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From the 1/21/2022 release of VAERS data:

Found 1,049,249 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 148 out of 10,493

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VAERS ID: 1984827 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-03
Onset:2021-12-26
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, COVID-19 pneumonia, Hypoxia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: From history and physical 12/26/21: Patient is a 50 y.o. female with HO HTN, obesity, partial COVID vaccination who presented to the ED today with back pain after a tripping on ornaments. In the ED she was febrile to 102, COVID positive and hypoxic with RA sats in the 80s. She is admitted for treatment of COVID pneumonia.she denies feeling ill prior to today.


VAERS ID: 1984834 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-18
Onset:2021-12-26
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, Condition aggravated, Diarrhoea, Dyspnoea, Exposure to SARS-CoV-2, Headache, Hypophagia, Malaise, Nausea, Neck pain, Oxygen saturation decreased, SARS-CoV-2 test positive, Sick relative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: From history and physical on 12/26/21: Patient is a 63 y.o. female with medical history significant for allergic rhinitis, anxiety, arthritis, T2DM, GERD, HTN, depression, OSA on CPAP, chronic back pain w/ h/o back surgery/spinal fusion, Raynaud''s who presents to the ED via EMS for evaluation of shortness of breath. She is known COVID positive. Has been symptomatic for ~ 1 week, husband at home also positive; + test 6 days ago, had monoclonal antibody infusion on Friday 12/24/21. Describes worsening shortness of breath yesterday, has been using nebulizer at home with little improvement; worse shortness of breath today, called EMS w/ oxygen sats low 80''s on arrival, placed on 4 liters w/ sat up to low 90''s. She describes no loss of taste or smell, has a headache and soreness in her neck; has chronic back pain which has been worse from lying around. No fever or chills. She has had nausea, diarrhea and decreased PO intake. She has been fully vaccinated but has not had her booster. Currently feeling her breathing is better with supplemental oxygen


VAERS ID: 1984875 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-12-26
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: admitted through the ED with sudden onset of congestion cough fatigue and fever


VAERS ID: 1984877 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-30
Onset:2021-12-26
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Fully vaccinated adult tested positive for COVID-19


VAERS ID: 1984883 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-12-07
Onset:2021-12-26
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3627 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Advair, Proair, Meloxicam, Spironolactone, Olmesartan, Nifedipine,
Current Illness: None
Preexisting Conditions: Asthma/COPD
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight soreness for 1 day then ache went away. On Sunday, 12/26/2021, Injection site began aching again to the point it became noticeable around noon. Has continued to grow in ache for past 2 days. Is beginning to become a sharp pain when I raise arm.


VAERS ID: 1984904 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

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

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

Write-up: dose 1 12/23/20 dose 2 1/11/21 booster 10/5/21 fully vax positive employee


VAERS ID: 1984926 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1984928 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1984957 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-28
Onset:2021-12-26
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / IM

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

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

Write-up: Fully vaccinated and tested positive for covid-19


VAERS ID: 1984969 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-10
Onset:2021-12-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1620 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, daily vitamin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, fresh apples, pears, peaches, cherries.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rashes along a strip of my torso, on the right side of my body. Shingles?


VAERS ID: 1985002 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-12
Onset:2021-12-26
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mechanical urticaria, Pruritus, Rash macular
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: 20mg Viibryd, 1x daily 10mg omperazole, 1x daily
Current Illness: N/A
Preexisting Conditions: Anxiety, depression, GERD
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dermatographia flareups started occurring on about 12/26/21 -- itchiness in different parts of body, with red splotches that appear and disappear within the span of about 30 minutes


VAERS ID: 1985017 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2020-12-31
Onset:2021-12-26
   Days after vaccination:360
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 3 UN / IM

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

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

Write-up: Fully vaccinated adult tested positive for COVID-19


VAERS ID: 1985019 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-12-16
Onset:2021-12-26
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Laboratory test, Loss of personal independence in daily activities, Magnetic resonance imaging, Mobility decreased, Speech disorder
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: Patient had CVA, CT, MRI, other labs during acute hospitalization after cva.
CDC Split Type:

Write-up: Patient had CVA 9 days after booster vaccine, patient has speech, mobility, and independence affected. Patient was independent and otherwise healthy prior to episode.


VAERS ID: 1985082 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-12-14
Onset:2021-12-26
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Troponin increased
SMQs:, Myocardial infarction (narrow), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: Elevated troponin, admitted for observation Normal echocardiogram
CDC Split Type:

Write-up: Chest pain and elevated troponin (by patient history) full medical records requested.


VAERS ID: 1985106 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-19
Onset:2021-12-26
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Pt was positive at facility on 11/19. Came to ED on 12/26 for ongoing symptoms. Will report breakthrough just in case facility didn''t.


VAERS ID: 1985128 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-13
Onset:2021-12-26
   Days after vaccination:257
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nasal congestion, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium carbonate (OS-CAL) 600 MG TABS Take 600 mg daily
Current Illness:
Preexisting Conditions: Asthma, seasonal allergies
Allergies: Ceclor
Diagnostic Lab Data: 12/26/21 COVID19 Antigen Detected Abnormal
CDC Split Type:

Write-up: 12/26/21 Patient presents with fever (102), cough, congestion and body aches that started today. No known exposure. Was with family yesterday. She is vaccinated. Physical Exam. Constitutional: General: She is not in acute distress. Appearance: She is well-developed. She is not ill-appearing, toxic-appearing or diaphoretic. HENT: Head: Normocephalic. Right Ear: Tympanic membrane, ear canal and external ear normal. Left Ear: Tympanic membrane, ear canal and external ear normal. Nose: Congestion and rhinorrhea (clear) present. Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Uvula midline. No oropharyngeal exudate or posterior oropharyngeal erythema.


VAERS ID: 1985183 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Vitamin D 5000units daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resting heart rate 113, lasted about 12 hours. Improved after that point however it is still elevated and increases rapidly with minor activity. High fever -103.9F


VAERS ID: 1985261 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2020-12-18
Onset:2021-12-26
   Days after vaccination:373
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, SARS-CoV-2 test positive, Sneezing, Throat irritation
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: COVID+ 12/26/2021 Sxs: sneezing, loss smell, coughing, itchy throat,


VAERS ID: 1985756 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-12-26
   Days after vaccination:275
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID PCR + 12/26/21
CDC Split Type:

Write-up: Admitted to hospital with breakthrough COVID 12/26/21


VAERS ID: 1985928 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-12-26
   Days after vaccination:333
Submitted: 0000-00-00
Entered: 2021-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM

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

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

Write-up: Patient symptomatic since 12/23/2021 with multiple symptoms. Tested COVID-19 positive on 12/26/2021. Isolated until 1/2/2022, then she needed follow-up. She did not participate in a clinical study and does not want antibody testing done.


VAERS ID: 1988241 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-12-26
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (1 glass a month); Non-smoker
Preexisting Conditions: Comments: no relevant medical history and no known drug allergies
Allergies:
Diagnostic Lab Data: Test Date: 20211227; Test Name: COVID-19 rapid POC test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20211258550

Write-up: This spontaneous report received from a patient concerned a 27 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: alcohol user (one glass a month), and non smoker, and other pre-existing medical conditions included: no relevant medical history and no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1820096 expiry: UNKNOWN) dose was not reported, 1 total, administered on 27-MAY-2021 for prophylactic vaccination (dose number in series is 1). No concomitant medications were reported. On 26-DEC-2021, at evening, the patient experienced symptoms of dry cough, dry throat and headache. On 27-DEC-2021, on the day of reporting, the patient tested positive with rapid home test (suspected clinical vaccination failure and suspected covid-19 infection). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000209034.; Sender''s Comments: V0-20211258550-Covid-19 vaccine ad26.CoV-2.s- Suspected clinical vaccination 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: 1988284 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-12-24
Onset:2021-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pain, Vaccination site warmth
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: arm is quite sore and red and hot; arm is quite sore and red and hot; arm is quite sore and red and hot; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (arm is quite sore and red and hot), VACCINATION SITE PAIN (arm is quite sore and red and hot) and VACCINATION SITE ERYTHEMA (arm is quite sore and red and hot) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 24-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Dec-2021, the patient experienced VACCINATION SITE WARMTH (arm is quite sore and red and hot), VACCINATION SITE PAIN (arm is quite sore and red and hot) and VACCINATION SITE ERYTHEMA (arm is quite sore and red and hot). The patient was treated with IBUPROFEN in December 2021 at an unspecified dose and frequency. At the time of the report, VACCINATION SITE WARMTH (arm is quite sore and red and hot), VACCINATION SITE PAIN (arm is quite sore and red and hot) and VACCINATION SITE ERYTHEMA (arm is quite sore and red and hot) had not resolved. No concomitant medications were reported Non drug treatment include icepack


VAERS ID: 1988368 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-12-18
Onset:2021-12-26
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Audiogram abnormal, Chills, Deafness unilateral, Laboratory test normal, Lymphadenopathy, Myalgia, Night sweats, Pyrexia, Sudden hearing loss
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, ibuprofen, labetalol,
Current Illness: None
Preexisting Conditions: Fibromyalgia
Allergies: Penicillin, sulfa, hydrochlrothyazide
Diagnostic Lab Data: Audio gram shows right ear hearing loss. Labs ordered by ENT doctor show no autoimmune system diseases that could contribute to sudden hearing loss.
CDC Split Type:

Write-up: Hearing loss to right ear. ENT doctor stated it?s acute, no infection,, moisture, sinus drainage or wax present. No previous history of ear issues. No sinusitis or rhinitis. Trying prednisone prescription to see if hearing loss gets better. MRI scheduled, second hearing test in two weeks. Could be permanent or temporary hearing loss. Booster shot symptoms lasted 6 days after shot(chills, fever, lymph node under arm pit bulging, muscle pain, night sweats).


VAERS ID: 1988451 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-21
Onset:2021-12-26
   Days after vaccination:280
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 - / IM

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

Write-up: patient hospitalized


VAERS ID: 1988619 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-12-26
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Patient vaccinated 5/13/2021, 4/22/2021. Hospitalized COVID positive 12/26/21


VAERS ID: 1988675 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-01
Onset:2021-12-26
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose normal, COVID-19, Cough, Dyspnoea, Dyspnoea exertional, Metabolic function test normal, Neutrophil percentage increased, SARS-CoV-2 test positive, Tachycardia, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: AFib, HLD, migraines, Crohn''s, OSA
Allergies: Amiodarone, amitriptyline, Augmentin, budesonide, clindamycin, Coumadin, Dilaudid, Diltiazem, Elavil, Eliquis, Flagyl, Floxin, Imuran, Keflex, Levaquin, Lexapro, Macrodantin, Metoprolol, Multaq, NSAIDs, Pradaxa, PPI, Urso, Verapamil
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/26/21: Patient presents to ED on 12/26 c chief complaint of COVID positive and worsening shortness of breath. Patient symptoms started 8 days prior to arrival. Symptoms include cough/shortness of breath/dyspnea on exertion. Upon presentation to hospital vital signs revealed respiratory rate of 25. Remainder of vitals within normal limits. Originally on room air-oxygen saturations in the upper 80s. Vital signs significant for 0 white blood cell count of 12, neutrophils 74. Metabolic panel significant for a blood glucose of 102 12. During ambulation c the ED physician patient had tachycardia and dyspnea on exertion. Patient is being brought in for further workup and management. Please note: Patient received first dose Pfizer vaccine on 2/15/21/2021 Lot # EL9265 and the second dose on 3/10/2021 Lot # EN6206 and booster on 10/1/21 Lot # FF2588


VAERS ID: 1988689 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-23
Onset:2021-12-26
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 3 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Feeling abnormal, SARS-CoV-2 test positive
SMQs:, Dementia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sulfasalazine DR, Hydrochlorothiazide, Pravastatin, Estradiol Patch, Multivitamin, Folic Acid, Calcium. Vitamin B2 and DHEA
Current Illness: None
Preexisting Conditions: Colitis, high cholesterol and hypertension
Allergies: Has some food intolerances
Diagnostic Lab Data: COVID19 Test: Positive
CDC Split Type:

Write-up: I started feeling poorly at the end of the day on 12/26/2021. I received a text the same day that my grandson had tested positive for COVID19. On Tuesday (12/28/2021), I made it to the Medical Center and got tested and I was positive for COVID19.


VAERS ID: 1988692 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-12-26
   Days after vaccination:258
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O32B212A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O48B21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IUD, multivitamin, vitamin D, fish oil, turmeric, melatonin,
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, fatigue


VAERS ID: 1988786 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / 4 LA / SC

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

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

Write-up: no adverse event. daughter had pt vaccinated at pharmacy in november..not written on card..son brought to me in december, vaccinated son and pt..card did not indicate pt received booster..found out when niece notified me that pt received booster in november..notified dr filled qre report..


VAERS ID: 1988918 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-08
Onset:2021-12-26
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID positive test 12/28/21
CDC Split Type:

Write-up: COVID vaccine breakthrough case


VAERS ID: 1988960 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-23
Onset:2021-12-26
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Influenza A virus test positive, Influenza B virus test positive, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: DM2, COPD, CHF
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB by Nucleic Acid Amplification, POC 12/29/21 detected
CDC Split Type:

Write-up: 12/26 cough, body aches, shortness of breath, tested positive for covid on 12/29 after roommates tested positive o


VAERS ID: 1988982 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-17
Onset:2021-12-26
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078J21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blindness transient, C-reactive protein increased, Culture urine positive, Deafness transitory, Dizziness, Dyspnoea, Full blood count abnormal, Gait disturbance, Laboratory test abnormal, Lymphadenopathy, Metabolic function test, Musculoskeletal stiffness, Oropharyngeal pain, Pain in extremity, Peripheral swelling, Rash, Serum sickness-like reaction
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: claritin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: The result is abnormalLab UA W/MICROSCOPIC W/CULTURE IF IND Dec 28, 2021 The result is abnormalLab CBC W/DIFFERENTIAL Dec 28, 2021 The result is abnormalLab COMPREHENSIVE METABOLIC PANEL Dec 28, 2021 The result is abnormalLab C-REACTIVE PROTEIN Dec 28, 2021 Component Your Value Standard Range Flag CRP 2.2 mg/dL 0.0 - 1.5 mg/dL H
CDC Split Type:

Write-up: Patient got a swollen lymph node on her left side in the collar bone area on 12/18/2021 and the on 12-26-2021 she started having joint pain and a severe rash all over her body and a sore throat and dizziness, loss of hearing and sight for short periods of time and breathing issues. we saw her Doctor on the 27th and she prescribed Claritin and Hydroxyzine The night of the 27th she had her first dizzy, loss of hearing, and sight and breathing became troubled so we call 911 and they recommended going to the ER. At the ER they diagnosed her with Serum syndrome and put her on Prednisone and Pepcid and Zyrtec. Along with the joint pains she has swollen arm and the left foot is painful to walk on and feels stiff. The ER Doctor recommended patient seeing a Allergist and a Immunologist.


VAERS ID: 1988991 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-15
Onset:2021-12-26
   Days after vaccination:314
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Headache, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking Metoprolol Succinate ER 25 MG Tablet Extended Release 24 Hour 1 tablet Orally Once a day, Taking Sotalol HCl 80 MG Tablet 0.5 tablet Orally two times a day, Notes: was recently decr. from 80 BID, Taking amLODIPine Besylate 5 MG Table
Current Illness: none
Preexisting Conditions: HTN: Dr., Hypothyroidism, Tobacco abuse Hx., Lichen sclerosis-vaginal, PSVT - diagnosed 2013, Neck mass 2013, symptomatic PACs, vulvar intraepithelial neoplasia (VIN 1 and III), with wide excisions in 2005 and 2011, followed by vulvar CA (with radical vulvectomy with urethral extension (Dr.), 9/2015), bilateral Carpal Tunnel Syndrome, pelvic osteomyelitis (complication after vulvectomy surgery), 2015- 2016, with prolonged IV antibiotic course, Lower extremity lymphedema (complication of pelvic osteomyelitis/post vulvectomy), episodic Atrial Fibrillaton ( most recently detected on Zio XT Patch monitor as part of the Study, ,mid June 2017)-$g had been recommended to start Xarelto, but has NOT started it, bil. LE cellulitis (w/ admission 5/2019), related to #11
Allergies: SULFA DRUGS: " felt funny" - Allergy, Flexeril: overly sedated - Side Effects, Nizoral: contact dermatitis - Allergy, Imiquimod: significant fatigue/hypotension - Side Effects.
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, cough, fever, shortness of breath, runny nose. starting 12/26/21


VAERS ID: 1989005 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-12
Onset:2021-12-26
   Days after vaccination:348
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: fully vax 12/24/21 1/12/21 covid pos 12/27/21


VAERS ID: 1989022 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-30
Onset:2021-12-26
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies: Nortriptyline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted as inpatient on 12/26 due to COVID-19 pneumonia. Patient was tested for COVID-19 and was positive on 12/26.


VAERS ID: 1989032 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-21
Onset:2021-12-26
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 LA / IM

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

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

Write-up: Symptomatic with cough, congestion with yellow sputum, sore throat, and body aches. Tested positive on 12/26/21 and isolated with her other son. Husband tested negative and her other son''s result is pending. Isolation period ends on 1/2/22, she will callback the hotline for f/u. She also participated in the Quasar studay, antibody testing after isolation is completed.


VAERS ID: 1989077 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

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

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

Write-up: 1st vaccine no side effects 2nd Vaccine- body aches , fatigue, covid arm 3rd vaccine booster- Fever, fatigue, body aches, headache , severe swelling , pain, redness and heat under injection site. Also has welp at injection site.


VAERS ID: 1989126 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-18
Onset:2021-12-26
   Days after vaccination:311
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized with dyspnea very mild no need for oxygen.


VAERS ID: 1989165 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Incorrect dose administered, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient was given an adult dose instead of a pediatric dose. Side effects: sore arm, chills, fever, achyness, tired, fatigue


VAERS ID: 1989198 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-12-26
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid +


VAERS ID: 1989208 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-14
Onset:2021-12-26
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea exertional, Fall, Head injury, SARS-CoV-2 test positive
SMQs:, Pulmonary hypertension (broad), Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: breast cancer - on chemo and radiation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: tested positive for covid 12/28
CDC Split Type:

Write-up: SOB worse with exertion for the last few days prior to admisson O2 sats 88% in ED on 2L, on 3L O2 (uses 2L O2 at home) fell 3 days prior to admission and hit head decadron started


VAERS ID: 1989211 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Type 1 diabetes, hypertension
Allergies: Biaxan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Allergic reaction all through my body, unusual swelling of my tongue and lips, took Benadryl to relieve the symptoms


VAERS ID: 1989219 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-05
Onset:2021-12-26
   Days after vaccination:265
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid +


VAERS ID: 1989243 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-12-26
   Days after vaccination:326
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: covid +


VAERS ID: 1989250 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-26
Onset:2021-12-26
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 - / -

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

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

Write-up: covid+


VAERS ID: 1989262 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-12-26
   Days after vaccination:270
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 - / -

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

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

Write-up: covid +


VAERS ID: 1989266 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Laboratory test, Muscle spasms, Myalgia, Pain, Pain in extremity, Pyrexia, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Stelara & Mercaptopurine.
Current Illness: None.
Preexisting Conditions: Crohn''s disease.
Allergies: N/A.
Diagnostic Lab Data: Any tests performed were done at the ER. At a minimum her WBC was high.
CDC Split Type:

Write-up: Wife is immunocompromised due to steroids, 6MP, and Stelara for Crohn''s disease but received her COVID-19 booster (3rd dose) on 12/26. She complained of arm pain on 12/26. On 12/27 she complained of a general feeling of fatigue and soreness that is commonly associated with receiving the vaccine. On 12/28 she complained that the fatigue, headaches, and muscle pain were getting worse. She developed a fever in the early evening and took tylenol for that and the pain. Overnight she had muscle cramps, pain, and the fever would not break. On the morning of 12/29 she was taken to the Emergency Room where her temperature was measured at 103 degrees and she had to be given pain medication.


VAERS ID: 1989277 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-20
Onset:2021-12-26
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Cardiac failure, Chest discomfort, Cough, Dyspnoea
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for dyspnea, cough, chest tightness in conjunction with Covid pneumonia plus heart failure exacerbation.


VAERS ID: 1989374 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-10-14
Onset:2021-12-26
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Headache, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Accu-Chek Guide - Strip use as directed In Vitro once a day ?Glimepiride 4 MG Tablet 2 tablets with breakfast or the first main meal of the day Orally Once a day ?Claritin-D 24 Hour 10-240 MG Tablet Extended Release 24 Hour 1 tablet
Current Illness: none
Preexisting Conditions: Asthma, mild intermittent, cough variant. Frequent HA''s. Central L5-S1 disc herniation with Right Sciatic Nerve root compression (ESI 7/8/05) with persistent lumbar back pain w/ pain med use (controlled substance agreement signed). Seasonal allergies. Erectile dysfunction. Right foot injury ( "it got bent by a tire", age 12). elevated A1c (8.4)/type 2 diabetes, 9/17. Vitamin D Deficiency. accidental GSW to L hand(5/20), w/ plastic surgery.
Allergies: Metformin HCl: diarrhea - Side Effects
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, sore throat, cough, fever, chills, body aches, sinus congestion, nasal congestion. starting 12/26/21


VAERS ID: 1989376 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-24
Onset:2021-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3594 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Eye haemorrhage, Incorrect dose administered, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Medication errors (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: no
Current Illness:
Preexisting Conditions: 2x cancer survivor, has had a heart attack, and asthma
Allergies: fish, iodine
Diagnostic Lab Data: no
CDC Split Type:

Write-up: On the right side of her eye she has blood in it. She has had diarrhea real bad and has not stopped. She has bumps around the outside portion of her eye. She stated that the pharmacist gave her more of a doseage than she should have rcvd.


VAERS ID: 1989448 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-18
Onset:2021-12-26
   Days after vaccination:342
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Eye pruritus, Nasal congestion, Oropharyngeal pain, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Taking Clopidogrel Bisulfate 75 MG Tablet 1 tablet Orally once a day, Taking diphenhydrAMINE HCl 50 MG Tablet 1 tablet 2 hours prior to exam Orally Once a day, Taking Doxazosin Mesylate 8 MG Tablet 1 tablet Orally once a day, Taking Ferrous
Current Illness: none
Preexisting Conditions: GERD, BPH, Varicose veins, Chest pain, non cardiac - ER visit only, Colon cancer 2005 with abdominal wall metastasis 2008, CAD with stent 6/2012, Left knee replacement 7/2019, 7/20/2015. Colonoscopy with normal biopsies. Repeat colonoscopy in 5 years., 6/23/2020. Normal colonoscopy, possible repeat in 5 years.
Allergies: Aspirin: hives - Allergy, Contrast Allergy PreMed Pack: hives - Allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore throat, nasal congestion, chills,itchy eyes, post nasal drainage starting on 12/26/21


VAERS ID: 1989475 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-31
Onset:2021-12-26
   Days after vaccination:329
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Nasal congestion
SMQs:, Anaphylactic reaction (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: ?Acetaminophen 500 MG Capsule 1 capsule as needed Orally every 6 hrs ?Artificial Tear - Gel Ophthalmic ?Hydrocortisone 2.5 % Ointment APPLY TOPICALLY 2 TIMES DAILY FACE External ?Mometasone Furoate 0.1 % Ointment APPLY TO AFFECTE
Current Illness: none
Preexisting Conditions: Obstructive sleep apnea. Hypertension. Negative stress testing in 1995 with marked hypertensive response. Dyslipidemia. GERD / Barrett''''s esophagus on EGD 4/2007, Dr. - yearly EGD. LV dysfunction, EF 47% on 12/2008 stress test. Aortic sclerosis. Hypersomnolence disorder - NOT narcolepsy. ejection fraction 55% on 1/15 ECHO. EGD 1/2015 (Pooler) - Barrett''''s - f/u recommended 2 yrs. 2018 NEUROPATHY - saw neuro and neuromuscular specialist at U of MN. 2019 CHRONIC INFLAMMATORY POLYNEUROPATHY - started IVIG infusions. 4/2019 received notice from pharmacy questioning ongoing prescription for sucralfate. Age-related cataract of both eyes, unspecified age-related cataract type. 3/2020 EGD Barrett''s - neg for dysplasia.
Allergies: Atorvastatin Calcium: leg cramps - Side Effects
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, nasal congestion starting 12/26/21


VAERS ID: 1989518 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair
Current Illness: Sinus infection
Preexisting Conditions: Asthma
Allergies: Levaquin cipro
Diagnostic Lab Data: Dr. Performed no tests..just knew it was a bad reacton.
CDC Split Type:

Write-up: Received my booster 7 months after 2 initial shots of moderna .had giant hive 5he size of grapefruit on my arm. 3 days after receiving it.. Had to go to ER for prednisone shot and pills for 5 days to stop the reaction. Had slight chills and huge know under my skin next day.


VAERS ID: 1989551 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Cardiac discomfort, Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Last vaccine dose, did not make the connection till third dose
Other Medications: Fish oils, biotin. Had heart issues after each vaccination, it wasn?t until my booster I made the connection.
Current Illness: Nope
Preexisting Conditions: Nope
Allergies: None
Diagnostic Lab Data: family clinic 12/28/2021
CDC Split Type:

Write-up: Heart pain, felt like somebody grabbing your heart and squeezing so that you can?t breathe. Had rapid heart rate while resting higher than 110, when testing heart rate is 60. Symptoms lasted for two hours. Since the first dose of the vaccine in March and second dose in April, have had an attack in April and one in July.


VAERS ID: 1989829 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-27
Onset:2021-12-26
   Days after vaccination:302
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Diarrhoea, Headache, Pain, Productive cough, Pyrexia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Taking Metoprolol Tartrate 50 MG Tablet as directed Orally 100 mg in am and 50 in pm, Taking Accu-Chek SmartView - Strip as directed - 2x/day, Taking Aspirin 81 MG Tablet 1 tablet Orally Once a day, Taking BD Pen Needle Nano U/F 32G X 4 MM
Current Illness: none
Preexisting Conditions: Diabetic mellitus ----type 2, CABG x3 ---- 5/14 , subsequent coronary artery stenting, now on Plavix, Dyslipidemia, HTN, Atrial fibrillation, resolved, Migraine, GERD, Left shoulder rotator cuff tear, Left hip pain , Left upper quadrant ? hernia , Low back pain, Morbid obseity, Anemia, postoperatively, Right arm abscess , Neuropathy , Left toe ingrown naild, Left knee meniscus tear, Fatigue, workup showed serum testosterone low at 161, Kidney stone .
Allergies: Atenolol: sexual desire less - Side Effects, Erythromycin: hallucinations - Side Effects, Lisinopril: cough - Side Effects, Lipitor: not covered by insurance - Lack of Therapeutic Effect
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, cough, fever, chills, body aches, phlegm, itchy throat, diarrhea (mild). starting 12/26/21


VAERS ID: 1989848 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-03
Onset:2021-12-26
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EE3592 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Ear pain
SMQs:, Anaphylactic reaction (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: ?Nexplanon 68 MG Implant as directed Subcutaneous
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, chills, ear pain off and on. starting 12/26/21


VAERS ID: 1990029 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT FAINTED AND LOOSE CONSCIOUSNESS FOR ABOUT 30 SECONDS AND THEN REGAIN CONSCIOUSNESS BUT WAS VERY PALE AND WEEK. EMS TOOK PT TO HOSPITAL.


VAERS ID: 1991107 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topical ketoconazole cream 2 x daily on R foot for treatment of athletes foot, been taking for approx 8 weeks before vaccination
Current Illness: No illnesses noted at time of vaccination or within 1 month prior to vaccination
Preexisting Conditions: No chronic or long standing health conditions noted
Allergies: No known food or drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the 11th day after receiving the covid booster I broke out in hives, all over my body from head to toe coming and going in different places and extremely itchy after a few days of Benadryl the hives still continued to come and I met with a dermatologist who confirmed he has seen some similar adverse reactions with some other patients and typically can last 3-6 weeks before usually resolving. He prescribed fexofenadine 180 mg twice daily along with 10 mg hydroxyzine every 6 hours as needed for breakthrough hives, and requested I make a follow up appointment for 3 weeks.


VAERS ID: 1992058 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 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: Pfizer Covid vaccine that had been in refrigerator was administered on day 33 in refrigerator instead of manufacturer limit of 31 days. Patient was offered revaccination. And proper labeling of vaccines has been enforced.


VAERS ID: 1992063 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 1 LA / -

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: Pfizer Adult covid vaccine at day 33 of refrigeration was administered, which is past manufacturer limit of 31 days in the refrigerator for storage. Patient was offered revaccination through guardian. Proper labeling of vaccine refrigeration times has been enforced.


VAERS ID: 1992070 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis, Gingival bleeding, Mucosal haemorrhage, Petechiae, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Gingival disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/27/2021 platelet count is 1
CDC Split Type:

Write-up: 12/24/2021 onset of petechia over entire body. 12/25/2021 onset of oral mucosal/gingival bleeding and recurrent epistaxis.


VAERS ID: 1992108 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 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: Pfizer adult covid vaccine was administered on day 33 of refrigeration, past the manufacturer limit of 31 days. Revaccination was offered. And proper labeling of vaccine refrigeration status has been enforced.


VAERS ID: 1992128 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 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: Almonds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer Covid vaccine was administered on day 33 of refrigeration, manufacturer limit is 31 days of refrigeration. Revaccination was offered. And proper labelling of stored vaccine as been enforced.


VAERS ID: 1992197 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 - / -

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: Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer covid vaccine was administered on day 33 of refrigeration, which is past the limit of 31 days provided by manufacturer. Pt was offered revaccination but said he is okay with administered dose at the moment. Proper labelling of vaccines has been enforced.


VAERS ID: 1992249 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2nd Moderna shot given on 3/4/21 - swollen lymph nodes lasting 6 weeks from time of shot
Other Medications: Vitamin D, Zinc, Vitamin C, Vitamin K, Zyrtec, Melatonin
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Emergency room visits on 12/28 - given prednisone, famotidine and 12/29 - Given epinephrine, hydroxyzine, prednisone, famotidine Follow up with family doctor on 12/30
CDC Split Type:

Write-up: Widespread severe hives over entire body due to no other allergy exposure, beginning on day 11 post booster shot through day 15


VAERS ID: 1992257 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-15
Onset:2021-12-26
   Days after vaccination:314
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Nasal congestion, Rhinorrhoea, Sinus congestion
SMQs:, Anaphylactic reaction (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: ?Ketoconazole 2 % Cream 1 application to affected area Externally Once a day ?Betamethasone Valerate 0.1 % Cream 1 application to affected area Externally Once a day ?Calcium 1200+D3 ?Loratadine 10 MG Tablet 1 tablet Orally As nee
Current Illness: none
Preexisting Conditions: Mild obesity. Chronic fungal otitis. Degenerative joint disease with bilateral knee arthroscopies. Bunions, status post bunionectomy. Low back pain, sciatica. Multiple keratosis, followed by dermatology. Chronic intertriginous yeast infection, under breasts and in groin. Cervical polyp. Prolapse of female pelvic organs. Vaginal atrophy.
Allergies: PENICILLIN DRUGS PredniSONE (Pak): Hives - Allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, runny nose, tired, sinus congestion, nasal congestion. starting 12/26/21


VAERS ID: 1992288 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-29
Onset:2021-12-26
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Respiratory symptom
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amitriptyline 25 mg oral tablet, 25 mg= 1 Tablet(s), Oral, At Bedtime, 3 refills amLODIPine 10 mg oral tablet, 1 Tablet(s), Oral, Daily, 3 refills ascorbic acid 1000 mg oral tablet, 1000 mg= 1 Tablet(s), Oral, Daily aspirin 81 mg oral ta
Current Illness:
Preexisting Conditions: cirrhosis 2/2 autoimmune hepatitis, mixed connective tissue disorder, Raynaud''s, seizure disorder, hypothyroidism, and GERD
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: WORSENING RESP SYMPTOMS WITH ADMISSION TO HOSPITAL


VAERS ID: 1992320 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-12-26
   Days after vaccination:338
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Hospitalized due to covid on 12/26/2021 at a local healthcare facility


VAERS ID: 1992342 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-12-21
Onset:2021-12-26
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Superior sagittal sinus thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Hyland''s leg cramps
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Spontaneous sagittal venous thrombosis


VAERS ID: 1992346 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 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: Pfizer covid vaccine was administered on day 33 of refrigeration. Current manufacturer limit is 31 days. Patient was offered revaccination. And proper labelling of stored vaccine has been enforced.


VAERS ID: 1992360 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-22
Onset:2021-12-26
   Days after vaccination:338
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 000000 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Headache, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Sinus congestion, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Ventolin HFA 108 (90 Base) MCG/ACT Aerosol Solution 2 puffs as needed Inhalation every 4 hrs, Notes: PRN ?FLUoxetine HCl 40 MG Capsule 1 capsule Orally once a day ?traZODone HCl 50 MG Tablet take 1.5 tablets by mouth once a day at be
Current Illness: none
Preexisting Conditions: Anxiety disorder. GERD. Hyperlipidemia. Reactive airway disease. Morbid obesity. RUL pneumonia with groundglass opacity (9/12/18)-$g radiology rec. 6 week recheck CXR. Dyslipidemia.
Allergies: Sulfa: gi upset; - Side Effects Augmentin: GI upset; - Side Effects
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever, body aches, headache, sore throat, cough, chills, nasal congestion, sinus congestion, post nasal drainage. starting 12/26/21


VAERS ID: 1992467 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Sinus disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D2-1.25mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nosebleed, clotting in both sinuses.


VAERS ID: 1992479 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-01
Onset:2021-12-26
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bell''s Palsy.


VAERS ID: 1992494 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-20
Onset:2021-12-26
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac failure congestive, Condition aggravated, Hypervolaemia
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad)

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

Write-up: ER Visit patient was volume overloaded due to CHF exacerbation, diuresed in ER and returned home


VAERS ID: 1992505 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-08
Onset:2021-12-26
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized cause unrelated to COVID infection


VAERS ID: 1992514 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-06
Onset:2021-12-26
   Days after vaccination:295
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Fall, SARS-CoV-2 test positive
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril Lipitor Metformin
Current Illness:
Preexisting Conditions: Type 2 diabetes Essential hypertension
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 12/28/21
CDC Split Type:

Write-up: FALLS, WEAKNESS


VAERS ID: 1992523 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-16
Onset:2021-12-26
   Days after vaccination:285
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Asthenia, COVID-19, Cough, Dry skin, Fatigue, Feeding disorder, Hyperglycaemia, Illness, Laboratory test abnormal, Nausea, Pyrexia, SARS-CoV-2 test positive, Upper respiratory tract infection, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: ADMISSION: 12262021: co illness x 1.5 weeks. sts "it feels like when I had DKA", abd pain n/v, unable to eat since Thursday, this is 3rd MD visit since illness onset, on Mon began abx for shortness of breath, cough, BA, chills, fatigue, & fever. Denies increased urine output. Presents to the emergency department today for nausea, vomiting, fever, and generalized abdominal discomfort. Patient is a type 2 diabetic controlled on multiple medications, initially metformin for years, then oral and eventually added insulin a year or two ago. He states a week and a half ago he had URI symptoms and tested COVID negative, got a Zpak from his PCP last Monday. Cough has persisted and fatigue. Felt weak today and felt "like when I had DKA before" and came back to the ED. On room air, COVID swab positive, lab not c/w DKA but dry and hyperglycemic. States had Johnson and Johnson vaccine last March and has not gotten booster because "I''m sick every time I think about making an appointment to get it". DISCHARGE: 12272021: no discharge instructions posted at this time.


VAERS ID: 1992974 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045J21A / 3 LA / IM

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

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

Write-up: Blister at site of injection. Started with redness at injection site then blister formed later the same day. Patient went to urgent care and said this is being treated similar to a chemical burn. MD put Silvadene cream on blister and advised patient to cover with gauze if blister opens. Patient also received an antibiotic.


VAERS ID: 1994872 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-12-26
   Days after vaccination:328
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Feeling tingling in her body everywhere; Numbness; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Feeling tingling in her body everywhere) and HYPOAESTHESIA (Numbness) in an adult female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Previously administered products included for an unreported indication: SHINGRIX in December 2021. In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In March 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In December 2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 26-Dec-2021, the patient experienced PARAESTHESIA (Feeling tingling in her body everywhere) and HYPOAESTHESIA (Numbness). At the time of the report, PARAESTHESIA (Feeling tingling in her body everywhere) and HYPOAESTHESIA (Numbness) outcome was unknown. No concomitants were provided. No treatment was provided.


VAERS ID: 1994897 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Severe vomiting; This spontaneous case was reported by an other health care professional and describes the occurrence of VOMITING (Severe vomiting) 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 26-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Dec-2021, the patient experienced VOMITING (Severe vomiting). At the time of the report, VOMITING (Severe vomiting) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication information was provided. No treatment medication were provided. The reporter reported case for daughter and asked whether vomiting was normal after vaccination or was vomiting noted in clinical trials.


VAERS ID: 1995899 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / UNK - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER PH7C2 / UNK LA / IM

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

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

Write-up: patient was vaccinated with 2 flu shots and not 1 flu and 1 moderna. Patient did end up receiving 2 flu shots and 1 moderna on this date. 1 flu shot in each arm and moderna shot in left arm all vaccinations done IM


VAERS ID: 1996000 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Vaccination site pain, Vaccination site swelling
SMQs:, 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: Zoloft, vitamin D
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I got the J&J vaccine on 4/1/2021, I had a bad fever 12 hours after I got the shot. It lasted from 10 pm - 3am, and I fell asleep after. My fever was gone the next day. Recently I got the Moderna booster shot, and it was sore and a little swollen where I got the vaccine. That lasted for 2 days. I started having explosive diarrhea on 12/29/2021 since the morning. It''s slowly getting better but I still have it now. My diet didn''t change at all so I was wondering if the vaccine caused this.


VAERS ID: 1996010 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood glucose normal, Condition aggravated, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

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

Write-up: Client received Moderna Covid vaccine at 21:30. Reported and noted with twitching of LUE at 21:45. Placed in enhanced supervision with clinical team. VS 140/80, HR 88, 98% RA. At 21:55 client began to have seizures. EMS called. Oxygen at 4L nasal cannula placed on patient. Positioned on floor for safety. Client left with EMS at 10:19pm. Alert/oriented x 4. Blood glucose 132. In stable condition.


VAERS ID: 1996323 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066H21A / 1 LA / IM

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

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

Write-up: Customer came in with red area on arm where vaccine had been given. She said it was swollen and was warm to the touch.


VAERS ID: 1996789 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019J21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Sleep disorder, Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: uncomfortable to sleep; left arm was sore to raise above shoulder; This spontaneous case was reported by a consumer and describes the occurrence of SLEEP DISORDER (uncomfortable to sleep) and VACCINATION SITE PAIN (left arm was sore to raise above shoulder) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 019J21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Dec-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Dec-2021, the patient experienced SLEEP DISORDER (uncomfortable to sleep) and VACCINATION SITE PAIN (left arm was sore to raise above shoulder). At the time of the report, SLEEP DISORDER (uncomfortable to sleep) and VACCINATION SITE PAIN (left arm was sore to raise above shoulder) was resolving. Reported approx.6 hours post vaccine, left arm was sore to raise above shoulder and uncomfortable to sleep on. It has been reported feels better wed am. No concomitant medications were reported. Treatment medications were not provided by the reporter.


VAERS ID: 1996971 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FO7218 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Vaccination site urticaria
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; MONTELUKAST; ALLEGRA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic rhinitis; Hypothyroidism; Iodine allergy (Known allergies: Iodine); Sulfonamide allergy (Known allergies: Sulfa)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101869974

Write-up: "COVID arm" - welt developed at injection site within 24 hours of injection and continues to grow in size and height; Dose number: 3; This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the patient. A 31-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 26Dec2021 at 15:00 (Lot number: FO7218) at the age of 31 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "Hypothyroidism" (unspecified if ongoing); "Allergic rhinitis" (unspecified if ongoing); "Iodine allergy" (unspecified if ongoing), notes: Known allergies: Iodine and "Sulfonamide allergy" (unspecified if ongoing), notes: Known allergies: Sulfa. Concomitant medications included: LEVOTHYROXINE; MONTELUKAST and ALLEGRA. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE; Lot Number: ER8727; Anatomical Location: Left arm; Route of administration: Unspecified), administration date: 23Mar2021, when the patient was 30 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, SINGLE; Lot Number: ER8731; Anatomical Location: Left arm; Route of administration: Unspecified), administration date: 13Apr2021, when the patient was 30 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 26Dec2021 at 15:00, outcome "unknown", described as "Dose number: 3"; VACCINATION SITE URTICARIA (non-serious) with onset 27Dec2021 at 12:30, outcome "not recovered", described as ""COVID arm" - welt developed at injection site within 24 hours of injection and continues to grow in size and height". Therapeutic measures were not taken as a result of vaccination site urticaria. Additional information: The patient did not receive any other vaccines within four weeks prior to the prior to the COVID-19 vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The events did not result in doctors or other healthcare professional office/clinic visit and emergency room/department or urgent care.


VAERS ID: 1996981 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3594 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Lymph node pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None, Comment: Other medical history: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101878362

Write-up: Swollen lymph nodes in left armpit causing significant level of pain; Swollen lymph nodes in left armpit causing significant level of pain; Dose number 3; This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the patient. A 46-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 26Dec2021 at 15:00 (Lot number: FE3594) at the age of 46 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "None", notes: Other medical history: none; Known allergies: no. There were no concomitant medications. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE; Anatomical location: left arm; Lot number: EP7534; Administration time: 17:00), administration date: 23Mar2021, when the patient was 45 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, SINGLE; Anatomical location: left arm; Lot number: EW0150; Administration time: 17:00), administration date: 13Apr2021, when the patient was 45 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 26Dec2021 at 15:00, outcome "unknown", described as "Dose number 3"; LYMPHADENOPATHY (non-serious), LYMPH NODE PAIN (non-serious) all with onset 27Dec2021, outcome "recovering", and all described as "Swollen lymph nodes in left armpit causing significant level of pain". Therapeutic measures were not taken as a result of lymphadenopathy and lymph node pain. Additional information: Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Pain occurred two days after the booster shot, pain continued on day 3 somewhat reduced. The events did not result in doctor or other healthcare professional office/clinic visit and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19.


VAERS ID: 1997517 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013H218 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Headache, Joint stiffness, Malaise, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking only vitamin supplements, tumeric
Current Illness: No other illnesses
Preexisting Conditions: None
Allergies: None known (until now)
Diagnostic Lab Data: I haven''t had any yet
CDC Split Type:

Write-up: I had a headache and malaise starting 12 hours after my shot. This shot was shot 3, a booster shot. I received my 2nd dose on 6/12/21. The adverse events I am reporting started three days after my third shot, 12/26/21. I suddenly had red, itchy hives covering my ankles, and portions of both legs. The next night, in addition to the leg hives, I now had hives on both arms. My knees were also stiff starting that night, limiting the motion range. Starting Friday 12/31, I had some hives on small portions of my torso. I have not, as of yet, had trouble breathing, rapid heartbeat, or a swollen face. The joint stiffness has improved. I do not suffer from seasonal allergies, so I did not have any allergy medicine on hand. I was snowed in for several days following 12/26-I could not get to a store until 12/31 due to the snow and my work schedules. I had some anti itch cream with menthol, which sometimes provided temporary relief for the itching. I started taking diphenhydramine (25 mg each pill) on 12/31. It seems to have relieved the emergence of hives and most of the flaring up of them, but they have not gone away yet.


VAERS ID: 1997764 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2022-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Same problem with both the second shot 5/5/21 as the booster on 12/22/21
Other Medications: Lysine, zinc, iron, D3, Vitamin C and Womens one a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Got my period 5 days after injection. Was in menopause.


VAERS ID: 1997843 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-12-14
Onset:2021-12-26
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2022-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Pain in extremity, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.. after reviewing others having the same symptoms who have had blood work it not showing any abnormalities.
CDC Split Type:

Write-up: After initial shot.. has right arm pain... approx 2 weeks later began getting hives/rashes over my back and arms. Each day it continues to get worse showing up more all over my body. HELP! its terribly painful and itchy


VAERS ID: 1997919 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059H21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Neck pain, Pain in extremity, X-ray
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid, protonix
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: xray showed nothing
CDC Split Type:

Write-up: extreme pain in left arm, shoulder, back of shoulder and left side of neck, was giving muscle relaxers. appt to see an otho dr Monday Jan 3


VAERS ID: 1998807 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-12-26
   Days after vaccination:283
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received 2 doses Pfizer vaccine Feb and March 2021, no booster; admitted Dec 2021 for hypoxic respiratory failure 2/2 covid19 pneumonia. Discharged home next day.


VAERS ID: 1999050 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-24
Onset:2021-12-26
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SC3182 / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily medications
Current Illness: No
Preexisting Conditions: MPN; Chronic migraines; allergies
Allergies: No
Diagnostic Lab Data: Covid test.
CDC Split Type: vsafe

Write-up: Tested positive for COVID after being fully vaccinated. Have received all 3 doses.


VAERS ID: 1999102 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-26
Onset:2021-12-26
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, Asthenia, Blood bicarbonate normal, Blood calcium increased, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood magnesium increased, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone normal, Blood urea normal, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Fatigue, Fibrin D dimer increased, Full blood count normal, Gait disturbance, General physical condition abnormal, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, Illness, Loss of personal independence in daily activities, Lung disorder, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume decreased, Mean platelet volume normal, Metabolic function test normal, Occult blood negative, Physical deconditioning, Platelet count increased, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width increased, SARS-CoV-2 test positive, Sitting disability, Troponin increased, Urine analysis, White blood cell count normal
SMQs:, Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tubulointerstitial diseases (broad), Hypoglycaemia (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet aspirin EC 81 MG enteric coated tablet Calcium Carb-Cholecalciferol (CALCIUM PLUS VITAMIN D3) 600-800 MG-UNIT TABS Cinnamon 500 MG CAPS citalopram (CELEXA) 10 MG tablet clobetasol (TEMOVATE) 0.05 % crea
Current Illness: 1. Dizziness 7/30/21 2. BPPV (benign paroxysmal positional vertigo), right 7/30/21
Preexisting Conditions: Circulatory Hypertension Infectious/Inflammatory Candidal dermatitis Nervous Other polyneuropathy Paresthesia of both hands Pain in both hands Cubital tunnel syndrome on left Vulvar itching Genitourinary Cystocele, midline Endocrine/Metabolic Hyperlipidemia IFG (impaired fasting glucose) Immune Rheumatoid arthritis Other Osteoporosis Skin lesion Expressive speech disorder Anxiety Thoracic outlet syndrome Vertigo Difficulty walking Poor balance Poor posture Neck stiffness
Allergies: No Known Allergies
Diagnostic Lab Data: Collected: 12/30/21 0856 Order Status: Completed Specimen: Blood, Venous Updated: 12/30/21 1012 D-Dimer Quant 3,650 High 0 - 500 ng/mL FEU Collected: 12/30/21 0856 Order Status: Completed Specimen: Blood, Venous Updated: 12/30/21 0957 C-Reactive Protein 117.4 High <=5.0 mg/L Collected: 12/29/21 0637 Order Status: Completed Specimen: Blood, Venous Updated: 12/29/21 0743 C-Reactive Protein 69.5 High <=5.0 mg/L Collected: 12/29/21 0637 Order Status: Completed Specimen: Blood, Venous Updated: 12/29/21 0722 D-Dimer Quant 1,380 High Collected: 12/28/21 1604 Order Status: Completed Specimen: Blood, Capillary Updated: 12/28/21 1610 Glucose, POC 136 High Collected: 12/28/21 1152 Order Status: Completed Specimen: Blood, Capillary Updated: 12/28/21 1155 Glucose, POC 111 High 70 - 99 mg/dL Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0920 Phosphorus Level 3.1 2.5 - 4.5 mg/dL Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0920 Sodium Level 140 134 - 146 mmol/L Potassium Level 4.1 3.4 - 5.0 mmol/L Chloride 107 98 - 112 mmol/L HCO3 23 21 - 29 mmol/L Anion Gap 10 9 - 18 mmol/L Glucose Level 102 High 70 - 99 mg/dL Blood Urea Nitrogen 15 8 - 20 mg/dL Creatinine 0.66 0.50 - 1.10 mg/dL MDRD eGFR $g60 $g=60 mL/min/1.73 m2 Calcium Level Total 8.4 Low 8.6 - 10.4 mg/dL Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0920 Magnesium Level 2.3 1.6 - 2.5 mg/dL Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0920 C-Reactive Protein 53.0 High <=5.0 mg/L Collected: 12/28/21 0902 Order Status: Completed Specimen: Blood, Capillary Updated: 12/28/21 0910 Glucose, POC 97 70 - 99 mg/dL Narrative: Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0904 D-Dimer Quant 2,110 High 0 - 500 ng/mL FEU Collected: 12/28/21 0736 Order Status: Completed Specimen: Blood, Venous Updated: 12/28/21 0843 White Blood Cell 6.53 4.00 - 10.80 x10*3/uL Red Blood Cell 4.83 4.20 - 5.40 x10*6/uL Hemoglobin 13.1 12.0 - 16.0 g/dL Hematocrit 38.3 37.0 - 47.0 % Mean Cell Volume 79.3 Low 80.0 - 100.0 fL Mean Cell Hemoglobin 27.1 27.0 - 33.0 pg NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL NRBC Automated 0.0 0.0 - 0.1 %WBC Mean Cell Hemoglobin Concentration 34.2 32.0 - 37.0 g/dL Red Cell Diameter Width 15.6 11.0 - 16.0 % Platelet 270 140 - 400 x10*3/uL Mean Platelet Volume 10.2 7.4 - 11 fL Collected: 12/28/21 0336 Order Status: Completed Specimen: Blood, Capillary Updated: 12/28/21 0340 Glucose, POC 107 High 70 - 99 mg/dL Collected: 12/27/21 2226 Order Status: Completed Specimen: Blood, Capillary Updated: 12/27/21 2230 Glucose, POC 109 High 70 - 99 mg/dL
CDC Split Type:

Write-up: Patient seen in ED and transferred for inpatient admission where she was hospitalized for 3 days. ED notes: Although patient alleges she can walk at home this seems very unlikely. She was unable to even sit up on her own here. Nurse had to help her get into the bed. They had to help her even take her shirt off. She seems very run down. Complete blood count is normal. Occult blood is negative. COVID-19 is detected. Temp here is 37.7. Pulse ox 96%. She is too weak to get an ambulatory sat on. She has had 2 COVID vaccines. CMP is relatively normal. In talking her further she has been sick since December 18th. She knows this because she saw her OB gyn doctor on the 17th and she was not sick that day and felt sick the next day. This is day 8 of illness. I will give her Decadron. TSH normal. BMP is normal. I did contact Dr. for admission however just before she called back the troponin came back at 21. They will require 2nd troponin. If the delta is less than 7 anticipate admission to Hospital. Patient signed out to Dr. Urinalysis and chest x-ray still pending. Inpatient notes: Patient is an 88 year female admitted for deconditioning s/p COVID 19. The patient is fully vaccinated. The patient presented to the ER for generalized fatigue and weakness which started on 12/17/2021. In the ED, CXR showed nonspecific patchy b/l airspace disease as seen with COVID. COVID testing was positive. The patient was not requiring oxygen. She was noted to be deconditioned and given inadequate home resources, was admitted for further evaluation and possible placement. PT/OT evaluated and recommended SAR. Patient refused and family felt it was ok for patient to return home with help from family. HHC was attempted to be arranged and no one would accept the patient. The patient was recommended to follow up with her PCP. She is high risk for readmission. She was discharged home in stable condition.


VAERS ID: 1999173 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-12-26
   Days after vaccination:277
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 - / -

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

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

Write-up: Pt had a COVID test due to requiring psychiatric admission. The test was positive and the patient was found to have COVID pneumonia and required admission.


VAERS ID: 1999202 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-08
Onset:2021-12-26
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 - / IM

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

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

Write-up: Covid monitoring documentation. PT admitted 12/26/21 documented to have positive covid. PT received Pfizer 2/13/21 Lot EM9809 for dose 1. Dose 2 was Pfizer given on 3/6/21 Lot EN6201. PT received Pfizer Booster on 10/8/21 Lot FF2590.


VAERS ID: 1999213 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: verapamil 180, metformin 500mg, prilosec 20mg , tramadol 10mg, gabapentin 600mg, oxcyburten 10mg, rosuvastatin 10mg, extra strength tylenol
Current Illness:
Preexisting Conditions: high blood pressure, heart disease , high cholesterol, COPD
Allergies: steroids
Diagnostic Lab Data:
CDC Split Type:

Write-up: When receiving the injection it was painful going in.


VAERS ID: 1999276 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 068H21A / 3 LA / IM

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

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

Write-up: Patient reported severe body aches, chills, sweats and fever (continues to go higher since 12/26/2021). Currently taking Tylenol. Patient also having severe headaches.


VAERS ID: 1999507 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-23
Onset:2021-12-26
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 56y.o. male with a hx of kidney transplant secondary to right kidney nephrectomy (2020) who presents to the ED for evaluation of shortness of breath with onset couple days


VAERS ID: 1999712 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8757 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra; Lexapro; omeprazole; birth control.
Current Illness: None
Preexisting Conditions: Mild Asthma
Allergies: None
Diagnostic Lab Data: Covid
CDC Split Type: vsafe

Write-up: 12/26/2021 Covid symptoms started and at first it was post nasal drop, but then on Tuesday I woke up with a cough and congestion. The cough lasted a couple of days and altogether symptoms lasted 4 days. I tested positive at urgent care on 12/28/21 with rapid test. I was exposed to someone positive on 12/23/21 at work.


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https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=148&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


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