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

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



Case Details (Reverse Sorted by Onset Date)

This is page 151 out of 6,867

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VAERS ID: 1554547 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, Axillary pain, Blood potassium decreased, Chest pain, Chills, Fibrin D dimer increased, Hypoaesthesia, Hypokalaemia, Hypotension, Intensive care, Magnetic resonance imaging head normal, Muscle spasms, Painful respiration, Paraesthesia, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (narrow), Sexual dysfunction (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxyine 25mg BID Prazosin 1mg qhs Quetiapine 100mg qam and 400mg qpm Topiramate 100mg midday, 150gm qam an qpm Docusate 100mg BID Fiber-lax 625gm daily
Current Illness: Schizophrenia Bipolar disorder
Preexisting Conditions: None reported
Allergies: Aspirin
Diagnostic Lab Data: D-dimer 0.62 - 8/12/2021 CTA scan - showed Few pulmonary emboli within the right upper and left upper lobes as well as involving the left lower lobe 8/12/2021
CDC Split Type:

Write-up: Patient is 34 year old female who was admitted to us with Pulmonary Emboli with past medical hx of bipolar and schizoaffective disorder presented with right sided chest pain of one day. It is crampy and sharp pain, about 6/1o in intensity, radiate to left axillary region and left arm, worse with breathing with no reliving factor. Pt reports left arm and left lower extremity tingling and numbness of one day duration. States it started after she got first dose of moderna vaccine earlier on August 11, 2021. Endorsed generalized weakness, chills but denies cough, shortness of breath, orthopnea or bilateral leg swelling. Denies headache, weakness of upper or lower extremities, blurring of vision, difficulty of swallowing. Denies urine or bowel habit change. On arrival to ER, pt was hypotensive 90s/60s otherwise stable, HR 80s and satting 98% on room air. Labs remarkable for mild hypokalemia, elevated d dimer 0.62. CTA showed Few pulmonary emboli within the right upper and left upper lobes as well as involving the left lower lobe. MRI brain showed no acute intracranial process. Pt received 1L of NS and transferred to ICU.


VAERS ID: 1554581 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure decreased, Headache, Hypotension, Lethargy, Loss of consciousness, Pallor, Presyncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Pt had a vasovagal response to first dose Pfizer ~3pm, about 8 minutes after receiving the vaccine with father present. Patient passed out, but remained in chair with no injuries and woke up quickly. Patient appeared pale and lethargic, but responsive and oriented to name/age. Ice pack applied to neck, feet propped up on chair, and juice given. BP was hypotensive at 55/34 and HR 44. Patient was transferred to the gurney with legs elevated and he expressed immediate relief of headache that he was experiencing. BP improved at 104/61 and HR 77. Patient drank more juice and water over the hour that he spent with us here in the COVID vaccine clinic. BP''s and HR remained stable with last check BP 101/65 and HR 74. Patient and father instructed to inform staff that he needs to receive second dose lying down when he comes for his next appointment. They verbalized understanding. Pt stated he felt back to normal before leaving our clinic and vitals remained stable.


VAERS ID: 1554757 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U6951AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR CM7KN / 1 RA / IM

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

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

Write-up: Pt. received her coivd vaccine, menactra, and tdap shot on 08/12/21. At 11:38 Am the Pt passed out for 30 seconds. pt. was very pale, diaphoretic, and stated she felt flushed. After the pt. came to the nurse took her vitals which were Bp92/60, HR97, O2 98%. The nurse had pt. lie down for a few minutes and gave her some food and water. At 11:57 Am the pt. passed out again for 30 seconds and came to. The nurse immediately laid the patient down and took her vitals. BP98/70, HR 53, O2 99%. Pt. was pale, diaphoretic and felt flushed. The nurse offered her more food and water and retook the vitals at 12:07 Pm Bp98/70, HR90, O2 98%. Pt. was able to leave at 12:44 Pm. F/U 8/13/21 no subsequent events, pt. was fine.


VAERS ID: 1554786 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-01
Onset:2021-08-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Headache, nausea, insomnia, hot flashes


VAERS ID: 1554787 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Diarrhoea, Erythema, Induration, Nausea, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (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: None
Current Illness: No
Preexisting Conditions: No
Allergies: Celebrex, Sulfa,Sulfites,certain perfumes n lotions
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 8/12/21 Induration 3 inches by 3inches, pain, redness, swelling upon awakening, by 8pm I had chills n fever. On 8/13/21 I continued with all of the above plus, nausea, diarrhea, weakness, body aches. I felt like I was getting COVID all over again. I was Positive for COVID 6/2020 and was still donating convalecent plasma until July 2021, I stop donating because my vein was disappearing. I still had antibodies to COVID


VAERS ID: 1554795 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Allergy to vaccine, Burning sensation, Chest pain, Electrocardiogram, Feeling hot, Gait disturbance, Grip strength decreased, Muscle twitching, Muscular weakness, Seizure like phenomena, Sleep disorder, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at time of vaccination
Current Illness:
Preexisting Conditions:
Allergies: Soy, Feraheme infusion
Diagnostic Lab Data: EKG 8/9/2021
CDC Split Type:

Write-up: This was about four days after my emergency room visit for an allergic reaction to the vaccine. On early Thur 8/12 morning between about 4-4:30 am I woke up shaking extremely bad, uncontrollable, similiar to a seizure. I was also notabley hot, I think the hottest I''ve ever been. The extreme shaking only lasted a couple minutes, I think. I still had tremors and jumping legs. I stood up and my lower legs were very weak. It was very hard to walk, my legs were shaking. It was hard to bend my toes. And it was hard to use my hands, I could not make fists. The hot feeling lasted a short time, about 15 minutes. The tremors and jumping nerves lasted about an hour to hour and a half. My leg, feet, and hand weakness continued longer. I had regained my strength and movement by about Noon-1:00. I also still had a burning sensation in my chest, back, and underarms off and on throughout the day. The burning at night lasted about a half hour to hour before I fell asleep.


VAERS ID: 1554964 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Facial pain, Haemangioma, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingrix first dose - Dec 2020 - age 67 - very very achy - could not function for approx 24 hrs.
Other Medications: Chlorothalidone 25mg Calcium 600 mg w Vit D 20 mcg Prednisolone Acetate 1% Magnesium 400 mg Zinc 15mg B12 1000mcg Vitamin C 500mg
Current Illness: None
Preexisting Conditions: Osteopenia, thyroid nodule, cornea transplant, high blood pressure, arthritis,
Allergies: Tetracycline Environmental allergies - dust mites, ragweed, trees, grasses, dogs, horses
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I woke up and the hemangioma on my left cheek had a larger bump - size of pea - and was painful (Thursday Aug 12). Next day I got up and it was normal.


VAERS ID: 1554977 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient received 1st dose of Pfizer vaccine. About 5-10 minutes she became light headed, flushed, dizzy, and nauseous. she ended up throwing up and her bp was 95/81. emt was called but she was not transported as she began to feel better.


VAERS ID: 1554979 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 RA / IM

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

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

Write-up: Patient was brought to pharmacy by nursing home for second covid shot. The facility did not have COVID card and were going to bring it up after getting the patient returned. Intern confirmed with nurse aid and patient this was 2nd dose of Moderna Vaccine. Intern did not check the system and when nurse aid brought COVID card back to pharmacy to be completed, the patient had received first dose of Pfizer vaccine in March 2021. Went ahead and completed card for second dose and Moderna information, spoke with nursing director and advised to watch for any signs and symptoms of reaction, but felt that there was minimal risk since patient was past due on the Pfizer series.


VAERS ID: 1555000 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-16
Onset:2021-08-12
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM

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

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

Write-up: Covid positive


VAERS ID: 1555203 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine a few years ago, caused arm to swell
Other Medications: ADIPEX, DEPO SHOT ON 8/3/2021
Current Illness: N/a
Preexisting Conditions: Osteoarthritis, peripheral neuropathy, Mitral valve prolapse
Allergies: Amoxicillin, cleaning, erthromycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed chills and a rash the worsens and become very red with heat..started on face, right side neck and inner thighs on Thurday and on Friday was worse after bath and had spread to back, and feet, upper thigh and trunk, mild itching


VAERS ID: 1555587 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adnexa uteri pain, Asthenia, Back pain, Chills, Decreased appetite, Fatigue, Headache, Muscle spasms, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (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: Sertraline 75mcg
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm that night and next day. early morning was the start of body aches, chills, low back pain, pain near ovaries like cramps but not related to menstrual cycle, extreme fatigue/weakness, low appetite, and headache.


VAERS ID: 1558037 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA748S / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: My chest hurts and is getting worse on the left side. As if I''ve done a hard chest day at the gym and pulled something, however, I haven''t worked my chest muscles in the gym in 2 weeks. It makes it hard to breathe.


VAERS ID: 1558039 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Flushing, Hyperhidrosis, Hypotension, Injection site pain, Paraesthesia, Sensory disturbance
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: PT SAID HER EXTREMITIES FELT UNUSUAL-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Weakness-Mild, Additional Details: PT SAID SHE HAS LOW BLOOD PRESSURE TO BEGIN WITH, SHE SAID HER EXTREMITIES FELT FUNNT LIKE BLOOD RUSHING BACK TO THE. BLOOD PRESSURE AT 540PM WAS 106/73, PULSE WAS 53. BLOOD PRESSURE AT 550PM WAS 107/76. PULSE 55.


VAERS ID: 1558056 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SC

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Numbness in entire arm including fingers and part of left face 15 minutes after vaccination. After going home, 2 hours later I developed a fever that spiked to 103.7 degrees and remained for approximately 36 hours. Numbness in arm, hand and face still has not subsided 48 hours after incident. I don''t know yet if the numbness in my face, arm and hand are permanent.


VAERS ID: 1558068 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Additional Details: PATIENT EXPERIENCED DIZZINESS POST IMMUNIZATION. RESOLVED BEFORE 15 MINUTE OBSERVERSATION PERIOD COMPLETE. LEFT PHARMACY AFTER 15 MINUTES STATING IT HAD RESOLVED.


VAERS ID: 1558069 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Lymphadenopathy, Musculoskeletal stiffness, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Body very itchy, lymph nodes swelling, stiff neck, very light headed


VAERS ID: 1558088 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Neck pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I had a red swollen arm after a flu shot in October of 2004
Other Medications: 50 mg of Benadryl, as recommended by allergist.
Current Illness: none
Preexisting Conditions: none
Allergies: Zithromax (hives, vomitting) bees/wasps - anaphylaxis tree nuts - anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1. On day 6 after injection, I awoke to painful swelling on left clavicle and left side of neck (likely swelling of the lymph nodes). It is still persisting. Pain decreased, swelling has not. 2. On day 8 past the injection, I awoke to a large, red, swollen, itchy, and painful area of my left arm near the injection site ("covid arm")


VAERS ID: 1558106 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: My adverse event relates to rashes and swelling developing at sites where I was previously stung by wasps (about a week earlier). Details and timeline below. 08/05/2021, ~7 pm ? Stung by wasps three times at two sites (2 stings to left wrist, 1 sting to inside of left ankle). The sting sites were painful for about an hour. I had no allergic reaction and did nothing to treat the stings. The ankle site remained slightly swollen for a day or two following; the wrist site did not swell. Within 3-4 days following the stings, I was fine and had no symptoms of the stings. 08/11/2021, 6:20 PM ? Received vaccination


VAERS ID: 1558108 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Blood test, Computerised tomogram, Echocardiogram, Epistaxis, Feeling hot, Limb discomfort, Magnetic resonance imaging, Muscular weakness, Paraesthesia, Scan with contrast, Sensory loss, Throat tightness, Ultrasound Doppler
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Disodium balsalizide
Current Illness:
Preexisting Conditions: History of CVA, ulcerative colitis
Allergies:
Diagnostic Lab Data: MRI (08/12/21) MRA, MRI carotid with contrast (08/13/2021) Cat scan (08/12/2021) Echocardiogram and with bubble study (08/12/2021) Carotid ultrasound (08/12/21) Bloodwork- 8/12-8/14
CDC Split Type:

Write-up: I was driving and R arm became heavy and very weak. I experienced and overall body heating and tingling sensation. My throat started to close up and my nose started to bleed. R arm weakness and decreased sensation lasted approximately 30 minutes and resolved. Went to ER and was admitted to the hospital for stroke protocol.


VAERS ID: 1558113 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-08-12
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Gastrooesophageal reflux disease, Hiccups, Throat tightness, X-ray with contrast upper gastrointestinal tract
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D /2 50,000 1 a day, Trimeq 600-50-300mg 1 a day, Ventolin inhaler as needed
Current Illness: Hiv Positive
Preexisting Conditions: Asthma
Allergies: powder sugar
Diagnostic Lab Data: Ive been to 2 ER clinics, Had an EKG done, Lab work between April-May, June 9th had an Upper GI performed, prescribed a bunch of meds, Visit my Personal Physican every 3 month check up and explained my symptoms and when it started. July 4th, Went to a Hospital ER after 5 hours of stomach acid kept wanting to come up, Prescribes meds to try to get it under control. On Aug 16 2021 I have another consultation with another GI Dr to test my PH levels in my stomach.
CDC Split Type:

Write-up: The closest determination by the Drs I have seen is Acid Reflux, but they still do not have a final diagnosis. Symptoms with the 1st shot - chronic hiccups, by the 2nd Shot: : Esophagus closes, chronic hiccups, bile/stomach acid comes up I Never had or Experienced Acid Reflux until after the Vaccine SHOTS and been dealing and trying to figure out that this is for 6 months now. I also sent a form in June, but the when uploading the form would not upload, so I sent it directly to the CDC email that was listed. followed up with a call a few week later to the CDC and spoke with someone about my adverse reactions and was suppose to get a call (a time and date was set) from an Rep but no one has never called.


VAERS ID: 1558118 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fatigue, headace, sneezing, runny nose


VAERS ID: 1558137 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myalgia, Pain in extremity, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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: Synthroid 75mcg daily amlodipine 5mg daily Zinc 50mg daily Vit D 1000 units daily Vit C 500mg daily
Current Illness:
Preexisting Conditions: Graves Disease Renal Aneursym repair Hypertension
Allergies: nka
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Patient experienced pruritis over her entire body. It began with her feet then spread to her arms, trunk, legs. The episode lasted 2 to 3 hours. Patient took 50mg benadryl and went to bed. Itching resolved upon waking but patient''s left arm was sore and she had myalgia, which resolved in 12 hours.


VAERS ID: 1558150 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Fatigue, Heart rate increased, Lymphadenopathy, Palpitations, Ventricular extrasystoles
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Heart Palpitations, PVC, Rapid Heart Beat Swollen lymph nodes around left clavicle and lower neck. Fatigue Pain in upper back


VAERS ID: 1558154 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approx at 1630, Patient c/o dizziness and burning sensation to left upper arm. Pt was assist to supine postion with legs elevated. Alert/oriented. Able to follow commands. Vital signs were taken at the time of event and remain stable. Gatorade was given for hydration. Approx 1700 EMS was notified and en route; Pt c/o dizziness. Pt assist inside mobile unit to lie down. Remain stable.


VAERS ID: 1558155 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: Developed rash to chest, abdomen and arms approximately 1 hour after injection. Went away after taking Claritin. Rash returned approximately 24 hours after taking 1 st dose of Claritin. Took a second Claritin, rash went away and returned the next morning. Rash noted to abdomen, chest, arms and legs at the time this report is being completed.


VAERS ID: 1558156 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-27
Onset:2021-08-12
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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: Developed COVID-19 8/12/2021


VAERS ID: 1558180 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-01
Onset:2021-08-12
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

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

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

Write-up: Small red dots all over my body.


VAERS ID: 1558195 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 LA / IM

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

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

Write-up: 12 YEAR OLD PATIENT WAS GIVEN MODERNA VACCINE. NO ADVERSE EVENTS REPORTED.


VAERS ID: 1558240 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo Loestrin birth control, One a Day Multivitamin, Meloxicam
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Fluoroquinolones
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: aches, chills, sweats, nausea


VAERS ID: 1558241 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Headache, body pain, left arm feels hot, lightheaded


VAERS ID: 1558245 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

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

Write-up: Bones felt like glass. Chills. Shaking. Lasted for 24 hrs.


VAERS ID: 1558246 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Temperature of 99 degrees started around 6 pm after getting vaccine at 9:30 am, temperature rose to 102 degrees by 12 am, temp was brought down to 100 degrees using both ibuprofen and acetaminophen. Following day a rash broke out on the legs and the whole body is itchy.


VAERS ID: 1558257 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

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

Write-up: Fever peaking at 102F, extreme tiredness lasting about 36 hours


VAERS ID: 1558262 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT CAME IN TO PHARMACY ON 8/14 WITH A VISIBLE REDNESS ON LEFT DELTOID WHERE VACCINE WAS ADMINISTED. SHE STATED THE ARM HURT THE DAY AFTER THE VACCINE, BUT HAS CONTINUED TO HURT AND THE REDNESS SHOWED. THE REDNESS ON ARM IS ABOUT AN INCH IN DIAMETER


VAERS ID: 1558267 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Facial pain, Headache, Hypoaesthesia oral, Pain in jaw, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Right jaw and face swollen. Painful. Tongue numb. Headache.


VAERS ID: 1558294 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-07
Onset:2021-08-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphonia, Dyspnoea, Headache, Hypersomnia
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)

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

Write-up: Patient just came in and told me he started having trouble breathing, headache, harsh voice and has been sleeping for about 20 hours a day since 2 days ago and still suffering from these symptoms.


VAERS ID: 1558316 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Blood pressure increased, Body temperature increased, Hyperhidrosis, Injection site swelling, Myalgia, Pain in extremity, Peripheral swelling, Skin abrasion, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Accidents and injuries (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel Fe, sertraline hcl 100mg
Current Illness: None
Preexisting Conditions: None
Allergies: Latex, tree nuts
Diagnostic Lab Data: Home calibrated blood pressure machine 8/12 and 8/13
CDC Split Type:

Write-up: Swollen injection site with abrasions warm to touch, entire arm through to arm pit sore and Swollen, still not cleared up 48 hours later. Blood pressure climbed from 110/77 to 128/91 by 10pm day of vaccination, down back to normal by 9am next morning. Muscles aches and excessive sweating and temp 100.6 for 36 hours starting 5 hours after vaccination.


VAERS ID: 1558366 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

Write-up: Over 42 days, 1st dose 06/10/21, 2nd dose 08/12/21


VAERS ID: 1558371 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

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

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

Write-up: over 42 days, 1st dose 06/10/2021, 2nd dose 08/12/21


VAERS ID: 1558375 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dysmenorrhoea, Fatigue, Heavy menstrual bleeding, Impaired work ability, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: After receiving the second dose in the serious I woke up the next morning to heavy vaginal bleeding. I was not due for my menstrual cycle so this was surprising. Since then I have had extremely bad cramping and bleeding. I am not pregnant, I don?t have any gynecological disorders and I usually don?t have cramping this bad. It has been 3 days of this so far. Then approximately 24 hours after the vaccination I became severely fatigued. So for the last 3 days I have been unable to work due to this pain and fatigue that makes me feel incredibly weak.


VAERS ID: 1558392 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Fatigue, Feeling hot, Headache, Oropharyngeal pain, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Initial reaction was painful/sore arm. On Wednesday night I started a sore throat and woke up the next day with a very sore throat which turned into aches body aches and tired. Very early in the morning my head hurt terribly and my body was very hot. Friday I spent the day on the couch and bed in pain. Today, Saturday, my head isn?t hurting as much but I?ve started a cough.


VAERS ID: 1558413 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Headache, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: A couple of hours after had muscle pain in left arm that slowed moved to upper shoulders and back eventually down the back, led to a headache and fever that night that lasted most of the next day.


VAERS ID: 1558442 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Swelling/knot on arm at injection site from day after injection to current.


VAERS ID: 1558452 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 4 LA / IM

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

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

Write-up: rash throat small difficulty to swallow. she took Benadryl. she is fine. I told her to go to emergency.


VAERS ID: 1558470 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Blood test normal, Chest pain, Chills, Dizziness, Dyspnoea, Fatigue, Fear, Headache, Hypoaesthesia, Influenza like illness, Loss of consciousness, Malaise, Muscle spasms, Oesophageal spasm, Pain, Pain in extremity, Paraesthesia, Presyncope, Pyrexia, X-ray normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill-aviane Ararat-Hydroxine 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: Morphine
Diagnostic Lab Data: 8/12-went to ER had X-ray and blood work and was told everything was normal-clearly it is not.
CDC Split Type:

Write-up: I got this on a Monday. This has been a horrible ordeal. I was a perfectly healthy person until mandated by work to get this vaccine. When I got the injection, before I left the pharmacy my left arm went numb. It stayed numb for a few hours. Then at dinner my esophagus spasmed and felt like a Charlie horse. That lasted for a few hours on and off. Then that night, normal flu/COVID symptoms which lasted for 1 -2 days-fever headaches, chills, achy, run down, trouble breathing. Thought I was on the mend and only had a slight fever Wednesday. Then Thursday I started to feel light headed and numb hands throughout the day. Around 1pm I had to pull my car over and have a friend continue driving as I was extremely light headed and my whole right arm had gone numb. Within 15 minutes of that I blacked out completely and when I came to, couldn?t breathe, both arms numb and tingling and then I continued to fade as if going to pass out again. My friend freaked out. And called 911 and I went to a hospital. They ran tests that apparently came back normal. I went home and that night and all day Friday I had chest pain, numb arms, dizziness and trouble breathing. Saturday morning (today)those symptoms were still present just not as pronounced only now I have sharp shooting pain randomly in my heart area, right rear of my head, and my legs. This is terrifying and I hope you people stop recommending this to healthy people.


VAERS ID: 1558476 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Unknown  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
CDC Split Type:

Write-up: Sore arm, fever 102F, aches, sore back. Throwing up, cant hold anything down (24 hours now)


VAERS ID: 1559250 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-27
Onset:2021-08-12
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, COVID-19, Cardiac failure congestive, Chronic kidney disease, Condition aggravated, Dyspnoea, Fluid overload, Hyperkalaemia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), 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 (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, aspirin, atorvastatin, vitamin b12, furosemide, insulin glargine, losartan, metoprolol ER, patiromer, ropinirole, tamsulosin
Current Illness:
Preexisting Conditions: Poorly controlled IDDM2 complicated by neuropathy and CKD3, HTN, CAD, PVD, HF with reduced EF, COPD
Allergies: Codine, iodine/contrast media, pioglitazone
Diagnostic Lab Data: COVID status positive on 8/12/21.
CDC Split Type:

Write-up: Patient received COVID vaccine Moderna 2 dose series on 2/27/21 and 3/27/21. On 8/12/2, patient presented to our facility with SOB and weakness and was admitted to the inpatient unit for COVID 19 (hx of COPD) w/out hypoxia, CHF with fluid overload, and AKI on CKD3 with hyperkalemia. As of today (8/14), patient is still admitted in the med/surg unit.


VAERS ID: 1559256 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Fatigue, Headache, Lymphadenopathy, Malaise, Pain, Pain in extremity, Palpitations, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/12/21 Blood work, telemetry, chest xray
CDC Split Type:

Write-up: 8/11/21 Received 1st dose of Moderna Covid shot 8/12/21 Woke up at 4am for work and heart was racing, left arm hurting. Heart rate continued 140 beats at rest for over an hour. Went to ER. Diagnosed with tachycardia and lactate 2.2. I was seen by two emergency doctors (shift change) and both agreed it was possible symptom of the shot. Was given 2 bags of fluid. After receiving fluid my glands starting aching and had headache. Mid day at home had 101.1 fever. slept on and off rest of day. Drank fluids and switched between Tylenol and ibuprophen as instructed by ED doctors 8/13/21 Woke up at 2am with 102.6 fever, 120 heart rate, headache and aches. Again took tylenol, drank fluids. 8/14/21 Glands in neck are swollen, 99.5 low grade fever, headache, fatigue and just not feeling great. Tylenol and ibuprophen with drinking fluids.


VAERS ID: 1560877 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ClaritinD 12 hour once a day Ibuprofen 400 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At injection site: red, hard, itchy, hot, raised skin roughly 4 inches in diameter began to appear with 18 hours of receiving the injection. Wednesday, August 11th at around 4pm was when I received the vaccine. I noticed this thing on my arm the next day around 1pm. It?s gotten bigger, more red, and more itchy. It is still going strong Sunday morning at 3:15?.3 1/2 days after receiving the vaccine. Benadryl nor ibuprofen seem to help much but cold feels wonderful. So does lightly scratching it.


VAERS ID: 1562015 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 2 AR / IM

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

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: lump under the arm after 2 days-Severe


VAERS ID: 1562821 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Feeling hot, Hallucination, Lethargy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Had several hours of chills/shivering, followed by several hours of being extremely hot with some hallucinations. Fever with body aches from head to toe. Extremely lethargic for 24 hours or so. Still not back to 100% energy level, but getting close.


VAERS ID: 1562829 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: Rash at injection site


VAERS ID: 1569044 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C2114 / 1 LA / SYR

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

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

Write-up: Ringing in ears. Constant.


VAERS ID: 1569051 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-03
Onset:2021-08-12
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 RA / IM

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

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

Write-up: Fully vaccinated with Moderna, last dose being 02/03/2021 provided at Hospital. Positive COVID Rapid collected on 08/13/2021.


VAERS ID: 1569052 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling, itching


VAERS ID: 1569055 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-03
Onset:2021-08-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye haemorrhage, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Statin, Premarin, Prozac, Adderall XR, Xiidra eye drops, Multi vit, calcium, CoQ10, probiotic, MK-7
Current Illness: none
Preexisting Conditions: ADHD, Fibromyalgia, Connective Tissue Disease: Sjogren''s Syndrome
Allergies: Penicillin, Indocin, lactose intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had two adverse reactions, but they started on different dates. Since the form only gave me one option for date it started, I am filling out a second form. I woke up on 8/12/21 to find my right eye was severely hemorrhaged. I took pictures and sent them to a nurse practitioner who said it appeared to be Subconjunctival hemorrhage. I also sent it to my eye doctor. My eye doctor could not get me in until Monday afternoon, so I found another eye doctor who did a Teladoc appointment with me. They are going to have me come back in Monday for an appointment as well. I have never had this happen before and have had a friend who had the exact same thing happen to her but to both eyes, also around the same time frame after getting this vaccine. I am more fatigued than normal and today woke up with very sore muscles mostly in my legs.


VAERS ID: 1569074 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Headache, Laboratory test normal, Rhinorrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Headache, runny nose Tuesday-Thursday then Thur evening started having chest and abdominal pain, the other symptoms went away except for the chest and abdominal pain


VAERS ID: 1569076 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site rash, Nausea, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient reported severe nausea/vomiting, large rash around injection site and significant pain in affected arm that radiated to entire body.


VAERS ID: 1569093 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna
Other Medications: I have vertigo after the vaccine, is that normal?
Current Illness: Fatty liver
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vertigo and nausea.


VAERS ID: 1569098 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Collagen with biotin 6000mg Vitamin D3 OrthOmega Mitocre vitamin Amlodipine Metoprolol Butalbital
Current Illness: Migraine headache
Preexisting Conditions: High Blood pressure
Allergies: Lisinopril Miloxican
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 8/12 loss available to taste and smell and still not able to. 8/14 little tired 8/14 little anxiety on and off


VAERS ID: 1569122 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Depression, Dizziness, Headache, Myalgia, Nausea, Neck pain, Pain in extremity, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin, DHA, probiotic, Vitamin D, Spirulina, Astaxanthin.
Current Illness: none. I haven''t been sick since fall of 2019.
Preexisting Conditions: none.
Allergies: none.
Diagnostic Lab Data: None done, because I wanted to wait it out for a few days before going to my primary doctor.
CDC Split Type:

Write-up: Started getting a headache around 30 minutes after the shot. I had a little dizziness too. The headache got worse throughout the day. I took Advil for the symptoms with little help during the first 24 hours. I had muscle aches throughout my body, the worst feelings being mostly concentrated in my neck and head. My left arm and leg felt like it had some nerve damage issues. I had a 101.8 fever the first night and I couldn''t sleep well. I developed nausea that lasted for 2 days. I was too weak and depressed to do anything, but sleep those first two days. It wasn''t until the third day that my headache finally subsided. I still have neck and arm pain.


VAERS ID: 1569178 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Epistaxis, Hallucination, Headache, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: Codeine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever of 103.2, sever weakness, severe headache, severe body pain all over, nose bleeds, hallucinations. (Received my covid vaccine at my local pharmacy. )


VAERS ID: 1569184 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fibromyalgia, Hyperaesthesia, Neck pain, Pain
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 07/21/2021 Pfizer Covid 19 FA6780
Other Medications: Cymbalta, Buspirone, Nexium, Vitamins b, c, d, magnesium, melatonin, tylenol
Current Illness:
Preexisting Conditions: Fibromyalgia, anxiety, depression
Allergies: cipro, adhesives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Neck pain 15 minutes after shot. Methobarbamol and tylenol Fibromyalgia flare (whole body pain) anything touching my skin in any way including clothes and even water was excruciating 10 out of 10, tylenol and sleep. Was bed bound for 45 straight hours. Still 70 hours later (right now) in terrible pain 6 out of 10


VAERS ID: 1569226 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-04-02
Onset:2021-08-12
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac stress test, Cardiomyopathy, Computerised tomogram thorax, Echocardiogram, Left ventricular failure, Polyuria, Ultrasound Doppler
SMQs:, Cardiac failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Cardiomyopathy (narrow), Tubulointerstitial diseases (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Echocardiogram 8/13/2021, stress test 8/14/3021, cardiac CT 8/13/3021, LE venous duplex 8/14/2021
CDC Split Type:

Write-up: Non-ischemic cardiomyopathy with systolic heart failure. Diuresis with IV lasix, metoprolol, Lisinopril.


VAERS ID: 1569243 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: Taking methyl prednisone dose pack
CDC Split Type:

Write-up: Hives from nipple line up chest and back neck and face


VAERS ID: 1569271 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Welchol
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus. Resolved in about two hours.


VAERS ID: 1569295 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache
SMQs:, Retroperitoneal fibrosis (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: Tropol, synthroid, atorvastatin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache day 1 thru currently day 5. Extreme tiredness from day 2 to currently. Back pain starting on day 2 and worsens by day to currently day 5.


VAERS ID: 1570774 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Anxiety, Appendicectomy, Depression, Fatigue, Headache, Pain in extremity, Palpitations, Upper-airway cough syndrome
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Since the Vaccine PT developed symptoms of headaches, arm pain, fatigue, nose drip, palpitations, anxiety, depression and cramping in stomach that resulted in an emergency visit to the hospital followed by Emergency appendectomy surgery.


VAERS ID: 1570778 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EV0584 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast pain
SMQs:, Lipodystrophy (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: Insulin, Adderall, iron supplements
Current Illness:
Preexisting Conditions: Type I diabetic; cardiomyopathy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme pain and burning in my left breast 3 days after receiving the first Pfizer vaccine in my left arm. It is extremely painful.


VAERS ID: 1571074 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Lip swelling, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins Benadryl
Current Illness: No
Preexisting Conditions: No
Allergies: Not sure, maybe food allergy, had lip swelling about 3 years ago
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Upper Lip very swollen with second dose. (Lower lip was slightly swollen with first dose and PCP advised to take Benadryl day before second dose and some days after second dose). Took Benadryl by mouth 25mg (2tabs) on 8/13/21 by 8:20am and also Bluebonnet NAC 500mg (2 capsules) by mouth on 8/13/21 by 7:15pm. In the morning of 8/14/21, the swelling was gone.


VAERS ID: 1571075 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-08-12
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Laboratory test, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Occasional vitamin c tablet, occasional multi vitamin
Current Illness: One week prior side effect from vaccine : fever, headache, muscle aches, and cough.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: See above tests/lab . I am sure more tests with a neurologist are forthcoming.
CDC Split Type:

Write-up: Two weeks after receiving my first dose, I experienced my first ever seizure which lasted approximately three minutes. I completely lost consciousness and regained it during the ambulance ride to the E.R. I have been referred to a neurologist. My C.T. scan and blood work at the E.R. were normal. I do not know if this is related to the vaccine, but thought it warranted reporting.


VAERS ID: 1571224 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis, Full blood count, International normalised ratio, Prothrombin time
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Nose bleeding x 3 days


VAERS ID: 1571643 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210826236

Write-up: VACCINE WAS GIVEN TO A 16 YEAR OLD MALE; OFF LABEL USE; This spontaneous report received from a pharmacist concerned a 16 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: UNKNOWN) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced vaccine was given to a 16 year old male. On 12-AUG-2021, the patient experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the off label use and vaccine was given to a 16 year old male was not reported. This report was non-serious.


VAERS ID: 1573627 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Cough, Disturbance in attention, Fatigue, Headache, Hyperhidrosis, Hypopnoea, Pain, Pain in extremity, Pyrexia, Secretion discharge
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none/ not known
Preexisting Conditions: none
Allergies: Not known
Diagnostic Lab Data: not yet taken
CDC Split Type:

Write-up: Same day and next day: Pain in right arm, followed by pain in whole right body side (incl leg and feet). Headache, feverish Starting next day and ongoing (getting worse): Pain in chest, shallow breathing, feeling pressure in lungs, occasional cough with mucus, sweating after small physical "exercise" (e.g., walking down and up 10 stairs), feeling weak and tired, difficulty to concentrate


VAERS ID: 1573799 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: EXTREMELY BLURRY VISION. I could not see my face standing in front of mirror. I had to put my nose on the mirror to see my face. Went to 3 different mirrors and was the same. The morning of 8/13/2021 my signt was a little better in the morning and fine by end of that day. I also had body aches


VAERS ID: 1573811 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Influenza like illness, Pain, Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Rash on chest and arms the first night along with flu like aches and pains. The next day more aches and pains but then my right eye started swelling and I broke out in hives all over. By the 3rd day my eye was swelled shut and more hives. On day 4 more hives and facial swelling. Doctor gave prescription for Prednizone. Day 5 still have eye and facial swelling alone with more hives all over body including eye and mouth.


VAERS ID: 1573822 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-02
Onset:2021-08-12
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / UNK - / -

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: Hospital 8/12/21


VAERS ID: 1573825 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Adnexa uteri pain, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: I?m healthy
Allergies: None
Diagnostic Lab Data: I did not go in , I just took Motrin for pain
CDC Split Type:

Write-up: Day 2 my arm was sore as expected but over the days I felt nauseous and lower abdominal pressure and discomfort, I feel loped a welt on my left thigh then my abdominal pain increased and I felt a lot of pressure in my womb area then my left ovary became swollen and very tender (I am not sexually active) I took Motrin for the pain, it started to radiate toward my thigh it hurt to even touch this is going on the fourth day and it seems to be going away, there still is a slight discomfort in my lower abdomin but not as bad as before. The tech who gave me my shot did a great job but I do believe this was a reaction to the vaccine.


VAERS ID: 1573844 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Dose given on 8/12 was not diluted and patient received the whole pfizer vaccine vial. Patient received 6x the amount of vaccine.


VAERS ID: 1573846 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-08-12
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Malaise
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: nothing
Current Illness: none
Preexisting Conditions: had the the two shots and still got sick from covid
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received both covid vaccine and still got covid


VAERS ID: 1573857 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-30
Onset:2021-08-12
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVEMIR, NOVOLOG, IBUPROFEN, METFORMIN, ERGOCALCIFEROL, ALBUTEROL, DICOLFENAC, CETIRIZINE, FLUTICASONE/SALMETEROL, ALOGLIPTIN, MONTELUKAST, GABAPENTIN, ASPIRIN, SILDENAFIL, LISINOPRIL, ATORVASTATIN, METOPROLOL, NITROGLYCERIN
Current Illness: NA
Preexisting Conditions: CHRONIC HYPOXEMIC RESPIRATORY FAILURE, TYPE 2 DIABETES, DIABETIC FOOT ULCER, MULTIPLE JOINT PAIN, MYOPIA, ASTIGMATISM, PRESBYOPIA, ALCOHOL ABUSE, ONYCHOMYCOSIS OF TOENAILS
Allergies: NKA
Diagnostic Lab Data: 08/12/21: POSITIVE SARS-COV-2 RNA
CDC Split Type:

Write-up: FEVER, HEADACE


VAERS ID: 1573873 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-10
Onset:2021-08-12
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Fatigue, Headache, Malaise, Myalgia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DICLOFENAC GEL, OMEPRAZOLE, AMLODIPINE, ATENOLOL
Current Illness: NA
Preexisting Conditions: BILATERAL KNEE PAIN, BENIGN HYPERTENSION
Allergies: CODEINE, ERYTHROMYCIN
Diagnostic Lab Data: 08/12/21: POSITIVE SARS-COV-2 RNA
CDC Split Type:

Write-up: FEELING TIRED/SICK, FEVER, HEADACHE, MUSCLE PAIN, RUNNY NOSE


VAERS ID: 1573875 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-08-12
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19/SARS-COV2, NAAT 8/12/21 POSITIVE
CDC Split Type:

Write-up: COVID positive $g14 days post vaccine series.


VAERS ID: 1573905 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-05
Onset:2021-08-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Exposure during pregnancy, Haemorrhage in pregnancy
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: prenatal vitamin multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I am 27 weeks pregnant and have not had any bleeding, anxiety, or complications to date. As one one week following receipt of my first dose of Pfizer, I have had 3 anxiety attacks (I have never experienced anxiety before), have trouble breathing, and had minor vaginal bleeding. I spoke with my doctor and will continue to monitor my fetal movement to identify any fetal health concerns.


VAERS ID: 1573913 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Heart rate irregular, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Irregular heartbeat/palpitations lasting 13 hours, fever/chills, headache


VAERS ID: 1573941 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Fatigue, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline, glipizide, insulin, quetiapine
Current Illness:
Preexisting Conditions: obesity, type 2 diabetes, encephalopathy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 hours post-vaccine she started symptoms of temp of 101, achy, and fatigue


VAERS ID: 1573998 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 RA / IM

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

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

Write-up: Patient was monitored for 15 minutes post vaccination as proper protocol. Patient was also called the next day (13AUG2021) and Patient was doing well.


VAERS ID: 1574014 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Inflammation, Injection site joint swelling, Pyrexia, Rash, Thirst
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol Vitamin C 1000
Current Illness: Albinsm Psoriasis
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, backpain, fever, joint and swelling in arm where the vaccine where inyected. Inflamation under the arm. Rash in the vaccinated arm. Tireness. Urge to drink water.


VAERS ID: 1574022 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO173 / 1 RA / ID

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Oropharyngeal pain, Pain, Piloerection
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Yes Metoprolol Tartrate 50 mg x 1 tablet, oral 07:00 AM MED Administered by LPN 08/16/2021 10:42 AM Warning: Hold for SBP < 100, HR < 65 Yes Gabapentin 100 mg x 1 capsule, oral 09:00 AM MED Administered by LPN 08/16/2021 10:42 AM Ye
Current Illness: F10.20 Alcohol use disorder, Severe I10 Essential (primary) hypertension F41.1 Generalized anxiety disorder M79.7 Fibromyalgia
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Chills, Body Aches, Sore throat, Headache, Piloerection and sore throat


VAERS ID: 1574038 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-01
Onset:2021-08-12
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: breakthrough case of covid 19 after 2 doses of Pfizer covid 19 vaccine given over 14 days prior to illness


VAERS ID: 1574094 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Blood test, Dyspnoea, Electrocardiogram, Heart rate increased, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: blood work, EKG (august 12)
CDC Split Type:

Write-up: patient had a rash at vaccination admin site starting august 14 , rapid heart beat, high blood pressure, shortness of breath, overall weakness


VAERS ID: 1574095 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2ND DOSE FOR COVID VACCINE WAS ADMINISTERED TWO WEEKS EARLY. NO ADVERSE SYMPTOMS OR SIGNS AT THE TIME VACCINE WAS ADMINISTERED.


VAERS ID: 1574101 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-24
Onset:2021-08-12
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Failure to thrive, Hypophagia, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Neonatal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CORONAVIRUS TESTED 8/10/2021 - positive
CDC Split Type:

Write-up: Pt admitted on 08/12/2021 with symptoms of failure to thrive. Pt is covid positive. Hx of dementia. She was diagnosed with COVID two days ago after being exposed to caregiver who was positive. The is vaccinated, but has had some malaise and low grade fevers. No oral intake for several days prior to hospitalization. Pt was given IV fluids and discharged on 8/14/2021.


VAERS ID: 1574104 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-08-12
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest discomfort, Dyspnoea, Productive cough, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, hydrochlorothiazide
Current Illness:
Preexisting Conditions: Diabetes, hypertension, hypercholesteremia
Allergies: lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt presented to ED on 8/12/2021 for shortness of breath, cough with white sputum, and chest discomfort. Pt tested positive for COVID-19 via PCR test and was ill enough to be admitted. He lives in another state , but was in town to visit family. Pt discharged from hospital on 8/15/2021. Pt was fully vaccinated with 2 doses of Pfizer (4/8/2021 and 4/29/2021)


VAERS ID: 1574107 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-08
Onset:2021-08-12
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       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? 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: Covid-19 test
CDC Split Type:

Write-up: Employee tested positive to Covid-19 after fully vaccinated


VAERS ID: 1574114 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Fatigue, Headache, Heavy menstrual bleeding, Hyperhidrosis, Malaise, Nausea, Presyncope, Thrombosis, Tremor, Vision blurred
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: On the day of vaccination, I had a heavy menstrual cycle with extremely painful abdominal cramps. around 6:00 PM I noticed large blood clots with white tissue after wiping my perineal area. Today is day 5 after vaccination and I am still having a heavy menstrual cycle. On day 2 following vaccination, I woke up with the same excruciating headache. Upon getting out of bed I suddenly felt very weak and nauseous. About 2 minutes later I experienced blurry vision, extreme diaphoresis, and my entire body was shaking. I believed I was going to faint so I sat down on the floor. My symptoms did not reside for 30 minutes. From around 6:00 PM after Vaccination to today (day 5 after vaccination) I have has a persistent headache and I am still experiencing fatigue and malaise.


VAERS ID: 1574143 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Condition aggravated, Discomfort, Electrocardiogram normal, Hypertension, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: zyrtec, losartin. zoloft, omeprazole
Current Illness: cold/sinus
Preexisting Conditions: miagraines, high blood pressure, reflux
Allergies: n/a
Diagnostic Lab Data: EKG, Blood Work (8/14/21)
CDC Split Type:

Write-up: Just over 24 hours after vaccine I started experience severe chest pains. Pains continued for about 1 hour then eased up for a bit and returned for another 20 minutes. Pain seemed to subside when reclined or prone. Within a few more hours hives started forming on biceps, wrists and hands. Within 72 hours after vaccine I was taken to the ER by EMS due to chest pains and extremly high blood pressure. EKG & blood work came back normal and was advised to follow up with GP. Hives are continuing to spread all over my body causing discomfort and itching. Chest pain has subsided for the last 14 hours. as of 8/16/21 14:00


VAERS ID: 1574152 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-03
Onset:2021-08-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Emotional disorder, Intermenstrual bleeding, Micturition urgency, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: Tramadol; Venaflaxine; Pregablin; Methadone; Topirimate; Vitamins B, D, & E; Magnesium.
Current Illness: I have suffered from Ankylosing Spondylitis since age 22. More recently within the month I passed some kidney stones. Otherwise I am/was well.
Preexisting Conditions: Ankylosing Spondylitis, Arthritis, Costochondritis, etc. It is an autoimmune disease.
Allergies: Lamotragine; Wellbutrin; Peanuts; Artificial Cinnamon; Tomato & Squash plants.
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 9 days after my first shot I started feeling cramps and like I had to urinate even after I just had. Then a few hours later I spotted menstrual blood. I thought was probably passing more kidney stones since my period isn''t supposed to occur for another 2 weeks. Then the next day I made sure to check where the blood was coming from and discovered it was indeed menstrual blood. The blood only comes when I use the bathroom and isn''t a ton but since my usual periods usually flow hard and fast, like 3 days max, this is obviously more than an early period- which I do not have. I am quite predictable. This is the most significant side effect innmy opinion. I also had an emotional outburst, probably harmonal and definitely not usual for me. I am on day 4 or 5 of spotting. Hopefully it won''t last too much longer.


VAERS ID: 1574177 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient was given her first dose of vaccine in her left deltoid and told to wait in the observation area for 15 mins. About 3-5 minutes after the vaccine was given the patient fainted. Patient was sitting in a chair and caught by her mother and laid flat on the floor. She did not suffer any falling injury. After a few seconds the patient came to and didn''t show or mention any additional symptoms when asked.


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