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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 147 out of 6,867

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VAERS ID: 1647185 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-14
Onset:2021-08-13
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Nasal Swab for Covid 19; Test Result: Positive.
CDC Split Type: USPFIZER INC202101047940

Write-up: This is a spontaneous report from a contactable consumer (patient). A 39-years-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 14Apr2021 (at the age of 39-year-old) as Dose 2,Single for COVID-19 immunization. The patient''s medical history and concomitant medications was not reported. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number and Expiration date not reported), via an unspecified route of administration in an unspecified anatomical location on an unspecified date as single dose for COVID-19 immunization. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient experienced covid 4 months later on 13Aug2021. No therapeutic measure was taken. The patient underwent lab tests and procedures which included sars-cov-2 test positive on 13Aug2021. The outcome of events was not recovered. Information on the Lot/batch number has been requested


VAERS ID: 1647206 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Confusional state, Movement disorder, Pain in extremity, Paralysis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101048370

Write-up: paralysis; swelling; chest pain; neurologic confusion; couldn''t'' move her right arm and leg, not very well; pain shot down her right side of her body and her arm and down her leg; Right arm is still having some pain and then the left thigh started to act up; This is a spontaneous report from a contactable consumer (Patient) via Medical Information Team. A 52-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: Not reported), via an unspecified route of administration on 13Aug2021 at 11:00 (at the age of 52-years-old) as dose 1, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that the patient received the first dose of the Pfizer COVID-19 vaccine on 13Aug2021 at 11 am and on same day she experienced a sharp chest pain around her rib cage. Patient stated that vaccine caused paralysis which some went away, but it was in limbs. Right arm, right leg and the upper part of left arm. Patient wanted to know if the vaccine could cause that. What was a concern of hers and it had been dismissed by the nurses was that she had significant toxin exposure and the symptoms were exactly the same and the limbs that had been exposed to the toxins including pesticides which caused the paralysis in the first place reacted the same ways towards this vaccine, so if this vaccine is going to cause more paralysis it''s going to cause more damage than good. As soon as the injection was going in her arm, the lower right side for brain which was where a lot of the toxins were, where it usually starts to react when she was exposed to toxins started to have the same sort of reaction and swelling like this was some sort of poising going into her body and then the pain shot down her right side of her body and her arm and down her leg, it was very painful and into chest and then couldn''t move her right arm and leg, not very well. Right arm was still having some pain and then the left thigh started to act up, and still with some sharp chest pains and a little neurologic confusion as well. Patient does not feel safe getting another dose of this not after these kinds of reactions and asked if she shall get the second dose. The outcome of the event paralysis was recovering, event right arm is still having some pain and then the left thigh started to act up (pain in arm) was not recovered and outcome of all the other events was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1647237 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-15
Onset:2021-08-13
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: covid test; Result Unstructured Data: Test Result:Positive; Comments: Positive
CDC Split Type: USPFIZER INC202101050093

Write-up: Patient has tested positive for COVID-19 following the completion of the COVID-19 vaccine series.; Patient has tested positive for COVID-19 following the completion of the COVID-19 vaccine series.; This is a spontaneous report from a non-contactable other hcp. A 49-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VAC-CINE, formulation: Solution for injection, Lot Number: EN5318, and Expiration date: Unknown), via an unspecified route of administration on 15Feb2021 (at the age of 48-year-old) as dose 2, single for COVID-19 immunization. Medical history and concomitant medications were not reported. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. It was unknown if the patient was diagnosed with COVID-19, prior to vaccination. Previously patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: EN5318, and Expiration date: Unknown), via an unspecified route of administration on 25Jan2021 (at the age of 48-year-old), as dose 1, single for COVID-19 immunization (No reaction on previous exposure to vaccine). It was reported that on 13Aug2021, "Patient has tested positive for COVID-19 following the completion of the COVID-19 vaccine series" and it resulted in doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included SARS-CoV-2 test (COVID-19 test): positive, on 13Aug2021. The type of the COVID test was unknown. It was unknown if the patient received treatment for the events. The outcome of the events was reported as not resolved. No follow up attempts were possible. No further information was expected.; Sender''s Comments: Based on the information in the case report and a plausible temporal relationship, a possible causal relationship between the reported events and suspect drug BNT162B2 cannot be excluded.


VAERS ID: 1647253 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-08-13
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Drug ineffective, Infection, SARS-CoV-2 test, Upper respiratory tract congestion
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Covid test PCR; Test Result: Positive ; Comments: Post vaccination: Nasal Swab
CDC Split Type: USPFIZER INC202101050582

Write-up: breakthrough infection diagnosed via PCR (mild head congestion and cough); breakthrough infection diagnosed via PCR (mild head congestion and cough); breakthrough infection diagnosed via PCR (mild head congestion and cough); breakthrough infection diagnosed via PCR (mild head congestion and cough); breakthrough infection diagnosed via PCR (mild head congestion and cough); This is a spontaneous report from a contactable consumer. A 50-years-old male patient received BNT162B2 (Pfizer-Biontech COVID-19 Vaccine, Solution for injection, Batch/lot number: unknown), via an unknown route of administration in Apr2021 (at the age of 50-years-old) as dose number unknown, single for COVID-19 immunisation. The patient''s medical history included asthma. Concomitant medications were not reported. No other vaccine in four weeks. On 11Aug2021, the patient had breakthrough infection diagnosed via PCR (mild head congestion and cough). Patient had not been diagnosed with COVID-19 prior to vaccination. He had tested post the vaccination. On 13Aug2021, the patient had Covid test PCR by nasal swab which resulted positive post vaccination. No treatment received. The outcome of the event was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1647254 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-08-08
Onset:2021-08-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VALACYCLOVIR [VALACICLOVIR]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Herpes NOS (Treatment: "Valacyclovir 1000mg tablets morning and night", was sexually transmitted disease)
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: corona virus 19, tested positive; Test Result: Positive
CDC Split Type: USPFIZER INC202101050589

Write-up: I got corona virus 19, I tested positive; I got corona virus 19, I tested positive; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 20-years-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 08Aug2021 (age at vaccination: 20 years) as dose number unknown, single for covid-19 immunisation at Pharmacy. Medical history included herpes (was sexually transmitted disease; Treatment: "Valacyclovir 1000mg tablets morning and night") from an unknown date and unknown if ongoing. Concomitant medication included valacyclovir [VALACICLOVIR] at the dose of 1000 mg, two times a day, taken for herpes virus infection, start and stop date were not reported. The patient got the vaccine 6 days ago and on 13Aug2021 (yesterday), tested positive on 13Aug2021, was feeling a little sick on an unspecified date in Aug2021 and went to the doctor and they tested the patient, and had corona virus. So, the patient was just wondering what the vaccine does if it does not stop the patient from getting corona virus. The patient underwent lab tests and procedures which included Corona virus 19, tested positive on 13Aug2021. The outcome of the event Covid-19 was unknown at the time of this report. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1647310 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high (Verbatim: High Blood Pressure)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101058024

Write-up: vertigo; blood pressure a little bit higher; This is a spontaneous report from a contactable consumer or non health care professional. A 61-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FC3180), dose 1 via an unspecified route of administration on 12Aug2021 Thursday (Age at vaccination: 61 years) as dose 1, single for covid-19 immunisation. Medical history included ongoing hypertension Verbatim: High Blood Pressure. Concomitant medications included Low dose high blood pressure pill. Prior vaccinations within 4 weeks were None. Reporter states that her husband takes this on an as needed basis. The patient experienced vertigo and blood pressure a little bit higher (condition aggravated) on 13Aug2021. Reporter wants to know if these symptoms are associated with Pfizer COVID-19 vaccine. Reporter says that her husband blood pressure has been fluctuating since before the vaccine; but since the vaccine it has been higher. Patient was taking low dose high blood pressure pill. The outcome of the events was not recovered.


VAERS ID: 1647318 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Pain in jaw
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: TYLENOL; ALEVE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101058163

Write-up: the worst headache of her life; jaw is also sore and hurts very very bad; This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number and expiration date was not reported), via an unspecified route of administration on 10Aug2021 as dose 1, single for COVID-19 immunization. The patient medical history was not reported. Concomitant medications included Paracetamol (TYLENOL) and Naproxen Sodium (ALEVE). On 13Aug2021 the patient experienced the worst headache of her life since friday and her jaw were also sore and hurts very very bad. She wants to know if jaw pains are common side effects of the vaccine, because she knows that headaches were common. The outcome of both events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1647367 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-22
Onset:2021-08-13
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / OT

Administered by: Work       Purchased by: ?
Symptoms: SARS-CoV-2 test, SARS-CoV-2 test positive, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101068340

Write-up: Both parents tested positive the following day; Both parents tested positive the following day; This is a spontaneous report from a contactable other health care professional (Nurse). A 42-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EL3248),via intramuscular route of administration, administered in Arm Left on 22Jan2021 13:45 (at the age of 42-years-old) as dose 1, single and received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EL3248), via intramuscular route of administration, administered in Arm Left 10Feb2021 13:45 (at the age of 42-years-old) as dose 2, single for Covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with Covid-19. Since the vaccination, the patient had been tested for Covid-19. On 13Aug2021, reported both parents tested positive the following day. The patient underwent lab tests and procedures which included Nasal Swab: positive on 13Aug2021. Treatment received for the events was unknown. The outcome of the events was resolving.


VAERS ID: 1647413 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-29
Onset:2021-08-13
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Covid-19; Test Result: Positive
CDC Split Type: USPFIZER INC202101081200

Write-up: tested positive for Covid; tested positive for Covid; This is a spontaneous report from a Pfizer-sponsored program. A contactable female consumer (patient) an unspecified age reported that she received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown, and Expiration date: Unknown), via an unspecified route of administration on 29Jul2021 as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. It was reported that the patient tested positive for Covid on 13Aug2021. The patient missed her scheduled second dose (yesterday), on 19Aug2021. The patient wanted to know how and when she could get her second dose. The patient declined to make a report. Stated she was just trying to get information and had been on the phone awhile now. She was asking if making this call will prevent her from getting the 2nd dose. The patient underwent lab tests and procedures which included SARS-CoV-2 test (COVID test): positive on 13Aug2021. Investigation assessment was not reported. The outcome of the events was unknown. Information on lot/batch number has been requested.


VAERS ID: 1647421 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-04
Onset:2021-08-13
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET9096 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101090548

Write-up: shingles on his stomach and back; This is a spontaneous report from a contactable consumer (patient sister). A 38-year-old male patient received bnt162b2 (COMIRNATY, Solution for injection, Batch/Lot Number: ET9096), via an unspecified route of administration on 04Aug2021 as DOSE 1, SINGLE for COVID-19 immunisation. Medical history and concomitant medications were not reported. The reporter was calling on behalf of her 38-year-old brother who had the first dose of the Pfizer Covid-19 vaccine on 04Aug2021 and on 13Aug2021 started seeing shingles on his stomach and back. The reporter was asking if her brother can get the second dose of the Pfizer Covid-19 vaccine due to the above complaints. Outcome of the event was unknown. Information on lot number/batch number has been requested.


VAERS ID: 1651612 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
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 034C21A / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Joint range of motion decreased, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Woke up at 5:30 am the morning after with sore left arm and very limited range of motion. The following day the pain went down to my knee joint and both areas have remained painful to this day?.almost 3 weeks later. Today I can hardly walk the pain is so intense in the bursa area of my knee. The pain remains in the elbow joint of my left arm, but is not as intense.


VAERS ID: 1653775 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hot flush, Nausea, Parosmia, Vaginal haemorrhage, Vertigo, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Prozac, probiotic
Current Illness: None
Preexisting Conditions: Hashimoto''s Disease POTS
Allergies: none
Diagnostic Lab Data: GYN told me hormone testing not very accurate to help with symptoms. Hopefully will go away soon. 8/26/21
CDC Split Type:

Write-up: 2 days after vaccine: Intense nausea, hot flashes (never had hot flashes before), increased sense of smell triggering vomiting (like when pregnant), Vertigo, vaginal spotting. Blurry vision Still have all symptoms (except spotting) just are more mild, going on 3 weeks.


VAERS ID: 1655020 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy (sulfa)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101048629

Write-up: Itching; rash; trouble breathe; This is a spontaneous report from a contactable consumer (patient reported for self). A 55-years-old (non-pregnant) female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: not reported), via an unspecified route of administration, administered in left arm on 11Aug2021 11:00 (at the age of 55-years-old) as dose number unknown, single for COVID-19 immunisation (Reason why batch/lot is Unknown: Unable to locate or read the details). Medical history included sulfa allergy. The patient''s concomitant medications were not reported. The patient previously received Shingles vaccine (Lot Number: not reported). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 13Aug2021 22:30, patient experienced itching, rash and trouble breathe. The events resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of adverse events, treatment: Benadryl. Outcome of the events was reported as not recovered. Device Date: 14Aug2021 The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1655036 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-02
Onset:2021-08-13
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210815; Test Name: PCR:Nasal Swab; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101057920

Write-up: Breakthrough case of Covid-19 infection after Covid-19 vaccination.; Breakthrough case of Covid-19 infection after Covid-19 vaccination.; This is a spontaneous report from a contactable physician. A 66-year-old male patient received second dose of bnt162b2 (BNT162B2), intramuscular on 02Mar2021 (Lot number was not reported) as single dose, first dose intramuscular on 03Feb2021 (Lot number was not reported) as single dose for covid-19 immunisation, age at vaccination 66-year-old. Medical history and concomitant medications were not reported. It was unknown if patient received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. On 13Aug2021 patient experienced covid-19 infection after covid-19 vaccination (reported as breakthrough case of Covid-19 infection after Covid-19 vaccination). Event resulted in Doctor or other healthcare professional office/clinic visit. No treatment was received. Since the vaccination, the patient has been tested for COVID-19. The patient underwent laboratory tests and procedures which included Polymerase chain reaction (PCR) Nasal Swab positive on 15Aug2021. Patient had not recovered from the event, at the time of the report. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.; Sender''s Comments: Based on the information available and close temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events . The case will be reassessed once new information is available.


VAERS ID: 1655579 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-30
Onset:2021-08-13
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Mental impairment, SARS-CoV-2 test positive, Sick relative
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Clonazepam, pantoprozole, escitalopram, meclizine, ipratropium, nasal spray, fluticasone nasal spray, mometasone topical lotion, oxycodone, donepezil, atorvastatin, pregabatin, ASA, dexamethasone.
Current Illness:
Preexisting Conditions: MDD, Fibromyalgia, Arthritis, hip/back pain, hyperlipidemia, dementia
Allergies: no known
Diagnostic Lab Data: COVID + 8/13
CDC Split Type:

Write-up: 8/13/2021. Breakthrough COVID 91 y/o female brought to ED for worsening mentation. Stated the patient''s partner was hospitalized with COVID. 8/22/2021: patient Discharged home with home O2. Note: patient previously vaccinated with Pfizer COVID-19 vaccine in January 2021.


VAERS ID: 1655598 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Shortness of Breath, irregular heart beat, chest pain and slowing of heart beat. it''s been ongoing since the vaccine it is not as bad now with rest but I still get the the irregular heart beat


VAERS ID: 1655749 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-02-20
Onset:2021-08-13
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Exposure to SARS-CoV-2, Respiratory tract congestion, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sinus disorder
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: ProAir HFA inhaler; Flovent HFA inhaler; Augmentin; Flonase; Claritin; Descovy
Current Illness: None
Preexisting Conditions: Asthma; irritable bowel syndrome
Allergies: Gatifloxacin eye drop to treat laser recovery
Diagnostic Lab Data: Covid test 08/13/2021 rapid test came back negative, PCR came back positive
CDC Split Type: vsafe

Write-up: We had a friend come into town and he brought his girlfriend with him. His girlfriend was not vaccinated. We hung out with them for a couple of hours. On Wednesday my friend called me and said his girlfriend tested positive for Covid. My fianc? was having flu like symptoms so I told him to go to the clinic to get tested. I was perfectly fine. I just had a little bit of congestion but I have allergies so I thought that was it. The clinic diagnosed me as asymptomatic. My fianc? tested positive so I went to get tested on 08/13/2021 and my rapid test came back negative, but my PCR came back positive. They gave me Augmentin to get rid of the sinus thing I had going on.


VAERS ID: 1655840 (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: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan, Lexapro, Tegretal, Attenial
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Lobster, Crab, Shrimp
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 1st dose of Moderna 08/13/2021. started experiencing symptoms 6hrs later, right hip (welps/hives), continuing to spread throughout the body. Some would disappear and new rashes would appear. Primary visit 08/18/2021 recommended steroid shot, Benadryl (continuing). Still continuing to appear.


VAERS ID: 1655980 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Pruritus, Scab
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: Tylenol and hydroxycut
Current Illness:
Preexisting Conditions:
Allergies: Bee sting allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately a few days after shot was given a red bump appeared on arm. It was slightly raised and mildly itchy. It scabbed over. Wore off then returned. It is still there 3 weeks after vaccine


VAERS ID: 1656116 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Gingival bleeding, Muscle spasms, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gingival disorders (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins, Allegra
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: Pcn, sulfas, corn
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Bleeding gums (x3 days). Fever, muscle spasms, body aches (all resolved within 24 hours). Severe weakness (weakness is persistent to this day).


VAERS ID: 1656306 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure abnormal, Chills, Diarrhoea, Fatigue, Heart rate abnormal, Nausea, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: increased heart rate and blood pressure.
Other Medications: Losartan 50 mg.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Amoxycillin, Ethromycin, Codein, Gluten
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Resting heart rate increased from 62 to 67 to 80''s - lasted 2 weeks. Heart rate increased and would not go down - periodically for 2 weeks.. Fatigue - had to take 1 to 2 hour per day naps for 2 weeks. Chills - one night all night. Projectile vomit. Diarrhea. Nausea. Blood pressure up 10 on top and bottom - lasted 12 days.


VAERS ID: 1656599 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Depression, Fatigue, Negative thoughts, Pruritus, Rash, Scab, Wound, Wound secretion
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (broad), Depression (excl suicide and self injury) (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: Velivet; B12 spray - daily - once spray in mouth; Didn''t take Valacyclovir more than a week before the vaccine) - take it as needed
Current Illness: No
Preexisting Conditions: Sinus infection last winter that was really bad 2020 started Scoliosis - S curve - mild case that is untreated - I go to chiropractor for that every now and then (had three visits with him total before vaccines) - saw him last in August 11th. I wear orthodoctics in my shoes. I have pronated ankles so I need more arch support. Herpes - I think I have genital herpes and I get outbreaks two or three times a year. I take a pill (Valacyclovir as needed) for that but I wasn''t at the time of the vaccination. And the beginning of August before the vaccine (about a week before) I had an outbreak - I did take it a couple of times in that first week of August 2021 when I had the outbreak. This rears it''s head about twice a year (outbreaks). HPV - have both types - the one that causes cervical cancer and genital warts but my body has kind of taken care of them - 2003 was when I had outbreaks while in College. I had a Leep procedure - where they cut out part of my cervix - in 2008. That took care of it with the HPV. Low Blood plate counts - And I had bloodwork done right before the vaccine and I did have low blood plate counts at that time.
Allergies: Antibiotics - 3 of them: Amoxicillin - Bad rash on butt when a baby; Metronidazole - I got really itchy palms and feet for about a half hour and a little rash the last time I took it; Bactrim - I got rashes - cyst on groin area from shaving and I took the Bactrim and it took care of it three years ago and the cyst came back in March of this year and took Bactrim again but this time within 10 minutes -I got hives stomach and arm and red in face and a little swollen; and itchy, too.
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: 09:00 pm - I realized I was getting itchy in some spots. I ended up finding out I had bumps popping out (like bug bites sort of) - like sores. They were in the most random spots: 12 spots appeared that night - one on my right back shoulder; one on right arm pit; one underneath my right breast on my chest; one on either side of my groin (right and left side); on left thigh; and one on inner right thigh; there were three about three inches apart or so on my left butt cheek and then on my right butt cheek; and two behind my left knee and then one on my left front ankle. They all itched. They popped out that night and I got two more appeared on Saturday morning after waking and then no more were popping out. Most showed up Friday night and Saturday night after that first 24 hours after the vaccine. I took one Benadryl at night both of those nights. They were like little open sores and they did ooze clear pus/liquid. I was trying not to itch these a lot but they did look like open sores when they popped out. They were small like a mosquito bite - maybe 2 mm. They started to scab up within 5 days for sure. But the thing is, they finally just started to disappear about two days ago. They were there for a solid 2 weeks. The most they were doing were that they were red and oozing the first few days and then they scabbed up. But even after they scabbed up they were still itchy. They are slowly fading away. I''m not sure if they are leaving scars - they seem to be fading away. I was also tired after the a vaccine right away that Friday but I did go on a hike on Saturday so I was better then. I called my doctor on that Sunday night after the vaccine and talked to a nurse on the phone. Virtual appt on Monday, 16th at 07:00 pm. Showed him virtually the spots - most of them that I could show over the computer. He said he was pretty sure it was caused by the vaccine. His reason for that is because when your body creates antibodies - and a few of them tries to create them - but no body is perfect and it kind of created a few defective antibodies. So my body noticed those defective or whatever they''re called antibodies and then they created a barrier around those and that came out on to my skin. He did say that I was fine and that I should get second vaccine but I am. The first three mornings after the first vaccine: Saturday, Sunday and Monday - feeling like something foreign was taking over my body. I could tell something was going on. The doctor said that was very normal and that it would make sense because the first 72 hours is when the antibody production is happening. No treatment was given. He thought it looked like they were starting to scab and take care of themselves. It took a full two weeks for the sores themselves to go away and I do still have some that are itchy - on my butt. They are still there a little bit. I did have some bit of bad depression - depressive, negative thoughts - and tiredness (feeling drained) last week (the second week from the 23-28th) . Last Thursday and Friday were really bad. I took a nap for 2-3 hours on Thursday night and Friday night. I made sure to be around people I care about during the weekend (I stayed with my parents one night and went to a friend''s house)- I''m doing better now with my mood and energy level - today I am feeling better - not out of the water with those symptoms but not nearly as bad as I was last week. I went to my an Appt on Sunday at 04:00pm - activates the higher brain - and after that session I felt better.


VAERS ID: 1657808 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-07-16
Onset:2021-08-13
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Illness, Impaired work ability, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: ill for a day; loss of appetite; he had to take off work because he did not feel good; chills; nauseous; overwhelming feeling like he would puke; fever; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (ill for a day), DECREASED APPETITE (loss of appetite), IMPAIRED WORK ABILITY (he had to take off work because he did not feel good), CHILLS (chills) and NAUSEA (nauseous) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 031A21A and 007C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Hypertension. Concomitant products included LISINOPRIL for an unknown indication. On 16-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-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 ILLNESS (ill for a day), DECREASED APPETITE (loss of appetite), IMPAIRED WORK ABILITY (he had to take off work because he did not feel good), CHILLS (chills), NAUSEA (nauseous), VOMITING (overwhelming feeling like he would puke) and PYREXIA (fever). The patient was treated with IBUPROFEN for Adverse event, at a dose of 1 dosage form. At the time of the report, ILLNESS (ill for a day), DECREASED APPETITE (loss of appetite), IMPAIRED WORK ABILITY (he had to take off work because he did not feel good), CHILLS (chills), NAUSEA (nauseous), VOMITING (overwhelming feeling like he would puke) and PYREXIA (fever) outcome was unknown. This case was linked to MOD-2021-289744 (Patient Link).


VAERS ID: 1657851 (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: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, Headache
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: USPFIZER INC202101057439

Write-up: Headache; vaccine was expired by one day; This is a spontaneous report from a contactable pharmacist. A 37-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 intramuscular, administered in Deltoid Left on 13Aug2021 (Lot Number: EW0196; Expiration Date: 12Aug2021) (at age of 37-year-old )as DOSE 1, 0.3 ML SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously took amoxicillin and Aspirin and experienced drug allergies. The patient experienced vaccine was expired by one day and headache on 13Aug2021. reporter stated that she considered this Medically Significant because even though she gave the expired vaccine, she had the patient stay for 15-20 minutes and the patient still had a headache. Treatment: There was No further treatment needed. The outcome of the event headache was not resolved. Causality: Yes related, the patient was not having any headache before the vaccine. Information on the Batch/Lot number has been requested. Follow-up (16Aug2021): New information reported from a contactable pharmacist includes: reporter updated,patient age, gender, suspect drugs details and event ''headache'' added. case was upgrade as serious now.; Sender''s Comments: Based on the available information and the close drug event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of event headache cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1658408 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Pain, Pyrexia, Rash, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Sciatica
Allergies: Iodine; Sodium; Benadryl; Histamine
Diagnostic Lab Data: No test was taken but observation and evaluation
CDC Split Type: vsafe

Write-up: 08/13/2021 PM general swelling, rash on the fore arm left arm then the right arm, by Sunday 08/15/2021 blister bowel pushing and hand formed mucus blister and blood blisters Fevers arches and pains until about 7 days and a round of 20mg Prednisone twice daily, two round of that and then after that given the antibodies Z-PAK. Not Azithromycin 250 Mg tablets.


VAERS ID: 1658445 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-08-13
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Immunosuppression, Lethargy, Pneumonia viral, Pyrexia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cinacalcet, diltiazem, hydralazine, losartan, magnesium oxide, pantoprazole, potassium/phosphorus/sodium (K-Phos Neutral), prednisone, tacrolimus
Current Illness:
Preexisting Conditions: obesity, hypertension leading to renal failure, on HD, renal transplant in 2019
Allergies: nka
Diagnostic Lab Data: COVID-19 PCR positive on 8/13/21
CDC Split Type:

Write-up: 8/13/2021: The patient reports that she is feeling lethargic with a low-grade temperature. Because of that and her immunosuppressive status, the patient went to the hospital for evaluation on 8/13 and was admitted. Test was positive for COVID-19 on 8/13/21. Diagnosed with acute covid 19 infection, hypoxic respiratory failure secondary to viral pneumonia. Note: previously received the Pfizer COVID-19 vaccine; First Dose: 03/11/21 Lot Number EN6208;Second Dose: 04/05/21 Lot Number EP6955 8/17/21: Discharged to home.


VAERS ID: 1658630 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-08-13
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Diarrhoea, Dyspnoea, Hypophagia, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cholecalciferol, zinc gluconate
Current Illness:
Preexisting Conditions: no significant PMHx
Allergies: nka
Diagnostic Lab Data: COVID-19 PCR positive on 8/11/21
CDC Split Type:

Write-up: 8/13/21: presents to the ED with worsening shortness of breath. Pt was in ED on 8-11-21 were he was diagnosed with COVID-19. Pt states his Sx started 7 days ago and over the last 2 days he has had worsening fever and SOB. He states he is unable to walk to the bathroom without getting SOB. He is currently taking prednisone and Azithromycin that he was prescribed. patient also complained cough, intermittent diarrhea, whole body ache from fever and poor oral intake. Pt states that he received the Johnson and Johnson COVID-19 vaccine on 07/29/2021. Diagnosed with: COVID-19 pneumonia 8/18/21: patient discharged. Admitted 8/13/21. Tested positive for Covid on 8/11/21. Diagnosed with covid 19 pneumonia and acute respiratory failure. Discharged to home on 8/18/21.


VAERS ID: 1658686 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21-2A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Atrial fibrillation, Computerised tomogram head, Dysarthria, Echocardiogram, Electrocardiogram abnormal, Hypoaesthesia, Hypoaesthesia oral, Laboratory test, Magnetic resonance imaging head, Muscle spasms, Neck pain, Neurological symptom
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/N
Current Illness: N/N
Preexisting Conditions: Orthopedic injuries
Allergies: NKDA / NKA
Diagnostic Lab Data: MRI, CT-Scan both of brain, Heart Echo and various labs performed at ER on 8/20/21
CDC Split Type:

Write-up: Three day post shot (8/13/21) had sever pain/spasms in left side of neck and left shoulder. Pain resolved in about 5-8 minutes. On 8/20/21 I was admitted via ambulance for acute left-sided neck spasms/pain and left shoulder pain accompanied with stroke-like symptoms (numbness of tongue, left arm, lower jaw, impaired speech) and for an AFIB ECG read by paramedics on scene. Transported to local ER. Remained in AFIB FOR SEVERAL HRS. Acute Neck pain/spasms have reoccured several times since ER discharge


VAERS ID: 1658780 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Flushing, Headache, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (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: During monitoring period post Pfizer COVID-19 vaccine, pt experienced Flushing, sweating, chills, dizzy, lightheaded headache. VS: 145/93, P 55, R 25, O2 97%. oMedications Ordered/Given Per Protocol: Benadryl 25mg IM x 1 per patient request, declined Epi-Pen. Patient remained in extended Observation with family member present. VS reassessed: 153/98, P 55, R 22, O2 99%. Patient elected to get lunch after 2 hours in observation. Reported still dizzy and lightheaded. Declined additional treatment. In a wheelchair, patient left the clinic in care of family. Emergency symptoms discussed with patient and family both verbalized understanding.


VAERS ID: 1658786 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Flushing, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: During monitoring period post Pfizer initial COVID-19 vaccine, pt experienced sweating, flushing, chills, lightheadedness, nausea. VS: 135/83, P 53, R 19, O2 95%. IM Benadryl administered per patient request, blanket and water provided. VS: 143/85, R 21, P 59, O2 100%, orange juice given. Repeat VS in opposite arm: VS 152/90, P 60, R 10, O2 100%. 12:41 VS: 140/75, R 20, P 60, O2 100%. o Patient was discharged to home in care of parent.


VAERS ID: 1658867 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), 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: covid-19 pfizer
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient had a Pfizer vaccine back on March 9, 2021 and after receiving the vaccine had chest palpitations and never received the second dose. His doctor advised him that he should get the Jansen Covid vaccine and not to complete the Pfizer series based on the adverse reaction he had with the first dose. So patient received two different vaccines 5 months apart, 1 pfizer and 1 jansen.


VAERS ID: 1658871 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-25
Onset:2021-08-13
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Hypoglycaemia, Hypoxia, Malaise, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Doxycycline, hydrocortisone, synthroid, metoprolol, prilosec,
Current Illness:
Preexisting Conditions: CAD, HTN, DM 2, GERD, Pacemaker, COPD, hypothyroidism
Allergies: Avandia, Januvia
Diagnostic Lab Data: 8/14/2021 SARS CoV 2 PCR COVID19 detected
CDC Split Type:

Write-up: 8/14/2021 Admitted. Sick at home x 7-10 days. He was found to have severe hypoglycemia by ambulance. He was screened with COVID testing, which turned out to be positive. Hypoxic, Admitted to COVID unit. Diagnosed with: Coronavirus pneumonitis Note: previously received COVID-19 Pfizer Vaccine: First dose: 01/04/21 Lot Number EL1284; Second dose: 01/25/21 Lot Number EL3247 8/17/21: patient discharged


VAERS ID: 1658980 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-08-13
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, Anosmia, COVID-19, COVID-19 pneumonia, Chest pain, Cough, SARS-CoV-2 test positive, Sepsis, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin, tamsulosin, lopressor, chlorthalidone, furosemide, pantoprazole, Xarelto, lisinopril, rosuvastatin, gabapentin, digoxin, diltiazemmetoprolol, levothyroxine
Current Illness: Paraplegic and neurogenic bladder
Preexisting Conditions: Paraplegia, diabetes, hypertension, hyperlipidemia, myocardial infarction, open heart surgery
Allergies: no known
Diagnostic Lab Data: COVID test + 8/16/2021
CDC Split Type:

Write-up: Admitted 8/16/2021 to Hospital with breakthrough COVID . C/O cough, chest pain and loss of taste and smell x3 days. Patient is fully vaccinated with Pfizer vaccine, 1st dose = May 14, 2nd dose = June 4. Diagnosed with COVID 19 pneumonia, acute hypoxemic respiratory failure and sepsis. Discharged 8/20/21


VAERS ID: 1659139 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-10
Onset:2021-08-13
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, hypertension
Allergies:
Diagnostic Lab Data: Cycle threshold 8/9/21 = 25.4
CDC Split Type:

Write-up: Hospitalization with COVID-19 Reported per vaccine EUA


VAERS ID: 1659202 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Excessive heavy bleeding with menstrual period lasting several days. Also numbness on her left side From jaw to leg) starting on 8/31/21


VAERS ID: 1659326 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: CHILD WAS GIVEN PFIZER COVID 19 VACCINE AT AGE OF 11. VACCINE IS APPROVED FOR 12 TO 17 YEARS OF AGE. NURSE WAS TOLD VERBALLY AND IN WRITING THAT CHILD WAS 12 YEARS OLD. NO ADVERSE SYMPTOMS HAVE OCCUR TO THE CHILD.


VAERS ID: 1660326 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Sensitive skin
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: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin was super-sensitive for a month, especially on the back of my head. I also randomly breakout.


VAERS ID: 1660994 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: SARS-CoV-2 antibody test; Result Unstructured Data: negative with an index of less than 0.01 or normal
CDC Split Type: USJNJFOC20210860141

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 59 year old male. The patient''s height and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609 expiry: UNKNOWN) dose was not reported, 1 total administered to left arm on 22-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-AUG-2021, the patient''s laboratory data included: SARS-CoV-2 antibody test (NR: not provided) negative with an index of less than 0.01 or normal (confirmed immunological vaccine failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint.; Sender''s Comments: V0: 20210860141 -COVID-19 VACCINE AD26.COV2.S-Confirmed Immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1661071 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), 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: sore arm; tiredness; Inadvertent administration of more than 2 doses; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (sore arm), FATIGUE (tiredness) and EXTRA DOSE ADMINISTERED (Inadvertent administration of more than 2 doses) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced MYALGIA (sore arm), FATIGUE (tiredness) and EXTRA DOSE ADMINISTERED (Inadvertent administration of more than 2 doses). On 13-Aug-2021, EXTRA DOSE ADMINISTERED (Inadvertent administration of more than 2 doses) had resolved. At the time of the report, MYALGIA (sore arm) and FATIGUE (tiredness) outcome was unknown. No concomitant medication was provided. No treatment medication was given. This case was linked to MOD-2021-291115 (Patient Link).


VAERS ID: 1661229 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-18
Onset:2021-08-13
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Pain, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PCR; Test Result: Positive; Comments: Covid test type post vaccination: Nasal Swab. covid test name post vaccination: PCR covid test date: 15Aug2021 covid test result: Positive
CDC Split Type: USPFIZER INC202101091589

Write-up: This is a spontaneous report from a contactable consumer. A 66-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EM9809 and Expiry date was not reported), via intramuscular route of administration on 18Feb2021 (at the age of 65-years-old) as dose 2, single for COVID-19 immunization. The patient medical history and concomitant medications was not reported. Previously patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Batch/Lot Number: EL9264 and Expiry date was not reported), via Intramuscular route of administration on 28Jan2021 as dose 1, single for COVID-19 immunization. The patient received other vaccine in four weeks was unknown. The patient was not diagnosed with COVID-19 prior to vaccination. Post vaccination the patient tested positive for COVID 19. On 13Aug2021, The patient experienced aches, pains, heavy cold symptoms, brief chills, headache, and loss of smell and taste. On 15Aug2021, the patient experienced positive pcr nasal swab. The patient underwent lab tests and procedures which included sars-cov-2 test positive on 15Aug2021. It was unknown if patient received treatment. The outcome for the events positive pcr nasal swab positive was unknown and for the event aches was recovered in 2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1662060 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ED8448 / 3 RA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1662127 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dyazide 37.5/25, Omeprazole 20mg, ASA 81mg, Evening Primrose Oil, Atorvastatin 10mg, Losartan 100mg, Melatonin 5mg, Claritin 10mg, Biotin, MVI, CO Q 10, Black Elderberry
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Penicillin, Keflex
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: 12 hours after injection, I began to have chills and rigors with elevated temp to 101.9 and dull headache. Approximately 16 hours after injection, I began to forcefully vomit, fever/chills/ rigors continued, and pounding headache developed. For the next 24 hours the fever, headache, nausea any myalgia continued.


VAERS ID: 1662148 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-08-13
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, COVID-19, Cough, Dyspnoea, Fatigue, Headache, Lacrimation increased, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Lacrimal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID19 PCR swab at ED on 8/29/21
CDC Split Type:

Write-up: Patient fully vaccinated with Pfizer: dose 1 on 3/17/21 and dose 2 on 4/7/21. patient is known to be immunocompromised at baseline. Patient reported COVID symptoms of cough, shortness of breach, headache, body aches, runny nose, watery eyes, fever, sore throat, fatigue, loss of taste starting on 8/13/21. Patient reported to the Hospital Emergency Department on 8/29/21 for worsening symptoms and then received a COVID test which was positive. Patient remains symptomatic as of 8/31/21.


VAERS ID: 1662179 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-08-13
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, COVID-19, Condition aggravated, Dizziness, SARS-CoV-2 test positive, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cholecalciferol (VITAMIN D3) 1000 UNIT tablet donepezil (ARICEPT) 10 MG tablet FLUoxetine (PROZAC) 20 MG capsule hydrochlorothiazide (HYDRODIURIL) 25 MG tablet memantine (NAMENDA) 5 MG tablet multivitamin (ONCE-A-DAY GEQ VIT) tablet
Current Illness: None known
Preexisting Conditions: Arthritis GERD (gastroesophageal reflux disease) HTN (hypertension) Hyperlipidemia Dementia (HCC) Depression with anxiety IFG (impaired fasting glucose) Overweight (BMI 25.0-29.9) Hyperuricemia Dizziness Left-sided weakness Horizontal nystagmus Acute pain of left shoulder Transient cerebral ischemia, unspecified type Elevated serum creatinine Former smoker Hypokalemia
Allergies: Rabeprazole
Diagnostic Lab Data: COVID-19 test positive on 8/13/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 8/13/2021 after testing positive for COVID-19 at an outside facility. She had complained of dizziness and had one instance of nonbloody emesis. Reports no other symptoms related to COVID-19 infection. She was given monoclonal antibodies while in the emergency department. Patient was discharged on 8/13/2021 from ED to home. Patient presented to the emergency department on 8/14/2021 after a syncopal episode while showering at home. Patient was admitted due to quarantine restrictions at assisted living facility. She remained asymptomatic for COVID-19 during admission. Patient was discharged on 8/23/2021 back to facility.


VAERS ID: 1662247 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04671A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Feeling of body temperature change, Hyperhidrosis, Injection site pain, Nodule, Oropharyngeal discomfort, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3 1000units (2 tablets 3 times daily); Eliquis 5mg (one tablet twice daily); Thride Shape 35grams (1 package daily)
Current Illness: None
Preexisting Conditions: Various
Allergies: Toradol; Haldol; DHE; Imitrex
Diagnostic Lab Data: Various Test Ran
CDC Split Type:

Write-up: Soreness at injection site, arm became swollen, golf ball size knot underneath arm, exhaustion, pain, consistent sweating, hot then cold, heaviness behind throat, chest pains


VAERS ID: 1662248 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-08-13
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chest X-ray normal, Chlamydia test negative, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Coronavirus test negative, Cough, Dehydration, Dyspnoea, Enterovirus test negative, Headache, Hiatus hernia, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Lung opacity, Mycoplasma test negative, Nausea, Oropharyngeal pain, Pain, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast abnormal, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (narrow), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen 500 mg oral tablet albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amoxicillin (AMOXIL) 500 mg tablet atorvastatin (LIPITOR) 80 mg tablet budesonide (PULMICO
Current Illness:
Preexisting Conditions: Nervous Atherosclerosis of native artery of both lower extremities with intermittent claudication Coronary artery disease of native artery of native heart with stable angina pectoris Pain syndrome, chronic Respiratory Incidental lung nodule Panlobular emphysema Chronic interstitial lung disease OSA (obstructive sleep apnea) Oropharyngeal dysphagia Circulatory Chronic diastolic heart failure Intracranial carotid stenosis, right Digestive Barrett''s esophagus without dysplasia Gastroesophageal reflux disease without esophagitis Tubular adenoma of colon Vitamin D deficiency Postgastrectomy malabsorption Lymphocytic colitis B12 deficiency Genitourinary Chronic renal disease, stage II Musculoskeletal Cervical disc disease Fibromyositis Disc degeneration, lumbar Primary osteoarthritis involving multiple joints Endocrine/Metabolic Mixed hyperlipidemia Infectious/Inflammatory COVID-19 Other Recurrent major depressive disorder Generalized anxiety disorder Insomnia Controlled substance agreement signed Personal history of nicotine dependence Recurrent incisional hernia Abdominal bloating
Allergies: CodeineHives / Urticaria, Shortness of breath / Dyspnea, Throat Swelling
Diagnostic Lab Data: 08/25/21 1819 Respiratory virus detection panel Collected: 08/25/21 1713 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 08/24/21 1729 POCT COVID-19 PCR Collected: 08/24/21 1728 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000277276 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 07/12/2022 Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast Resulted: 08/30/21 0804 Order Status: Completed Updated: 08/30/21 0804 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: 1. No pulmonary embolism identified. 2. Emphysematous change. 3. Mild peripheral groundglass opacity in the lower lungs, potentially related to the patient''s COVID 19. END OF IMPRESSION: INDICATION: Worsening oxygen requirement, COVID positive. Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstruction with MPR coronal, oblique and sagittal images were created. 3D shaded surface images also created on a separate workstation and permanently stored. Images were obtained without and with contrast. CONTRAST: 80mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was adequate. COMPARISON: 4/14/2020. FINDINGS: No filling defects are identified in the pulmonary arteries. There is mild calcified plaque in the aorta and coronary arteries. There is moderate emphysematous change. Prior noted borderline mildly prominent lymph nodes are stable. Mild peripheral groundglass opacity is potentially related to the patient''s COVID 19. No pleural effusion nor pneumothorax is present. No lung mass is detected. The airways are preserved. The patient is status post gastric surgery. There is a small hiatal hernia. No acute finding is identified in the upper abdomen. There is mild degenerative change in the spine. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 2 views Resulted: 08/25/21 1318 Order Status: Completed Updated: 08/25/21 1319 Narrative: XR CHEST 2 VW IMPRESSION: Stable chest. No acute cardiopulmonary abnormalities are identified. END OF IMPRESSION: INDICATION: COVID+ yesterday, states feeling dehydrated , +N/V covid. TECHNIQUE: PA and lateral projections of the chest are acquired. COMPARISON: Chest x-ray 7/28/2021. FINDINGS: The cardiac contour is stable. The pulmonary vessels appear normal. Mild interstitial prominence in the lungs appears stable. No new parenchymal consolidation, pleural effusion or pneumothorax is identified. There are minimal degenerative changes in the thoracic spine.
CDC Split Type:

Write-up: HA, body aches, sore throat, coughing ED to Hosp-Admission Discharged 8/25/2021 - 8/27/2021 (2 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath COVID-19 Hospital Course Patient is an 55 y.o. female with PMH of CAD, HLD, gastric bypass, COPD, emphysema who presents with nausea and vomiting and shortness of breath. Patient was well until 8/24 when she noticed that her nausea and vomiting worsen. She also noticed associated shortness of breath which has progressively worsened in the last 2 days. Patient has associated headaches, cough which she describes as dry. Patient is vaccinated with the Pfizer vaccine x2. Patient has obstructive sleep apnea and is not compliant on her CPAP machine because she feels like she has been smothered. She uses 2L O2 at night when he goes to sleep. Patient admitted to family medicine service. Her COVID test was positive. She was started on remdesevir and decadron. CT chest revealed COVID pneumonia without PE. Her nausea and vomiting improved overnight. Patient had a rest and exercise oximetry test which revealed that she did not have an oxygen requirement at rest or with exercise. Patient was discharged home on remote patient monitoring and VNA home health aide. Her remdesevir was discontinued and she was sent home on 8 more days of decadron for her COVID pneumonia. Patient discharged home in stable condition.


VAERS ID: 1662279 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Hypertension, Pulmonary embolism, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: not aware of
Current Illness: not aware of
Preexisting Conditions: not aware of
Allergies: not aware of
Diagnostic Lab Data: Patient was admitted to the hospital twice.
CDC Split Type:

Write-up: One week later the patient developed covid arm. She also had high blood pressure, was very tired, and had breathing problems. She said she was admitted to the hospital twice. Monday Aug 30 and Monday Aug 23,2021. The patient said she had difficulty breathing and had pulmonary embolism.


VAERS ID: 1662330 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Adenovirus test, Ageusia, Alanine aminotransferase increased, Anxiety, Arthralgia, Aspartate aminotransferase increased, Asthenia, Blood creatinine increased, Blood lactic acid normal, Blood sodium normal, Blood urea increased, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiomegaly, Chest X-ray abnormal, Chest pain, Chlamydia test negative, Coronavirus test negative, Cough, Diarrhoea, Dizziness, Dyspnoea, Electrocardiogram normal, Enterovirus test negative, Exposure to SARS-CoV-2, Fatigue, Haematology test normal, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Laboratory test normal, Lung infiltration, Lung opacity, Metabolic function test, Myalgia, Mycoplasma test negative, Nervousness, Oropharyngeal pain, Palpitations, Procalcitonin increased, Pyrexia, Respiratory failure, Respiratory syncytial virus test negative, Respiratory tract congestion, Respiratory viral panel, SARS-CoV-2 test positive, Taste disorder, Troponin normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (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), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinoL (ZYLOPRIM) 300 mg tablet amLODIPine (NORVASC) 5 mg tablet BYSTOLIC 10 mg tablet vit A/vit C/vit E/zinc/copper (PRESERVISION AREDS ORAL)
Current Illness:
Preexisting Conditions: Chronic idiopathic gout involving toe of left foot without tophus Mixed hyperlipidemia Impaired fasting glucose Benign prostatic hyperplasia without urinary obstruction Family History
Allergies: NKA
Diagnostic Lab Data: 08/29/21 0735 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/27/21 1532 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/29/21 0735 COVID-19 PCR Collected: 08/27/21 1532 | Final result | Specimen: Swab from Nares 08/27/21 1841 Respiratory virus detection panel Collected: 08/27/21 1658 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 1 view, Portable [3300547557] Resulted: 09/01/21 0813 Order Status: Completed Updated: 09/01/21 0813 Narrative: XR CHEST 1 VW PORT IMPRESSION: Bibasilar infiltrates, left greater than right, unchanged. This nonspecific imaging pattern can be seen with COVID-19. Other considerations include but are not limited to other infectious etiologies or noninfectious etiologies. END OF IMPRESSION: INDICATION: Hypoxia, Covid-19. Very short of breath. Male; 83 years TECHNIQUE: Portable AP upright chest 5:04 AM COMPARISON: August 31, 2021 FINDINGS: Again noted are infiltrates at the left lung base, unchanged. Minimal medial right lung base infiltrate is also unchanged. Pulmonary vasculature is normal. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3300306339] Resulted: 08/31/21 0752 Order Status: Completed Updated: 08/31/21 0752 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. No significant change in bilateral patchy airspace opacities in the lung bases. This nonspecific imaging pattern can be seen with COVID-19. Other considerations include but are not limited to other infectious etiologies or noninfectious etiologies. END OF IMPRESSION: INDICATION: Hypoxia, Covid-19. TECHNIQUE: Portable view(s) of the chest are provided. COMPARISON: 8/29/2021 FINDINGS: EKG leads overlie the chest. The lungs are adequately inflated. Persistent patchy airspace opacities are seen in the left lung base and right medial lung base. The cardiac silhouette, pulmonary vasculature and bony thorax are without significant interval change. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3300146957] Resulted: 08/29/21 1241 Order Status: Completed Updated: 08/29/21 1241 Narrative: XR CHEST 1 VW PORT IMPRESSION: New infiltrate or atelectasis at the left mid and lower lung. Small pleural effusion. Persistent interstitial markings prominence at the right medial lung base,. END OF IMPRESSION: INDICATION: hypoxia. TECHNIQUE: Single view of the chest. COMPARISON: 8/27/2021. FINDINGS: Mild cardiomegaly and normal pulmonary vascularity. Stable interstitial markings prominence at the right medial lung base. New opacification at the left lower lung. Lungs otherwise clear and well-expanded. Suspect blunting of the left costophrenic angle. The bony thorax and soft tissues are unremarkable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view - Portable [3300049653] Resulted: 08/27/21 1721 Order Status: Completed Updated: 08/27/21 1721 Narrative: XR CHEST 1 VW PORT ,8/27/2021 4:58 PM EDT IMPRESSION: There is moderate increased interstitial markings in the left and right lung bases, probably due to pneumonia. Suggest clinical correlation. END OF IMPRESSION: INDICATION: Dyspnea, hypoxia. 83 years, Male TECHNIQUE: Portable AP view of the chest. COMPARISON: 10/1/2008 chest x-ray FINDINGS: The heart is normal in size. There is moderate increased interstitial markings in the left and right lung bases, probably due to pneumonia. No pleural effusion. There is no pneumothorax.
CDC Split Type:

Write-up: Chief Complaint Patient presents with ? Fatigue pt states food just does not taste right, he feels like he has no taste, sx started about 2 - 3 weeks ago, was around positive exposures ED to Hosp-Admission Current 8/27/2021 - present (5 days) Patient is being admitted to medical surgical unit. Acute hypoxic respiratory failure. Bilateral pneumonia secondary to coronavirus infection. o Patient''s COVID-19 virus testing is positive. o Treatment protocol will be implemented. o Steroids are going to be used orally o Empiric antibiotics are initiated. Chief Complaint Patient presents with ? Shortness of Breath Patient is an 83 y.o. male presented to Emergency Care Unit for evaluation of fever, fatigue, decreased taste and cough. Patient does have a reported exposure to coronavirus about 2 weeks ago. He had been tested in the past and the test was positive. He denies having nausea, vomiting or diarrhea. During the initial stages of evaluation in emergency care unit the following test and imaging were ordered. I have personally reviewed the results: o Hematology panel is generally unremarkable. o Procalcitonin is mildly elevated 2.41 ng/mL. o Troponin is 0.03 ng/mL. o Comprehensive metabolic panel is revealing depleted sodium to 140 mmol/L. o BUN and creatinine are elevated indicative of the acute renal injury. o Patient does have elevated AST and ALT. o Lactate is within normal range. o Microbiology studies reviewed detected corona virus?COVID-19. o Imaging studies confirm bilateral interstitial changes in both lung bases. o EKG is revealing normal sinus rhythm Review of Systems Constitutional: Positive for appetite change, fatigue and fever. HENT: Positive for congestion and sore throat. Eyes: Negative. Negative for discharge. Respiratory: Positive for cough and shortness of breath. Cardiovascular: Positive for chest pain and palpitations. Gastrointestinal: Positive for diarrhea. Endocrine: Negative. Genitourinary: Negative. Negative for difficulty urinating. Musculoskeletal: Positive for arthralgias and myalgias. Skin: Negative. Negative for rash. Allergic/Immunologic: Negative. Neurological: Positive for dizziness and weakness. Hematological: Negative. Negative for adenopathy. Psychiatric/Behavioral: The patient is nervous/anxious. All other systems reviewed and are negative.


VAERS ID: 1662379 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-08-13
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aspiration pleural cavity, COVID-19, Chest X-ray abnormal, Cough, Diarrhoea, Dyspnoea, Fatigue, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lung consolidation, Nausea, Pleural effusion, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid COVID test positive on 8/19/2021; Influenza A and B negative on 8/19/2021
CDC Split Type:

Write-up: Patient presented to the emergency department on 8/19/2021 with fever and cough that started 6 days ago. While at home he has had mild shortness of breath, nausea, diarrhea, and fatigue. Chest Xray shows interval development of a moderate size right pleural effusion and adjacent consolidation. Patient had a thoracentesis with removal of 1.7 L.


VAERS ID: 1662453 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: Two days after the patient received the vaccination, 8/13/21, patient starting developing a rash below the neck area. The rash was itchy. It did go away but the patient was still itching in that area. Patient is currently taking hydroxyzine to help with the itching. The patient also reported not feeling her normal self after the vaccination. She feels more tired than normal no matter how much rest she gets. The patient did report having COVID-19 in May. Patient came in on 9/1/21 to report the adverse effect.


VAERS ID: 1662522 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain, Appendicitis, Computerised tomogram, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: CT and US ~8/13/21?
CDC Split Type: 415138

Write-up: ~3-4 days following vaccination c/o severe abdominal cramping and bloating. Went to ER d/t suspecting appendicitis.


VAERS ID: 1662534 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-11
Onset:2021-08-13
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Fatigue, Nausea, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Congestive heart failure
Allergies:
Diagnostic Lab Data: 08/18/2021 PCR+ COVID-19 test
CDC Split Type:

Write-up: Fever $g100.4, Subjective fever (felt feverish), New loss of taste or smell, Cough, Shortness of breath or difficulty breathing, Fatigue or tiredness, Nausea or vomiting, Went to urgent care for COVID test at start of symptoms and was diagnosed with pneumonia. Then symptoms worsened and he was hospitalized at Hospital


VAERS ID: 1663149 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Heavy menstrual bleeding, Menstruation irregular, Pain, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility 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: Birth control Loryna
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfanomide
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 8/11/2021 received vaccine dose #1. 8/13/2021 6 am woke up with heavy bleeding. She was not due for her period. Bleeding lasted 3 days. Started bleeding again 8/29/2021. Started menstrual bleeding again and lasted 2 days. Had already bled at the beginning of the month, so ended up with a total of 3 episodes of bleeding in same month. Bleeding heavier than her usual menstrual bleeding. Also had body aches and severe abdominal pain on 8/18/2021. She thought it was bad gas. She bought Gas-X and was not relieved.


VAERS ID: 1663926 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-08-13
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Discomfort, Dizziness, Dyschromatopsia, Dyspnoea, Dyspnoea exertional, Feeling abnormal, Loss of consciousness, Paralysis, Speech disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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 100MG, Lisinopril 40MG, Amlodipine Besylate 10MG, Bupropion HCL XL 300MG
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Since the day of my second Moderna shot I have been short of breath at the slightest exertion. My doctor referred my to a cardiologist, which I was forced to decline because of lower income due to the pandemic. In the past month I''ve had several dizzy spells. On August 13 in the evening I suddenly became very weak in my upper body. I sat down to try to relax and drank a few sips of soda to get some sugar in me. After 5 minutes I was feeling worse and my vision was fading like the color was desaturating. I was breathing harder but felt that I was unable to get enough oxygen. I stood up to try to shake it off and my vision became dark and I felt heavy. My wife called 911 at this point. I began breathing very rapidly and deeply trying to get oxygen as I began to lose consciousness. I laid down on the couch and could hear clearly but couldn''t move or speak. My wife says I became fully unconscious for a few minutes, and my breathing was nearly imperceptible. I then regained consciousness and remained lying on the couch. EMS arrived. They offered to take me to the hospital but as I was feeling better and I still have no money to pay for an ER visit, I declined. After visiting my doctor, she once again referred me to a cardiologist, and I have an appointment scheduled for September 3.


VAERS ID: 1665509 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-13
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Neck pain, Spinal pain, Vaccination site pain
SMQs:, Arthritis (broad)

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

Write-up: she had pain in her neck & down through her spine & arm, down to the wrist.; she had pain in her neck & down through her spine & arm, down to the wrist.; she had pain in her neck & down through her spine & arm, down to the wrist.; she had pain in her neck & down through her spine & arm, down to the wrist.; This spontaneous case was reported by an other health care professional and describes the occurrence of NECK PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), SPINAL PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), VACCINATION SITE PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.) and ARTHRALGIA (she had pain in her neck & down through her spine & arm, down to the wrist.) 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 an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced NECK PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), SPINAL PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), VACCINATION SITE PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.) and ARTHRALGIA (she had pain in her neck & down through her spine & arm, down to the wrist.). At the time of the report, NECK PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), SPINAL PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.), VACCINATION SITE PAIN (she had pain in her neck & down through her spine & arm, down to the wrist.) and ARTHRALGIA (she had pain in her neck & down through her spine & arm, down to the wrist.) 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. No concomitant medications were reported. No treatment information was provided.


VAERS ID: 1665742 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1665755 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665757 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1665994 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1666068 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Dizziness, Electrocardiogram, Extrasystoles, Fatigue, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (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: Tetanus booster, age 41
Other Medications: Vit C; Vit D; toxin pull
Current Illness:
Preexisting Conditions: Auto Immune; lyme disease
Allergies: Bactrim; Macrobid
Diagnostic Lab Data: Blood work, EKG, Chest X-ray
CDC Split Type: vsafe

Write-up: The next morning I was sitting in my chair watching tv and my fit bit buzzed and my heart rate was 120. I was tired and fatigued and my heart rate stayed elevated for a week and I became dizzy and my heart rate kept spiking and I had a lot of skipped beats and palpitations. I went to doctor.


VAERS ID: 1666229 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-03
Onset:2021-08-13
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW9162 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myeloid leukaemia, Bone marrow transplant, Chemotherapy, Computerised tomogram head, Computerised tomogram neck, Ear pain, Induration, Lymphadenopathy, Otitis media, Ultrasound scan abnormal, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: azelastine nasal spray methylphenidate 40 mg LA capsule
Current Illness: None
Preexisting Conditions: ADD asthma
Allergies: None
Diagnostic Lab Data: CT head and neck with ultrasound
CDC Split Type:

Write-up: 17 yo previously healthy male that seen in clinic Friday 8/27/2021 for sports physical. Only complaint with right ear pain that was previously diagnosed as otitis media in after hours clinic. Still with symptoms. On exam large right lymph node, hard, nontender, nonmobile right angle of jaw. Additional left superior anterior SCM 8 cm lymph node with similar description. WBC 50K. Patient sent to Hospital ER and currently admitted and diagnosed with AML. He is undergoing bone marrow transplant and 6 weeks of chemotherapy.


VAERS ID: 1666257 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac failure, Fluid retention, Headache, Myocardial infarction, Pain, Pulmonary oedema, Pyrexia, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: High Blood Pressure and arthritis medication and cholesterol control medication
Current Illness: None
Preexisting Conditions: In need of knee replacements
Allergies: None
Diagnostic Lab Data: Hospitalization, Kidney treatments, lasix did NOT work. Switched medicines and two days later, fluids began to subside. Kidneys HAVE started working again, but still in recovery. Lungs have mostly cleared, but still in recovery. Heart attack caused MAJOR damage and could not be checked due to excess fluids and lack of kidney function. He now is at ONLY 30% heart function with Heart Failure. He is home with a long road to recovery...WE HOPE! Now has a Cardiologist.
CDC Split Type:

Write-up: Headaches, soreness, mild fever continued until the following Thursday and fever spiked. After Tylenol, fever subsided some then spiked again and we took him to the ER followed by admission into Hospital where we found he had suffered a heart attack and had massive fluid retention and his kidneys were ceasing funtion, plus fluid in his lungs.


VAERS ID: 1666485 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram, Electrocardiogram ambulatory normal, Headache, Nausea, Palpitations, Pericarditis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG and blood work (exact blood work not known) on 8/20/21 24 hour holter & echo on 8/26/21
CDC Split Type:

Write-up: COVID vaccine given at on 8/12/21 @3pm, employee states on 8/13/21 @3-4pm had the following symptoms: chest pain, SOB, feeling of heart racing, weakness, headache and occasional nausea. Went to on 8/20/21, dx with pericarditis, with EKG and blood test being done (exact blood work not known). Instructed to start Ibuprofen 600mg TID. On 8/26/21 a 24hr holter & echo were done, both normal. On 8/31/21 saw his PCP steroids were started.


VAERS ID: 1666554 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Oropharyngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe sore throat next day, severe shoulder muscle pain


VAERS ID: 1666662 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Unknown  
Location: Tennessee  
Vaccinated:2021-02-22
Onset:2021-08-13
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 022M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Chest pain, Chills, Convalescent plasma transfusion, Cough, Diarrhoea, Dyspnoea, Headache, PO2 increased, Pneumonia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ABGs showed PO2 of 60 Chest XRay showed bilateral pna
CDC Split Type:

Write-up: Presented to the ED with c/o headache, chest pain, shortness of breath, cough, fever, chills and diarrhea. Patient was diagnosed with COVID 19 days ago. patient was admitted to the hospital. patient was given remdisvir and convalescent plasma. Patient was discharged home on 08/21/2021


VAERS ID: 1666910 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-25
Onset:2021-08-13
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Full blood count normal, Immediate post-injection reaction, Laboratory test normal, Metabolic function test normal, Thyroid function test normal, Vaccination complication, Vertigo positional
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow), Hypersensitivity (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: 1/28/2021 COVID 1st Moderna COVID arm that was severe raised and red and itching like crazy that lasted about 5-7 days. (five da
Other Medications: Xarelto; Thyroid medication; Vitamin D supplement; Calcium; low dose of Keflex
Current Illness: No
Preexisting Conditions: Intermittent atrial fibulation - it comes and goes; slightly Low thyroid - treated for that; a little arthritis; frequent bladder infections
Allergies: Have a lot - Darvon; a couple of different eyedrops - Ristasis and another one; Azo dye.
Diagnostic Lab Data: Blood count CBC; panel metabolic and thyroid panel Lab - this past Tuesday - they were all in the normal range; nothing in the unusual range.
CDC Split Type: vsafe

Write-up: COVID arm but milder than the after the first vaccine for COVID - happened immediately. It only happened at night when I went to bed and when I moved. I had to stare straight ahead and then it would go away. Every single time I moved it would come - a type of dizziness. If I tried to turn over - it happened again. Benign Paroxysmal Positional Vertigo. BPPV - it usually lasts a couple weeks, they say. Mine is 99% gone. I have only had one little tinge of it in the last 4 or 5 days. So, it only lasted about 2 weeks. Once I was upright, I didn''t have any symptoms at all. It was only when I was lying down. Has to do with the inner ear. No treatment. I checked in with my family doctor and she said it sounds typical to this condition. By the time I called her, it was starting to decrease. If my head was in the back condition and head turning side to side. When I leaned back into the bowl where they wash your hair at my recent haircut - I did have a momentary occurrence of the symptoms. It''s still happening but not very often.


VAERS ID: 1666916 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-04
Onset:2021-08-13
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aspiration, Confusional state, Diarrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: He was hospitalized d/t aspiration, and admitted on the 08/13 to Hospital. His sx. were diarrhea and increased confusion, which began on the 9th.


VAERS ID: 1666947 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-05
Onset:2021-08-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Depression, Exposure during pregnancy, Foetal death, Stillbirth
SMQs:, Depression (excl suicide and self injury) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The patient had a mostly uneventful pregnancy. She was treated at one point for depression, but stopped the medication and coped well. She received the vaccine on 8/5 and reported a very active baby that day. Five days later, she felt the baby move for the last time, and came in for evaluation the next day, and the baby had passed away. I am uncertain if the vaccine had anything to do with the stillbirth, but I wanted to report it as everything was healthy and normal leading up to it.


VAERS ID: 1669463 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-01-13
Onset:2021-08-13
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 1802259 / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood cholesterol, COVID-19, SARS-CoV-2 test, Vaccination failure, Vitamin D
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN; PILOCARPINE HYDROCHLORIDE; MAGNESIUM OXIDE; ESTRADIOL; COLECALCIFEROL; FLONASE [MOMETASONE FUROATE]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib; Allergy (on medication); Blood cholesterol abnormal (on medication); Vitamin D deficiency (on medication)
Allergies:
Diagnostic Lab Data: Test Name: Blood cholesterol; Result Unstructured Data: Test Result:abnormal; Test Name: COVID-19 virus test; Test Result: Positive ; Test Name: Vitamin D; Result Unstructured Data: Test Result:deficiency
CDC Split Type: USPFIZER INC202101101180

Write-up: COVID-19 DELTA/Pfizer COVID-19 vaccine (1st dose : 23-Dec-2020 and 2nd dose : 13-Jan-2021; COVID-19 DELTA/Pfizer COVID-19 vaccine (1st dose : 23-Dec-2020 and 2nd dose : 13-Jan-2021; This is a solicited report from a non-Pfizer sponsored program, from a contactable consumer, based on information received by Pfizer from Bristol-Myers Squibb (manufacturer control number: US-BRISTOL-MYERS SQUIBB COMPANY-BMS-2021-083107), license party for apixaban. This 63-year-old female patient was involved in a patient support program. The patient received APIXABAN. The report describes a case of COVID-19 (COVID-19 DELTA). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), (all at 62 years old) dose 2 via an unspecified route of administration on 13Jan2021 (Batch/Lot number was not reported) as DOSE 2, SINGLE, dose 1 via an unspecified route of administration on 23Dec2020 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation, apixaban, oral from 2018 (Batch/Lot Number: 1802259; Expiration Date: Oct2023) to an unspecified date, at 5 milligram, bid for cerebrovascular accident prophylaxis. The patient''s past medical history included AFib, Blood cholesterol abnormal (on medication), Vitamin D deficiency (on medication) and Allergy (on medication). Concomitant medications included atorvastatin taken for an unspecified indication, start and stop date were not reported; pilocarpine hydrochloride taken for an unspecified indication, start and stop date were not reported; magnesium oxide taken for an unspecified indication, start and stop date were not reported; estradiol taken for an unspecified indication, start and stop date were not reported; colecalciferol taken for an unspecified indication, start and stop date were not reported; mometasone furoate (FLONASE [MOMETASONE FUROATE]) taken for an unspecified indication, start and stop date were not reported. Previously administered products included for COVID-19 immunization: Pfizer COVID-19 vaccine (1st dose : 23-Dec-2020 and 2nd dose : 13-Jan-2021) from 23-Dec-2020 to 13-Jan-2021; for Product used for unknown indication: Prednisone. Past adverse reactions to the above products included Heartbeats increased with Prednisone. In 2018, the patient started APIXABAN (batch no. 1802259) (Oral), (5 milligram, twice a day). On 13-Aug-2021, the patient experienced COVID-19 (COVID-19 DELTA). The patient was treated with azithromycin (Zithromax) for COVID-19,. The action taken with APIXABAN(Oral) was unknown. At the time of the report, COVID-19 did not resolve. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: Positive. For APIXABAN(Oral), the reporter did not provide any causality assessments. Therapy with apixaban was given for prophylaxis stroke. It was reported that ''she has had fever, not productive coughing, nasal discharge that seemed like a sinus infection, really bad jaw pain, ocular pain (felt like eyes would pop out), and headaches. she was prescribed Zithromax and Prednisone. she has taken the Zithromax but she has not fill the prescription for Prednisone. she is going to have an IV treatment called bamlanivimab. she stated that her doctor thinks that the COVID-19 vaccine effectiveness maybe waning for her''. The outcome of the events was not recovered. Causality of event COVID-19 for drug Apixaban was assessed by the reporter as no information, by company (Bristol-Myers Squibb) as not related.; Sender''s Comments: Based on temporal association, a causal relationship between the events and bnt162b2 cannot be completely excluded. The events are unrelated to apixaban. The case will be reassessed when additional information becomes available.


VAERS ID: 1669654 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Diarrhea really bad; Bad Vomiting; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea really bad) and VOMITING (Bad Vomiting) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021 at 2:00 PM, 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) (Intramuscular) 1 dosage form. On 13-Aug-2021, the patient experienced VOMITING (Bad Vomiting). On 13-Aug-2021 at 3:00 AM, the patient experienced DIARRHOEA (Diarrhea really bad). On 13-Aug-2021, DIARRHOEA (Diarrhea really bad) and VOMITING (Bad Vomiting) had resolved. No Concomitant medications were reported No treatment medications were reported.


VAERS ID: 1669866 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC31870 / 1 LA / IM

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

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

Write-up: Systemic: Headache-Severe, Additional Details: Patient stated she experienced a migraine for 1 week after the administration of her first vaccination. She said she took Tylenol, but the migraine still persisted.


VAERS ID: 1670143 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Headache, Myalgia, Nausea, Neck pain, Pain in extremity, Photophobia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Alprazolam Rosuvastatin Losartan Vitamin D3 Multivitamin
Current Illness: Allergic reaction to oxcarbazepine
Preexisting Conditions: High blood pressure High Cholesterol Major Depression Anxiety Disorder
Allergies: Sulfa drugs oxcarbazepine Trileptal Lamotrigine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Nausea, diarrhea, severe headache, dizziness, arm & neck pain, weakness, muscle aches, sleepiness, light sensitivity. Symptoms started about 12 hours after vaccine and lasted for 3-5 days.


VAERS ID: 1670249 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-08
Onset:2021-08-13
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Asthenia, Brain natriuretic peptide increased, Bronchitis, COVID-19, COVID-19 pneumonia, Cardiac failure, Cardiac failure acute, Cardiac failure congestive, Chest X-ray abnormal, Chills, Cholecystitis, Computerised tomogram thorax, Cough, Diastolic dysfunction, Dizziness, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram normal, Fatigue, Full blood count normal, Hypotension, Hypoxia, Lung opacity, Metabolic function test abnormal, Nausea, Oedema peripheral, Oxygen saturation decreased, Pacemaker generated rhythm, Pleural effusion, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Syncope, Tachypnoea, Ventricular hypokinesia
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler allopurinol (ZYLOPRIM) 100 MG tablet atorvastatin (LIPITOR) 20 MG ta
Current Illness: Found to be COVID-19 positive 8.21.21 - ED visit (8.21.21) - SYNCOPE Acute bronchitis - seen in office 7.28.21 (chronic shortness of breath) from ED visit 8.21.21: ED Provider Notes (Physician) ? ? Addiction Medicine Patient was signed out to me by the prior emergency department provider. For original emergency department report details, please see prior note. At the time of sign-out, patient was awaiting a CT angiogram of the thorax to rule out PE in the setting of new COVID infection diagnosis and syncopal episode. Patient was never noted to be hypoxic, but did arrive mildly hypotensive. He was given 2 L of IV fluids prior to sign-out and had responded to fluids nicely with normalization of his blood pressures. Patient does report feeling severe generalized fatigue and cough and assumed he had bronchitis. He does appear mildly fatigued here, but is still satting 97% on room air and has otherwise normal vital signs. His CT scan came back negative for PE but did show signs of congestive heart failure verses airspace disease. Given that patient does have a positive COVID test and also has an elevated BNP, he could certainly have a combination of both heart failure and COVID infection causing these findings on CT scan. I did tell him he should follow up with his PCP about possibly having an echocardiogram at some point. He does have lower extremity edema which he states is not new for him. The CT also commented on a an inflamed appearing gallbladder without gallstones, and I asked the patient if he has had any right upper quadrant abdominal pain, and he denies this. I examined him he had a completely nontender abdomen, in particular nontender in the right upper quadrant. Overall, the patient felt comfortable going home. He states he has a pulse oximeter at home. He ambulated with no difficulty and did not have any desaturation episodes. Ultimately this confirmed that he was appropriate for discharge home and patient was in agreement. He understood follow up instructions and return precautions. All questions are answered and patient is discharged in stable condition
Preexisting Conditions: History of non-Hodgkin''s lymphoma Mild persistent asthma without complication Gastroesophageal reflux disease Gout, unspecified cause, unspecified chronicity, unspecified site Chronic obstructive pulmonary disease, unspecified COPD type Essential hypertension Hyperlipidemia, unspecified hyperlipidemia type Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin Sarcoidosis of lung with sarcoidosis of lymph nodes Stage 3a chronic kidney disease Lymphedema Acute bronchitis, unspecified organism Pneumonia due to COVID-19 virus Gout GERD (gastroesophageal reflux disease) COPD (chronic obstructive pulmonary disease) Acute on chronic combined systolic and diastolic congestive heart failure
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive (8.21.21) - hospitalized on 8.28.21 due to COVID (fully vaccinated) Discharge Information: Admission Date: 8/27/2021 Discharge Date: 09/02/2021 Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM: Hypoxia Acute on chronic congestive heart failure, unspecified heart failure type Pneumonia due to COVID-19 virus COVID-19 HOSPITAL COURSE: Patient is a 71 y.o. male who presented to the emergency department with complaints of shortness of breath. He has a past medical history of chronic obstructive pulmonary disease, hypertension, GERD, gout, non-Hodgkin''s lymphoma, CKD stage 3, type 2 diabetes, and lymphedema. Patient states that on 08/18/2021, he started having symptoms of COVID-19 including shortness of breath, fatigue, chills, fever, congestion, rhinorrhea, nausea, dizziness and weakness. On 08/21/2021, he presented to the emergency department and COVID-19 was confirmed. He states that since then he has had increasing shortness of breath. Yesterday afternoon, a home health nurse checked his oxygen saturation and found it to be 87% on room air. He presented to the emergency department after realizing he was hypoxic on room air. In the emergency department, patient was febrile, tachypneic, and required 2 liters/minute supplemental oxygen via nasal cannula to maintain a saturation greater than 90%. Complete blood count was unremarkable. BMP was remarkable for chronic kidney disease. BNP was 2261 in the emergency department, and increase from 1296 last week. EKG showed V paced rhythm. Chest x-ray showed few patchy opacities in the right perihilar region and left lower lung along with small bilateral pleural effusions. Echocardiogram from 08/16/2020 shows LVEF of 45% with mild septal hypokinesis. Additionally, it shows diastolic dysfunction stage I. Suspect hypoxia related to COVID-19 pneumonia. Patient has been admitted for further evaluation management of COVID-19 pneumonia and acute on chronic combined systolic and diastolic congestive heart failure. Patient was admitted and diuresed with Lasix. Had echocardiogram done recently on 08/16 was obtained from outpatient and found to have a stable ejection fraction of 40-45%. He diuresed well with improvement of his renal function to his baseline. He was treated with steroids and remdesivir. He was able to be weaned off of oxygen but continued to have persistent dyspnea and exertional shortness of breath with cough. With continued treatment the symptoms eventually improved and was felt he was stable to be discharged home for continued care. He will follow salt and fluid restrictions, and his Lasix was increased to twice daily. He will have a BMP drawn within 1 week and will follow up with tip in the latter more within the next week. He is greater than 10 days from onset of symptoms so he no longer needs to self isolate.


VAERS ID: 1670347 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-09
Onset:2021-08-13
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Biopsy bone marrow normal, Blood test abnormal, Contusion, Dizziness, Intensive care, Laboratory test, Malaise, Petechiae, Platelet count decreased, Platelet transfusion, Red blood cell count decreased, SARS-CoV-2 test negative
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Anastrozole; 1 mg Oral once a day with meals at 1PM aka:ARIMIDEX Valsartan-hydroCHLOROthiazide; 160 mg12.5mg oral tablet once a day with meals at 1PM aka: DIOVAN-HCT
Current Illness: None
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: See above: Patient given 30 day pill supply of predniSone 20mg 3 times per day for 30 days
CDC Split Type:

Write-up: 30 days after Janssen Injection, patient felt ill, dizzy. Noticed large quantity of small red blood dots on legs, thighs, lower extremities. Small bruise on left hand and left elbow blossomed in to massive black and blue and brown bruise. Patient went to Well Center on 8/28/2021. Doctors immediately send patient to Emergency Center. Dr. took blood test and determined that patient was in critical condition with blood platelet count below <3k where normal platelet count should be 150k to 400k. Patient Emergency evacuated via Ambulance Hospital main facility bypassing Emergency room and going directly in to critical Care unit. Dr. took another blood sample and verified Platelets and red blood cell counts extremely low. A platelet IV was administered to prevent patient from crashing. Patient moved to Critical Care Unit upstairs where teams of doctors started determining action plan for recovery and initial cause of incident. Patient blood tested for COVID, came back negative and count was normal. Dr.''s tested Kidneys, Liver, Spleen, lower abdomen for any irregularities and found none. Then performed a Bone Marrow Needle biopsy with a MRI for needle placement. Bone Marrow test came back Normal. Patient stayed in hospital until 9/1/2021 with a platelet count of 159k. Patient given 30 day pill supply of predniSone 20mg 3 times per day for 30 days. Massive bruising of hands, elbow, legs. Looked like patient had been in car accident.


VAERS ID: 1670352 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-06
Onset:2021-08-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram abnormal, Heart rate increased, Sinus tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: meningitis vaccine gave me all the symptoms of meningitis
Other Medications: delzacol, low estrogel 0.3, spirolactone, vit b12 500, zoloft, zyertec
Current Illness: None
Preexisting Conditions: Ulcerative Colitis Asthma
Allergies: Latex, Walnuts, Penicillin, Nexium
Diagnostic Lab Data: 3 lead showed sinus tachacardia, normal BP and o2 sats.
CDC Split Type:

Write-up: About a week after vaccine, developed rapid heart rate with any exertion. Resting HR 70''s, with any exertion it would go up to 140-150 and I became short of breath. this lasted about 4 days. I just would sit and rest and do deep breathing and eventually it would come back down.


VAERS ID: 1670537 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

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

Write-up: Shortness of breath, weak, heart palpitations.


VAERS ID: 1670551 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-09
Onset:2021-08-13
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

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

Write-up: Patient failed to advise they received a first dose of the Moderna Vaccine on 01/09/2021 at another facility and came into Pharmacy requesting a first dose of the Pfizer. After giving her the dose and submitting to the system we discovered the first dose.


VAERS ID: 1670579 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670588 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670620 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient came into the school clinic on Aug. 13, 2021 to receive her first Pfizer vaccine. The nurse who administered the vaccine failed to check the patient''s birthdate and went ahead and gave the vaccine. The patient was only age 11 at time of vaccine and Pfizer states the patient must be 12 and up. The patient did not have any adverse reactions to the first dose. On Sept. 3, 2021 another nurse checked the patient''s birthdate and realized the patient was not eligible to receive a second dose, and shouldn''t have received the first dose.


VAERS ID: 1670626 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670632 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670644 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670659 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Heart rate increased, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None nothing.
Current Illness:
Preexisting Conditions: Heart, Lipedema,allergies,
Allergies: Lactose, ragweed, certain pollens, mold.
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 8/13/2021, 8/14/21 still feel heart elevated and fatigue. Fever, chills, elevated heart rate, fatigue, pain at injection sight. Felt like I had covid again.


VAERS ID: 1670680 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670693 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670729 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
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: Error: Improper Storage (temperature)-


VAERS ID: 1670842 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Eczema, Hypoaesthesia, Mobility decreased, Pain in extremity, Paraesthesia, Tendonitis, X-ray limb abnormal
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZyrTEC 10 mg oral tablet, 10 mg= 1 tab, Oral, Daily
Current Illness: none known
Preexisting Conditions: Eczema
Allergies: none known
Diagnostic Lab Data: Diagnostic Results Imaging XR Shoulder Complete 2+ Views Left 08/31/21 07:49:55 IMPRESSION: Calcific tendinitis. No acute osseous abnormality.
CDC Split Type:

Write-up: Left arm numbness. Gradual onset with 2nd COVID shot 8/13/2021. States feels like pins and needles. This is a 55 Years old Female with history of eczema is presenting with pain to the left upper extremity that occurred on the 13th. Patient reports that she had received the Pfizer COVID-19 vaccine, following, her left arm went numb and began to tingle and has been an ongoing symptom. Reports not being able to move arm well but is able to close her left hand. Symptoms occurred gradually and are still present. Symptoms are described as moderate in nature. Negative vomiting. Negative nauseousness. Negative diarrhea.


VAERS ID: 1670882 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Coordination abnormal, Dyspnoea, Fall, Feeling abnormal, Feeling cold, Hyperhidrosis, Hypoaesthesia, Pallor, Tachycardia, Visual impairment
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

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

Write-up: Pale, cool, diaphoretic with tachycardia and c/o SOB and "not feeling right"; legs uncoordinated, left hand numbness. Reported falling and visual disturbances.


VAERS ID: 1671600 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Hot flush, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Dizziness. Severe for first couple of days to include nausea, chills, hot flash. Comes and goes few times a week. Lasts for few minutes to few hours. Has been occurring for 3 weeks. Extreme fatigue on days with dizziness.


VAERS ID: 1672284 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Hyperhidrosis, Nausea, Seizure, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Entresto 49/51mg twice daily Carvedilol 12.5mg twice daily Zyrtec 10mg daily Pravastatin 40mg daily Spirinolactone 25mg daily Aspirin 81mg daily
Current Illness: None
Preexisting Conditions: Hypertension Hyperlipidemia
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intermittent Chest pain with Profuse sweating for 8-12 hour periods, extreme tremors/convulsing during sleep (without fever) from 8/13/21-8/18/21, nausea and dizziness.


VAERS ID: 1672405 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040CZ1A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Dizziness, Gait disturbance, Hypersomnia, Nasopharyngitis, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TAMOXIFEN; METOPROLOL; METFORMIN; SIMVASTATIN
Current Illness: Breast cancer (left breast)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Body temperature; Result Unstructured Data: 102.2 degree F in the evening and later decreased to 101.2 degree F; Test Date: 20210815; Test Name: Body temperature; Result Unstructured Data: 97.4 degree F; Test Date: 20210816; Test Name: Body temperature; Result Unstructured Data: 99.1 degree F.
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Dizzy; Unsteady on her feet; Chills/ Chilling badly; Had temperature of 102.2 degree Fahrenheit; Cold; Could not wake up/ Wanted to sleep all day; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS, NASOPHARYNGITIS, HYPERSOMNIA, GAIT DISTURBANCE, and CHILLS in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040CZ1A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. Concurrent medical conditions included Breast cancer (left breast). Concomitant products included TAMOXIFEN for Cancer, METFORMIN for Diabetes, METOPROLOL for Tachycardia, SIMVASTATIN for an unknown indication. On 12-Aug-2021 at 2:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Aug-2021, the patient experienced NASOPHARYNGITIS, HYPERSOMNIA, and CHILLS. 13-Aug-2021, the patient experienced PYREXIA. On an unknown date, the patient experienced DIZZINESS and GAIT DISTURBANCE. At the time of the report, DIZZINESS, NASOPHARYNGITIS, HYPERSOMNIA, GAIT DISTURBANCE, CHILLS, and PYREXIA outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Aug-2021, Body temperature: high 102.2 degree F in the evening and later decreased to 101.2 degree F. On 15-Aug-2021, Body temperature: (normal) 97.4 degree F. On 16-Aug-2021, Body temperature: (normal) 99.1 degree F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was unknown. No treatment medication information was provided. Concomitant medication included diuretic every few days. Historical vaccine included shingles vaccine.


VAERS ID: 1672726 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-23
Onset:2021-08-13
   Days after vaccination:112
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Oropharyngeal pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: throat pain; a runny nose; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (throat pain) and RHINORRHOEA (a runny nose) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-May-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 OROPHARYNGEAL PAIN (throat pain) and RHINORRHOEA (a runny nose). At the time of the report, OROPHARYNGEAL PAIN (throat pain) and RHINORRHOEA (a runny nose) outcome was unknown. Concomitant medications included psychiatric medications (unspecified). No treatment medications were provided.


VAERS ID: 1672829 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-10
Onset:2021-08-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Heart rate, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210813; Test Name: Heart rate; Result Unstructured Data: increased
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Myalgia; chest pain; shortness of breath; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Myalgia), CHEST PAIN (chest pain) and DYSPNOEA (shortness of breath) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939902) for COVID-19 vaccination. No Medical History information was reported. On 10-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 MYALGIA (Myalgia), CHEST PAIN (chest pain) and DYSPNOEA (shortness of breath). At the time of the report, MYALGIA (Myalgia), CHEST PAIN (chest pain) and DYSPNOEA (shortness of breath) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 13-Aug-2021, Heart rate: increased (High) increased. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product was not provided by the reporter. Treatment information was not provided.


VAERS ID: 1672933 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (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: Felt diffuse chest pressure throughout the chest; This spontaneous case was reported by an other health care professional and describes the occurrence of CHEST DISCOMFORT (Felt diffuse chest pressure throughout the chest) 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 12-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 CHEST DISCOMFORT (Felt diffuse chest pressure throughout the chest). On 14-Aug-2021, CHEST DISCOMFORT (Felt diffuse chest pressure throughout the chest) 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 medications were provided. Treatment information was not provided. This case was linked to MOD-2021-293700 (Patient Link).


VAERS ID: 1673222 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burn oral cavity, Hypoaesthesia oral, Lymphadenopathy, Oropharyngeal pain, Paraesthesia oral, Pyrexia, Tenderness, Throat irritation, Vaccination site erythema, Vaccination site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (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: Medical History/Concurrent Conditions: Allergic reaction to analgesics; Environmental allergy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101058337

Write-up: Tongue warm, tingling, and numb-ish.; Injection site 5 inch swollen; fevered; injection site red; Under same arm, lymph gland swollen about same size and tender; Under same arm, lymph gland swollen about same size and tender; Tongue warm, tingling, and numb-ish.; Tongue warm, tingling, and numb-ish.; Glands in throat itchy and random sharp pain.; Glands in throat itchy and random sharp pain.; This is a spontaneous report from a non-contactable consumer (patient). A 56-year-old female patient (not pregnant) received the second dose of BNT162B2 via an unspecified route of administration on the left arm on 13Aug2021 at 12:00 (Lot Number: FC3180) at the age of 56-year-old as single dose for COVID-19 immunization. Medical history included multiple environmental allergies. Prior to vaccination, the patient was not diagnosed with COVID-19. Known allergies included demerol. Since the vaccination, the patient had not been test for COVID-19. The patient didn''t received other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medication included Spring Valley 10. The patient previously received Demerol and experienced allergy. The patient previously received the first dose of BNT162B2 via an unspecified route of administration on the left arm on 23Jul2021 at 10:00 AM (Lot Number: FA6780) at the age of 56-year-old as single dose for COVID-19 immunization. On 13Aug2021 at 14:00, the patient experienced injection site 5 inch swollen, fevered, and red. Under same arm, lymph gland swollen about same size and tender. Glands in throat itchy and random sharp pain. Tongue warm, tingling, and numb-ish. No treatment was received. The outcome of events was not recovered. No follow-up attempts are possible; No further information is expected.


VAERS ID: 1674518 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Chest pain, Condition aggravated, Dyspnoea, Psoriasis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I went to Urgent Care on 9/2/2021 to investigate into the intermittent chest pain and shortness of breath. My heart and lungs were checked out by a doctor and determined to be in good health. No explanation as to why I''m experiencing the chest pain other than possible anxiety (according to the doctor)
CDC Split Type:

Write-up: Psoriasis flare up in areas of the body where I''ve never had psoriasis before. After 4 weeks the new flare ups have calmed but the patches have not gone away. Starting on the first day after the vaccine, I experienced mild chest pain and shortness of breath intermittently for about 14-16 days.


VAERS ID: 1674701 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Electrocardiogram ambulatory, Feeling hot, Heart rate abnormal, Hypoacusis, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vytorin 10/80; atenolol; Lorazepam; Isosorbide mononitrate; levothyroxine; clopidogrel; baby aspirin; allopurinol; nitroglycerin patch
Current Illness:
Preexisting Conditions: heart disease since 1993
Allergies:
Diagnostic Lab Data: EKG showed something I don''t remember the name. heart holter Monitor
CDC Split Type: vsafe

Write-up: First event, I had a sudden increase in heart rate, I checked my beats it was 116 BPM, normal for me is 60 BPM, that lasted about 15 minutes then it went down to 95. Then a week later at 5:58pm on the 19th, I checked my pulse oximeter it was 135 BPM. Went to see my doctor on the 20th. He told ne to take my beta blocker 1/2 when I got home and the other half before bed. I do have an arrhythmia. By 6:25 it was between 70 -80 BPM. On the 25th at 09:25PM heart rate increasing 134 BPM resting that lasted till 9:55PM. On Friday the 27th it happened again at 07:20PM my BPM was 159, it lasted a while my BP was way up. Monday the 30th I went in to my doctor, he did an EKG on me. The EKG showed something I don''t remember the name. Doctor sent EKG to Cardiologist. the cardiologist order a heart minter for 2 weeks. The whole time since my vaccine I can''t hear out right every time these episodes happen, it sounds like I can hear the ocean. Last night on September 3rd I could feel my heart racing, but I was getting hot and the earthing was happening again that I couldn''t hear. Last night I took atenolol and a lorazepam. By 10:30 my pulse was down 62BPM.


VAERS ID: 1674707 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Hot flush, Sleep disorder
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe chest pain so much to wake patient from sleep. Hot flashes. NSAIDs were used to treat symptoms.


VAERS ID: 1675011 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-13
Onset:2021-08-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthma, Condition aggravated, Dizziness, Headache, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxychlorequine Imuran Adderall Aspirin Propranolol B-12 shot
Current Illness: Asthma, Lupus, RA, migraine, hypertension
Preexisting Conditions: Asthma, Lupus, RA, migraine, hypertension
Allergies: Vicodin, sulfa drugs, Doxepin, bananas, latex, environmental allergies, pollen, grass, trees
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Light headed, headache, severe wheezing, multiple asthma attacks, used nebulizer treatments, rescue haler did not work to alleviate asthma attacks or severe wheezing.


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