National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 151 out of 3,524

Result pages: prev   52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250   next


VAERS ID: 1327428 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chills, Dyspnoea, Headache, Limb discomfort, Myalgia, Nausea, Pollakiuria, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fever, huge headaches, muscle pain, joints pain, difficult in breathing, heavy chest, nausea, frequent urinations, random pinching sensation on my arms.


VAERS ID: 1327526 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Incorrect product formulation administered
SMQs:, Medication errors (narrow)

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

Write-up: After an investigation determined that patient received 0.3cc of air and did not receive vaccine. Patient''s mother notified. SHe is bring patient back today to get re-vaccinated.


VAERS ID: 1327556 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Vaccination 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: After thorough investigation found that patient received 0.3cc of air with no vaccine. Patient''s mother notified right away. She will be bringing patient back on Tuesday 5/25/2021 for re-vaccination.


VAERS ID: 1327603 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site cellulitis
SMQs:

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

Write-up: cellulitis in left arm.....was seen by emergency room doctor


VAERS ID: 1327607 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too Low


VAERS ID: 1327705 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lethargy, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: He became nauseated, skin turned pale, and he became lethargic.


VAERS ID: 1327725 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-20
Onset:2021-05-16
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Facial paralysis, Magnetic resonance imaging head, Ultrasound scan
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Aortic aneurysm
Allergies: Penicillin
Diagnostic Lab Data: May 18, 2021 Ct scan MRI Ultrasound
CDC Split Type:

Write-up: Bell?s palsy. Drooping of mouth on right side


VAERS ID: 1328020 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Ocular hyperaemia, Rash, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Nonw
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vomiting second day morning followed by rash on face around eyes. Rash subsiding but left eye has blood hemorrhage ( blood shot eye). 24 hrs later second eye also blood shot. Tightness of chest also started third day but now improving. No discharge from eye, no discomfort as of now.


VAERS ID: 1328034 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2A5AZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: muscle pain in my left leg for the last three days unable to sit or use my leg to stand up pain meds do not work


VAERS ID: 1328038 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Malaise, Pallor, Presyncope, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received vaccine and within 5 minutes was not feeling well. Patient fainted and then when conscious began vomiting. Patient also became very pale and clammy. Patient has experienced vasovagal symptoms before when having blood work done but not during vaccination. Patient also stated afterwards that she had not eaten any food all morning prior to receiving the vaccine.


VAERS ID: 1328055 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Oropharyngeal pain, Pain, Respiratory tract congestion, Vomiting
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Eating Disorder
Allergies: NKDA
Diagnostic Lab Data: 5/18- Rapid Covid, Flu, Strep negative
CDC Split Type:

Write-up: vomiting began 3 days after vaccination fever up to 102 began 4 days after vaccination sore throat, congestion, body aches persist 5 days after


VAERS ID: 1328503 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient complained of dizziness about 5 minutes after vaccination. Patient was sitting at the clinic lobby with her mother. I assisted the patient inside the exam room to lay down on the exam table. Patients was so dizzy and about to faint. She could hardly get up to the exam table. I instructed her to get up to the exam table one more time. She was able to get up and lay down on the table. Patient did not lose consciousness. Vitals were taken and were stable. Mother gave patient gatorade to drink. Patient stayed laid down on the table for about 10-15 minutes. Mother was watching the patient. Patient was fully alert and no longer feeling dizzy. Patient walked with her mother. My assistant walked them outside our facility.


VAERS ID: 1328540 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Delusion, Depression, Insomnia, Irritability, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (narrow), Hypoglycaemia (broad)

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

Write-up: Swelling, no sleep, pain in entire body, delusional, very irritable, depressed


VAERS ID: 1328724 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Experienced 102 fever 24 hours post dose, 48-72 hours extremely painful and swollen left lymph node--still experiencing this, extreme fatigue.


VAERS ID: 1328903 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Horrible itchy rash over the entire body, including back of neck, scalp, torso, legs. Lasting for days.


VAERS ID: 1329152 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Headache, Injection site pain, Off label use, Product administered to patient of inappropriate age
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532189

Write-up: STOMACH WAS BOTHERING - THINKING GETTING PERIOD; HEADACHE; SORE ARM AT INJECTION SITE; ADOLESCENT RECEIVED THE JANSSEN COVID 19 VACCINE; OFF LABEL USE; This spontaneous report received from a parent concerned a 14 year old female. The patient''s weight was 150 pounds, and height was 170.18 centimeters. The patient''s concurrent conditions included non-smoker, and other pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 203A21A expiry: 23-JUN-2021) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced adolescent received the janssen covid 19 vaccine. On 16-MAY-2021, the subject experienced off label use. On 16-MAY-2021, the subject experienced headache. On 16-MAY-2021, the subject experienced sore arm at injection site. On 17-MAY-2021, the subject experienced stomach was bothering - thinking getting period. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and the outcome of adolescent received the janssen covid 19 vaccine, off label use, stomach was bothering - thinking getting period and sore arm at injection site was not reported. This report was non-serious.


VAERS ID: 1329163 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Accidental exposure to product, Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532768

Write-up: MEDICATION ERROR DUE TO ACCIDENTAL EXPOSURE INTO EYES; FREAKING OUT; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 16-MAY-2021, the subject experienced medication error due to accidental exposure into eyes. On 16-MAY-2021, the subject experienced freaking out. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the medication error due to accidental exposure into eyes and freaking out was not reported. This report was non-serious.


VAERS ID: 1329164 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Skin mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DIPHENHYDRAMINE
Current Illness: Alcohol use (Once a month); Cigarette smoker (Every day)
Preexisting Conditions: Comments: Patient had no known allergies or drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532939

Write-up: LUMP IN ELBOW; CHILLS; JOINT PAIN; This spontaneous report received from a patient concerned a 50 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcohol user, and cigarette smoker, and other pre-existing medical conditions included patient had no known allergies or drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1816022 expiry: 01-JUL-2021) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. Concomitant medications included diphenhydramine. On 16-MAY-2021, the subject experienced lump in elbow. On 16-MAY-2021, the subject experienced chills. On 16-MAY-2021, the subject experienced joint pain. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 17-MAY-2021, was recovering from joint pain, and had not recovered from lump in elbow. This report was non-serious.


VAERS ID: 1329873 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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? 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: Sore arm, fever, chills, headache and dizziness. All symptoms resolved within 36 hours except headache and dizziness. Dizziness is the biggest complaint 4 days post vaccine.


VAERS ID: 1329919 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood culture negative, Brain natriuretic peptide normal, Chest X-ray normal, Chest discomfort, Cough, Dyspnoea, Electrocardiogram normal, Full blood count normal, Injection site nodule, Metabolic function test, Pain, Pharyngeal swelling, Pyrexia, Speech disorder, Swelling, Troponin normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Topamax 50mg 1QD morning Topamax 100 QD nightly Sertraline 50mg QD Carvedilol 6.25 BID Famotidine 20 QD Eletriptian 40mg 1 PRN Q2Hours Not exceed 2 Prochlorpromazine 5mg Q8 hrs PRN nausea Ventolin inhaler PRN Zyrtec 10mg QD
Current Illness: Chronic Hemipelegic Migraines Exhibiting Stroke Like Symptoms Since 2016 Vasovagal Response HTN Rapid Heart Rate With Palpitations Anxiety With Panic Attacks
Preexisting Conditions: Same as above
Allergies: I have had odd food allergy flares and have suffered from Beef and Pork allergies in the past.
Diagnostic Lab Data: Troponin CBC CMP BNP Blood Cultures EKG Chest X-ray All done 05/18 all within normal limits
CDC Split Type:

Write-up: Pain, fever, swelling, hard knot at injection site, chest pressure, shortness of breath, throat feel like it was swelling shut, cough, difficulty talking. The chest pressure began Sunday morning and readily got worse eventually resulting to a trip to the ER when Benadryl, rescue inhaler, and EPI pen didn?t work.


VAERS ID: 1329972 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High


VAERS ID: 1329986 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Eye haemorrhage, Scan, Vitreous detachment, Vitreous floaters, Vitreous haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (broad), Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone, tadalafil, anastrozole fish oil, vitamin d3, k, c, b6, curcumin, zinc
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Multiple eye scans/photos and Doctor magnification examination on May 17
CDC Split Type:

Write-up: Posterior vitreous detachment in the left eye resulting in a vitreous hemorrhage. Examination showed bleeding near the optic nerve with no retina damage. Treatment is a follow-up in 3 weeks to monitor the retina and no heavy lifting or gym for 2 weeks. There is a large blood swirl/floater in the left eye.


VAERS ID: 1330057 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Nerve block, Panic attack
SMQs:

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

Write-up: Felt panicky and nervous. Pulse 105 SPO2 97 B/P 110/78 Getting back to normal to go home.


VAERS ID: 1330269 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-22
Onset:2021-05-16
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Pulmonary embolism, Ventilation/perfusion scan abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad)

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

Write-up: received vaccine on 4/22/21 at unknown location; admitted on 5/16; Internal reported event states: Patient presented to the ED on 5/16/21 with shortness of breath, and VQ scan showed high probability of pulmonary embolism. Patient had second dose of Moderna COVID vaccine on 4/22/21, and admitting PA felt PE could potentially be related to the vaccine. Workup still underway to r/o lung cancer given history of smoking, link to vaccine not definitive at this point.


VAERS ID: 1330421 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330447 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330471 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Weakness, Nausea. Seen by onsite EMS. 16:23 HR 84 regular Spo2=96% BP=79/55 16:31 Reported symptoms resolved. left with parent. HR 83 regular Spo2=97% BP=105/84 Discharged with mother at 16:35. Recorded by RN.


VAERS ID: 1330562 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram normal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma Allergic Rhinitis
Allergies: NKDA
Diagnostic Lab Data: Troponin: 1.27 -$g 1.62 -$g 1.74 -$g 1.62-$g1.05 -$g 1.06 -$g 0.99
CDC Split Type:

Write-up: Left sided chest pain few days after second shot. Noted troponin to be elevated. Troponin: 1.27 -$g 1.62 -$g 1.74 -$g 1.62-$g1.05 -$g 1.06 -$g 0.99. Normal ECHO. Normal EKG. Dx with myocarditis. Patient''s pains symptoms resolved in 1-2 days; observed in hospital until troponin trended down.


VAERS ID: 1330605 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Erythema, Fatigue, Headache, Pyrexia, Vaccination site pain, Vaccination site reaction, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), 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: n/a
Current Illness: none
Preexisting Conditions: n/a
Allergies: penicillins
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: headache, lightheadedness, fatigue, and a fever of 100.4 - site of vaccine has a slight redness/tenderness (mom reports mild - consistent with vaccine localized reaction). Sxs have persistent through from 5/16/2021 to 5/18/2021, temperature has slightly improved at 99 with Motrin, but headache/fatigue persisting, and then patient woke 5/18/2021and vomited x 1. day 3 with slightly elevated temp, persisting headache, fatigue, and new onset sx of vomiting today. Motrin for fever, fluids, rest, and monitoring at home.


VAERS ID: 1330644 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Cardioversion, Ventricular tachyarrhythmia
SMQs:, Torsade de pointes/QT prolongation (broad), Ventricular tachyarrhythmias (narrow), Torsade de pointes, shock-associated conditions (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sotalol Atorvastatin Spironolactone Aspirin
Current Illness: None
Preexisting Conditions: ARVC/D
Allergies: None
Diagnostic Lab Data: Many tests during overnight hospital stay on may 16th. Heart was 160bpm for an extended period on May 16th (most of the day).
CDC Split Type:

Write-up: Awoke early Sunday 16th with Heart arrhythmia - VTach. Necessitated 911 call and hospitalization for cardioversion.


VAERS ID: 1330657 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Gait inability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient received 0.5ml of Janssen in right deltoid on 5/16/21. He experienced side effects (fever, chills and joint pain) starting that night at 8pm. He reports that his knees hurt so bad that he could not walk. He is treating with tylenol and ibuprofen and side effects have improved


VAERS ID: 1330703 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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:
Preexisting Conditions: Asthma
Allergies: peanuts, shellfish, tree nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt had fever the night after taking the vax. The next day she when she woke up her entire right side of the body was sore and had diarhea. She had fatigue and developed a rash on her left arm. Three days later she still has a rash, sore arm, slight fever and diarhea. Pt will be going to urgent care today for treatment.


VAERS ID: 1330728 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

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

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

Write-up: Today, I received a call from Walgreens saying that my two kids that received their Pfizer first shots on Sunday, need to get another shot because the vaccine was mixed with water instead of saline, so the vaccine that was administered was not going to work.


VAERS ID: 1330771 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0168 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fibrin D dimer increased, Hypoaesthesia, Injected limb mobility decreased, Lymphadenopathy, Oedema peripheral, Pain in extremity, Pallor, Radial pulse decreased, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gentle iron, vitamin C, vitamin D, Vitamin Z+, Thymex (herbal supplement)
Current Illness: None
Preexisting Conditions: Iron deficiency anemia, joint pain at multiple sites, ovarian cysts
Allergies: Gluten, animal dander, lecithin, pollen. milk (lactose), califlower, dawn dish soap, NKDA
Diagnostic Lab Data: Elevated D-Dimer 563, Negative VL Duplex, Negative PVR
CDC Split Type:

Write-up: Pt developed severe left arm /shoulder pain, limiting range of motion, and edema in whole arm 4 days after recieving the vaccine with decreased left radial pulse, with intermittant pale/numb hand. She had an elevated D-Dimer on 5/17/2021, negative work up for thrombus. Left arm pain continues to worsen with extremely limited range of motion. Tylenol is ineffective in managing pain. Cool packs and hot packs have helped slightly. Enlarge lymph nodes noted in left axilla and supraclavicular.


VAERS ID: 1330801 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient is 17 years old and this Vaccine only for 18 years old and above called the mother on the 17th but no one answer the mother called the pharmacy on the 18th. she Mentioned that her Daughter is doing fine now. She states that we ( the parents ) want her to take JNJ vaccine


VAERS ID: 1330881 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330888 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330898 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330935 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Unknown  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330966 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-05-16
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Epistaxis, Headache
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Migraines, Hypothyroidism,
Allergies: Echinacea, Effexor, Prozac, Ibuprofen, Celexa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe epistaxis, bloody nose, headache


VAERS ID: 1330972 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330989 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1330995 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water


VAERS ID: 1331003 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331014 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331025 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331038 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331043 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331048 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331056 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331081 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Unknown  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331086 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

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

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331105 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Pfizer vaccine mixed incorrectly (used sterile water)


VAERS ID: 1331129 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphthous ulcer, Genital ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, Allegra, Flonase
Current Illness: no
Preexisting Conditions: mild asthma, seasonal and animal allergies
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: genital aphthous ulcers


VAERS ID: 1331144 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Not reported
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with vasovagal syncope. Rapidly improved with position change, hydration, and monitoring. Returned home with mother as the driver.


VAERS ID: 1332391 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Pro air
Current Illness: Cold
Preexisting Conditions: Asthma (exercise induced)
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA, numbness in the arm and hand of the vaccination site, touch sensitivity around upper arm/area of vaccination site. Both lasted into the next 2 days (05/17-05/18) until fading throughout the day of 05/18.


VAERS ID: 1332418 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 20YA21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Fatigue, Feeling hot, Feeling of body temperature change, Hallucination, Headache, Hypokinesia, Poor quality sleep, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532149

Write-up: TIRED; SLIGHT HEADACHE; HALLUCINATING; COULD NOT MOVE; COULD NOT SPEAK; ALTERNATING BETWEEN HOT AND COLD; REMAINED AWAKE; ANXIETY; FEELING VERY HOT; FEVER; This spontaneous report received from a patient concerned a 48 year old male. The patient''s height, and weight were not reported. The patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 20YA21A expiry: UNKNOWN) dose was not reported, 1 total, administered on 16-MAY-2021 11:15 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021 evening around 19:00 or 20:00, the patient, had a fever, however he did not get a definite temperature reading because he did not use a thermometer. The patient felt very hot and began hallucinating or anxieties. It was reported that throughout the night he was alternating between hot and cold. The patient could not move or speak and the fever got worse during the night. The patient remained awake from that evening until the reporting morning. The patient took unspecified pain reliever and dosage was unknown but it was two tablets and was taken at 11 am on the reporting day. At the time of this report the patient felt tired and had a slight headache but he felt better. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hallucinating, could not move, could not speak, alternating between hot and cold, anxiety, feeling very hot, and fever on MAY-2021, was recovering from tired, and slight headache, and the outcome of remained awake was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210528105- Covid-19 vaccine ad26.cov2.s-Hallucinating. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1332429 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Herpes zoster, Sleep disorder
SMQs:, Retroperitoneal fibrosis (broad), Opportunistic infections (broad)

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

Write-up: I got my second dose of Phizer May 10th at facility. May 16th I started to have back pain over my left kidney. May 17th the pain was unbearable at night. I was not able to sleep. I went to the Clinic May 18th at 9am. I was diagnosed with Shingles.


VAERS ID: 1332432 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0182 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kirkland adult gummie vitamin. Nature made vitamin d 2500 IU. I?m low on vitamin D and can?t retain it well. Trunature women?s probiotic, Zyrtec, Flonase.
Current Illness: None. But I didn?t react well to the first dose. I had mild nausea and weakness, and extremely fatigued. But other than that, I?m health and active all day 5 days a week, and active when off. I eat well etc.
Preexisting Conditions: Nothing. Other than low vitamin D for unknown reasons never to be determined.
Allergies: Zopfran I got a rash from like 10 years ago.
Diagnostic Lab Data: None. Called pharmacy on Tuesday and reported the rash. And spoke with my doctors office a few times and was told by them to contact pharmacy and you guys. I only spoke with the receptionist on the phone. As they couldn?t see me that day.
CDC Split Type:

Write-up: I started with a fever at 1pm the day of vaccine and was tired. The next morning I woke up with a rash on my neck and had fever, and horrible diarrhea . At around 1, I got Benadryl, took two. The rash kept spreading. The rash spread and continued too until after I had safety taken Benadryl 3 times. It was on my neck, chest, and back of neck and inside elbow of my right arm. My rash cleared mostly by the next morning. But my diarrhea did not. And seems to have finally settled down kinda today. I have only had 4 trips today to the restroom with diarrhea. Other than that, I?m fine, you can still barely see my rash. I can tell it?s still slightly pink. But it?s gone enough.


VAERS ID: 1332484 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210534702

Write-up: TIREDNESS; FATIGUE; HEADACHE; This spontaneous report received from a patient concerned a 54 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced tiredness. On 16-MAY-2021, the subject experienced fatigue. On 16-MAY-2021, the subject experienced headache. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) Negative. The action taken with covid-19 vaccine was not applicable. The patient recovered from headache on MAY-2021, and had not recovered from tiredness, and fatigue. This report was non-serious. This case, from the same reporter is linked to 20210535066.


VAERS ID: 1332499 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: West Virginia  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Hypoaesthesia, Limb discomfort, Pain, 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)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210516; Test Name: Body temperature; Result Unstructured Data: 100.4
CDC Split Type: USJNJFOC20210535249

Write-up: NUMBNESS IN THE RIGHT ARM; HEAVY RIGHT ARM; FEVER; BODY ACHES; This spontaneous report received from a patient concerned a 29 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 23/JUN/2021) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced body aches. On 16-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 100.4. On 18-MAY-2021, the subject experienced numbness in the right arm. On 18-MAY-2021, the subject experienced heavy right arm. The action taken with covid-19 vaccine was not applicable. The patient recovered from fever on 17-MAY-2021, and had not recovered from body aches, numbness in the right arm, and heavy right arm. This report was non-serious.


VAERS ID: 1332872 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 121C21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (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: advil, tylenol, vitamin C
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: enlarged axillary lymph node on L side - vaccination given on L deltoid. soft, palpable tender to touch, no nodules palpated. Decreasing in size slowly


VAERS ID: 1332873 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Fatigue, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Pravastatin, Bumetanide, Iron, Flecainide, Magnesium, Metoprolol, Potassium, Pantoprazole
Current Illness: None
Preexisting Conditions: High cholesterol, Congestive heart failure, dementia, lower kidney function
Allergies: Latex, sulfa
Diagnostic Lab Data: Contact Hospital where she was taken to the ER and admitted to the hospital on 5/16/2021
CDC Split Type:

Write-up: Severe weakness, severe fatigue, muscle pain, joint pain, chills, nausea, vomiting


VAERS ID: 1332967 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Hemiplegia
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Down''s syndrome
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532320

Write-up: STROKE; LEFT SIDED PARALYSIS ( (INCLUDES FACE AND BODY); This spontaneous report received from a consumer concerned a white and Not Hispanic or Latino, 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included down''s syndrome. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: UNKNOWN) dose was not reported,1 total, administered on left arm on 05-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 16-MAY-2021 stroke and left sided paralysis on face and body. Ambulance was arrived around 20:00. The patient was hospitalized over night. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from stroke, and left sided paralysis. This report was serious (Other Important Medical Condition).; Sender''s Comments: V0: 20210532320- Covid-19 vaccine ad26.cov2.s- Stroke, left sided paralysis- This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1333197 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Computerised tomogram thorax normal, Dehydration, Echocardiogram normal, Electrocardiogram normal, Intensive care, Laboratory test normal, SARS-CoV-2 antibody test positive, Troponin increased, Vaccination complication
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin with mineral taken daily
Current Illness: None
Preexisting Conditions: None
Allergies: No Known Allergies
Diagnostic Lab Data: As mentioned above -troponin was elevated (1.546 at peak, then declined to 0.585 prior to discharge home). Other tests normal.
CDC Split Type:

Write-up: Patient received first dose of Pfizer vaccine (lot EW0170) on 4/24/21 at University and received 2nd dose of Pfizer vaccine (lot EW0182) on 5/15/21 also at University. Came to hospital ED on 5/16 AM with diagnosis of acute chest pain, acute dehydration, and adverse reaction to vaccine administration. Was discharged to home and returned to ED on 5/17/21 for continued chest pain (central, throbbing, non-radiating chest pain). Medical tests and laboratory results revealed elevated troponin level (1.546 at peak, then declined to 0.585 prior to discharge home). Patient was admitted to PICU for close monitoring. CT angiogram of chest was negative, chest x-ray was negative, EKG showed normal sinus rhythm, echocardiogram was done and it was a normal study. Dr. discussed with the cardiology department at Hospital. Possible myocarditis due to vaccine. COVID-10 IgG IgM antibodies were positive for the patient which indicates good efficacy of the vaccine. Patient to have follow-up with outpatient pediatric cardiology Dr. Discussion with father on 5/20/21 indicates that patient''s symptoms were improving.


VAERS ID: 1333212 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Balance disorder, Condition aggravated, Dizziness, Fall, Flushing, Heart rate increased, Hypotension, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: While waiting for 15-mins monitoring after getting Johnson&Johnson covid vaccine, he fainted and fell off the chair. Pharmacy staff rushed to his aid and he regained consciousness within a minute. He said he was feeling flushed and dizzy. He said he was having too much anxiety and has had fainting issue with vaccinations/MRI in the past. His blood pressure was low with high heart rate. We called 911 and paramedics came immediately. He was still unstable so the paramedics took him for further evaluation


VAERS ID: 1333254 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, Vitamin D, Vitamin C
Current Illness:
Preexisting Conditions: Acid Reflux (or LPR), mild Sensory Motor Neuropathy, WPW (extra electrical pathway on heart), Erythromelalgia, Rosacea.
Allergies: Penicillin, Amoxicillin, Macrobid
Diagnostic Lab Data:
CDC Split Type:

Write-up: Have had a little, very light, tinnitus before, but it became noticeably louder after 2nd Moderna Vaccine. I am 6 days post 2nd vaccination and it is still very loud. Still thankful for the Covid vaccine and would do it again, but would have a little concern if booster might make it worse. Might consider Pfizer for a booster.


VAERS ID: 1333469 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe


VAERS ID: 1333527 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Mobility decreased, Peripheral swelling, Underdose
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Medication errors (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: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Severe, Error: Wrong Dose of Vaccine - Too Low, Additional Details: pt states her arm swelled up the 2nd day (sunday) and could not move it. Sought an opinion from her pcp who gave her a cortisone shot, told her to take ibuprofen and take a week off. Vaccination nurse from another day said an "X" was marked where the md said the shot site was. She pointed near her elbow (about 3 fingers above). Per phone conversation with pt, she thinks the site was 3 fingers above the elbow but on the back of the arm. The swelling is between and orange and grapefruit size


VAERS ID: 1333547 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 AR / 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? 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: Systemic: Fainting / Unresponsive-Severe


VAERS ID: 1333549 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1079 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking Fish Oil 1000 mg capsule 1 cap(s) orally 2 times a day, Taking Lipitor 10 mg tablet 1 tab(s) orally once a day, Taking l-methylfolate 15 mg tablet 1 tab(s) orally once a day, Taking Nortrel 0.5/35 35 mcg-0.5 mg tablet 1 tab(s) orally
Current Illness:
Preexisting Conditions: mild asthma
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Facial rash/burning started within 24 hours


VAERS ID: 1333696 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac telemetry normal, Catheterisation cardiac normal, Chest discomfort, Chest pain, Chills, Discomfort, Echocardiogram normal, Electrocardiogram abnormal, Laboratory test normal, Myocarditis, Pain, Palpitations, Pyrexia, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Allergies: peanut
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: 23 y.o. male with no pmhx however did receive 2nd pfizer COVID vaccine 5/14/21 and began to experience fevers, body aches, and chills as of 5/15/21. He did have prn ibuprofen with good effect however 5/16/21, he experience anterior chest pressure that radiated into his back prompting his mother to bring him to the ER. He had negative EKG for acute ischemia however troponin 14.2 on Istate and 9.2 on lab work. Otherwise lab work unremarkable. Bedside echo w/ ERP w/ intact wall motion (Reported). No other recent illnesses or complaints. Low grade fever in ER. Patient did endorse palpitations w/ fever and his mother reports a pulse ox that read a HR of 122 at time of complaint. He is SR in ER. No further reported palpitations. Laying flat comfortable. No dyspnea Hospital Course: # myocarditis likely related to pfizer vaccine. Chest pain and fever now resolved. Noted to have elevated troponin at 14 with repeat is trending down. Abnormal EKG likely secondary to myocarditis . He was admitted with telemetry monitor without significant event. Was seen in consultation by Cardiology. Echocardiogram unremarkable. Underwent cardiac catheterization without occlusive disease, see report. He was advised to avoid NSAID, no strenuous physical activity. Follow up with Cardiology in 2-3 weeks.


VAERS ID: 1333900 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-05-16
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Immunology test, Platelet factor 4, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1. CTA. 2. PF4 ELISA Ab
CDC Split Type:

Write-up: Acute Pulmonary embolus


VAERS ID: 1333950 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NIL
Current Illness: NIL
Preexisting Conditions: NIL
Allergies: NIL
Diagnostic Lab Data: No tests done.
CDC Split Type:

Write-up: Got the 1st dose of COVID-19 Pfizer vaccine and after 24hours, kid got rash on the stomach and left shoulder and it became worse day by day. Have seen the pediatric and after examination, she mentioned that it could be Pityriasis Rosea and advised to see a dermatologist and also report this event. I am reporting this as advised by the pediatrician. Not sure if this is the side effect of vaccine but believe it could be because this started after 24hrs of receiving vaccine.


VAERS ID: 1333992 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-20
Onset:2021-05-16
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Bacterial test positive, COVID-19, Confusional state, Cough, Depression, Essential hypertension, Fall, Joint dislocation, Joint dislocation reduction, Nitrite urine present, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypertension (narrow), Depression (excl suicide and self injury) (narrow), Arthritis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Parkinson''s Disease, Hypertension, dementia
Allergies: Vicodin, Suprax, Cedax, Benadryl, PCN, quinine, VIoxx, Bextra
Diagnostic Lab Data: COVID-19 PCR test 5/16/2021
CDC Split Type:

Write-up: Paraphrase from provider discharge to swing bed note: 83 y/o female brought to ED for fall and left shoulder pain. Baseline dementia, poor historian, early onset Parkinson''s Disease. Fully vaccinated for COVID-19, showing no obvious symptoms of COVID. Cough, no dyspnea per review of systems. Problem list includes: Anterior shoulder dislocation, reduction. COVID-19. Essential Hypertension, Acute confusion, baseline dementia, urine + for nitrite and bacteria, started on macrobid. Depression. Unable to enter required fields for Q.#21, Hospitalization. Currently Hospitalized


VAERS ID: 1334091 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-18
Onset:2021-05-16
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Axillary vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: axillary vein thrombosis (left)


VAERS ID: 1334092 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Magnetic resonance imaging heart, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Troponin peak of 6 CRP $g100 MRI showed subepicardial gadolinium enhancement in the basal inferolateral wall.
CDC Split Type:

Write-up: Same day fever associated with chest pain that was positional. Admitted to the hospital, diagnosed with Myopericarditis based on elevated troponin, CRP, clinical history, and cardiac MRI.


VAERS ID: 1334434 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-05
Onset:2021-05-16
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Nodule, Pain in extremity
SMQs:, Acute pancreatitis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PAIN IN LEGS; KNOTS IN LEGS; NAUSEA


VAERS ID: 1334481 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (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: Multi vitamin Dimetap
Current Illness: Seasonal allergy
Preexisting Conditions:
Allergies: Cashew and pistachio allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, chills and arm pain -18-48 hours Headache and nauseous 18 hours after and still present after 5 days


VAERS ID: 1334612 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW-0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Angiogram normal, Aspartate aminotransferase increased, C-reactive protein increased, Chest pain, Computerised tomogram abnormal, Electrocardiogram ST-T change, Fatigue, Fibrin D dimer increased, Headache, Liver function test increased, Lymphadenopathy, Myocarditis, Pyrexia, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 antibody test, SARS-CoV-2 test negative, Troponin increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen
Current Illness: none
Preexisting Conditions: in utero diagnosis of agenesis of corpus callosum- asymptomatic, no meds, no seizures
Allergies: none
Diagnostic Lab Data: EKG- Ste elevation (v1+v3, possible R ventricle hypertrophy CT scan- enlarged R axillary lymphnodes ALT/AST 102/241. (5/19) Troponin 23,642 -$g19.4-$g15.28-$g13.41-$g11.18-$g 10.72 (am 5/20) 5/19: CRP 11.3 (nl), D dimer 1.19, ESR 15, COVID AB (spike protein IgG): POS, COVID PCR NEG. Viral respiratory panel NEGATIVE$g infectious workup otherwise pending (adeno, entero, CMV, EBV, bartonella, Parvo, HHV6) Nucleocapsid COVID antibody pending
CDC Split Type:

Write-up: Chest pain, fever, headache and fatigue starting morning after vaccination. Progression of chest pain prompting evaluation in the emergency room where he was found to have a Troponin of 23,000 (nl less then 50). D''Dimer mildly elevated. ST changes on EKG. CTA negative. LFT mildly elevated. Sent to hospital where admitted to cardiology service pm 5/19 and given a diagnosis of myocarditis. Still under care at this time of report.


VAERS ID: 1334617 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: C-reactive protein increased, COVID-19, Chest pain, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Pericarditis, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid 19 IgG Ab- Postive (5/18), Troponin 10.03 (5/18), CRP 20.5 (5/19), ESR 18 (5/18), SARS-CoV-2 PCR NP swab positive (5/18)
CDC Split Type:

Write-up: Presented 3 days after Covid vaccination with ongoing chest pain since then. He was found to have elevated troponin and elevated ST segments consistent with pericarditis. He was also found to have be Covid positive by PCR. No medications initiated. ECHO normal.


VAERS ID: 1334618 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Fatigue, Feeling hot, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Visually monitored pt for return of color to face. Pulse remained steady 65-70 bpm. pt stated she had not eaten anything besides a cookie before her shot at 1:30pm.
CDC Split Type:

Write-up: Pt appeared clammy and ashen in face 5 min after receiving 1st Pfizer vaccine . Had pt lay on floor in the event of passing completely out. Elevated pt''s feet on the chair. Pt''s hands where sweaty. Pt continued talking throughout process while laying on the floor. Pt stated she felt tired and tingly and hot. Monitored pt for next 15 minutes until she felt well enough to sit up. Pulse was normal and steady. After 15-20min pt had color returning to face. Pt felt well enough to sit up while still on floor. Had pt sit 5 min on floor and texted on phone. Pt felt well enough to sit on chair. Pt sat 5 min on chair. Pt felt well enough to stand and walk. Mom and I monitored pt walking and doing well. We sent pt home with mom.


VAERS ID: 1334851 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Swelling face, Vertigo
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine, lorazepam, quetiapine
Current Illness:
Preexisting Conditions: GAD, ADHD, asthma, OCD, Autism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue since day given vaccine. Cheek swelling, headache and dizziness/vertigo for one day (5/18).


VAERS ID: 1335991 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Emergency care examination, Respiratory arrest, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Respiratory failure (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: Zofran
Current Illness: Gastrointestinal issues, weight loss, loss of appetite
Preexisting Conditions:
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Allergic reaction. Unable to breathe and face swelling. Required ER visit


VAERS ID: 1336094 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO170 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray normal, Chest discomfort, Chest pain, Chills, Echocardiogram, Ejection fraction normal, Electrocardiogram PR shortened, Electrocardiogram ST segment elevation, Haematocrit normal, Haemoglobin normal, Influenza virus test negative, Injection site pain, Liver function test normal, Myalgia, Pericardial effusion, Platelet count normal, Pyrexia, Renal function test normal, SARS-CoV-2 test negative, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Conduction defects (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data: VS in ED: 113/76, Pulse 80-90''s, RR16 100% O2 sat on room air. Covid and Flu PCR''s were negative, C reactive Protein elevated at 3.55 (nl <0.5)LFT''s, renal function, Hb/Hct, plts all WNL Troponin peaked in 48 hours at 0.696at 8:55 AM on 5/17/21 and came down to 0.570 prior to discharge to home on 5/18/21. All symptoms gradually resolved on Colchicine and low dose Ibuprofen
CDC Split Type:

Write-up: Pt. developed arm site pain, fever chills and muscle aches day after 2nd dose, 05/14/2021 symptoms resolved by night time. He awoke on 5/15/2021 with waxing and waning chest pain/ burning and chest pressure, seemed too improve but by 5 AM on 5/16/21 was more intense and he presented to E.D. where EKG showed diffuse ST elevations and PR interval depressions. Troponin was elevated at 0.494, increased in next hour to 0.569 and patient was admitted. TTecho showed normal E.F. of 60-65%, nl valves and trace pericardial effusion. CXR was negative for pulmonary infiltrates, (no Hx of Covid Dx) P.E. showed no conjunctivitis, no rashes, all else also WNL


VAERS ID: 1336248 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D 5000 iu, Vitamin B complex with 200 mg C
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu like symptoms, all over body aches, fever of up to 103.2 which has been ongoing for about 5 days now, loss of appetite, symptoms are finally subsiding.


VAERS ID: 1336295 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Pain in extremity, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210537598

Write-up: INNER LEFT ANKLE FELT HOT TO TOUCH; LEFT LEG PAIN; BULGING VEIN ON LEFT LEG; This spontaneous report received from a consumer concerned a 59 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient had no known drug allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 15-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced bulging vein on left leg. On 16-MAY-2021, the subject experienced left leg pain. On 19-MAY-2021, the subject experienced inner left ankle felt hot to touch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from left leg pain, bulging vein on left leg, and inner left ankle felt hot to touch. This report was non-serious.


VAERS ID: 1336600 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis, Nervousness, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: PT WAS VERY NERVOUS, DIAPHORETIC, PALE, PARAMEDICS ON SITE, BP 99/64, HR 63, SX RESOLVED, REFUSED TRANSPORT, AMA SIGNED.


VAERS ID: 1336702 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 RA / IM

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

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

Write-up: Two days after getting his first Moderna Covid vaccine shot my father suddenly lost his ability to hear from his left ear.


VAERS ID: 1336933 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adjustment disorder with anxiety, Arthralgia, Burning sensation, CSF culture negative, Condition aggravated, Confusional state, Conversion disorder, Diarrhoea, Dyspnoea, Dysstasia, Fall, Gram stain negative, Guillain-Barre syndrome, Headache, Hypersomnia, Hypokinesia, Joint instability, Joint range of motion decreased, Lumbar puncture normal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Muscle twitching, Muscular weakness, Neurological examination abnormal, Palpitations, Panic attack, Paraesthesia, SARS-CoV-2 test negative, Scan with contrast normal, Sensory loss, Varicella virus test negative, Wheelchair user
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Demyelination (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol MDI, cephalexin 500 mg TID, cetirizine 5 mg daily, cholecalciferol 1000 units daily, cyproheptadine 4 mg daily, fluticasone 110 mcg MDI BID, hydroxyzine 25 mg bedtime, mupirocin ointment, sertraline 50 mg daily, triamcinolone 0.1%
Current Illness: Ingrown toenail treated with mupirocin, triamcinolone, cephalexin.
Preexisting Conditions: hypogammaglobulinemia, asthma, IBS, anxiety, panic attacks
Allergies: amoxicillin, azithromycin
Diagnostic Lab Data: MRI brain/spine - normal LP - normal, culture gram stain - neg; varicella-zoster PCR - neg COVID neg
CDC Split Type:

Write-up: 12 yo male presenting with bilateral lower extremity paresthesias and confusion. Admitted to the hospital. Pending discharge to rehab facility. ED Note 5/19/21 Patient is a 12-year-old male with hypogammaglobulinemia, asthma, IBS who presents with weakness in his lower extremities. 6 days ago, patient had seafood and later that night vomited once, nonbloody, nonbilious. 4 days ago, he received the first dose of the Pfizer SARS-CoV2 vaccination. That day, he also felt some burning over the anterior parts of his bilateral ankles. Over the past 3 days, he has been sleeping a lot and had a headache. He has not had a fever or other muscle aches, no subsequent N/V, abdominal pain. Last night, he reported ankle pain to his mom. Today at school, he was playing kickball when he had the sensation that his ankles were not working/gave out and he fell to the ground. He had difficulty getting up and required a wheelchair. He did not lose consciousness, denied CP, palpitations, SOB, headache, vision change during or before that episode. He was not incontinent of urine/stool and had no abnormal movements noted at the time. Since then he has noted twitching in his thighs, calves and toes. He reports weakness throughout both lower extremities and has difficulty with intentional movements at the toes/ankles/knees, weakness in hips. He reports a burning sensation over the anterior ankles/dorsum of foot b/l. Denies fevers, chills, cough, SOB, CP, palpitations, abdominal pain, N/V/C. He endorses diarrhea 3x daily which is his baseline. He has panic attacks 3x daily w palpitations/SOB that self resolve. He has been on keflex for an ingrown toe nail for the last week. MRI performed with normal brain and spine. However, on repeat exam patient has diminished sensation in the bilateral feet and diminished ability to dorsiflex or plantarflex both ankles with very limited toe range of motion. Still with preserved reflexes in the patella and Achilles. Discussed at length with neurology and the family. Differential diagnosis at this point of functional neurological disorder versus Guillaine Barr? syndrome. Neurology note 5/21/21 Patient is a 12yo M with hypogammaglobinemia, IBS, and poorly controlled anxiety, presenting with 4 days of lower extremity paresthesias and 1 day of hyperacute onset of lower extremity weakness and perhaps some mild confusion. History notable for covid vaccine three days prior to presentation and anixety surrounding covid and return to school. His general examination is notable for anxious affect with difficult to localize neurologic exam. Exam shows possible bilateral lower extremity weakness of TA and hamstring$gquad/IP that is very challenging to grade due to poor effort and giveway, and decreased sensation in a bilateral stocking/glove distribution to all sensory modalities. MRI w/wo contrast brain and spinal cord normal on admission. LP perfromed in ED also normal. Given negative workup and history of anxiety with recent psychosocial stressors, most likely sudden onset weakness is secondary to a functional neurologic disorder. Plan for discharge to rehab pending PT evaluation.


VAERS ID: 1337234 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Shot was given quickly. Needle was pulled out before full dose was given. Pharmacist gave another shot. Amount of fluid administered in first shot unknown


VAERS ID: 1337347 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort inhaler, Claritin, and Albuterol (as needed)
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin- reaction was severe hives Omnicef- reaction was extreme swelling of lips, hives, and difficulty breathing
Diagnostic Lab Data: None-Email and phone correspondence with pediatrician beginning on May 16. Physical exam on May 20. We were seeking guidance on if we should proceed with the second vaccine in three weeks.
CDC Split Type:

Write-up: My son developed a rash sometime on Sunday, May 16 after receiving his first dose of the Pfizer shot on Saturday, May 15. The rash is located near the injection site, the chest, stomach, legs, and opposite arm of vaccination site. Unfortunately, I do not know the exact time of the onset of the rash. The rash is very itchy and looks like hives. I took pictures and messaged the pediatrician. They were not sure if it was a reaction or contact dermatitis. My son has not changed soaps, laundry detergents, etc. the only new thing he encountered was the vaccine. The rash is still itchy and is improving a little bit every day. I expect him to be perfectly fine, but the rash is still present.


VAERS ID: 1337396 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chest pain
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: none
Current Illness: none
Preexisting Conditions:
Allergies: Milk Protein, Strawberries
Diagnostic Lab Data: was seen in the Urgent Care on May 20, 2021 around 4pm.
CDC Split Type:

Write-up: Several days of chest pain and abdominal pain throughout the rib cage.


VAERS ID: 1337622 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-09
Onset:2021-05-16
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / IM

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

Write-up: PUI was admitted PUI went due to shortness of breath & chest pain


VAERS ID: 1337639 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-05
Onset:2021-05-16
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac, Echocardiogram abnormal, Myocardial infarction, Stent placement
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxyzine 25mg PRN
Current Illness:
Preexisting Conditions: COPD - Chronic Bronchitis, Allergy and Stress Induced Asthma
Allergies: Bee Stings
Diagnostic Lab Data: Heart Cath w/stent 05/16/2021, ECHO 05/17/2021
CDC Split Type:

Write-up: Inferior RCA MI on 05/19/2021


VAERS ID: 1337676 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Headache, Hypertension, Infarction, Magnetic resonance imaging head abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypertension (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 5mg, atovastatin 40mg, chlorthalidone 12.5mg, more$g
Current Illness: patient reports no illnesses
Preexisting Conditions: anxiety, benign essential hypertension, benign prostatic hyperplasia with urinary hesitancy, Coronary artery disease
Allergies: Amoxicillin
Diagnostic Lab Data: 5/18/21- BP 230/126, Pulse 101. MRI shows subacute infarct plus multiple other infarcts.
CDC Split Type:

Write-up: 5/18/21 patient presents to ER with complaint of Headache and Hypertension. The headache began on Sunday and become more intense. Patient felt like his forehead was swollen. Patient is compliant with blood pressure medication. Patient admitted to hospital for hypertensive emergency.


VAERS ID: 1337679 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: 14-year-old patient brought in by Ambulance to our ED last Sunday complaining of numbness and vomiting 3 hours after he received a Pfizer Vaccine . In ED pt given 1L NS, Zofran 4mg IVP, Pt given discharge script for Zofran ODT


VAERS ID: 1337709 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB, Chest pain, Echocardiogram abnormal, Electrocardiogram abnormal, Fibrin D dimer, Intensive care, Malaise, Metabolic function test, Myocarditis, SARS-CoV-2 test negative, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg - one tablet
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Troponins Levels (ng/ml) : May 16: 14559, May 17: 26495, May 18: 14381, May 19: 3814, May 20: 2238, May 21:291 EKG Echo CPK-MB Covid-19 (not detected) CMP D-Dimer
CDC Split Type:

Write-up: A day after receiving the vaccine (on May 15, 2021) patient complaints of not feeling well and he took 1 tablet of Zyrtec 10mg to treat his allergy symptoms. On May 16, he developed chest pain and went to the Emergency Department at the hospital. Patient presented high levels of troponins and was admitted to the Intensive Care Unit (ICU). An EKG and Echocardiogram were performed and patient was diagnosed with Myocarditis. Patient continues to be hospitalized in the unit and he is receiving Lovenox 70mg Q12hrs, Ibuprofen 600mg, Aspirin 81mg daily, Colcrys 0.6mg daily. Chest pain has been resolved and his troponins levels are decreasing.


VAERS ID: 1337781 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, C-reactive protein, Dizziness, Full blood count, Headache, Metabolic function test, Myalgia, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular 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: Acyclovir
Current Illness: None reproted
Preexisting Conditions: None reported
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, CRP, UA - ordered 05/20/2021
CDC Split Type:

Write-up: Myalgias, dizziness, headaches and abdominal pain.


VAERS ID: 1340208 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210517; Test Name: Body temperature; Result Unstructured Data: 100 F
CDC Split Type: USJNJFOC20210532091

Write-up: BODY ACHES; NAUSEA; CHILLS; FEVER; This spontaneous report received from a patient concerned a 49 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1821286, expiry: 23/JUL/2021) dose was not reported, administered on 16-MAY-2021 11:45 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021 21:30, the subject experienced chills. On 16-MAY-2021 21:30, the subject experienced fever. On 17-MAY-2021, the subject experienced body aches. On 17-MAY-2021, the subject experienced nausea. Laboratory data included: Body temperature (NR: not provided) 100 F. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from fever, chills, body aches, and nausea. This report was non-serious.


Result pages: prev   52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=151&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166