CoV-2 test positive is not applicable having in mind that the mRNA-1273 does not contain a virus capable of causing infection.


VAERS ID: 1645260 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fruit allergy (Allergic to pineapple); Milk allergy; Seasonal allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Laryngeal swelling with laryngitis; extreme fatigue; fever; This spontaneous case was reported by an other health care professional and describes the occurrence of LARYNGITIS (Laryngeal swelling with laryngitis), FATIGUE (extreme fatigue) and PYREXIA (fever) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Milk allergy, Fruit allergy (Allergic to pineapple) and Seasonal allergy. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced LARYNGITIS (Laryngeal swelling with laryngitis) (seriousness criterion medically significant), FATIGUE (extreme fatigue) (seriousness criterion medically significant) and PYREXIA (fever) (seriousness criterion medically significant). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at a dose of 1 dosage form and PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, LARYNGITIS (Laryngeal swelling with laryngitis), FATIGUE (extreme fatigue) and PYREXIA (fever) had not resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medication was reported by reporter. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded The case was reported as serious but on an event level described as non-serious for each criterion.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded The case was reported as serious but on an event level described as non-serious for each criterion.


VAERS ID: 1645393 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Cough, Muscle tightness, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dystonia (broad), Hypersensitivity (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? No
Previous Vaccinations:
Other Medications: EPIPEN
Current Illness: Allergy; Hypertension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Anaphylaxis reaction; Broke out in hives; Itching; Cough on and off/still has a cough; Tightness in her neck; Broke out with rash; This spontaneous case was reported by an other health care professional and describes the occurrence of ANAPHYLACTIC REACTION (Anaphylaxis reaction), URTICARIA (Broke out in hives), PRURITUS (Itching), COUGH (Cough on and off/still has a cough), MUSCLE TIGHTNESS (Tightness in her neck) and RASH (Broke out with rash) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. Concurrent medical conditions included Hypertension and Allergy. Concomitant products included EPINEPHRINE (EPIPEN) for Allergy. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced ANAPHYLACTIC REACTION (Anaphylaxis reaction) (seriousness criteria medically significant and life threatening), URTICARIA (Broke out in hives) (seriousness criterion life threatening), PRURITUS (Itching) (seriousness criterion life threatening), COUGH (Cough on and off/still has a cough) (seriousness criterion life threatening), MUSCLE TIGHTNESS (Tightness in her neck) (seriousness criterion life threatening) and RASH (Broke out with rash) (seriousness criterion life threatening). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date at a dose of 25 milligram. At the time of the report, ANAPHYLACTIC REACTION (Anaphylaxis reaction), URTICARIA (Broke out in hives), PRURITUS (Itching), COUGH (Cough on and off/still has a cough), MUSCLE TIGHTNESS (Tightness in her neck) and RASH (Broke out with rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant included some unknown medications for blood pressure. Treatment medication was not reported. Company Comment : Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, patient''s medical history of allergies treated with EpiPen remains a contributory factor. Though symptoms were reported separately, they could all be subsumed under the anaphylactic reaction experienced by this patient.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, patient''s medical history of allergies treated with EpiPen remains a contributory factor. Though symptoms were reported separately, they could all be subsumed under the anaphylactic reaction experienced by this patient.


VAERS ID: 1645394 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-08-13
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Outpatient Medications acetaminophen (TYLENOL ORAL) losartan (COZAAR) 100 mg tablet multivitamin with iron (ONE DAILY MULTI-VIT W-MINERAL) tablet Clinic-Administered Medications albuterol HFA (PROVENTIL;VENTOLIN) inhaler 2 puff diphe
Current Illness:
Preexisting Conditions: Nervous Injury of peroneal nerve Polyneuropathy Idiopathic progressive neuropathy Numbness Macular degeneration, left eye Right sided sciatica Circulatory Essential hypertension Varicose veins Venous stasis Digestive Tubular adenoma of colon Diverticulosis Musculoskeletal Disc degeneration, lumbar Osteoarthritis Scoliosis Low bone mass Endocrine/Metabolic Pure hypercholesterolemia Infectious/Inflammatory COVID-19 virus infection Immune Hypogammaglobulinemia Other Living will in place Visit for screening mammogram Patient has active power of attorney for health care
Allergies: PravastatinMyalgia / Muscle Pain SimvastatinMyalgia / Muscle Pain Hydrochlorothiazide Amoxil [Amoxicillin]Rash GabapentinDiarrhea
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: Sore throat Runny nose Cough


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