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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 149 out of 10,493

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VAERS ID: 1999716 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-29
Onset:2021-12-26
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Jardiance; Januvia; Livalo; lisinopril; diltiazem; metformin; Bayer aspirin; potassium; magnesium; Osteo Bi-Flex
Current Illness: None
Preexisting Conditions: Type 2 Diabetes
Allergies: Penicillin
Diagnostic Lab Data: COVID test 12/22/2021 negative. COVID test 12/26/2021 positive.
CDC Split Type: vsafe

Write-up: COVID positive. It started with a cough and extreme fatigue and sinus headache and occasionally lose the voice. They told me to take aspirin and get lots of sleep and told me to take Flovent to prevent COVID pneumonia. I''m still having the sinus headaches and extreme fatigue and the cough is very occasional now. Quarantine for 11 days and that was up this past Sunday. Scheduled for another COVID test tomorrow 01/04/2021.


VAERS ID: 1999793 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kansas  
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 032H21A / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Chills, Fatigue, Feeling abnormal, Headache, Influenza virus test negative, Migraine, Nausea, Pain, Photophobia, Pyrexia, SARS-CoV-2 test negative, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Culturelle probiotic; black cohosh; celecoxib; generic Valtrex; montelukast; vitamin D3; prenatal vitamin; generic Protonix; fish oil; glucosamine; chondroitin; Flonase Sensimist
Current Illness: Tick bite on 12/17/2021 waiting for blood tests; Sinus infection (started taking medication on 12/13 for 7 days)
Preexisting Conditions: Hypothyroidism; Seasonal allergies; Arthritis; Herpes; GERD
Allergies: Some antibiotics; Cat hair
Diagnostic Lab Data: Flu test, negative. COVID test negative, Blood panel for tick, still awaiting results.
CDC Split Type: vsafe

Write-up: I woke up the morning of the 12/26, with chills and fever the whole night before. That whole day, I felt feverish and headache-y. 12/27 I had fevers, and headaches and brain fog, highest fever 101. I took Tylenol every 6 hours while I was awake. Tuesday, 12/28/2021 fever was 102. Wednesday 12/29 same thing but headaches were the strongest they had ever been. Fatigue. I went to a walk-in clinic and did not have a fever when I was there but that''s when I noticed I was light sensitive when I drove myself there. There, she prescribed doxycycline and said this was normal with the vaccine and by then it was 6 days by this point. She suggested for me to go for a walk and ice on back of neck for headaches. That evening I had another 101 fever. I had been setting an alarm to take Tylenol throughout the night. Thursday, headaches still continued so I called my GP and I told them the situation and they had me do a flu & COVID testing and both came back negative. Then they suggested I also do a blood panel for the tick. When I was there, they prescribed me sumatriptan 25mg for migraines. For the first time since my migraines started, I finally had relief for the first time. There was also brain fog. 12/31 brain fog, 01/01 headaches. Christmas day there was also nausea and throughout the symptoms. On Saturday it was the same nausea and weakness and it wasn''t as bad because the headaches were finally managed. I had a fever on 12/31 but it was only 99. Saturday 1/1 3 hours where I was not in pain. Sunday 1/2 half the day, I went half the day without any pain. I also did take Tylenol every 6 hours. Today I had a Tylenol this morning for a headache. I''ve also lost 4 pounds since the beginning of symptoms. Fatigue was also present during duration of symptoms.


VAERS ID: 1999852 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04U21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Hypersensitivity, Joint stiffness, Lip swelling, Muscle tightness, Musculoskeletal stiffness, Swelling face, Trismus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Peanuts, tree nuts, all legumes and natural soy products (edamame, tofu, soy milk)
Diagnostic Lab Data: No medical tests taken; also did not have to call the paramedics. 50 mgs of Benadryl seemed to circumvent the full onset of severe reaction (possible anaphylactic given the tightening of jaw, neck and swelling of lips). Have contacted my allergist to report the reaction and to schedule a follow up visit if required. Am waiting on their call back.
CDC Split Type:

Write-up: Appointment time was 3:45pm, received the booster shot at about 4:15pm. Waited in the store for 45 minutes after the shot - anaphylactic reaction to peanuts, tree nuts, legumes, natural soy, etc., so was asked to wait at least 30 mins - was also waiting on a friend who was also getting booster, so did not leave pharmacy until about 5:00pm. Dropped friend off at her place close by and headed home. While on the drive home, my jawline began to lock up, both sides of my neck began to stiffen, my upper lip started swelling (was about 5:10pm at this time). Recognizing the signs of severe allergic reaction, I took two (a total of 25 mgs) of children''s chewable Benadryl (I carry it at all times along with my Epipens per doctor''s advice). Symptoms were not relieved by the time I arrived home at 5:15pm, so took an adult Benadryl (another 25 mg) and called my neighbor to come over in case I needed to call 911. She stated my face was very red and swollen. Symptoms began to relieve at about 5:30pm; neighbor stayed with me for another hour. Almost all symptoms were gone by 7:00pm; the only thing that remained was tightness in the joints of my jaw on both sides. That finally dissipated by 10:00pm. Since symptoms began to dissipate after taking the Benadryl, I did not have to call 911 and elected not to go to hospital given that they are very full right now.


VAERS ID: 1999994 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-18
Onset:2021-12-26
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Dyspnoea, Fatigue, Lung infiltration, Malaise, Neutrophil count, Oxygen saturation decreased, Productive cough, Pyrexia, Red blood cell sedimentation rate normal, SARS-CoV-2 test negative, Wheezing, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq 25 mg q day Synthroid 25 mcg q day Rosuvastatin 20 mg HS
Current Illness: none
Preexisting Conditions: History of recurrent Hodgkin''s Lymphoma. S/P autologous stem cell transplant 1/11/18
Allergies: NKDA
Diagnostic Lab Data: Chest xray PA/lateral on 12/27 demonstrated faint patchy infiltrates, no frank pneumonia. WBC elevated at 9.7 with proliferation of neutrophils. ESR nl.
CDC Split Type:

Write-up: Sunday, 12/26, rather acute onset shortness of breath, O2 saturation in low 90s/high 80s, low grade fever (102.8 was highest), malaise, fatigue. Productive cough, wheezing. Symptoms progressed over the next 48 hours and have very slowly now begun to taper. Nasal PCR swab was negative for COVID-19. I was unable to find a clinic for oral swab


VAERS ID: 2000283 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-12-24
Onset:2021-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Ear discomfort, Lymph node palpable, Lymphadenitis, Lymphadenopathy, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (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: Vitamin D3, Probiotics, Beef Liver supplement
Current Illness: none
Preexisting Conditions: Thyroid Cancer, currently.
Allergies: none known
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: about 24 to 36 hours after vaccination, after a low grade fever and some chills, I developed a large lump under my left armpit. This large swelling remained for about a week, and once it diminished, there is still palpable inflamation of lymphnodes and tissues under arm. Additionally, about 1 week after vaccine, significant Tinnitus and a feeling of pressure in the left ear started, and is still continuing


VAERS ID: 2000361 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-12-26
   Days after vaccination:269
Submitted: 0000-00-00
Entered: 2022-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Insomnia, Loss of personal independence in daily activities, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20224

Write-up: 11 days later had body hives after the Moderna Booster; 11 days later had itchy/very itchy hives; Can''t sleep; Can''t take a shower; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (11 days later had body hives after the Moderna Booster), PRURITUS (11 days later had itchy/very itchy hives), INSOMNIA (Can''t sleep) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Can''t take a shower) 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. In April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In May 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Dec-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 URTICARIA (11 days later had body hives after the Moderna Booster), PRURITUS (11 days later had itchy/very itchy hives), INSOMNIA (Can''t sleep) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Can''t take a shower). At the time of the report, URTICARIA (11 days later had body hives after the Moderna Booster), PRURITUS (11 days later had itchy/very itchy hives), INSOMNIA (Can''t sleep) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (Can''t take a shower) outcome was unknown. No concomitant product use was provided. No treatment medication was provided. Later 11 days the patient had itchy, very itchy hives, can''t sleep , can''t take a shower, this was insane and Patient never had a reaction like this ever and was never been allergic to anything before and this booster was just a nightmare.


VAERS ID: 2000708 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest X-ray, Computerised tomogram, Haemoglobin decreased, Pulmonary haemorrhage, Pulmonary thrombosis, Syncope, Transfusion, Transient ischaemic attack
SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen, tramadol, citalopram, metformin
Current Illness: Alzheimers
Preexisting Conditions: Diabetes, alzheimers
Allergies: None
Diagnostic Lab Data: Chest x-ray, CT Scan, 1/1/2022
CDC Split Type:

Write-up: 4 days after the vaccines began having multiple transient ischemic attacks, and episodes of syncope. Admitted to the hospital 10 days after vaccine with internal bleeding in her lungs, lungs full of blood clots and covid pneumonia. She required 2 blood transfusions because her hemoglobin was so low. She has been placed on hospice.


VAERS ID: 2000995 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-20
Onset:2021-12-26
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 RA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 2000996 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-10
Onset:2021-12-26
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 2000998 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-06-24
Onset:2021-12-26
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 2001271 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-27
Onset:2021-12-26
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 2001398 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-12-26
   Days after vaccination:282
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive contact unknown


VAERS ID: 2001410 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-10-04
Onset:2021-12-26
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF25909798 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, COVID-19, Chest X-ray normal, Chills, Condition aggravated, Cough, Electrocardiogram normal, Headache, Heart rate increased, Nasal congestion, Painful respiration, Pulmonary pain, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Covid Vaccine (1st Dose), I had a rapid heartbeat (2/21/2021).
Other Medications: None
Current Illness: None
Preexisting Conditions: Type 2 Diabetic
Allergies: Sulfa; penicillin; bee stings
Diagnostic Lab Data: Covid Test positive (12/27/2021), EKG (12/29/2021), blood work (12/29/2021), chest X-ray (12/29/2021).
CDC Split Type: vsafe

Write-up: On 12/26/2021 I had a headache behind my right eye. My nose felt stuffed up intermittently. I got tested on 12/27/2021 in the morning and it was positive for covid. I had a stuffy nose, chills, and headache. Later in the evening when I breathed in deeply it felt like razor blades were cutting the inside of my lungs, but short breaths didn''t hurt as much. 12/28/2021 I had chills, cough, headache, and stuffy nose. 12/29/2021 I had a rapid heartbeat so I went to the hospital. The doctor said I was normal and fine. On new years eve I had a rapid heartbeat again. It lasted for a little while then it stopped. It happened on and off for a few days. I have had chills throughout this time. The last couple of days I''ve been sneezing, light coughing, mild headache, and chills.


VAERS ID: 2001412 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-23
Onset:2021-12-26
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive contact unknown


VAERS ID: 2001700 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-04
Onset:2021-12-26
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea, Fall, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: hypertension
Allergies: Lyrica
Diagnostic Lab Data: Sars COV2 positive on Dec 28/2021
CDC Split Type:

Write-up: Event occurred after 2nd vaccine. 12/28/2021: 65-year-old female who presented to emergency department complaining of 2 days of worsening weakness, cough, mild shortness of breath patient presented Facility department with fall yesterday


VAERS ID: 2001808 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-25
Onset:2021-12-26
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive contact unknown


VAERS ID: 2001999 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Malaise, Pain in extremity, Rhinorrhoea
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: sore arm, headache, malaise and runny nose for 5 days, symptoms resolved with OTC vitamin c and anti-histamine


VAERS ID: 2002021 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-28
Onset:2021-12-26
   Days after vaccination:332
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive contact unknown


VAERS ID: 2002934 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-12-13
Onset:2021-12-26
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 064H21A / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Rash, Skin warm, 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: Zoloft 25mg
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives, rash, hot to touch and itchy. The hives appear randomly and Benedryl has not been helping.


VAERS ID: 2003159 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-12-24
Onset:2021-12-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2022-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059H21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure systolic increased, Chest pain, Heart rate increased, Interchange of vaccine products, Sick relative
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Medication errors (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Brilinta, Metoprolol. lisinopril
Current Illness: Tooth abscess - active infection at time of booster
Preexisting Conditions: hypertension
Allergies: Amoxicillin
Diagnostic Lab Data: ER for severe chest pain high BP & potential heart attack on 12-28.
CDC Split Type:

Write-up: 1st two doses were Pfiser had NO side effects. Did not have tooth abscess during either This Moderna booster caused my Systolic Blood Pressure to exceed 200 for 3 days in a row with fast heart rate above 100 putting me in the ER and lucky to survive. My significant other became EXTREMELY sick for 10 days and got her booster the same time I did. We are still trying to recover from 2 weeks ago. What a nightmare! There must be something wrong with that Moderna Lot # and please let us know asap.


VAERS ID: 2005470 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-12-14
Onset:2021-12-26
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT DOCUMENTED / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT DOCUMENTED / 2 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT DOCUMENTED / 3 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Cough, Electrocardiogram abnormal, Hypoxia, SARS-CoV-2 test positive, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin atorvastatin (LIPITOR) 80 MG tablet diphenoxylate-atropine (LOMOTIL) 2.5-0.025 MG per tablet guaiFENesin (MUCINEX) 600 MG 12 hr tablet insulin glargine (LANTUS SOLOSTAR) 100 UNIT/ML pen-injector loperamide (IMODIUM) 2 MG capsule pan
Current Illness:
Preexisting Conditions: Type 2 diabetes mellitus with hyperglycemia, neuropathy, nephropathy Weakness Personal history of colon cancer, stage II Small bowel obstruction due to adhesions Small bowel obstruction C. difficile diarrhea PAD (peripheral artery disease) Unstable angina CHF (congestive heart failure), NYHA class III, acute, systolic Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris Mixed hyperlipidemia Nonrheumatic aortic valve stenosis DVT (deep venous thrombosis) Cardiomyopathy Hypotension Carcinoma of colon
Allergies: Metformin Glimepiride
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 12/26/2021; COVID-19 positive 12/26/2021; fully vaccinated plus booster BRIEF OVERVIEW: Admission Date: 12/26/2021 Discharge Date: 01/03/2022 HOSPITAL COURSE: a 91 y.o. male with history of insulin-dependent type 2 diabetes, coronary artery disease, CKD 3 A who presented with weakness and cough. Patient was found to have COVID with mild hypoxia requiring oxygen. He was started on Decadron PT and OT were consulted who recommended subacute rehab. Physical therapy and occupational therapy reassessed on 1/2 when patient was out of isolation and confirmed this.. Consults: None Procedures: None " Interim hospital course: Patient hospitalized for acute hypoxic respiratory failure secondary to COVID-19 pneumonia. Patient was treated with Decadron with improvement in his symptoms weaned to room air and stable with his oxygen saturations prior to discharge. Patient was also seen by PT OT for generalized weakness with recommendation for subacute rehab which he will discharge to in stable medical condition on 01/03/2022. In regards to his insulin he had been requiring Lantus 48 units during his stay while on Decadron, dexamethasone will be discontinued at discharge and insulin will be reduced to 35 units from his home 30 units given that he will not be on Ozempic while at subacute rehab. Recommend patient follow-up with his home primary care physician, other medications remain the same at discharge. Do recommend the patient continue to hold midodrine given his normotensive pressures here in the hospital. Of note patient did have an EKG at the onset of his hospitalization that was noted by previous physician read as AFib, I do note P waves although does appear irregular with PVCs would recommend routine cardiology follow-up as deemed necessary by primary care physician following repeat EKG on follow-up care as an outpatient.


VAERS ID: 2005556 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-12-18
Onset:2021-12-26
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022BZ1A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Occasional Heartburn
Allergies: None
Diagnostic Lab Data: Standard blood panel and blood clotting tests with normal results.
CDC Split Type:

Write-up: I have had full body itching and hives starting about 8 days after my booster shot. I had a similar but much smaller reaction to my 2nd Moderna shot in May of 2021, but it was limited to just a few bumps and itching on one leg for two days, so I didn''t know for sure that it was because of the vaccine. Now I''ve been itching all over my body for 10 days, I''ve tried benadryl and some topical OTC medications to relieve itching and they help a bit. Any time I touch my skin, move, or put on clothes, I get hives where there is significant friction with the skin and it itches incredibly badly. My doctor had me start prednisone (40mg per day) yesterday, and I''m on my 2nd dose today but the itching is getting slightly worse again if anything.


VAERS ID: 2005590 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-09
Onset:2021-12-26
   Days after vaccination:292
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Dyspnoea, Exposure to SARS-CoV-2, Hypoxia, Lethargy, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknonw
Current Illness: unknown
Preexisting Conditions: Down syndrome, bipolar disorder
Allergies: Chloromycetin, penicillin
Diagnostic Lab Data: SarsCOV2- positive 12/26/2021
CDC Split Type:

Write-up: 12/26/2021: Event occurred after 2nd vaccine. 58-year-old male with past medical history of Down syndrome, bipolar disorder presents emergency department from a group home after patient was having progressive worsening shortness of breath. He is currently residing in a group home which multiple residents were tested positive for Covid. Patient reportedly was tested positive couple days ago and has been having progressive worsening shortness of breath and lethargy. Also had a fever today.Noted to be hypoxic 80% on room air that improved to 96% on 4 L nasal cannula. CXR clear. Given pt''s hy[oxia with positive covid, pt will be admitted for steroids. Given first dose of Decadron 10mg IV here.


VAERS ID: 2005635 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-12-26
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Gastrointestinal haemorrhage, Haematemesis, Hypotension, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Hep C
Allergies: IV contrast dye
Diagnostic Lab Data: 12/26/2021- Sarscov2 Positive.
CDC Split Type:

Write-up: 12/26/2021: Event occurred after 2nd vaccine. Patient is a 61-year-old male past medical history significant for hepatitis C, possible recent HCC diagnosis presenting to the ED for vomiting bright red blood. Denies fever, chills, chest pain, shortness of breath, weakness, numbness, vision changes, bruising, rash, dysuria. He is hypotensive, remaining vitals are stable. Remains in hospital on Jan 5 2022. GI Bleed


VAERS ID: 2005673 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-30
Onset:2021-12-26
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A1A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anion gap, Aortic dilatation, Asthenia, Blood bicarbonate normal, Blood calcium decreased, Blood chloride increased, Blood creatinine normal, Blood culture negative, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Clostridium test, Condition aggravated, Cough, Creatinine renal clearance decreased, Dizziness, Dyspnoea, Full blood count abnormal, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin decreased, Hypoxia, Legionella test, Lung infiltration, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Metabolic function test abnormal, Platelet count normal, Pneumonia, Procalcitonin normal, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width increased, SARS-CoV-2 test positive, Streptococcus test negative, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen; Allopurinol; Amlodipine Besylate; Aspirin; Atorvastatin Calcium; Cholecalciferol; Famotidine; Fluoxetine HCl; Furosemide 20 MG TAKE 1 TABLET DAILY hydrALAZINE HCl 25 MG TAKE 1 TABLET TWICE A DAY hydroCHLOROthiazide 12.5 mg Or
Current Illness:
Preexisting Conditions: Past Medical History: Diagnosis Date o Acute kidney failure (HCC) 2/9/2018 o AK (actinic keratosis) o Arthropathy of Past Medical History: Diagnosis Date o Acute kidney failure (HCC) 2/9/2018 o AK (actinic keratosis) o Arthropathy of cervical facet joint 08/2011 MRI of the cervical spine without contrast C2-3 and C4-5 and to the left o CAD (coronary artery disease) Minimal in RCA o Carotid artery dissection (HCC) Left Carotid--Vascular & Interventional radiologist o Circadian rhythm sleep disorder, delayed sleep phase type 1/24/2011 o Colon, diverticulosis o Colonic polyp 08/22/2007/Repeat in 5 yrs Colonoscopy o Contact dermatitis and other eczema, due to unspecified cause o Degenerative arthritis of thoracic spine T9-10 o Diabetes mellitus o Dry eye syndrome 5/19/2010 o Dysphagia 2ary to GERD requiring esophageal dilatation- o ED (erectile dysfunction) o Episode of recurrent major depressive disorder (HCC) 2/22/2020 o Excessive daytime sleepiness 11/23/2010 o Family history of early CAD Father died of MI @ age of 44 y.o. o GERD (gastroesophageal reflux disease) o Headache o Hepatitis A o History of prostate cancer In remission--s/p radical prostatectomy- o Hyperlipidemia o Hypertension o Hypothyroidism 5/5/2011 o IBS (irritable bowel syndrome) o Kidney cyst 2002 o Male pattern baldness o MGUS (monoclonal gammopathy of unknown significance) o Migraine Cluster o Multiple thyroid nodules 10/2010 CTA neck Right lobe enlarged & w nodules - o Obesity o OSA (obstructive sleep apnea) 12/2010 split night RDI 55 oxygen min 81% CPAP 7 cwp o Prophylactic antibiotic o Seizure (HCC) 4/4/2018 o Skin cancer Scalp--Excised o Snoring 11/23/2010 o Stroke due to embolism (HCC) 4/29/2019 o Tear film insufficiency, unspecified 05/2010 o Type II or unspecified type diabetes mellitus without mention of complication, not stated as uncontrolled 10/31/2009 o Unspecified cerebral artery occlusion o Vitamin D deficiency 10/2009 o Vitreous degeneration
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (12.26.21 - 1.3.22); COVID-19 positive (12.26.21); Fully vaccinated - J&J x1 Home covid + test Discharge Summary Admission Date: 12/26/2021 Discharge Date: 1/3/2022 Active Hospital Problems Diagnosis Date Noted POA o Pneumonia due to COVID-19 virus 12/27/2021 Unknown Resolved Hospital Problems No resolved problems to display. Pre-Existing Active Problems Diagnosis Date Noted POA o Dilated aortic root (HCC) 10/30/2021 Unknown o LFT elevation 12/20/2020 Unknown o Memory disturbance 09/07/2020 Unknown o Gastroesophageal reflux disease without esophagitis 09/07/2020 Unknown o Chronic gout of multiple sites 09/07/2020 Unknown o Peripheral vascular disease, unspecified (HCC) 09/07/2020 Unknown o Dry eyes, bilateral 07/10/2020 Unknown o Non-proliferative diabetic retinopathy, left eye (HCC) 07/10/2020 Unknown o Episode of recurrent major depressive disorder (HCC) 02/22/2020 Unknown o Skin cancer Unknown o Shortness of breath 05/22/2019 Unknown o CVA (cerebral vascular accident) (HCC) 04/29/2019 Unknown o Diplopia 04/23/2019 Unknown o MGUS (monoclonal gammopathy of unknown significance) 02/13/2019 Unknown o History of carotid artery dissection 05/30/2018 Unknown o Focal epilepsy (HCC) 04/04/2018 Unknown o History of common carotid artery stent placement 02/26/2018 Unknown o History of kidney stones 02/26/2018 Unknown o History of prostate cancer 02/26/2018 Unknown o Type 2 diabetes mellitus without ophthalmic manifestations (HCC) 02/09/2018 Unknown o Posterior vitreous detachment, right 06/19/2015 Unknown o Hyperopia, bilateral 06/19/2015 Unknown o Arthropathy of cervical facet joint Unknown o OSA (obstructive sleep apnea) 07/25/2011 Unknown o Hypothyroidism 05/05/2011 Unknown o HTN (hypertension), benign Unknown o Coronary artery disease involving native coronary artery of native heart without angina pectoris Unknown o Hyperlipidemia 08/05/2009 Unknown Discharge Disposition: Active Issues Requiring Follow-up: CAP : Completed abx therapy. Outpatient follow-up with PCP in 5-7 days. Chest x-ray in 6 weeks to ensure resolution. Close monitoring of symptoms. Pending Labs Order Current Status Peripheral Blood Culture Preliminary result Peripheral Blood Culture Preliminary result DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Community acquired pneumonia, unspecified laterality Pneumonia due to COVID-19 virus COVID-19 a 79-year-old gentleman with past medical history significant for DM 2, carotid artery dissection, CAD, hypertension, hyperlipidemia, MGUS, hypothyroidism, hepatitis a, prostate cancer in remission, obesity, CVA who was admitted on 12/26/2021 for evaluation of symptoms of generalized weakness/nonproductive cough/shortness of breath. Had tested positive for COVID-19 on 12/22 at home. Monoclonal antibody infusions were to be arrange but patient had not received them. In the emergency department patient was hypoxic with ambulation and was extremely weak and dizzy. Imaging with chest x-ray showed left basal infiltrate. CPAP was suspected and patient was started on Rocephin and azithromycin. Admitted to internal medicine for continued care. Post admission given patient was stable on room air no treatment was started for the COVID-19. Blood cultures were obtained. Urine strep, urine Legionella were negative. Procalcitonin was negative as well. Antibiotic therapy with Rocephin and azithromycin was continued. Blood cultures remain negative at 48 hours. PT/OT evaluated the patient and recommended discharge home with assist. Pulmonary have evaluated the patient and not see the need for oxygen at home. Patient being discharged in a stable condition with recommendations to follow up with PCP in the next 5-7 days. CONSULTS / RECOMMENDATION: Consult Orders (From admission, onward) None INPATIENT PROCEDURES: Surgery and Procedures None Non-surgical Procedures (From admission, onward) None BP 153/97 | Pulse 85 | Temp 36.9 ?C (Oral) | Resp 20 | Ht 1.829 m | Wt 114 kg | SpO2 90% | BMI 34.09 kg/m? Physical Exam Constitutional: Appearance: He is well-developed. HENT: Head: Normocephalic and atraumatic. Eyes: Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulmonary: Effort: Pulmonary effort is normal. Breath sounds: Normal breath sounds. Abdominal: General: Bowel sounds are normal. Palpations: Abdomen is soft. Musculoskeletal: Cervical back: Normal range of motion. Skin: General: Skin is warm. Neurological: Mental Status: He is alert and oriented to person, place, and time. Lab Results Last 24 Hours Recent Results (from the past 24 hour(s)) Clostridioides difficile Toxin Status: Normal Specimen: Rectum; Stool Result Value Ref Range Status C difficile Toxin Negative Negative Final POCT GLUCOSE NOVA METER AUTO Status: Abnormal Result Value Ref Range Status Glucose, POC 135 (H) 70 - 99 mg/dL Final Narrative Basic Metabolic Panel (BMP) Status: Abnormal Result Value Ref Range Status Sodium Level 142 134 - 146 mmol/L Final Potassium Level 3.8 3.4 - 5.0 mmol/L Final Chloride 107 98 - 112 mmol/L Final HCO3 24 21 - 29 mmol/L Final Anion Gap 11 9 - 18 mmol/L Final Glucose Level 136 (H) 70 - 99 mg/dL Final Blood Urea Nitrogen 17 8 - 20 mg/dL Final Creatinine 1.01 0.60 - 1.30 mg/dL Final MDRD eGFR $g60 $g=60 mL/min/1.73 m2 Final CG eCrCl 65 mL/min/1.73 m2 Final Calcium Level Total 8.5 (L) 8.6 - 10.4 mg/dL Final Complete Blood Count without Differential Status: Abnormal Result Value Ref Range Status White Blood Cell 9.68 4.00 - 10.80 x10*3/uL Final Red Blood Cell 4.88 4.60 - 6.00 x10*6/uL Final Hemoglobin 13.2 (L) 14.0 - 18.0 g/dL Final Hematocrit 42.4 42.0 - 52.0 % Final Mean Cell Volume 86.9 80.0 - 100.0 fL Final Mean Cell Hemoglobin 27.0 27.0 - 33.0 pg Final NRBC Absolute Count 0.00 0.00 - 0.01 x10*3/uL Final NRBC Automated 0.0 0.0 - 0.1 %WBC Final Mean Cell Hemoglobin Concentration 31.1 (L) 32.0 - 37.0 g/dL Final Red Cell Diameter Width 15.1 11.0 - 16.0 % Final Platelet 302 140 - 400 x10*3/uL Final Mean Platelet Volume 10.9 7.4 - 11 fL Final POCT GLUCOSE NOVA METER AUTO Status: Abnormal Result Value Ref Range Status Glucose, POC 142 (H) 70 - 99 mg/dL Final Narrative Admission Date: 12/26/2021 Discharge Date: 1/3/2022 Active Hospital Problems Diagnosis Date Noted POA o Pneumonia due to COVID-19 virus 12/27/2021 Unknown Resolved Hospital Problems No resolved problems to display. Pre-Existing Active Problems Diagnosis Date Noted POA o Dilated aortic root (HCC) 10/30/2021 Unknown o LFT elevation 12/20/2020 Unknown o Memory disturbance 09/07/2020 Unknown o Gastroesophageal


VAERS ID: 2005761 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-30
Onset:2021-12-26
   Days after vaccination:271
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

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

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

Write-up: Pt received Jansseen vaccine on 03/30/2021. Pt presented to the ED on 1/5/22 with complaints of not feeling well overall. Pt noted that he tested positive for COVID on 12/26/21.


VAERS ID: 2005934 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-11-20
Onset:2021-12-26
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013F21A / 3 LA / 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Covid-19 test.
CDC Split Type: vsafe

Write-up: I had fatigue, sore throat, congestive, headache, and body aches. These lasted for about 2 days on most of the symptoms and about 5 days on the fatigue. I went on Dec 28th to a clinic to get tested for Covid-19, positive result. I also took an at home Covid-19 test, positive result on Jan. 2nd.


VAERS ID: 2005991 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-27
Onset:2021-12-26
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive contact unknown


VAERS ID: 2006101 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H2A / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta 54 mg Prozac 20 mg
Current Illness: Runny nose one week prior to booster
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hives started on December 26 and have been ongoing since. He has been taking Claritin and Benadryl to help.


VAERS ID: 2006355 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-11
Onset:2021-12-26
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ear infection
SMQs:

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

Write-up: Middle Ear Infection; Azithromycin; the antibiotic ended the infection


VAERS ID: 2006361 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-03
Onset:2021-12-26
   Days after vaccination:267
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Delirium, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (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? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Unknown
Preexisting Conditions: Breast cancer (recurrence on anasrazole and abemaciclib), ESRD on peritoneal dialysis, DM, CAD, dyslipidemia, HTN, h/o MI, L eye blindness
Allergies: Coconut, Penicillin, Gadolinium contrast
Diagnostic Lab Data: COVIDD-19 PCR positive 12/29/2021
CDC Split Type:

Write-up: Pt received 2 doses of Moderna COVID-19 vaccine on 3/6 & 4/3. Around 12/26 she developed some waxing mentation, which persisted and worsened until being brought to the hospital by family on 12/29/21. In ED, she tested positive for COVID-19.


VAERS ID: 2006530 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-11-18
Onset:2021-12-26
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG33527 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Influenza virus test negative, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Respiratory syncytial virus test negative, Rhinorrhoea, SARS-CoV-2 test positive
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), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: HTN, GERD''s
Allergies: NKDA
Diagnostic Lab Data: Dec 26, 2021@15:17:04 _FLU A (CEPHEID) NEGATIVE , FLU B (CEPHEID) NEGATIVE , RSV (CEPHEID) NEGATIVE SARS-CoV-2 POSITIVEA*
CDC Split Type:

Write-up: fever, cough, nasal congestion, nasal drainage, sore throat, and bodyaches


VAERS ID: 2006617 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradycardia, Confusional state, Dizziness, Feeling abnormal, Migraine, Night sweats, Pharyngeal swelling, Vertebral artery dissection
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: dizziness (within first 10 minutes), vertigo ,confusion, migraine, bradycardia (heart rate dropped to 49, 50, 52 then 53), night sweats, swelling throat ( took 3 crushed antihistamines--2 then 2 hours later a 3rd-- and reported this to the ER nurse). It felt as if someone was sitting on my chest and my head was a hot air balloon. I used breathing techniques learned in previous therapy sessions to control my breathing and take shallow breaths. I moved very little so as to not alter my breathing pattern. Talking and swallowing unusually interrupted my breathing so I limited talking. I spit my saliva in empty water bottles to avoid swallowing. The dizziness and vertigo was so intense that I laid down the first three days. I only got off of my beanbag to go use the restroom. I used my fitness Watch to document my heart rate before I was able to get myself to an ER (I am also uninsured since my health insurance expired two months prior and have been waiting for approval.) By 12/31, I couldn''t take it anymore so that was when I took the 2 antihistamines and visited an ER--taking the 3rd one while waiting. I also took 10mg Rizatriptan on this date for the migraine. After 1/1 I felt much better and all of the pre existing reactions dissipated. I have an appt with a Neurologist this week 1/6 as well as cardiologist to make sure that this did not further affect me in any way.


VAERS ID: 2007111 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7218 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A as of now but have been doing research trying to find out the connection between the vaccine and tinnitus. There is a lot of material on this subject available, and more being published daily it seems. If unresolved in the near-future, I will be reaching out to my primary care physician and an ENT to start with.
CDC Split Type:

Write-up: I now have constant tinnitus in my ears. I never had anything like this before . I suspect there are countless unreported cases like this on top of those that have been reported. It is up to the FDA/CDC to act on this and also demand that the vaccine manufacturers (Pfizer in my case) list this as a known side-effect, and also determine what can be done to help resolve the issue!


VAERS ID: 2007212 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-18
Onset:2021-12-26
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2022-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen PRN, amlodipine, baby aspirin, enalapril, MVI, furosemide, gabapentin, hydrochlorothiazide, omeprazole
Current Illness:
Preexisting Conditions: hypertension
Allergies: NKDA
Diagnostic Lab Data: COVID status positive 12/26/21.
CDC Split Type:

Write-up: Patient received Moderna COVID vaccine on 5/21/21 and 6/18/21. On 12/26/21, patient was tested positive for COVID. On 1/2/22, patient admitted to our inpatient facility with acute hypoxic respiratory failure due to COVID-19 pneumonia. As of today (1/5/22), patient is still admitted in the med/surg unit requiring high flow O2 and on dexamethasone.


VAERS ID: 2008882 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Emotional distress, Nerve injury, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad), Medication errors (narrow), Hypoglycaemia (broad)

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

Write-up: The lady who administered the shot, gave it to me in my shoulder, causing nerve damage. Ever since then, all along my arms and upper chest, I have a felt different sensations. This made me think I have myocarditis/heart problems. In reality, it has caused me anxiety and distress for nearly 2 weeks!


VAERS ID: 2009840 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-18
Onset:2021-12-26
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: SARS-CoV-2 test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: COVID test pending 06JAN22
CDC Split Type:

Write-up: Pt developed urticaria on back, chest, arms, and face that wax and wane throughout the day. Symptoms started 26DEC and worsened over 3 days to include stridor. Pt presented to the ER for evaluation and was given IV antihistamines and steroids. Discharged from ER with 6 day steroid burst, pepcid, and loratadine. Symptoms failed to improve and pt has now been started on maximal antihistamine therapy.


VAERS ID: 2010048 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-12-26
   Days after vaccination:295
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / UNK RA / IM

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

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

Write-up: Hospitalization 12/26/21 2nd COVID shot 3/27/21, Pfizer, EN6203, IM/LD


VAERS ID: 2010259 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-11-12
Onset:2021-12-26
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058F21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 positive through family contact...Client did receive booster


VAERS ID: 2010260 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-12-20
Onset:2021-12-26
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL1007 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, SARS-CoV-2 test negative, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Seen by Pediatrician 2 times, not viral
CDC Split Type:

Write-up: Vomiting, nausea Chronic persistent headache, hives and nausea lasting more than 2 weeks and beginning 24 hours post vaccine. Not viral according to pediatrician. Covid tested 12/20 and 12/28 negative.


VAERS ID: 2010427 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-12-03
Onset:2021-12-26
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Developed Covid on 12/19/2021. Wants to note this.


VAERS ID: 2010473 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: New York  
Vaccinated:2021-12-06
Onset:2021-12-26
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Atrial fibrillation, Cardiac failure congestive, Catheterisation cardiac, Echocardiogram, Laboratory test
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin C, vitamin D, iron supplement
Current Illness: One month prior diverticulitis
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data: Hospitalization, cardiac catheterization, echocardiogram and laboratory tests
CDC Split Type:

Write-up: NSTEMI, new onset atrial fibrillation and congestive heart failure. Patient stabilized and discharged


VAERS ID: 2010572 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-09
Onset:2021-12-26
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Diarrhoea, Dizziness, Dyspnoea, Heart rate increased, Nausea, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bcomplex,calcium citrate/D,garlique,lantanoprost,magnesium citrate,,multi vit/minerals,fish oil,turmeric,azo
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scan 12/30/2021 - blood clots in lungs
CDC Split Type:

Write-up: Rapid heart rate (105) for 3 days, shortness of breath,dizzy, nausea, diarrhea .Diagnosis, blood clots in lungs


VAERS ID: 2010660 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E2119 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash, Rash macular, 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: Full Body Rash (Dx:Pityriasis rosea), 26 yrs, 01/05/2021, COVID-19, Moderna (First Shot)
Other Medications: Prozac 20mg
Current Illness: None
Preexisting Conditions: Major Depressive Disorder, Lactose Intolerant
Allergies: Aspartame
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I developed a full-body rash around 10-11 days after my Moderna booster. The rash progressively got worse over 4 days and has remained. The rash presents as hives. It is itchy, with red splotches. Pressure and scratching make the rash worse. Antihistamines help the rash. On a scale of 1-10 (1 Not Painful; 10 Very Painful), the rash is between a 2-4. I take cetirizine HCL10mg every AM, and Fexofenadine HCL 60mg additionally if there is a breakthrough rash.


VAERS ID: 2010669 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-12-16
Onset:2021-12-26
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Aphonia, COVID-19, Fatigue, Headache, Influenza virus test negative, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: High blood pressure; Coronary artery disease
Allergies: N/A
Diagnostic Lab Data: Covid-19 test, Flu test.
CDC Split Type: vsafe

Write-up: I had fatigue, headache, and low-grade fever. I have sore throat and lost of voice. I have these symptoms over a week now. I went to the doctor for a Covid-19 test, positive result. They also did a Flu test, negative result.


VAERS ID: 2010673 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-29
Onset:2021-12-26
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031H21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Condition aggravated, Constipation, Injection site pain, Irritable bowel syndrome
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Psyllium, Align probiotic, Vitamin D, Vitamin K, Red Rice Yeast, Magnesium Citrate (in the form of Calm powder).
Current Illness: IBS and migraines. I use prescription drugs as needed to manage.
Preexisting Conditions: IBS and migraines
Allergies: Hydrocodone/Norco
Diagnostic Lab Data: I called my GI and had a telehealth visit. We decided it is most likely an IBS-C flare and I started adding MiraLAX to my IBS supplement regimen. I had a bowel movement the next day and have been mostly regular since. The low back pain has abated enough that it doesn''t hurt or affect my abilities. I think I''m still evening out, so any little stress could cause another flare cycle, but I''m at the tail end of the precarious zone.
CDC Split Type:

Write-up: No immediate reactions other than soreness at injection site. A few weeks later I experienced low back pain that was sharp. First right side, then both sides. I had been constipated for 2 days and felt motility had slowed. Back pain made it hurt to bend, get up and down, tie shoes. I thought it might be an IBS flare, but I hadn''t experienced this back pain from a flare before. I remember feeling muscle aches after my first 2 COVID Moderna vaccines that felt similar, so I wasn''t sure if this IBS flare might be related to the vaccine booster. My flares are brought on by stress, which can be anything from a full schedule to eating wrong foods.


VAERS ID: 2011631 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-11-13
Onset:2021-12-26
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 3 RA / -

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

Write-up: Bell''s Palsy on right side of my face


VAERS ID: 2011636 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-12-17
Onset:2021-12-26
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041J21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain, Pruritus, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, Epicor, Vitamin D, Athletic Greens
Current Illness: N/A
Preexisting Conditions: GERD, CFS, IBS
Allergies: Ceftin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I had no adverse reactions for the first 2 doses of the Moderna vaccine. On the 3 dose, I experienced chills, fatigue, headache, body aches, and fever, which started roughly 12 hours after administration. These symptoms were severe for 1 day and resolved over the course of 3-4 days. Then, roughly 9 days after the 3rd dose, I started experiencing small itchy patches on my skin, which developed into hives 2 days later. I discontinued taking my supplements thinking that it might be the cause, to no avail (I have taken all of the listed supplements for prolonged periods of time, 8+ months). In addition, I have had no significant changes to my diet and have not introduced any new foods. I am currently experiencing small patches of hives that move around my body throughout the day and severe itchiness, primarily on my ancles, feet, hands, armpits, and scalp. The itchiness and hives come and go - no rhythm or reason. Taking Zyrtec resolves 95% of my symptoms. However, if I discontinue Zyrtec, my symptoms return. I am traveling internationally on 1/8 and plan to be evaluated at my final destination should my symptoms persist.


VAERS ID: 2013969 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-12-13
Onset:2021-12-26
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 LA / SYR

Administered by: Unknown       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: Levothyxine - 50mcg daily
Current Illness: None
Preexisting Conditions: Autoimmune Hypothyroidism
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chronic Uticaria- hives. All over body not at injection site. Began 2 weeks after booster. Appears on legs, arms. Frets, hands, chest. Everywhere


VAERS ID: 2014278 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-17
Onset:2021-12-26
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Diarrhoea, Fatigue, Night sweats, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: NIGHT SWEATS, VOMITING, LOOSE STOOLS, COUGH, FATIGUE, LOSS OF TASTE AND SMELL, NASAL DRAINAGE


VAERS ID: 2014383 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-01
Onset:2021-12-26
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / -

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid Positive
CDC Split Type:

Write-up: Tested positive for Covid on Dec. 31,2021


VAERS ID: 2014649 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-01
Onset:2021-12-26
   Days after vaccination:328
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Chest discomfort, Electrocardiogram, Feeling abnormal, Painful respiration
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oh boy....Aspirin 81mg, Carbidopa/Levo 25/100mg, Duloxetine 90mg, Multaq 400g, Rexulti .5mg, Rosuvastian 20mg, Sumatriptan 6mg shot, Sumatriptan 100mg tab, Topiramate 200 mg, Wellbutrin 300mg, Vitamin D3 50 mcg, Trazodone 300mg
Current Illness:
Preexisting Conditions: migraines depression
Allergies: none
Diagnostic Lab Data: Tests will be done next week.
CDC Split Type:

Write-up: Adverse event at home, 12/26/21. Fifteen minutes after breakfast I developed severe pressure over my heart area. Lasted for five hours then suddenly dissipated and a strange feeling moved to the center of my chest. With each inhale, there was a squeezing in my chest and I felt as if a balloon (from both sides of my chest and from my neck to my belly button) was fully inflated. More pressure. These. two feelings lasted for seven hours. Two days later, an EKG revealed that I did not have a heart attack. A stress test and an echocardiogram are scheduled next week to obtain more information.


VAERS ID: 2014745 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-18
Onset:2021-12-26
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Respiratory tract congestion, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: congestion, cough, short of breath + COVID test


VAERS ID: 2014753 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-27
Onset:2021-12-26
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / 2 UN / UN

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

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

Write-up: congestion, cough + COVID test


VAERS ID: 2014760 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-28
Onset:2021-12-26
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 UN / UN

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

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

Write-up: cough +COVID test


VAERS ID: 2014769 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-07
Onset:2021-12-26
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypoxia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: short of breath, hypoxia + COVID test


VAERS ID: 2014779 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-25
Onset:2021-12-26
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: chills, fever, cough, short of breath, myalgia + COVID test


VAERS ID: 2014784 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-15
Onset:2021-12-26
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive, Stridor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, short of breath, stridor + COVID test


VAERS ID: 2014882 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-12-26
   Days after vaccination:263
Submitted: 0000-00-00
Entered: 2022-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

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

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

Write-up: Due to traveling with family that were diagnosed with COVID, she had a COVID test completed that was positive and she received monoclonal antibodies. She had minor respiratory symptoms including a three day nonproductive cough. No fevers or chills.


VAERS ID: 2017445 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-06
Onset:2021-12-26
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no medical history of chronic illness. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211258916

Write-up: SEVERE HEADACHE; This spontaneous report received from a patient concerned a 25 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non-smoker, and non-alcohol user. The patient had no known drug allergies and no medical history of chronic illness. The patient was not pregnant at the time of reporting The patient received covid-19 vaccine ad26.cov2.s (dose number in series: 1) (suspension for injection, intramuscular, batch number: Unknown and expiry: Unknown) dose was not reported, 1 total administered on an unspecified date in APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. It was unspecified whether patient experienced any adverse events following the administration of covid-19 vaccine ad26.cov2.s (dose number in series: 1). The action taken with covid-19 vaccine ad26.cov2.s was not applicable The patient received non-company suspect vaccine mrna 1273 (Moderna, dose number in series: 2) (form of admin, route of admin, and batch number were not reported) dose was not reported, administered on 06-NOV-2021 for prophylactic vaccination. On christmas eve, following mrna 1273 vaccination, it was reported that patient had a close contact with a person who had flu like symptoms prior to christmas eve, and that he was tested positive for covid-19 thereafter. On 26-DEC-2021, the patient experienced severe headache. (Dose number in series: 2) The action taken with mrna 1273 was not reported. The patient had not recovered from severe headache. This report was non-serious


VAERS ID: 2017452 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:2021-12-05
Onset:2021-12-26
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 20211227; Test Name: COVID-19 antigen test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20211260946

Write-up: SORE THROAT; HEADACHES; This spontaneous report received from a patient concerned a female of unspecified age, race and ethnicity. The patient''s height, and weight were not reported. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (dose number in series 1) (suspension for injection, route of admin not reported, batch number: 1802072, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 06-MAR-2021 to right arm for prophylactic vaccination. It was unknown whether patient had any adverse event following vaccination with covid-19 vaccine ad26.cov2.s (dose number in series 1). The patient received booster dose of non-company suspect vaccine included: MRNA 1273 (Moderna) (dose number in series 2) (form of admin, route of admin, and batch number were not reported) dose was not reported, 1 total administered on 05-DEC-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 26-DEC-2021, the patient experienced sore throat, and headaches (dose number in series 2). On 27-DEC-2021, Laboratory data included: Antigen Rapid test ((BinaxNOW) coded as COVID-19 antigen test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s, and MRNA 1273 (Moderna) was not applicable. The outcome of the headaches and sore throat was not reported. This report was non-serious.


VAERS ID: 2017599 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-26
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: 2 time resulted Positive
CDC Split Type: USJNJFOC20220109707

Write-up: CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 49 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 213D21A, expiry: UNKNOWN) dose was not reported, administered on 24-DEC-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-DEC-2021, the patient experienced confirmed covid-19 infection. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) 2 time resulted Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed covid-19 infection was not reported. This report was non-serious.


VAERS ID: 2017696 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059H21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Accidental underdose
SMQs:, Medication errors (narrow)

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

Write-up: Patient received half-volume of Moderna COVID-19 vaccine; This spontaneous case was reported by a pharmacist and describes the occurrence of ACCIDENTAL UNDERDOSE (Patient received half-volume of Moderna COVID-19 vaccine) in a 37-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 059H21A) for COVID-19 vaccination. No Medical History information was reported. On 26-Dec-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .25 milliliter. On 26-Dec-2021, the patient experienced ACCIDENTAL UNDERDOSE (Patient received half-volume of Moderna COVID-19 vaccine). On 26-Dec-2021, ACCIDENTAL UNDERDOSE (Patient received half-volume of Moderna COVID-19 vaccine) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported by the reporter. No treatment was reported by the reporter.


VAERS ID: 2017703 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202112; Test Name: SARS-CoV-2 test; Test Result: Positive; Result Unstructured Data: SARS-CoV-2 test positive.
CDC Split Type: USMODERNATX, INC.MOD20214

Write-up: Covid-19 Virus Test Postive; I don''t have smell; This spontaneous case was reported by an other health care professional and describes the occurrence of ANOSMIA and SARS-COV-2 TEST POSITIVE 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 23-Dec-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Dec-2021, the patient experienced ANOSMIA. On an unknown date, the patient experienced SARS-COV-2 TEST POSITIVE. At the time of the report, ANOSMIA and SARS-COV-2 TEST POSITIVE outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available) in December 2021, SARS-CoV-2 test positive SARS-CoV-2 test positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were reported. No treatment medication were reported. This is a spontaneous case concerning a patient of unknown age and gender, with no relevant medical history, who experienced the unexpected non serious event of anosmia and Covid-19 Virus Test Positive as an added event. The events occurred approximately 3 days after the unknown dose of mRNA-1273 COVID 19 Vaccine. The rechallenge was not applicable, as information about further dosing was not disclosed. The events outcome was unknown. The benefit-risk relationship of mRNA-1273 COVID 19 Vaccine, is not affected by this report.


VAERS ID: 2018668 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-12-23
Onset:2021-12-26
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back injury, Hypersensitivity
SMQs:, Angioedema (broad), Accidents and injuries (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:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101858972

Write-up: My back is like broken or something; I have many allergic reaction from vaccine; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A patient (no qualifiers provided) received bnt162b2 (BNT162B2), administration date 23Dec2021 (Lot number: FF2593) as dose number unknown, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: BACK INJURY (non-serious) with onset 26Dec2021, outcome "unknown", described as "My back is like broken or something"; HYPERSENSITIVITY (non-serious) with onset 26Dec2021, outcome "unknown", described as "I have many allergic reaction from vaccine". No follow-up attempts are needed. No further information is expected.


VAERS ID: 2018678 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-12-26
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, Anxiety, Chest pain, Cough, Decreased appetite, Dizziness, Headache, Insomnia, Loss of consciousness, Malaise, Near death experience, Palpitations, SARS-CoV-2 test
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211226; Test Name: Covid-19/Flu A''||CHR(38)||''B rapid; Result Unstructured Data: Test Result:Positive; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101862854

Write-up: and had a near death experience; passed out; feel ill; headache; dizziness/light headedness; loss of appetite; loss of sense of smell; sleeplessness; coughing; chest pain; anxiety; palpitation; This is a spontaneous report received from a contactable reporter(s) (Other HCP) from product quality group. The reporter is the patient. A 30 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 01May2021 (Lot number: EW0153) at the age of 30 years as dose 2, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Past drug history included: Shellfish, reaction(s): "Allergy"; Peanut, reaction(s): "Allergy"; Cashew nut, reaction(s): "Allergy". Vaccination history included: Bnt162b2 (Dose Number: 1, Batch/Lot No: ER8736, Location of injection: Arm Left, Route of Administration: Intramuscular), administration date: 10Apr2021, when the patient was 30 years old, for COVID-19 Immunization. The following information was reported: NEAR DEATH EXPERIENCE (medically significant) with onset 26Dec2021, outcome "recovering", described as "and had a near death experience"; MALAISE (non-serious) with onset 26Dec2021, outcome "recovering", described as "feel ill"; LOSS OF CONSCIOUSNESS (non-serious) with onset 26Dec2021, outcome "recovering", described as "passed out "; HEADACHE (non-serious) with onset 26Dec2021, outcome "recovering", described as "headache"; DIZZINESS (non-serious) with onset 26Dec2021, outcome "recovering", described as "dizziness/light headedness"; DECREASED APPETITE (non-serious) with onset 26Dec2021, outcome "recovering", described as "loss of appetite"; ANOSMIA (non-serious) with onset 26Dec2021, outcome "recovering", described as "loss of sense of smell"; INSOMNIA (non-serious) with onset 26Dec2021, outcome "recovering", described as "sleeplessness"; COUGH (non-serious) with onset 26Dec2021, outcome "recovering", described as "coughing"; CHEST PAIN (non-serious) with onset 26Dec2021, outcome "recovering", described as "chest pain"; ANXIETY (non-serious) with onset 26Dec2021, outcome "recovering", described as "anxiety"; PALPITATIONS (non-serious) with onset 26Dec2021, outcome "recovering", described as "palpitation". The events "covid-19 positive", "covid-19 positive", "and had a near death experience", "feel ill", "passed out ", "headache", "dizziness/light headedness", "loss of appetite", "loss of sense of smell", "sleeplessness", "coughing", "chest pain", "anxiety" and "palpitation" were evaluated at the emergency room visit. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. There were no any other medications the patient received within 2 weeks of vaccination. The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26Dec2021) positive, notes: Nasal Swab. Therapeutic measures were taken as a result of vaccination failure, covid-19, malaise, loss of consciousness, headache, dizziness, decreased appetite, anosmia, insomnia, cough, chest pain, anxiety, palpitations.; Sender''s Comments: Based on the temporal association between the events Near death experience, malaise, loss of Conscience, headache, Decreased Appetite, Anosmia, Insomnia, Cough, Anxiety, Palpitations , chest pain ,Dizziness, and the suspect drug BNT162B2 cannot be excluded The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate


VAERS ID: 2018711 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-10-22
Onset:2021-12-26
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 2 - / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Maternal exposure during pregnancy, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211224; Test Name: Covid-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20211224; Test Name: Nasal Swab; Test Result: Positive ; Test Date: 20211226; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101864719

Write-up: Tested positive for Covid-19 on 26Dec2021.; Tested positive for Covid-19 on 26Dec2021.; Currently 37 weeks pregnant and fully vaccinated.; This is a spontaneous report received from a non-contactable reporter(s) (Other HCP) from product quality group. The reporter is the patient. A 31 year-old female patient (pregnant) received bnt162b2 (BNT162B2), intramuscular, administration date 22Oct2021 (Lot number: Fh8020) as dose 2, single and intramuscular, administration date 01Oct2021 (Lot number: Ff8839) as dose 1, single for covid-19 immunisation. Date of last menstrual period: 07Apr2021. The patient was 28 weeks pregnant at the time of exposure to bnt162b2. The patient was 37 weeks pregnant at the event onset. The patient is expected to deliver a baby(s) on 12Jan2022. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Flu (other vaccine 4weeks product=Flu vaccine). The following information was reported: COVID-19 (medically significant), VACCINATION FAILURE (medically significant) all with onset 26Dec2021, outcome "not recovered" and all described as "Tested positive for Covid-19 on 26Dec2021."; MATERNAL EXPOSURE DURING PREGNANCY (non-serious) with onset 26Dec2021, outcome "not recovered", described as "Currently 37 weeks pregnant and fully vaccinated.". The patient underwent the following laboratory tests and procedures: covid-19: (24Dec2021) negative, notes: Nasal Swab; sars-cov-2 test: (24Dec2021) positive; (26Dec2021) positive. Therapeutic measures were not taken as a result of covid-19, vaccination failure, maternal exposure during pregnancy. Additional information: The patient did not took other medications in two weeks. The patient did not have Covid prior vaccination. The patient tested for Covid post vaccination. No follow-up attempts are possible. No further information is expected.


VAERS ID: 2018729 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-02-18
Onset:2021-12-26
   Days after vaccination:311
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: known allergies: No other medical history: No
Allergies:
Diagnostic Lab Data: Test Date: 20211226; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101871369

Write-up: I came down with COVID / I tested positive; I came down with COVID / I tested positive; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. The reporter is the patient. A 53 year-old male patient received bnt162b2 (BNT162B2), administration date 18Feb2021 (Lot number: EL3247) at the age of 52 years as dose 2, single and administration date 28Jan2021 (Lot number: EL3247) as dose 1, single for covid-19 immunisation. The patient had no relevant medical history. No known allergies and no other medical history. There were no concomitant medications. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 26Dec2021, outcome "recovering" and all described as "I came down with COVID / I tested positive". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26Dec2021) positive, notes: Nasal Swab. Therapeutic measures were not taken as a result of vaccination failure, covid-19. Neither received other vaccine in four weeks nor other medications in two weeks.Did not had covid prior vaccination. covid tested post vaccination. No follow-up attempts are possible. No further information is expected.


VAERS ID: 2018805 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-29
Onset:2021-12-26
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Oropharyngeal pain, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), 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: Test Date: 20211227; Test Name: Covid Test; Test Result: Positive; Comments: Nasal Swab.
CDC Split Type: USPFIZER INC202101878270

Write-up: Breakthrough Covid infection; Breakthrough Covid infection; Sore throat; slight cough; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. The reporter is the parent. A 18 year-old male patient received bnt162b2 (BNT162B2), administration date 29Jun2021 (Lot number: EW0181) at the age of 18 years as dose 2, single for covid-19 immunisation. The patient''s relevant medical history was not reported. There were no concomitant medications. Vaccination history included Bnt162b2 (Dose: 01, Lot No EN0217), administration date: 08Jun2021, when the patient was 18 years old, for Covid-19 immunization. The following information was reported VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 26Dec2021, outcome recovering; OROPHARYNGEAL PAIN (non-serious) with onset 26Dec2021, outcome recovering; COUGH (non-serious) with onset 26Dec2021, outcome recovering. The patient underwent the following laboratory tests and procedures sars-cov-2 test (27Dec2021) positive, Nasal Swab. Advil was taken as the Therapeutic measures as a result of vaccination failure, covid-19, oropharyngeal pain, cough. Patient was detected Covid positive on 28Dec2021. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient did not receive any other medications within 2 weeks of vaccination.


VAERS ID: 2018825 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ8762 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Headache, Immunisation, Pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MICROGESTIN; ZINC; VITAMIN C [ASCORBIC ACID]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (Known allergies: Penicillin)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101882241

Write-up: For 4 days - sore left arm; Sore left armpit; Swollen left armpit; 1 day - body aches; Headache; Dose received: 3; This is a spontaneous report from a contactable reporter (Consumer or other non-HCP). The reporter is the patient. A 29-year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in left arm, administration date 26Dec2021 at 14:00 (Lot number: FJ8762) at the age of 29 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "Penicillin allergy" (unspecified if ongoing), notes: Known allergies: Penicillin. Concomitant medications included: MICROGESTIN; DAILY VITAMIN; ZINC and VITAMIN C. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE, Lot Number: EW0187, Anatomical Location: Left arm, Administration time: 16:00), administration date: 27May2021, when the patient was 29 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, SINGLE, Lot Number: EW0181, Anatomical Location: Left arm, Administration time: 16:00), administration date: 17Jun2021, when the patient was 29 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 26Dec2021 at 14:00, outcome "unknown", described as "Dose received: 3"; PAIN IN EXTREMITY (non-serious) with onset 26Dec2021 at 22:00, outcome "recovered" (30Dec2021), described as "For 4 days - sore left arm"; AXILLARY PAIN (non-serious) with onset 26Dec2021 at 22:00, outcome "recovered" (30Dec2021), described as "Sore left armpit"; SWELLING (non-serious) with onset 26Dec2021 at 22:00, outcome "recovered" (30Dec2021), described as "Swollen left armpit"; PAIN (non-serious) with onset 26Dec2021 at 22:00, outcome "recovered" (27Dec2021), described as "1 day - body aches"; HEADACHE (non-serious) with onset 26Dec2021 at 22:00, outcome "recovered" (27Dec2021), described as "Headache". Therapeutic measures were not taken as a result of pain in extremity, axillary pain, swelling, pain and headache. Additional Information: The duration of the events PAIN and HEADACHE was reported as 1 day while that of the events PAIN IN EXTREMITY, AXILLARY PAIN, SWELLING was reported as 4 days. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Prior to the 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 doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care.


VAERS ID: 2018844 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-23
Onset:2021-12-26
   Days after vaccination:306
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Pain, Pyrexia, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211227; Test Name: home Ag; Test Result: Positive ; Test Date: 20211230; Test Name: home Ag; Test Result: Positive
CDC Split Type: USPFIZER INC202101883507

Write-up: Covid Ag test positive/ due to exposure on 25Dec2021 family event CC chills fever body aches; Covid Ag test positive/ due to exposure on 25Dec2021 family event CC chills fever body aches; chills; fever; body aches; This is a spontaneous report received from a non-contactable reporter(s) (Other HCP) from product quality group. A 41 year-old male patient received bnt162b2 (BNT162B2), administration date 23Feb2021 (Lot number: EL3247) at the age of 40 years as dose 2, single and administration date 04Feb2021 (Lot number: EL3247) as dose 1, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 26Dec2021, outcome "recovering" and all described as "Covid Ag test positive/ due to exposure on 25Dec2021 family event CC chills fever body aches"; CHILLS (non-serious) with onset 26Dec2021, outcome "recovering", described as "chills"; PYREXIA (non-serious) with onset 26Dec2021, outcome "recovering", described as "fever"; PAIN (non-serious) with onset 26Dec2021, outcome "recovering", described as "body aches". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (27Dec2021) positive; (30Dec2021) positive. Clinical course: The events did not Result in death, Life threatening, hospitalization, Disabling/Incapacitating, Congenital anomaly/birth defect. It did not know if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information in the case report, a possible causal relationship between the events and suspect drug BNT162B2 cannot be excluded.


VAERS ID: 2018845 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-05
Onset:2021-12-26
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211228; Test Name: PCR; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101883666

Write-up: This is a spontaneous report received from a non-contactable reporter(s) (Other HCP) from product quality group. An adult female patient (not pregnant) received bnt162b2 (BNT162B2), administration date 05Nov2021 (Lot number: FF2589) as dose 3 (booster), single, administration date 16Feb2021 (Lot number: EL3247) as dose 2, single and administration date 26Jan2021 (Lot number: EL3247,) as dose 1, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 26Dec2021, outcome "recovering" and all described as "Patient colleague got sx 26Dec after exposure 25Dec and tested + covid PCR 28Dec2021". The event "patient colleague got sx 26dec after exposure 25dec and tested + covid pcr 28dec2021" and "patient colleague got sx 26dec after exposure 25dec and tested + covid pcr 28dec2021" was evaluated at the physician office visit. The patient underwent the following laboratory tests and procedures: polymerase chain reaction: (28Dec2021) positive, notes: Nasal Swab. It was unknown if therapeutic measures were taken as a result of vaccination failure, covid-19. Since the vaccination, the patient has been tested for COVID-19. Case reported as non-serious. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on limited information in the case , a possible causal association between the reported events Vaccination failure, COVID -19 and the suspect drug BNT162B2 cannot be excluded.


VAERS ID: 2019330 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-12-16
Onset:2021-12-26
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2022-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chronic spontaneous urticaria
SMQs:, Immune-mediated/autoimmune disorders (broad)

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

Write-up: Chronic Spontaneous Urticaria (Hives) 10 days after the booster injection, I began experiencing hives all over my body. Today is day 13 of continuous symptoms. I am concerned this will be an ongoing adverse effect.


VAERS ID: 2019805 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-12-04
Onset:2021-12-26
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Atypical pneumonia, Chest X-ray abnormal, Cough, Gait disturbance, Headache, Hyperventilation, Mobility decreased, Polymenorrhoea, Pulmonary oedema, Pyrexia, SARS-CoV-2 test negative, Sleep disorder
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (broad)

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

Write-up: I got the booster shot on December 4th . I had a low-grade fever the next day (around 100, with ibuprofen) and headaches most of the next week. I did not have headaches after the first two shots. I also had my period 3 days early, which rightly or wrongly) I correlated with the vaccine and possibly the headaches. I flew on the 23rd and drove up to another city, at 8,500 feet altitude. I had a slight bronchial cough before coming out to Colorado. It was so minimal, it didn''t register as a worry, but I did have to clear my lungs each morning and would hack a bit while biking on my way to work. By mid-day, it would clear. I still have that bit of a cough. I slept restlessly my first three nights. On the 24th and the 25th I had a slight headache, manageable with ibuprofen. I woke up on the 26th with a splitting headache, dry cough, and unable to walk up stairs without hyperventilating. I felt a little better after taking acetaminophen and drinking a liter of water. I felt a lot better at later in the morning when we descended (6,000 feet altitude). I didn''t immediately feel worse when we came back up, but about half way through lunch I felt my energy levels tank. In retrospect, it was probably actually my oxygen levels. I lay down for an hour nap. When the alarm rang, I could barely wake up. It took me at least 30 minutes to make it out of my bed to the basement couch, and another 15 to make it upstairs to the living room couch. My dry cough was back, but a lot worse. At some point, I forget when, I started experiencing rales (i.e., when I tried to breathe deeply, it felt like I was breathing through a brittle filter that would vibrate with the breath). Going up or down stairs caused severe hyperventilation, worse than in the morning. I did not experience any relief when we descended around 6:00. We went to the ER around 8:00PM. My oxygen level was 63, dropping to the 50s upon movement. The ER put me on 4 liters of oxygen somewhere around 8:00PM. By 2:00 AM, before any medical intervention other than oxygen, I was doing better and if I focused on breathing and sat still, I could keep my oxygen above 90 on my own. The X-ray showed liquid in the lungs and white blood count indicated an infection. The PCR test was negative for Covid. They diagnosed me with atypical pneumonia, put me on antibiotics and steroids (prednisone) and sent me home. My oxygen dropped to 84 Monday night, so we asked for supplemental oxygen at home which I used the next two nights. By Friday, I was sleeping comfortably without supplemental oxygen. I flew back on Monday, January 3rd, without incident. I had a follow-up appointment with a pulmonologist on Wednesday, January 5th. The X-ray showed that the lungs were perfectly clear. The pulmonologist said that bacterial pneumonia, even with antibiotics, does not clean up that fast, so it was probably either viral pneumonia or high altitude pulmonary edema . No doctor mentioned any possible relation between the illness and the vaccine. I saw online that interstitial lung disease seems to be a possible, though exceedingly rare, response to the Covid vaccine (and the flu vaccine). It seems unlikely that I experienced interstitial lung disease, but I am reporting just in case.


VAERS ID: 2019808 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-12-26
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 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? Yes
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: positive covid tests
CDC Split Type:

Write-up: covid infection


VAERS ID: 2019919 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-12-01
Onset:2021-12-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F63524 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Fatigue, Influenza virus test negative, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan, Esomeprazole Magnesium, baby Aspirin, Mucinex, Vitamins D3 and C, Omega 3
Current Illness: None
Preexisting Conditions: Chronic allergic rhinitis, heart-burn, uterus fibroid.
Allergies: Dust, detergents
Diagnostic Lab Data: POCT Rapid Molecular Influenza A&B (NMG/RMG) - negative; POCT SARS-CoV-2-Nat - negative.
CDC Split Type:

Write-up: Fever (~100 degree F) and fatigue on one evening only (26 Dec); since then -- running nose, chest congestion, coughing up dark phlegm.


VAERS ID: 2019922 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-12-17
Onset:2021-12-26
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2022-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 067H21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Skin disorder, 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: Woman''s One A Day Multivitamin, Ibuprofen
Current Illness:
Preexisting Conditions: Endometriosis, herpes simplex
Allergies: Clairitin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itchiness and hives that started on the back of head and back. Was mostly upper body but now includes entire body. Taking Benadryl and using witch hazel on skin. Seems to help but still have hives and itchiness. 12/28/2021 given Prednisone for 12 days - made it worse Given Permetherin cream on 1/4/2022 as a treatment for possible skin mites. Did one treatment, not better.


VAERS ID: 2020695 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-10-29
Onset:2021-12-26
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 positive through work contact...Client did receive booster dose


VAERS ID: 2020889 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-04
Onset:2021-12-26
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Menstruation delayed, Ultrasound scan normal, Urine analysis normal
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C; Elderberry; and rose hip.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Took urine and blood tests as well gotten an ultrasound completed and all came back negative.
CDC Split Type:

Write-up: Missed menstrual cycle. 15 days late. Currently not pregnant.


VAERS ID: 2021167 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-12-15
Onset:2021-12-26
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 069H21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Erythema, Exposure during pregnancy, Laboratory test normal, Mechanical urticaria, Pruritus, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Rabies vaccination, given in 2002, reaction to third dose in prophylactic series, involved fever, headache, neuralgia in left ar
Other Medications: Prenatal Vitamins, Supplemental iron/B12 tablets, low dose aspirin (81 mg per day).
Current Illness: None.
Preexisting Conditions: Celiac disease. Well controlled asthma.
Allergies: Celiac Disease (gluten), Sulfonamide antibiotics. Clarithromycin. Doxycycline.
Diagnostic Lab Data: 12/28/21: Liver profile and bile acids, all values within normal limits including ALT, ALP, bilirubin and bile acids.
CDC Split Type:

Write-up: At time of vaccination, 20 weeks gestation. No immediate reaction noted. Redness, tenderness developed within 24 hours and subsided within 72 hours. No other signs. However, starting December 26 (day 10 post vaccination), hives appeared on my elbows, abdomen, eyes, neck and breasts. Intense itching also started at the same time, and whenever itched, red welts appeared. Itching was throughout the body, from feet to head, and along all extremities. Visit to obstetrician on the 27th, and 50 mg diphenhydramine started q6 hours, which would control 80% of symptoms but did not resolve all hives or pruritis. Completed liver bloodwork to exclude cholestasis of pregnancy on December 28th. Saw dermatologist on the 29th for persistent signs despite use of diphenhydramine and was changed to 10 mg certirizine q24 hours, which resolved 90-95% of the pruritis, 100% of hives/urticaria, but dermatographia persists even after 12 days of continuous therapy and pruritis returns when dosing interval id complete. There is no known topical or oral exposure to allergen to cause signs, and there are no signs in other members of the household.


VAERS ID: 2021306 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-30
Onset:2021-12-26
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: SARS-COV-2 RNA, NAAT positive 12/30/2021
CDC Split Type:

Write-up: developed covid symptoms 12/26/2021


VAERS ID: 2021357 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-12-02
Onset:2021-12-26
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211D21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Influenza A virus test, Influenza B virus test, Nucleic acid test, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, CHF, COPD, DM, Macular Degeneration, Pacemaker,
Allergies:
Diagnostic Lab Data: SARS-CoV-2 (COVID-19) and Influenza AB by Nucleic Acid Amplification, POC
CDC Split Type:

Write-up: Worsening SOB


VAERS ID: 2021551 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-10-01
Onset:2021-12-26
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2022-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dysphagia, Fatigue, Malaise, Oropharyngeal pain, SARS-CoV-2 test positive, Sleep disorder, Viral test negative
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: dilantin
Diagnostic Lab Data: 12/26 home kit positive for covid. 12/27 PCR test positive for covid. (other viruses tested for at the same time negative)
CDC Split Type:

Write-up: Break through case of covid 19. Severe sore throat, severe chills, malaise, fatigue, mild coughing. Felt fine going to bed at 10PM on 12/25 but awoke at 2AM on 12/26 with severe chills and sore throat with difficulty swallowing. Mild cough. Home test kit for covid positive morning of 12/26. Symptoms continued and worsened over 12/26 and 12/27. Never short of breath. Oxygen sats mostly above 96%. Obtained PCR confirmation testing on morning of 12/27--positive for covid. Arranged monoclonal infusion for 4pm on 12/27 (sotrovimab). Dramatic symptomatic improvement with monoclonal infusion. Felt partial improvement by 6-8 hours and by 15 hours felt 80% back to normal. By 12/29 felt completely recovered. I isolated myself from the rest of household as soon as my home kit was positive. 5 other household members were in the house and none got sick and all stayed negative on testing (home kits and PCR).


VAERS ID: 2024225 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-12-26
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Overweight, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211226; Test Name: tested positive for Covid-19; Test Result: Positive
CDC Split Type: USPFIZER INC202101873640

Write-up: tested positive for Covid-19; tested positive for Covid-19; overweight; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 43 year-old male patient received bnt162b2 (COMIRNATY), administration date Jul2021 (Batch/Lot number: unknown) at the age of 43 years as dose 2, single and (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant) with onset 26Dec2021, outcome "unknown", COVID-19 (medically significant) with onset 26Dec2021, outcome "recovering" and all described as "tested positive for Covid-19"; OVERWEIGHT (non-serious) with onset 2021, outcome "unknown", described as "overweight". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26Dec2021) positive. Clinical courses: Symptoms were moderate for approximately 3 days and are now subsiding. While the patient is considered overweight he is otherwise in good health. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 2024972 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-28
Onset:2021-12-26
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute myocardial infarction, Blood creatinine increased, Brain natriuretic peptide increased, COVID-19, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Chronic kidney disease, Dyspnoea, Myocardial ischaemia, Positron emission tomogram abnormal, SARS-CoV-2 test positive, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Chronic kidney disease (narrow), Tumour lysis syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: He has a past medical history of Hypertension.
Allergies: none
Diagnostic Lab Data: 12/26/21 COVID19: positive 12/26/21 chest xray: Cardiomegaly.
CDC Split Type:

Write-up: Vaccinated with Pfizer COVID19 on 07/28/21 and 08/18/21. Presented to ER on 12/26/21 with COVID19. Presented to the ed with 3 weeks of shortness of breath found to have NSTEMI, acute CHF, and covid positive. Labs remarkable for BNP $g3000, troponin 15. SCR 2.4. patient doing well on room air and dexamethasone and remdesivir held. CXR with cardiomegaly. Nephrology consulted for new AKI on CKD. Cardiology consult; rec cath but patient declining due to risk of worsening AKI/CKD, patient agreeable to stress. Currently awaiting d/c of covid precautions for stress test. Patient underwent cardiac PET scan done suggestive of mild ischemia. Patient was offered cardiac catheterization which patient declined stating for now he will continue taking medications and follow up with cardiology in the office. Prior to discharge patient was feeling back to baseline health and did not need any oxygen. Discharged on 1/5/22


VAERS ID: 2025461 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028K21A / 2 AR / IM

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

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

Write-up: EXTRACTION OF THE MODERNA VACCINE FROM THE VIAL WAS NOT CONSISTENT WITH A MODERNA TECHNIQUE (I.E. MORE THAN 20 BOOSTER DOSES WERE DRAWN UP FROM THE 15ML VIAL).


VAERS ID: 2025471 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032H21A / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Epilepsy
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Generalised convulsive seizures following immunisation (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: Seizures occurring within one week after first and second COVID-19 vaccination.
Other Medications: Tamsulosin, Lisinopril, Levetiracetam, Eliquis, Multivitamin, Vitamins: D3, E, B, C, Fish Oil, Spirulina, Adult 50+ probiotic
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: None Known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Epileptic seizure within a week of vaccination.


VAERS ID: 2025909 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-29
Onset:2021-12-26
   Days after vaccination:272
Submitted: 0000-00-00
Entered: 2022-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Polymerase chain reaction
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), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amiodarone, apixaban, pravastatin, verapamil
Current Illness: sick sinus syndrome, cardiac pacemaker, paroxysmal afib, osteoporosis, mixed hyperlipidemia
Preexisting Conditions: sick sinus syndrome, cardiac pacemaker, paroxysmal afib, osteoporosis, mixed hyperlipidemia
Allergies: contrast dye
Diagnostic Lab Data: Cycle threshold: 19.2
CDC Split Type:

Write-up: Acute hypoxic respiratory failure 2/2 to COVID-19 PNA


VAERS ID: 2027439 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:2021-07-18
Onset:2021-12-26
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Drug ineffective, Headache, Nasal congestion, Oropharyngeal pain, Pyrexia, Suspected COVID-19
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101883844

Write-up: extreme pain on my throat; experiencing a breakthrough infection, likely from the new COVID-19 strain Omicron; experiencing a breakthrough infection, likely from the new COVID-19 strain Omicron; headaches; high fever; cough; congestion; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) for a Pfizer sponsored program (005570). The reporter is the patient. A patient (no qualifiers provided) received bnt162b2 (BNT162B2), administration date 18Jul2021 (Batch/Lot number: unknown) as dose 2, single and administration date 04Jul2021 (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), SUSPECTED COVID-19 (medically significant) all with onset 26Dec2021, outcome "unknown" and all described as "experiencing a breakthrough infection, likely from the new COVID-19 strain Omicron"; HEADACHE (non-serious) with onset 26Dec2021, outcome "unknown", described as "headaches"; PYREXIA (non-serious) with onset 26Dec2021, outcome "unknown", described as "high fever"; COUGH (non-serious) with onset 26Dec2021, outcome "unknown", described as "cough"; NASAL CONGESTION (non-serious) with onset 26Dec2021, outcome "unknown", described as "congestion"; OROPHARYNGEAL PAIN (non-serious) with onset 27Dec2021, outcome "unknown", described as "extreme pain on my throat". Addition information: It was reported that: The vax clinician told me to come back in 6 months to get the booster. Fast Forward to 25Dec2021. Right after the holidays I started experiencing a breakthrough infection, likely from the new COVID-19 strain Omicron. Typed on 3rd. The lot number for bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 2027637 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-24
Onset:2021-12-26
   Days after vaccination:277
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Nasal congestion, Pain, SARS-CoV-2 test, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy (known allergies: Penicillin products)
Allergies:
Diagnostic Lab Data: Test Date: 20211230; Test Name: Covid test/Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202200011438

Write-up: Tested positive for covid; Tested positive for covid; Wet cough; diarrhea; chills; stuffy nose; body aches; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from product quality group. The reporter is the patient. A 23 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administered in arm left, administration date 24Mar2021 (Lot number: EP6955) at the age of 22 years as dose 2, single and administered in arm left, administration date 03Mar2021 (Lot number: EL3248) as dose 1, single for covid-19 immunisation. Relevant medical history included: "known allergies:Penicillin products" (unspecified if ongoing), notes: known allergies: Penicillin products. The patient''s concomitant medications were not reported. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 30Dec2021, outcome "recovering" and all described as "Tested positive for covid"; COUGH (non-serious) with onset 26Dec2021, outcome "recovering", described as "Wet cough"; NASAL CONGESTION (non-serious) with onset 26Dec2021, outcome "recovering", described as "stuffy nose"; DIARRHOEA (non-serious) with onset 26Dec2021, outcome "recovering", described as "diarrhea"; CHILLS (non-serious) with onset 26Dec2021, outcome "recovering", described as "chills"; PAIN (non-serious) with onset 26Dec2021, outcome "recovering", described as "body aches". The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (30Dec2021) positive. Therapeutic measures were not taken as a result of vaccination failure, covid-19, cough, nasal congestion, diarrhoea, chills, pain. Additional information : patient did not receive any other vaccine in four weeks, Patient did not receive any treatment for AE. prior vaccination patient not tested covid positive , post vaccination Patient tested covid positive . patient have Penicillin products allergies


VAERS ID: 2027655 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-12-26
Onset:2021-12-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33030BD / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperaesthesia, Immunisation, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202200019893

Write-up: Left ankle swelled up with great deal of sensitivity, but no underlying injury. It went away suddenly after two days.; Left ankle swelled up with great deal of sensitivity, but no underlying injury. It went away suddenly after two days.; dose number=3; This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the patient. A 51-year-old male patient received bnt162b2 (BNT162B2), administered in arm left, administration date 26Dec2021 at 15:00 (Lot number: 33030BD)at the age of 51 year(s) as dose 3 (booster), single for COVID-19 immunisation. The patient''s relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 2, SINGLE; Lot number: EW0177; Route of administration: Unspecified; Anatomical site: Left arm; Administration time: 12:00), administration date: 17May2021, when the patient was 51 year(s) old, for COVID-19 immunisation and Bnt162b2 (DOSE 1, SINGLE; Lot number: EW0171; Route of administration: Unspecified; Anatomical site: Left arm; Administration time: 11:30), administration date: 26Apr2021, when the patient was 51 year(s) 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"; JOINT SWELLING (non-serious), HYPERAESTHESIA (non-serious) all with onset 27Dec2021 at 22:00, outcome "recovered" (29Dec2021), and all described as "Left ankle swelled up with great deal of sensitivity, but no underlying injury. It went away suddenly after two days". Therapeutic measures were not taken as a result of joint swelling and hyperaesthesia. Additional Information: Prior to the 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 doctor or other healthcare professional office/clinic visit, emergency


VAERS ID: 2028020 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066H21A / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio, Anion gap, Aspartate aminotransferase, Basophil count decreased, Bilirubin conjugated, Blood albumin increased, Blood alkaline phosphatase, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea nitrogen/creatinine ratio, Brain natriuretic peptide increased, COVID-19, Carbon dioxide normal, Cardiac flutter, Cardiomegaly, Chest X-ray abnormal, Chest discomfort, Chest pain, Differential white blood cell count normal, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Eosinophil count normal, Eosinophil percentage increased, Fibrin D dimer, Full blood count, Globulin, Glomerular filtration rate normal, Haematocrit decreased, Haemoglobin, Heart rate increased, International normalised ratio normal, Left ventricular dilatation, Left ventricular dysfunction, Lung opacity, Lymphocyte percentage decreased, Mean cell haemoglobin concentration, Mean cell volume, Mean platelet volume normal, Metabolic function test, Mitral valve incompetence, Monocyte count normal, Neutrophil count normal, Palpitations, Platelet count decreased, Protein total, Prothrombin time prolonged, Pulmonary congestion, Red blood cell count normal, Red cell distribution width increased, Right ventricular dilatation, Right ventricular dysfunction, SARS-CoV-2 test positive, Troponin I normal, White blood cell count normal
SMQs:, Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (narrow), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prescriptions: Metformin (500 mg), Atorvastatin (40mg), Valcyclovir (500mg) Supplements: Vitamin C, Vitamin D, Vitamin B12, Calcium/Magnesium, Chromium, Iron, Co-Q10, Omega3, Probiotic, Centrum Multivitamin for Men, Green Coffee Bean Extrac
Current Illness: None
Preexisting Conditions: Morbid obesity, depression, binge-eating disorder
Allergies: Codeine, Dairy Milk (liquid only)
Diagnostic Lab Data: 12/30 - Chest X-Ray 12/31 - D?DIMER,QUANTITATIVE ?D?DIMER? 12/31 - Echocardiogram Narrative Value Ref Range % Performed At DEPARTMENT OF CARDIOLOGY Pathologist Signature DEPARTMENT OF CARDIOLOGY - 12/31/2021 2:03 PM Transthoracic Echocardiographic Report Gender: M Study Date: 12/31/2021 12:15:06 PM Ht(Cm): 185 Wt(Kg): 325.7 BSA: 4.09 Location: Heart Rate: 100 BMI: 95.16 Procedures: Echocardiographic Report: 93306 - Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording; when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography. Indications: A-Fib/Flutter, and Technically difficult study due to limited acoustic windows. Findings: Left Ventricle: Mildly dilated left ventricle. Moderately depressed left ventricular systolic function. LV Ejection Fraction is visually estimated 30-35 %. Right Ventricle: Mildly dilated right ventricle. Mildly depressed right ventricular systolic function. Left Atrium: Mildly dilated left atrium. Right Atrium: The right atrium is normal in size. Mitral Valve: The mitral valve demonstrates normal leaflet morphology. There is moderate mitral valve regurgitation. Aortic Valve: Normal appearance and function of the aortic valve. Tricuspid Valve: Tricuspid valve not well visualized. Pulmonic Valve: Pulmonic valve not well Pericardium: Normal pericardium with Aorta: Not well visualized. IVC: Not well visualized. Measurements: 2D/M Mode Measurement LVIDd 2D LVIDs 2D IVSd 2D LVPWd 2D Value 6.5 5.7 1.00 1.00 Normal Range [4.2-5.9]cm [2.3-3.9]cm [0.60-1.00]cm [0.60-1.00]cm Doppler Measurement Value AV Peak Vel 140.0 AV Mean Vel 99.2 AV Peak PG 6.0 AV Mean PG 5.0 Normal Range [ 100.0 - 170.0 ] cm/sec [ 70.0 - 90.0 ] cm/sec [2.0-9.0]mmHg [2.0-4.0]mmHg Conclusions: visualized. no pericardial effusion. AVA Vmax AVA VTI 3.6 [ 2.0 - 4.0 ] cm2 3.3 [ 2.0 - 4.0 ] cm2 1. Technically difficult study due to limited acoustic windows. 2. Mildly dilated left ventricle. Moderately depressed left ventricular systolic function. LV Ejection Fraction is visually estimated 30-35 %. 3. Mildly dilated right ventricle. Mildly depressed right ventricular systolic function. 4. The mitral valve demonstrates normal leaflet morphology. There is moderate mitral valve regurgitation. Electronically Signed By: 2021-12-31 14:02:59 Procedure Note ? 12/31/2021 Formatting of this note might be different from the original. Transthoracic Echocardiographic Report Patient Name: Gender: MStudy Date: 12/31/2021 12:15:06 PM Ht?Cm?: 185 Wt?Kg?: 325.7 BSA: 4.09 Heart Rate: 100 BMI: 95.16 Procedures: Echocardiographic Report: 93306 ? Echocardiography, transthoracic, real?time with image documentation ?2D?, includes M?mode recording; when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echocardiography. Indications: A?Fib/Flutter, and Technically difficult study due to limited acoustic windows. Findings: Left Ventricle: Mildly dilated left ventricle. Moderately depressed left ventricular systolic function. LV Ejection Fraction is visually estimated 30?35 %. Right Ventricle: Mildly dilated right ventricle. Mildly depressed right ventricular systolic function. Left Atrium: Mildly dilated left atrium. Right Atrium: The right atrium is normal in size. Mitral Valve: The mitral valve demonstrates normal leaflet morphology. There is moderate mitral valve regurgitation. Aortic Valve: Normal appearance and function of the aortic valve. Tricuspid Valve: Tricuspid valve not well visualized. Pulmonic Valve: Pulmonic valve not well visualized. Pericardium: Normal pericardium with no pericardial effusion. Aorta: Not well visualized. IVC: Not well visualized. Measurements: 2D/M Mode Doppler Measurement Value Normal Range Measurement Value Normal Range LVIDd 2D 6.5 [ 4.2 ? 5.9 ] cm AV Peak Vel 140.0 [ 100.0 ? 170.0 ] cm/sec LVIDs 2D 5.7 [ 2.3 ? 3.9 ] cm AV Mean Vel 99.2 [ 70.0 ? 90.0 ] cm/sec IVSd 2D 1.00 [ 0.60 ? 1.00 ] cm AV Peak PG 6.0 [ 2.0 ? 9.0 ] mmHg LVPWd 2D 1.00 [ 0.60 ? 1.00 ] cm AV Mean PG 5.0 [ 2.0 ? 4.0 ] mmHg AVA Vmax 3.6 [ 2.0 ? 4.0 ] cm2 AVA VTI 3.3 [ 2.0 ? 4.0 ] cm2 Conclusions: 1. Technically difficult study due to limited acoustic windows. 2. Mildly dilated left ventricle. Moderately depressed left ventricular systolic function. LV Ejection Fraction is visually estimated 30?35 %. 3. Mildly dilated right ventricle. Mildly depressed right ventricular systolic function. 4. The mitral valve demonstrates normal leaflet morphology. There is moderate mitral valve regurgitation. Electronically Signed By: 2021?12?31 14:02:59 Performing Organization Address CARDIOLOGY Lab Results (12/31): D?DIMER, QUANTITATIVE ?D?DIMER? ? Final result ?12/31/2021 12:03 PM? Component D?Dimer Value 0.59 ?H? Comment: Reference Range Comment: . <0.50 Negative . 0.50 - 2.00 Possible Thrombotic Event . $g2.00 Suggestive of DIC Increases in D-Dimer concentration observed with thromboembolic events can be variable due to localization, extension and age of thrombus. Therefore, a thromboembolic event cannot be excluded with certainty solely on the basis of a D-Dimer concentration being within the reference range of ostensibly healthy persons. Results of this test should always be interpreted in conjunction with the patient''s medical history, clinical presentation and other findings. Ref Range <0.50 ug/mLFEU Performed At Pathologist Signature Specimen Blood ? BLOOD Performing Organization Address Phone Number CORONAVIRUS ?COVID?19?, PCR, RAPID ?CORONAVIRUS ?COVID?19?, NAA, RAPID? ? Final result ?12/31/2021 12:50 AM? Component Value Ref Range Performed At Pathologist Signature Patient No Symptomatic Specimen Nasopharyngeal ? NASOPHARYNGEAL Performing Organization Address SARS?CoV?2,RNA, Negative Negative Rapid Comment: A positive result for COVID-19 indicates that RNA from SARS-CoV-2 was detected and the patient is infected with virus and presume to be contagious. Laboratory result should always be considered in the context of clinical observations and epidemiological data in making a final diagnosis and patient management decisions. A negative test result for this test means SARS-CoV-2RNA was not present in the specimen above the limit of detection, However, a negative result does not rule out COVID-19 and should not be used as the sole basis for treatment or patient management decisions. A negative result does not exclude the possibility of COVID-19. When diagnostic testing is negative, the possibility of a false negative should be considered if the context of a patient''s recent exposures and the presence of clinical signs and symptoms consistent with COVID-19. If COVID-19 is still suspected based on exposure history together with other clinical findings , re- testing should be considered. This laboratory is certified under the Clinical Laboratory Improvement as qualified to perform moderate to high complexity clinical laboratory testing. This assay is for in vitro diagnostic use under the FDA Emergency Use Authorization and should be used for clinical purposes. SCANNED RESULT: GENERAL NON?INTERFACED LAB ?GENERAL NON INTERFACED LAB? ? Final result ?12/31/2021 12:00 AM? Narrative This result has an attachment that is not available. XRAY CHEST 1 VIEW FRONTAL PORTABLE ? Final result ?12/30/2021 11:57 PM? Anatomical Region Laterality Modality Chest, Body N/A Computed Radiography Specimen Impressions IMAGING CENTER AND DEPARTMENT - 12/31/2021 6:08 AM Cardiomegaly with findings suggesting pulmonary edema. Reviewed and Interpreted 12/31/2021 6:08 AM Narrative IMAGING CENTER AND DEPARTMENT AT - 12/31/2021 6:08 AM EXAM: XRAY CHEST 1 VIEW FRONTAL PORTABLE DATE: 12/30/2021 11:57 PM HISTORY: Chest Tightness. TECHNIQUE: Single frontal view of the chest was obtained. COMPARISON: None FINDINGS: The lung volumes are low. There is pulmonary vascular congestion and mild bilateral interstitial opacities with pulmonary cephalization. No large pleural effusion or pneumothorax. The heart size is enlarged. The bones are intact. Procedure Note 12/31/2021 Formatting of this note might be different from the original. EXAM: XRAY CHEST 1 VIEW FRONTAL PORTABLE DATE: 12/30/2021 11:57 PM HISTORY: Chest Tightness. TECHNIQUE: Single frontal view of the chest was obtained. COMPARISON: None FINDINGS: The lung volumes are low. There is pulmonary vascular congestion and mild bilateral interstitial opacities with pulmonary cephalization. No large pleural effusion or pneumothorax. The heart size is enlarged. The bones are intact. IMPRESSION: Cardiomegaly with findings suggesting pulmonary edema. Reviewed and Interpreted 12/31/2021 6:08 AM Performing Organization IMAGING CENTER AND DEPARTMENT MEDICAL CENTER Phone Number TROPONIN I ? Final result ?12/30/2021 11:30 PM ? Component Troponin I Value 0.02 Comment: <=0.04 ng/mL: NEGATIVE - repeat testing in four to six hours if clinically indicated. 0.041-0.39 ng/mL: Suspicious for myocardial injury. Serial measurement may be necessary to confirm or exclude the diagnosis of acute coronary syndrome. Repeat testing in four to six hours if indicated. 0.40 ng/mL or greater: Consistent with myocardial injury. Clinical and laboratory correlation recommended. Ref Range 0.00 ? 0.04 ng/mL Performed At Pathologist Signature Specimen Performing Organization Address Phone Number PROTIME?INR ?PROTHROMBIN TIME? ? Final result ?12/30/2021 11:30 PM? Component Value Ref Range Performed At Pathologist Signature Prothrombin Time 14.0 11.3 ? 15.4 sec. INR 1.1 <1.3 Comment: The new Thromboplastin Reagent for PT testing and Coumadin monitoring has an International Sensitivity Index (ISI) of 1.27. Specimen Blood ? BLOOD Performing Organization The International Normalized Ratio (INR) will continue to be reported for each PT. The change in the PT seconds does not affect the INR or the recommendations for oral anticoagulant therapy. Recommendations as outlined by the College of Chest Physicians: New Populations INR Value PT VALUE (sec) Low-intensity OAC therapy 1.5-2.0 18.1-22.7 Moderate-intensity OAC therapy 2.0-3.0 22.7-31.2 High-intensity OAC therapy 2.5-3.5 or 27.0-35.2 3.0-4.0 31.2-39.1 BRAIN NATRIURETIC PEPTIDE ?B?TYPE NATRIURETIC PEPTIDE ?BNP?? ? Final result ?12/30/2021 11:30 PM? Component B?Type Natriuretic Peptide Specimen Blood ? BLOOD Value 543 ?H? Ref Range 0 ? 100 pg/mL Performed At Pathologist Signature Phone Number Performing Organization Address COMPREHENSIVE METABOLIC PANEL ?METABOLIC PANEL, COMPREHENSIVE ?CMP?? ? Final result ?12/30/2021 11:30 PM? Component Value Sodium 141 Chloride 105 Anion Gap 16.0 Ref Range 136 ? 145 mEq/L 94 ? 108 mEq/L Performed At Pathologist Signature Glucose Random 107 65 ? 110 mg/dL Potassium 4.0 3.5 ? 5.1 mEq/L Total Co2 24 22 ? 30 mEq/L Calcium 9.0 8.8 ? 10.5 mg/dL Calculated 300 278 ? 305 mOsm/kg Osmolality LAB Bun 18 LAB 8 ? 26 mg/dL 6.4 ? 8.5 G/dL 2.4 ? 3.5 G/dL 0.0 ? 0.3 mg/dL 38 ? 126 IU/L 15 ? 37 U/L Creatinine 1.1 0.7 ? 1.2 mg/dL Bun/Creatinine Ratio Total Protein Globulin Direct Bilirubin Alkaline Phosphatase Aspartate Aminotransferase Specimen Blood ? BLOOD 16 8.0 4.3 ?H? 0.2 44 44 ?H? Estimated GFR $g 60 $g60 Albumin 3.7 3.5 ? 5.0 g/dL A/G Ratio 0.9 ?L? 1.0 ? 2.0 Total Bilirubin 1.0 0.4 ? 2.0 mg/dL Alanine 112 ?H? 17 ? 63 IU/L Aminotransferase LAB Performing Organization Phone Number CBC WITH DIFFERENTIAL ? Final result ?12/30/2021 11:30 PM? Component Value WhiteBloodCount 9.4 Ref Range 4.5 ? 11.0 x1000 14 ? 18 G/dL 78 ? 97 fl 33 ? 37 % 150 ? 500 x1000/uL Performed At Pathologist Signature Red Blood Count 4.76 4.4 ? 6.0 Mill/uL Hemoglobin Mean Corpuscular Volume Mean Corpuscular Hgb Conc Platelet Count 13.1 ?L? 85.8 32.1 ?L? 200 Hematocrit 40.9 ?L? 45 ? 52 % Mean Corpuscular 27.6 ?L? 28 ? 32 pg Hemoglobin RBC Distribution 15.7 ?H? 11.6 ? 14.6 % Width Mean Platelet 8.0 7.4 ? 10.4 fl Volume Type Of Differential Lymphocyte Eosinophil Neutrophil Monocyte Basophil Specimen Blood ? BLOOD AUTO 3.1 0.1 58.4 7.5 0.3 Seg Neutrophil 5.5 1.8 ? 8.4 x10*3/uL 0.9 ? 5.5 x10*3/uL 0.0 ? 0.6 x10*3/uL Monocyte 0.7 0.1 ? 0.9 x10*3/uL Basophil 0.0 0.0 ? 0.2 x10*3/uL 40 ? 76 % 2.0 ? 8.0 % 0.0 ? 2.0 % Lymphocyte 32.7 20 ? 50 % Eosinophil 1.1 0.0 ? 5.0 % Performing Organization Address Phone Number
CDC Split Type:

Write-up: Beginning on/around 12/26/2021: - Chest pain - Shortness of breath - Feelings of having a fast-beating, fluttering, or pounding heart


VAERS ID: 2028387 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-12-22
Onset:2021-12-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 070H21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Respiratory tract congestion, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amiodarone, apixaban, aspirin, cetirizine, dapagliflozin propanediol, levothyroxine, metoprolol, rosuvastatin, sitagliptin/metformin
Current Illness:
Preexisting Conditions: DM, COPD, CHF, HTN, HLD
Allergies: penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with booster dose of Moderna on 12-22-21 Pt started having SOB, cough and chest congestion 12-26-21 12-29-21: presents to ED and tests positive for COVID-19 - symptomatic (note: booster given on 12-22-21, therefore did not have full protection form vaccine when tested positive) in ED pt was given 2L O2, remdesivir and steroids 12-30-2021:discharged home on room air, prednisone 1-6-21: pt returned to ED with worsening cough and SOB CXR showed improvement from 12-29-21 and patient was sent home with albuterol, benzonatate, guaifenesin and incentive spirometry


VAERS ID: 2028577 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-21
Onset:2021-12-26
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Vaccine breakthrough infection
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: RAPID COVID-19 TEST-POSIVTIVE
CDC Split Type:

Write-up: HOSPITALIZED BREAKTHROUGH CASE VACCINATED WITH MODERNA ON 3-24-21 AND 4-21-21. SYMPTOMS-FEVER, RUNNY NOSE AND COUGH. COMMUNITY ASSOCIATED CONTACT WITH A POSITIVE CASE.


VAERS ID: 2028823 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-27
Onset:2021-12-26
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2022-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Just Asthma
Allergies: None
Diagnostic Lab Data: Covid Rapid Test - 12/29/2021 - Positive Covid PCR Test - 12/29/2021 - Positive Covid Rapid Test - 01/10/2021 - Negative
CDC Split Type:

Write-up: I had all the symptoms of the flu, plus loss of taste and smell. Symptoms began 12/26/2021, and lasted 1 week. Smell came back within the first week. Taste came back 10 days later.


VAERS ID: 2030928 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-12-26
   Days after vaccination:261
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 - / OT
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20211227; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20220104898

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; CHEST IS HEAVY; This spontaneous report received from a patient concerned a 55 year old female. Initial information was processed along with the additional information received on 05-JAN-2022 and 10-JAN-2022. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (dose number in series 1) (suspension for injection, route of admin, and batch number:1808982, expiry: Unknown) dose was not reported,1 total, administered on 09-APR-2021 on left arm for prophylactic vaccination. The patient received non-company suspect vaccine included: MRNA 1273 (dose number in series 2) (form of admin, route of admin, and batch number were not reported), dose not reported, administered on an unspecified date for prophylactic vaccination. No concomitant medications were reported. On 26-DEC-2021, the patient experienced itchy throat, shortness of breath (subsumed under confirmed covid-19 infection) and felt like chest was heavy. On 27-DEC-2021, she did Covid-19 test by going to a testing center (unsure of PCR/antigen test). On 29-DEC-2021, the result received as Covid-19 positive, hence confirmed clinical vaccination failure (dose number in series 1 and 2). The action taken with covid-19 vaccine ad26.cov2.s was not applicable and, MRNA 1273 was not reported. The patient was recovering from confirmed covid-19 infection, and chest is heavy, and the outcome of confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20220104857. This report was associated with product quality complaint: 90000210194. The suspected product quality complaint has been confirmed to be the reported allegation could not be determined. A manufacturing related root cause could not be identified based on the PQC evaluation/investigation performed.; Sender''s Comments: V0: 20220104898-covid-19 vaccine ad26.cov2.s-confirmed clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 2031377 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-09
Onset:2021-12-26
   Days after vaccination:292
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 33130BA / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hyperglycaemia, Hyperglycaemic hyperosmolar nonketotic syndrome
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for HHS, hyperglycemia, COVID 12/26/21-1/12/22.Treated with ,zinc 50 mg daily, vitamin D3 50 mcg daily, and vitamin C 1,000 mg daily 12/27/1/12 for COVID.


VAERS ID: 2031407 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-12-26
   Days after vaccination:289
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / UNK LA / IM

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

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

Write-up: COVID


VAERS ID: 2031410 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-10-28
Onset:2021-12-26
   Days after vaccination:59
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / UNK LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012H21B / UNK 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? 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


VAERS ID: 2031643 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-12-02
Onset:2021-12-26
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, CSF protein increased, Electromyogram abnormal, Gait disturbance, Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture abnormal, Magnetic resonance imaging spinal normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Acute myelogenous leukemia, treated with allogeneic stem cell transplant in 9/2020, post transplant course complicated by GVHD, CMV reactivation
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI total spine unrevealing Lumbar puncture 1 week after onset of symptoms with no cells, negative cytology and flow cytometry, negative viral encephalitis panel, elevated protein (68) EMG/NCS on 1/11/22 with absent f waves in arms and legs and no evidence of denervation in muscles consistent with axonal guillain barre
CDC Split Type:

Write-up: Patient presented with ascending weakness and numbness, significant decline in ability to walk over 5 days, clinically improved but incompletely after 4d course of IVIG starting 12/30/21


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