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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 152 out of 3,524

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VAERS ID: 1340227 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
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 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye irritation, Fatigue, Feeling hot, Myalgia, Nausea, Pain, Rash, Rash erythematous, Rash pruritic
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LYRICA; NAPROXEN; HYDROCHLOROTHIAZIDE
Current Illness: Abstains from alcohol; Drug allergy; Fibromyalgia; Non-smoker
Preexisting Conditions: Comments: patient had allergic reactions to antidepressants. The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210536574

Write-up: RASHES THAT BURN; RED ITCHY RASH; BURNING EYES; BUMPY RASH ON WHOLE BODY EXCEPT FOR FACE AND VACCINATION SITE; FELT VERY HOT ( LIKE HAD A FEVER); FELT TIRED; FELT A BIT QUEASY; MUSCLE ACHES; ACHES AND PAINS; This spontaneous report received from a patient concerned a 45 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcoholic, non-smoker, fibromyalgia, and allergic reactions to antidepressants, and other pre-existing medical conditions included patient had allergic reactions to antidepressants. the patient had no drug abuse or illicit drug usage. The patient experienced swelling of throat due to allergy when treated with erythromycin, and paroxetine hydrochloride. The patient received covid-19 vaccine (suspension for injection, route of admin not reported and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 15-MAY-2021 for prophylactic vaccination. Concomitant medications included pregabalin for fibromyalgia, hydrochlorothiazide, and naproxen. On 16-MAY-2021, the subject experienced aches and pains. On 16-MAY-2021, the subject experienced felt tired. On 16-MAY-2021, the subject experienced felt a bit queasy. On 16-MAY-2021, the subject experienced muscle aches. On 18-MAY-2021, the subject experienced felt very hot ( like had a fever). On 19-MAY-2021, the subject experienced rashes that burn. On 19-MAY-2021, the subject experienced red itchy rash. On 19-MAY-2021, the subject experienced burning eyes. On 19-MAY-2021, the subject experienced bumpy rash on whole body except for face and vaccination site. The action taken with covid-19 vaccine was not applicable. The patient recovered from aches and pains, felt tired, felt a bit queasy, and muscle aches on 16-MAY-2021, had not recovered from bumpy rash on whole body except for face and vaccination site, red itchy rash, rashes that burn, and burning eyes, and the outcome of felt very hot ( like had a fever) was not reported. This report was non-serious.


VAERS ID: 1340756 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Vaccine left at room temp for over 2 hours after being punctured and administered to Pt. Pt received vaccine about 2&1/2 hours after puncture.


VAERS ID: 1340779 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: Vaccine administered after being punctured and left at room temp over 2 hours. Pt received vaccine about 4&1/4 hours after initial puncture.


VAERS ID: 1340789 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: Vaccine was administered after vial was punctured and left at room temp for more than 2 hours. Pt received vaccine about 4&1/2 hours after initial puncture.


VAERS ID: 1341028 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Chest pain, Electrocardiogram abnormal, Pain, Pericarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nyquil cold and flu every 6 hours prn
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: amoxicillin
Diagnostic Lab Data: EKG- early repolarization indicative of STEMI vs pericarditis Positive Troponin- 0/43
CDC Split Type:

Write-up: Body aches, fever from date of vaccination and then on 5/16, woke up with significant pain on the right side of chest.


VAERS ID: 1341642 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Elevated heart rate at rest and active Fatigue Dizzy Out of breath We had him rest - lasted 3 days


VAERS ID: 1341841 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-06
Onset:2021-05-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Pain, Pharyngeal swelling, Throat irritation, Tongue haemorrhage
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cephalexin 500mg 4x a day; Parotexine 20mg 1x a day; Doxycycline 100mg 1x a day; Metformin 500mg 1x a day; Lisinopril 20mg 1x a day; Almodipine 5mg 1x a day; Glyburide 5 mg 1x a day;
Current Illness: Bacterial operation on clavicle, swollen testicle
Preexisting Conditions:
Allergies: Cats, seasonal allergies, anesthetics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen and sore throat, skin in throat coming out of mouth, bleeding tongue, body aches and pains.


VAERS ID: 1342017 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Respiratory rate increased, Tinnitus, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (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: No known illnesses
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Received her first dose of the Pfizer COVID-19 vaccine on Sunday May 16,2021 at around 2:50 pm. At around 7:20 pm on May 16,2021 she stood up to walk to the bathroom. She began feeling nauseous when she stood up. While she was washing her hands, after going to the bathroom, she began to have difficulty with her vision. She describes white and blue dots obstructing her vision in both eyes. She also began to experience loud tinnitus. She described hearing multiple frequencies. The problem with her vision and the tinnitus continued as she walked through our house to a couch where she laid down. The vision problem and tinnitus continued while she laid on the couch. Her breathing was rapid but she thinks this may have been due to the stress caused by her other symptoms. This episode lasted for several minutes and then the vision problem resolved. The tinnitus continued for several minutes after the vision problem resolved. The intensity of the tinnitus slowly decreased until it finally stopped. The following evening, she experienced tinnitus for a few minutes but it was less intense than it was the previous evening. She very rarely has experienced tinnitus in the past. She has very infrequently experienced brief episodes of orthostatic hypotension when she was dehydrated. When this event occurred, she felt like she was well hydrated. This event lasted much longer and she has never experienced this problem with her vision in the past.


VAERS ID: 1342153 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Aspiration pleural cavity, Computerised tomogram thorax abnormal, Cough, Cytology abnormal, Dyspnoea, Full blood count normal, Hilar lymphadenopathy, Lung opacity, Metabolic function test normal, Pleural effusion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor, gabapentin, irbasartan, ropinirole, lantus, metoprolol, singulair,
Current Illness: none
Preexisting Conditions: past hx of lung cancer 2007, relapse in 2010 tx with radiation- in remission since. dm-2, htn, RLS, tobacco use, neuropathy, hyperlipidemia
Allergies: none
Diagnostic Lab Data: cmp normal cbc normal
CDC Split Type:

Write-up: Pt was vaccinated on 4/12/21 and 5/12/21 and presented to the emergency department on 5/16 with complaint of worsening shortness of breath and cough. According to the patient her shortness of breath started couple of weeks back just after her first covid vaccine but it got worse in the last few days following her second vaccine. imaging revealed a large R pleural effusion. a thoracentesis was done. and she was sent home. she was tested and was covid neg . cytology was significant for reactive mesothelial cells and negative for any malignancy. CT chest showed Vague ground-glass opacities left lung base possibly representing pneumonitis or atelectasis. Confluent right hilar lymphadenopathy and a large effusion was seen she was discharged home to follow up with her pcp on 5/17


VAERS ID: 1342168 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-09
Onset:2021-05-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816077 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: T4
Current Illness: Hypothyroidism
Preexisting Conditions:
Allergies: Gluten intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria


VAERS ID: 1342192 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dehydration, Dizziness, Pallor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Dehydration (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 known
Current Illness: None known
Preexisting Conditions: N/A
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt light headed and was dehydrated and need to sit down. Lost color and we elevated her feet.


VAERS ID: 1342401 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-05-16
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Exposure to allergen, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, Buspirone, Ashlyna, N-acetyl cysteine, Multivitamin, Vitamin D, Benadryl
Current Illness: None
Preexisting Conditions: Depression, Anxiety,
Allergies: Morphine
Diagnostic Lab Data: None. Making PCP appointment tomorrow.
CDC Split Type:

Write-up: Overactive immune response, itching and welps on areas of skin that are coming into contact with grass (no previous allergies), cat and dog hair (no previous allergies), my own hair, dirt/dust (no previous allergies), heat, as well as welping and red streaking rash when rubbing up against clothing. Will develop and subside quickly, and then show up elsewhere. Locations: hands, feet, arms, scalp, trunk, legs (pretty much everywhere)


VAERS ID: 1342440 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Conjunctivitis, Ophthalmological examination
SMQs:, Severe cutaneous adverse reactions (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (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: Sertraline - 100mg Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Visual exam - 5/17/21
CDC Split Type:

Write-up: Got the vaccine, woke up 48 hours later with pink eye that can?t be linked elsewhere. It was a Sunday so I decided to wait until Monday to go to urgent care, and by Monday morning it was in both eyes. Prescribed erythromycin which seemed to clear it up.


VAERS ID: 1343018 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-06
Onset:2021-05-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, losartan
Current Illness: none
Preexisting Conditions: High blood pressure, deficient thyroid, arthritic right knee
Allergies: sensitive to some antihistamines
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: My blood pressure is through the roof, and have had to double my medication. I get very, very winded going up only one flight of stairs, and have to sit and rest for one to two minutes after I go up stairs.


VAERS ID: 1343026 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-02-25
Onset:2021-05-16
   Days after vaccination:80
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction, Stent placement
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lipitor
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: 5/16/21 and 5/17/21
CDC Split Type:

Write-up: heart attack; stent put in; awaiting further treatment


VAERS ID: 1343058 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-15
Onset:2021-05-16
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose fluctuation, Seizure
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications: Vitamins - B, C, D
Current Illness: Type one Diabetes
Preexisting Conditions: I?ve had Type one diabetes for 6 years.
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: High and low swings to my blood sugar levels. Low blood sugars to the point of seizure requiring emergency attention .


VAERS ID: 1343066 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-30
Onset:2021-05-16
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood glucose normal, Brain natriuretic peptide normal, C-reactive protein decreased, Fibrin D dimer, Haemoglobin normal, Myocarditis, Platelet count normal, Red blood cell sedimentation rate normal, Respiratory syncytial virus test negative, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative, Serum ferritin normal, Troponin, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: doxycycline, retin A
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: initial troponin 9, follow up troponin 1 =1 , cpk 128 , d dimer 0.19, bnp 25, feritin 35, crp x 2 was <0.4, esr =0, glu 106, ALT 108, AST 45, WBC 4.3 hgb 15.6, plts 217 , Covid 19 AB for spike protein was +, Covid 19 PCR neg. initial resp panel PCR neg. workup ongoing with not collected yet hep B and Hep A antibodies, peds resp panel, CMV and EBV antibody panel. HSV igm and igg antibodies, Parvo B19 Igg and igm and others ordered by peds cardiologists
CDC Split Type:

Write-up: myopericarditis


VAERS ID: 1343146 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Injection site pain, Nausea, Pain in extremity, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Tiredness, headache, injection site pain, upper arm pain, nausea - started within hours of first injection and lasted a couple of days. Around 11:45pm the same day, I started feeling like I might pass out. Vertigo when I stood. Soon after vomited. These later symptoms did not last very long.


VAERS ID: 1343196 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-05
Onset:2021-05-16
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, C-reactive protein, Differential white blood cell count, Full blood count, Immunology test, Metabolic function test, Red blood cell sedimentation rate
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 10 mg daily Modafinil 200 mg daily Cranberry pill daily
Current Illness: none
Preexisting Conditions: depression sleep disorder
Allergies: No allergies but sensitivity to codeine
Diagnostic Lab Data: Tests run: CBC Differential C Reactive Protein Comprehensive Metabolic Panel Lyme AB with reflex to western blot Tick Borne Pathogen Panel ESRA Erythrocyte Sedimentation Rate
CDC Split Type:

Write-up: I had Bells Palsy in 1997 and again in 2000. I don''t remember if the same side was affected. I started to develop symptoms of Bells Palsy again on Sunday May 16 in the evening. It got progressively worse so I went to my primary care provider on Wednesday, May 19, 2021. PA-C ran a variety of tests and prescribed prednisone. She also made a referral to a neurologist. I have not gotten an appointment set for the neurologist. My symptoms have continued to worsen and I will contact my primary care provider later today about that. She ran Lyme''s disease and other tick borne illness tests. We live in a high Lyme disease area. I had a large tick on me (not sure if was actually attached) a few days prior.


VAERS ID: 1343276 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Vision blurred, Visual impairment, Vitreous detachment, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BHRT (bioidentical hormone replacement therapy) Pellets - SubQ Q 4 mo: *estradiol 10 mg *testosterone 100 mg ~progesterone 200 mg PO QHS BHRT (replacement) ~melatonin 3 mg PO QHS (GERD and sleep) ~Calcium 1000 mg PO BID (replacement) ~gluc
Current Illness: Non
Preexisting Conditions: Seasonal allergies
Allergies: PCN (angioedema), ZOFRAN (akathisia) , ULTRAM (hypotension), echinacea (hives) Watermelon (throat itchy & edema)
Diagnostic Lab Data: 5/18/21 optometry evaluation and they dilated and did slit lamp test and regular eye exam. Dr 5/20/21 Ophthalmology appt Dr Did same eval as Dr but pressure tested and evaluation lengthier Summary: posterior vitreous detachment and left eye liquefaction. Both eyes have floater with right eye very significant visual disturbance. No safe treatment for now wait and see if retina affected
CDC Split Type:

Write-up: Blurred vision suddenly onset. Right eye diagnosed with posterior vitreous detachment and left eye liquefaction. Both eyes have floater with right eye very significant visual disturbance. No safe treatment (surgical) so it is wait and see to determine if retinal will be affected


VAERS ID: 1343301 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 IM/LD / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient has sx and EKG consistent with pericarditis


VAERS ID: 1343308 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Erythema, Nasal congestion, Pruritus, Seasonal allergy
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red skin on the arm that took the vaccine. Feel Itchy on the same arm. My pollen alergy symptom gets worse - noses are completely blocked and hard to breathe.


VAERS ID: 1343349 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Multi-vitamin, Tylenol when needed for headaches
Current Illness: Gallstones
Preexisting Conditions: Migraines, psoriasis
Allergies: Food: MSG, Kiwi, pineapple, tomato, latex
Diagnostic Lab Data: Have appointment tomorrow with cardiologist.
CDC Split Type:

Write-up: Chest pain


VAERS ID: 1343398 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-05-16
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805026 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VBT Positive COVID-19 test 05/22/2021. Symptomatic- Shortness of breath, Transferred to another facility for further workup.


VAERS ID: 1343528 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-05-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: I am in menopause and haven''t had a period in 9 months. I recieved an intense, heavy, and extremely painful period on May 16th. I have not had such a painful period since my 20''s. I needed to take pain medication and lie on an ice pack. The period lasted a week.


VAERS ID: 1343689 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac monitoring, Chest pain, Computerised tomogram, Echocardiogram, Headache, Heart rate increased, Interchange of vaccine products, Lethargy, Nausea, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Medication errors (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: X-ray, bloodwork, cat scan, echo on her heart, heart monitor.
CDC Split Type:

Write-up: My child was accidentally given moderna instead of Pfizer even though she is under 18. After the mistake was made she began to have nausea and vomiting, headache and lethargic. After 6 days she began to have chest pain, rapid heartbeat and the nausea continued. We have ended up in the hospital admitted because of the tachycardia.


VAERS ID: 1343720 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium


VAERS ID: 1343751 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood gases, Blood lactic acid, Computerised tomogram head, Full blood count, Hyperhidrosis, Loss of consciousness, Metabolic function test, Seizure, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: N/A
Allergies: Fluoxetine
Diagnostic Lab Data: 05/16 = Head CT, Lactic Acid, CBC, CMP, Troponin, Venous Blood Gas. 05/21 = CMP and CBC
CDC Split Type:

Write-up: Diaphoresis started same day following COVID vaccine 05-15-2021. On 05-16-2021, patient lost consciousness and had a seizure. Taken to ED for evaluation.


VAERS ID: 1343863 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-08
Onset:2021-05-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hypersomnia, Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Movement disorder, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Gluten and dairy. Also severe yearly allergies and allergy induced asthma to some allergens.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Typical tiny bit sore arm immediately after injection that was relieved by Tylenol. whole body aches the next 2-3 days that also was relieved by Tylenol. All symptoms subsided by after the initial few days and I was back to normal. I am an athlete and was able to run and do my normal highly active routine after injection until 10 days later when I suddenly woke at 2:30 am unable to barely move. My whole body felt numb and super weak. I was severely dizzy and lightheaded so I went back to bed until 6:30 am and the symptoms persisted so much and scared my husband enough to stay home from work to keep an eye on me. I slept so much that day and severely lightheaded dizzy and body numbness even on 1,000mg Tylenol. I am a highly sensitive person and a red head. I waited this long to get the shot because I know myself so well and wanted to see everyone else?s reaction. My husband got the Johnson and Johnson a week after mine and he was fine. No reaction. I called the cdc immediately after my reaction, I also had an odd swollen arm at injection site that wasn?t there for 10 days that appeared out of no where and it was super tender and painful and hot and itchy. The CDC said to call my doctor who said they haven?t seen or heard of this reaction yet and I should go to the ER if needed. We don?t have health insurance and I wasn?t having troubles breathing and felt they couldn?t do anything for me so I decided to stay home and rest. I am 2 1/2 weeks out now and still dizzy and lightheaded but no swollen arm, that lasted day 10-12. I am concerned getting the second dose as I hear it way worse.


VAERS ID: 1343893 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-02
Onset:2021-05-16
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8730 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Ear pain, Ear, nose and throat examination, Herpes zoster, Stress
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: benazepril, prilosec, vitamin d
Current Illness: none
Preexisting Conditions: blood pressure (treated)
Allergies: none known
Diagnostic Lab Data: evening of 5/19/2021, clinical review of my ear (with scope).
CDC Split Type:

Write-up: I was diagnosed with shingles (possibly the rare Ramsey Hunt syndrome form) on 5/19/2021 I had a great immune system (never got Covid) and although had some recent work stress, nothing that I hadn''t done before without incident. No other trigger factors known. The pain started as I would I thought was an ear infection. Blisters were found on my left inner earlobe and acyclovir was started.


VAERS ID: 1343923 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-05-16
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Patient had his first dose of Pfizer COVID-19 vaccine on 4/8/2021 and his second dose on 5/13/2021. He developed Shingles on 5/16/2021.


VAERS ID: 1343997 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Malaise, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: After first covid shot (L arm), got a little bit of chest pain, went away 9 days after, got a large whelp on L deltoid, eventually went away Had 2nd shot 5/12/2021 (R arm), next day had some malaise "completely what I expected" The Sunday after, had pain on R FA and veins were larger/darker than normal Some ankle pain Repeat on chest pain again Would be worse after deep breathe or laying down, other times no apparent rhyme or reason


VAERS ID: 1344126 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-12
Onset:2021-05-16
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Fatigue
SMQs:, Retroperitoneal fibrosis (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: Calcium & D3 600mg, BID; Multivitamin; 81 mg aspirin; escitalopram 10mg; Losartan HCTZ 100-25mg ;omeprazole 20mg, Tamsulosin 0.4mg, Semi Staten 20mg, Ipratropium .03% spray QID
Current Illness: none
Preexisting Conditions: Hypertension, anxiety
Allergies: huckleberries
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: On 2/16/2021 in the morning I found that I was fatigue for about 4 - 5 days and at 85 it knocked me ion a ditch., with fatigue and a bad back it exploded a bit. I felt a little winded and did deep breathing exercises. I did not see a doctor, as I expected some symptoms. I spoke to my doctor about my back and I went to see a chiropractor and he gave me some adjustments and I felt real good after that


VAERS ID: 1344214 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 UN / IM

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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: allergic rhinitis, allergy to nut
Allergies: Sulfa drugs, Peanut, Chickpeas
Diagnostic Lab Data: History and Physical in office
CDC Split Type:

Write-up: nonspecific small raised red bumps on back that spread to pts trunk, rash was pruritic in nature as well


VAERS ID: 1344267 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Unknown  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Chest pain, Echocardiogram, Ejection fraction normal, Magnetic resonance imaging heart, 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? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: COVID Pfizer 1st- mild chest pain
Other Medications: yes- Depo Testosterone SQ weekly (transitioning from female to male)
Current Illness: none
Preexisting Conditions: none
Allergies: Amoxicillin (hives)
Diagnostic Lab Data: Cardiac MRI (5/19/2021): late gadolinium enhancement involving the basal inferior and inferolateral segments is consistent with myocarditis Echo (5/17/2021): EF 65%, normal biventricular size and function. Normal valve function troponin (5/17/2021 at 4:54pm): peak 4.08
CDC Split Type:

Write-up: Patient developed severe 8/10 chest pain 2 days after the 2nd COVID Pfizer vaccine. Troponin elevated 4. Cardiac MRI was consistent with myocarditis. Echo is normal.


VAERS ID: 1344304 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, 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), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: ONE MINUTE AFTER ADMINISTERING PAITENT HIS FIRST DOSE OF PFIZER COVID-19 VACCINE, THE PATIENT FELL TO THE FLOOR. PATIENT REPORTS , " HE FELL ASLEEP", BUT CLAIMED HE WAS OKAY. THE PATIENT WAS ESCORTED TO THE WAITING AREA AND INSTRUCTED TO WAIT FOR 15-30 MINUTES FOR OBSERVATION. SOON AFTER SITTING IN THE WAITING AREA,THE PHARMACIST WHO ADMINISTERED THE VACCINE REPORTS THE PATIENT PASSED OUT FOR THE SECOND TIME. PER PHARMACIST REPORT, THE PATIENT WAS UNRESPONSIVE AND SEEMED NOT TO BE BREATHING. EPINEPHRINE 0.3MG DOSE WAS GIVEN INTRAMUSCULARLY AND EMERGENCY WAS CALLED AT 11:56AM. THE PATIENT REVIVED AND REPORTED HE "FELT FINE". EMERGENCY HEALTHCARE AND AMBULANCE ARRIVED AT 12:06PM AND TOOK OVER CARE OF THE PATIENT.


VAERS ID: 1344642 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 RA / IM

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

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

Write-up: PATIENT BROKE OUT IN RASH ONE DAY AFTER HIS SECOND SHOT. HIS TRUNK, ARMS AND LEGS ARE COVERED IN HIVES.


VAERS ID: 1344851 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

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

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

Write-up: Person complained of light headiness, dizziness and blurred vision after receiving the first dose of the Pfizer vaccine. EMS was called and treated the individual on scene and was released on their own.


VAERS ID: 1344893 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Unevaluable event
SMQs:

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

Write-up: vaccine administered to a patient with a signed consent, mother was not aware the consent was for a vaccine and wanted a test instead.


VAERS ID: 1344908 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-27
Onset:2021-05-16
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arrhythmia, Atrial fibrillation, Blood magnesium, Blood thyroid stimulating hormone, Electrocardiogram, Full blood count, Heart rate increased, Metabolic function test
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MMR vaccine severe reaction at approx 1 year old
Other Medications: Montelukast SOD 10mg; Cetirizine Hydrochloride 10mg; Fluticasone Propionate Nasal Spray 50mcg; Melatonin 2mg supplement; Elderberry supplement; Albuterol Sulfate HFA Inhalation Aerosol; Pseudoephedrine Hcl 30mg.
Current Illness:
Preexisting Conditions: Asthma
Allergies: Gluten allergy, MMR vaccine adverse reaction.
Diagnostic Lab Data: EKG 12 Lead, basic metabolic panel (non-fasting), blue tube hold, differential automated, hemogram, magnesium, TSH cascade on 5/16.
CDC Split Type:

Write-up: Developed high heart rate $g150bpm with irregular rhythm on 5/16 around 12:00pm, Sought care at Emergency Department, diagnosed with paroxysmal atrial fibrillation, first known occurrence. Treated with metoprolol and metoprolol tartrate, and returned to normal rate and sinus rhythm by 3:00pm.


VAERS ID: 1345420 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-05-16
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Headache, Heart rate increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamins Vitamin C Lecithin Whitefish supplement
Current Illness: None.
Preexisting Conditions: Diagnosed with high blood pressure in February 2020, when also diagnosed with a virus. I tested negative for Covid-19 at the time. Daily lecithin supplement has helped to keep blood pressure under control.
Allergies: Intollerant to Lactose and Penecillin Allergic to Cats, Dogs, Wool, Poison Ivy, Poison Oak
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Heart rate seemed much higher than normal. I felt pressure on my chest, especially on the upper right side of my chest, all day. Breathing was also more difficult than normal. These symptoms lasted all day and were very concerning, but they seemed to have subsided by the next day (Monday May 17th), so I did not seek medical attention. On Monday May 17th, I had a headache from the time I awoke and for hours thereafter. But that went away shortly after I took an aspirin. This is my third reaction event to this vaccine. The first was a headache 3 days after the vaccine. The second was severe vomiting 3.5 weeks after the vaccine. This increased heart rate, chest pressure, difficulty breathing, and headache is the third event.


VAERS ID: 1345751 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenopia, Gingival swelling, Headache, Malaise, Oral mucosal blistering, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies. No drug abuse/ illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210540368

Write-up: BLISTERS IN THE MOUTH; SWELLING IN GUMS; MALAISE; HEADACHE; LOWGRADE FEVER; EYE STRAIN; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included abstains from alcohol, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies. no drug abuse/ illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 15-MAY-2021 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 eye strain. On 16-MAY-2021, the subject experienced malaise. On 16-MAY-2021, the subject experienced headache. On 16-MAY-2021, the subject experienced low grade fever. On 19-MAY-2021, the subject experienced blisters in the mouth. On 19-MAY-2021, the subject experienced swelling in gums. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, eye strain, malaise, low grade fever, blisters in the mouth, and swelling in gums. This report was non-serious.


VAERS ID: 1345758 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Glossodynia
SMQs:, 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: GABAPENTIN; METHADONE
Current Illness: Abstains from alcohol; Smoker (five cigarettes a day)
Preexisting Conditions: Medical History/Concurrent Conditions: Hip replacement (Patient is taking Methadone and Gabapentin for the post surgery pain as and when required.); Comments: The patient had no known allergies, and drug abuse or illicit use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210541047

Write-up: TONGUE HURTS TO CHEW AND EAT; This spontaneous report received from a patient concerned a 72 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included hip replacement surgery on right side, and concurrent conditions included smoker, and non alcoholic, and other pre-existing medical conditions included the patient had no known allergies, and drug abuse or illicit use. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, and batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. Concomitant medications included gabapentin for post hip replacement pain, and methadone for post hip replacement pain. On 16-MAY-2021, the subject experienced tongue hurts to chew and eat. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from tongue hurts to chew and eat. This report was non-serious.


VAERS ID: 1345782 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Rhode Island  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Expired product 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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544466

Write-up: ADMINISTERED VACCINE AFTER EXPIRED AT ROOM TEMPERATURE; This spontaneous report received from a health care professional concerned 3 male patients. 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: 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 administered vaccine after expired at room temperature. The action taken with covid-19 vaccine was not applicable. The outcome of administered vaccine after expired at room temperature was not reported. This report was non-serious. This case, from the same reporter is linked to 20210545147.


VAERS ID: 1345938 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Rhode Island  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210544367

Write-up: VACCINE BEING AT ROOM TEMPERATURE FOR OVER 2 HOURS AFTER FIRST PUNCTURE; ADMINISTRATION OF EXPIRED VACCINE; This spontaneous report received from a health care professional 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: 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 administration of expired vaccine. On an unspecified date, the subject experienced vaccine being at room temperature for over 2 hours after first puncture. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of expired vaccine and vaccine being at room temperature for over 2 hours after first puncture was not reported. This report was non-serious.


VAERS ID: 1346358 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Heart rate increased, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: patient complained of headache, cold sweats, and elevated and heart rate


VAERS ID: 1346370 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001CHA / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse reaction, Insomnia
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: norvac 10mg, Percocet 10, baclofen, skelaxin 800, vitamins d3, centrum vitamin, flowmax, Paxil, Xanax
Current Illness: none
Preexisting Conditions: high blood pressure, chronic pain, panic attack disorder, ptsd, bipolar 1
Allergies: codeine, Cymbalta, latex, buspar, amatryptlin
Diagnostic Lab Data: contact Dr. she knows all the test preformed
CDC Split Type:

Write-up: can not sleep, when adverts reaction happened up to today I have had 26.5 hrs of sleep


VAERS ID: 1346460 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA DON''T KNOW / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Impaired driving ability, Influenza like illness, Pain, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Obesity
Allergies: Penicillin, Kiwi
Diagnostic Lab Data: N/A, recently changed jobs so I don''t have health coverage. Thanks to healthcare being the most overpriced ripoff in the country I can''t get any tests right now.
CDC Split Type:

Write-up: The day after, I had the normal fever, flu-like symptoms, and my left ankle/right knee ached pretty badly. Starting Monday 05/17, my right knee was unbearably painful. If I moved it at all away from a ~30 degree angle, my entire leg lit up with the worst pain I''ve ever felt. Not as bad as if I put pressure on it though, that was even worse. I couldn''t walk, couldn''t drive, could barely get out of bed for days. I got through that with over the counter pain killers and Biofreezing the knee like crazy. Starting Friday 05/21 I believe, my knee pain suddenly went away only to be replaced with pain in my left foot. It''s not nearly as bad as the knee was, but the entire left side is in constant pain made worse with pressure. I can drive now that my right leg works fine, but still can''t walk without some form of assistance. I was reporting all of this in the V-safe health checker, but it apparently doesn''t care outside of 7 days. Tempted to put "permanent damage" for Item 21 as the result, but I''m hoping this goes away soon.


VAERS ID: 1346479 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Delayed allergic reaction. Redness and swelling and itching at injection sight


VAERS ID: 1346518 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-05-16
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 RA / IM

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

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

Write-up: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.


VAERS ID: 1346546 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Patient Too Young for Vaccine Administered


VAERS ID: 1346672 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-25
Onset:2021-05-16
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain upper, Lipase increased
SMQs:, Acute pancreatitis (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Probiotic
Current Illness:
Preexisting Conditions:
Allergies: n/a
Diagnostic Lab Data: Lipase: 1,495 (on May 21) Lipas: 583 (on May 24)
CDC Split Type:

Write-up: My Lipase levels went up to 1,495 on Friday (May 21). I was suffering from sharp stomach pains. I''ve since reduced my food intake and drank a lot of liquids. As of Monday (May 24) my Lipase levels went down to 583.


VAERS ID: 1346821 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Mouth swelling, Swelling, Swelling face, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cyanocobalamin 100 MCG tablet Take 100 mcg by mouth daily. ? methylpheniDATE (RITALIN) 10 MG tablet Take 10 mg by mouth. ? glatiramer (COPAXONE) 40 MG/ML prefilled syringe for injection Inject 1 mL into the sk
Current Illness: none
Preexisting Conditions: History of MS
Allergies: bee sting
Diagnostic Lab Data:
CDC Split Type:

Write-up: hives and swelling (whole body including mouth, tongue, face)


VAERS ID: 1346850 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-14
Onset:2021-05-16
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Tested positive for Covid-19 with symptoms


VAERS ID: 1346991 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-04
Onset:2021-05-16
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident
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)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hormone, Vitamin D, Celebrex
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Azithromycin, hydrocodone, morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient suffered a stroke 12 days post vaccination.


VAERS ID: 1347047 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Brain oedema, Cerebral haemorrhage, Cerebrospinal fluid drainage, Cerebrospinal fluid retention, Confusional state, Haemorrhagic stroke, Motor dysfunction
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient suffered a hemorrhagic stroke (brain bleed) in the right deep brain structures with significant brain swelling and build up of cerebral spinal fluid requiring drainage. Patient''s confusion and motor function have been improving and the bleeding has not worsened.


VAERS ID: 1347101 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram, Hypoaesthesia, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: Ekg, Ct scan, Full Blood work
CDC Split Type:

Write-up: Shortness of breathe, chest pain, numbness which resulted in pulmonary embolism


VAERS ID: 1347201 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discharge, Dizziness, Dyspnoea, Fatigue, Headache, Intermenstrual bleeding, Migraine, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (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: COVID-19 VACCINE ON 4/16/2021
Other Medications: N/A
Current Illness: None
Preexisting Conditions: MS - clinical isolated syndrome
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face got swollen and I continue to experience sudden swelling of face, discharge/clotting when not on menstrual cycle, dizzy spells, fatigue, headaches/migraines ongoing, shortness of breathe.


VAERS ID: 1347214 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Rash on chest 3-4 days after vaccine on 5/13. Patient complains of itching. Rash has persisted 12 days, ongoing, but healing.


VAERS ID: 1347471 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: red, itchy welt rash on arm and front & back of the torso


VAERS ID: 1347515 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-27
Onset:2021-05-16
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Beta hcg (x3) No ultrasound
CDC Split Type:

Write-up: I believe I was very early on in my pregnancy (as in, implantation or first week after conception) when I received the second dose of the vaccine. EDD was January 9th, 2022. I had brown spotting every day for the duration of my pregnancy, obviously concerning and something I paid attention to (though not altogether unusual in early pregnancy). I ended up miscarrying naturally at 6 weeks. I am strongly in favor and appreciative of this vaccine and would be surprised if there was a direct link, but I do know there is a growing conversation about its impact on women''s menstrual cycles. I wanted to submit my experience just in case it was in fact a trend for other trying-to-conceive or early pregnant females.


VAERS ID: 1347646 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Headache, Heart rate decreased
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Pt c/o dizziness, headache, difficulty breathing, OxSat 99%, HR 107-109, dropped 75-79. Fire department took over care


VAERS ID: 1347662 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dental examination abnormal, Ear pain, Ear swelling, Endodontic procedure, Lymph node pain, Lymphadenopathy, Nerve injury, Osteitis, Pain in jaw, Pulpitis dental, Tinnitus, Toothache
SMQs:, Angioedema (broad), Accidents and injuries (narrow), Hearing impairment (narrow), Osteonecrosis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, multivitamin
Current Illness:
Preexisting Conditions: occasional migraine with aura
Allergies: none
Diagnostic Lab Data: Urgent care ear exam revealed swelling/inflammation. Endodontist exam revealed nerve damage in tooth and severe inflammation.
CDC Split Type:

Write-up: ringing in ears, pain in left inner ear and left jaw. Swelling in both ears confirmed at urgent care and began course of decongestants, Allegra, flonase. Pain and inflammation progressed in left jaw and localized to molar tooth (#18). Upon dental visit, it was determined there was extreme inflammation surrounding tooth #18 and underwent emergency root canal on 5/21/21. Persistent inflammation post-root canal with 3200mg Ibuprofen daily, pain and swelling in left lymph node under chin.


VAERS ID: 1348036 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Bursitis, Chills, Diarrhoea, Fatigue, Headache, Heart rate increased, Malaise, Nausea, Pain, Pyrexia, Toothache
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles shots (Shingrix ?), 09/2020 and 11/2020. Dose #1 made me feel tired about 6 hours in. Dose #2: 15 hours in, I awoke
Other Medications: Levothyroxine, Coq10, VitD-3, B-12, Colace, Cranberry, Digestive Enzymes, Peppermint (with ginger and fennel), Restasis
Current Illness: None
Preexisting Conditions: IBS-C, and sometimes D.
Allergies: Sulfa drugs and Wellbutrin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At 10 hours in, I had body aches, fatigue, chills, elevated heart rate, a very bad headache, joint aches (only in area I currently having, or have had, issues with... my back (not current), my knees, and my ischial bursitis area (current)), and my teeth hurt! At 18 hours in, I awoke to a splitting headache, nausea, slight fever. I later had diarrhea. I felt crummy all day. It took about 30 hours in to feel back-to-normal. I took both Advil and Tylenol to alleviate my symptoms, and stayed in bed most of the day, with light covers, so as not to elevate the fever.


VAERS ID: 1348040 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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: Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called today on 5/25/21 and said she is feeling tired and unable to walk


VAERS ID: 1348055 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (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: Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s wife states patient having problem with his knees


VAERS ID: 1348074 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Condition aggravated, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Pt reported that she wanted to try the J&J vaccine because it contained Polysorbate instead of PEG
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported bloating that kept her up the night of the vaccination. The bloating had not resolved 9 days post vaccination. She has experienced this type of bloating in the past but not to this extent. She is seeking further information from the hospital to determine if they believe the polysorbate from the vaccination is the cause or an alternate cause.


VAERS ID: 1348333 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Blood glucose increased, Contusion, Fatigue, Gait disturbance, Headache, Insomnia, Pain in extremity, Somnolence, Vision blurred
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (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: Lantus, Apidra, metformin, trazodone, testosterone, gabapentin, tramadol, duloxetine
Current Illness:
Preexisting Conditions: Diabetes
Allergies: Sulfa, Penicillin
Diagnostic Lab Data: Blood sugar elevated
CDC Split Type:

Write-up: Patient came to the pharmacy 5/25/21 at 1:20pm to alert us that she had reactions that started 4-5 days after getting her first dose of Pfizer. She reports that her blood sugar increased $g400 and $g600 4-5 days after the dose. The patient spoke with her Dr and the Dr told her to increase her Lantus and Apidra. The patient also reports getting pain in her right leg that caused trouble walking, bruising on hip that both started 4-5 days after the dose. Patient reports headache, insomnia due to pain and increased blood sugar. Patient reports now sleeping a lot because of exhaustion and having to check her blood sugar every 2 hours and drink lots of water as directed by her Dr. Patient says she finally got her blood sugar down below 120 on Friday 5/21/21. Patient reports she lost some vision and had blurry vision in her left eye that started 5-6 days after the dose. Patient says her A1C was 5.6 before the Pfizer dose and after the dose her blood sugar was uncontrolled. Patient says her Dr told her to go to the ER if her symptoms continued. Patient also spoke with someone at the CDC and they told her they would follow up with her regarding her symptoms and they will let her know if she should get her second dose.


VAERS ID: 1348340 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-24
Onset:2021-05-16
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Blood test normal, Carditis, Chest pain, Computerised tomogram normal, Echocardiogram normal, Electrocardiogram normal, Troponin increased, X-ray normal
SMQs:, Myocardial infarction (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro and oral birth control
Current Illness: No
Preexisting Conditions: No
Allergies: Tylenol
Diagnostic Lab Data: All Sunday, 5/16/2021: CT, Echo, xray, and EKG - clear All Sunday, 5/16/2021: Blood work clear, Troponin blood work 1.87 All Monday, 5/17/2021: Angiogram - clear
CDC Split Type:

Write-up: Cardiac inflammation, chest pain for about 3 hours


VAERS ID: 1348491 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-07
Onset:2021-05-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site rash, 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? 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: Developed a bad rash on left arm about one inch lower than injection site. Rash was non itchy, but slightly painful to the touch. Identical to ?Covid arm?


VAERS ID: 1348620 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine at outside institution so lot number is not available. PCP is also at outside organization so limited information available. Below is information from Emergency room visit. 12 y.o. male who presented to the emergency department for Rash that the patient noticed around noon today while at his friends house after a sleep over. Patient received his first COVID vaccine yesterday at outside retail pharmacy at 1030am. Mother states it was Pfizer. Patient states "noticed the rash last night when they went to and has no other symptoms such as fever, chills, runny nose, head congestion, difficulty breathing, swelling of the lips, tongue, mouth, throat. Denies nausea, vomiting, abdominal pain. Patient states that is very itchy and they have been spreading and more been popping up since he noticed them. He denies any history of eczema, sensitive skin, food allergies. Mother does state that 2 years ago, the patient had a severe to the influenza vaccine in which she describes it as 8 inch area of redness, hot to touch, swelling around the injection site. No anaphylaxis reaction at that time either. Discharged with oral decadron and benadryl. Follow-up with PCP next day.


VAERS ID: 1348639 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-28
Onset:2021-05-16
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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

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

Write-up: Took my second dose of moderna on 3/28/2021 and suffering shingles now


VAERS ID: 1349078 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Fatigue, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Myasthenia gravis; Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210546942

Write-up: TIGHTNESS OF CHEST; SHORTNESS OF BREATH; VOMITING; COUGH; NAUSEA; FATIGUE; This spontaneous report received from a patient concerned a 75 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included myasthenia gravis, and penicillin allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 043A21A expiry: 21-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 tightness of chest. On 16-MAY-2021, the subject experienced shortness of breath. On 16-MAY-2021, the subject experienced vomiting. On 16-MAY-2021, the subject experienced cough. On 16-MAY-2021, the subject experienced nausea. On 16-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from tightness of chest, shortness of breath, cough, nausea, fatigue, and vomiting. This report was non-serious.


VAERS ID: 1349673 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bone pain, Dizziness, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021555644

Write-up: he had the second dose of Pfizer''s covid vaccine and it gave him a headache, body aches and bone pain that all went away within two days.; he had the second dose of Pfizer''s covid vaccine and it gave him a headache, body aches and bone pain that all went away within two days.; covid vaccine and it gave him a headache, body aches and bone pain that all went away within two days.; On 16May, he began to feel very dizzy and in the early morning he rose from dizziness; This is a spontaneous report from a contactable consumer. A 43-year-old male consumer (patient) reported for himself that, received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), dose 2 via an unspecified route of administration on an unspecified date as 2nd dose, single for COVID-19 immunization. The patient''s medical and concomitant medication history were not reported. Historical vaccination included 1st dose BNT162B2 (COMIRANTY) for COVID-19 immunization. It was reported that, on an unknown date, the patient had the second dose of Pfizer''s covid vaccine and it gave him a headache, body aches and bone pain that all went away within two days. On 16May2021, patient began to feel very dizzy and in the early morning rose from dizziness. The patient wanted to know what he can do to treat the dizziness or if he should wait for it to go away. Follow-up attempts not completed. No further information expected.


VAERS ID: 1350520 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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: Allegra Flonase nasal spray
Current Illness: None
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain, runny nose, fever, muscle aches, headache. Second dose symptoms were less severe than first dose. He had a severe headache after the second dose but not the first. All symptoms resolved within 24 hours, however first dose symptoms lasted longer than the first dose. He had a more severe reaction and longer duration to the first dose than he did the second dose.


VAERS ID: 1350629 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Full blood count, Metabolic function test
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Severe dizziness


VAERS ID: 1350632 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-04
Onset:2021-05-16
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood iron normal, Blood thyroid stimulating hormone normal, Disorientation, Disturbance in attention, Full blood count normal, Glycosylated haemoglobin normal, Headache, Hypoaesthesia, Hypoaesthesia oral, Iron binding capacity total normal, Memory impairment, Metabolic function test, Paraesthesia, Serum ferritin normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra D
Current Illness:
Preexisting Conditions:
Allergies: Cashews, pistachios
Diagnostic Lab Data: CBC w/ diff, CMP, ferritin, Hemoglobin A1C, iron and TIBC, and TSH drawn on 5/21/21
CDC Split Type:

Write-up: Patient was seen on 5/19/21 complaining of numbness and tingling in both of his hands, face, and mouth, and stated that it started three days prior. He was not having any fevers and there was no known injuries. Dr. ordered a CBC w/ diff, CMP, ferritin, Hemoglobin A1C, iron and TIBC, and TSH, all of which came back normal. Patients'' mom called hospital on 5/22/21 stating that he had an incident during a game on 5/21/21 where he became disoriented and felt like he became less alert. He went to the Emergency Department on 5/23/21 with numbness and tingling that was present for one week and a headache for one day. After evaluation it was decided that neurology would see him outpatient. Neurology saw him on 5/25/21 and he said he has had difficulty concentrating and maintaining attention. He has also had memory issues. They ordered an MRI and EEG which have not occurred yet.


VAERS ID: 1350829 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Depressed mood, Depressive symptom, Fatigue, Social avoidant behaviour, Tearfulness
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 40 mg PO daily Adderall XR 5 mg PO BID (morning and noon) Drospirenone-Ethynil Estradiol 3-0.02 mg, 1 tablet PO daily Melatonin 3 mg PO qhs
Current Illness: None.
Preexisting Conditions: Generalized Anxiety Disorder ADHD
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after administration of vaccine, the patient experienced 5 days of depressive symptoms including low mood, fatigue, tearfulness, and social isolation/school avoidance. After 5 days, the patient returned to her previous baseline. No other clear stressors/triggers could be identified.


VAERS ID: 1350881 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 020B21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Left ventricular dysfunction, Mitral valve incompetence, Myocarditis, Pulmonary hypertension, Tricuspid valve incompetence, Troponin increased, Ventricular hypokinesia
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Flu vaccine-reported pericarditis
Other Medications:
Current Illness:
Preexisting Conditions: ADHD
Allergies: codeine
Diagnostic Lab Data: Echocardiogram May 17th revealed decreased LV function with ejection fraction of 30-35%. Global hypokinesis. Mild MR. Moderate TR. Mild pulmonary hypertension with right ventricular systolic pressure 38 mm Hg. No pericardial effusion. MRI May 17th consistent with myocarditis
CDC Split Type:

Write-up: Patient presented with chest pain. Troponins were elevated. Echocardiogram revealed decreased left ventricular systolic function with an ejection fraction of 30-35%, MRI was consistent with myocarditis.


VAERS ID: 1351076 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Chest pain, Cough, Illness, Nausea, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: azithromycin (ZITHROMAX) 250 mg tablet buPROPion SR (WELLBUTRIN SR) 150 mg 12 hr tablet clonazePAM (KlonoPIN) 1 mg tablet fenofibrate micronized (LOFIBRA) 134 mg capsule fexofenadine (ALLEGRA) 180 mg tablet isosorbide mononitrate (IMDUR) 30
Current Illness:
Preexisting Conditions: Respiratory SOB (shortness of breath) Circulatory Coronary artery disease due to calcified coronary lesion Hypertension Digestive Gastroparesis Gastroesophageal reflux disease Musculoskeletal Full thickness rotator cuff tear Closed displaced fracture of distal phalanx of right great toe, initial encounter Abrasion, right knee, initial encounter Contusion of right knee, initial encounter Endocrine/Metabolic Hypercholesteremia Hyperlipidemia Other Anxiety Depression
Allergies: NKA
Diagnostic Lab Data: 05/18/21 1716 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/18/21 1313 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical XR CHEST 2 VW. IMPRESSION: No acute process radiographically. END OF IMPRESSION: INDICATION: Acute shortness of breath. COVID-19 TECHNIQUE: PA and lateral projections of the chest COMPARISON: 3/13/2021 FINDINGS: Lungs are clear of acute infiltrates, edema, or effusions. Heart and central pulmonary vessels within normal limits. Bones are unremarkable. No incidental pulmonary nodules. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Result History X-ray chest 2 views (Order #3284877020) on 5/25/2021 - Order Result History Report
CDC Split Type:

Write-up: Note Does the patient have current symptoms of illness? Yes Date symptoms started: 5/16/21 1. Does the patient have a fever (subjective or confirmed)? No 2. Does the patient have a new onset of cough? Yes 3. Does the patient have a new onset of shortness of breath? Yes, slightly with exertion. NAD. ? If Yes: Is the patient having difficultly breathing or in distress? No 4. Additional symptoms: Congestion, runny nose, nausea and vomiting. Bronchitis Suspected COVID-19 virus infection Chest pain, unspecified type Progress Notes Encounter Date: 5/25/2021 ? ? Signed Patient is here for MAB Infusion Consent for infusion prior to this visit reviewed and verified. O2 sats $g or = 90% Signs of potential reaction reviewed with patient. Tolerated IV start and MAB infusion without complication. Pt has access to pulse oximeter and thermometer for home monitoring Provided fact sheet for patients, parents and caregivers- Emergency Use Authorization of BAM for Coronovirus Disease 2019 for pt to review. Discharge instructions reviewed. Patient denies any questions Instructions COVID 19 Monoclonal Antibody (MAB) Infusion Patient Reference Guide MAB Infusion Treatment Team:


VAERS ID: 1351102 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Conjunctivitis, Cough, Eye disorder, Headache, Nasal congestion, Oropharyngeal pain, Presyncope, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BLISOVI 24 FE 1 mg-20 mcg (24)/75 mg (4) per tablet escitalopram (LEXAPRO) 10 mg tablet fexofenadine (ALLEGRA) 180 mg tablet methylPREDNISolone (MEDROL, PAK,) 4 mg tablet triamcinolone acetonide (NASACORT NASL)
Current Illness:
Preexisting Conditions:
Allergies: Aspirin Cephalexin Clindamycin Penicillins
Diagnostic Lab Data: 05/19/21 2252 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/19/21 1241 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Dx Headache ? Sore Throat ? Fever ? Eye Problem ? Cough ? Covid-19 Screening ? Nasal Congestion Sore throat Acute nonintractable headache, unspecified headache type Fever, unspecified fever cause Cough Nasal congestion with rhinorrhea At increased risk of exposure to COVID-19 virus Conjunctivitis due to COVID-19 Vagal reaction


VAERS ID: 1351163 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014CZ1A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Erythema, Fatigue, Mobility decreased, Pain, Pain in extremity, Pruritus, Taste disorder
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Parkinson-like events (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Had adverse event following the Moderna Shot 1 on April 18, 2021. Filled out VAERS online on May 2, 2021 and received Temporary
Other Medications: IC Oxycodone HCL Oral Solution
Current Illness: First shot was on April 18 and Covid Arm started on day 10. I still was going through adverse effects of the first shot when I got the second shot.
Preexisting Conditions: MVP. Laryngeal dystonia, oromandibular dystonia, hand dystonia, blepharospasm, spasmodic torticollis, and generalized dystonia.
Allergies: sulpha and seasonal allergies
Diagnostic Lab Data: Doctor did not prescribe tests or laboratory work.
CDC Split Type:

Write-up: --Sunday, May 16, 2021: at 3:45 PM, I received the Moderna Shot 2 at Pharmacy. Stayed at pharmacy 30 min after shot, no pain, no redness, nothing. I felt good. -- Sunday, May 16: at 7:45 PM, my arm starts to get sore and I cannot lift it. Covid Arm starts with redness. --Monday, May 17 at 1 AM, fever for 12 hours. Followed by shivering chills for 10 hours. Face ruby red, Covid Arm getting worse. I cannot lift arm all day today. Pain in arm is severe. --Tuesday, May 18, I can move arm, but it is painful and burning. Aches and pains throughout both arms and both legs. Covid arm worsens. --Wednesday, May 19, arm is painful and burning. Aches and pains throughout both arms and both legs. Covid arm worsens. --Thursday, May 20, arm is starting to get better, still red, painful, and burning, with soreness. My legs feel better today. --Friday, May 21, arm is getting better, redness is getting better, pain is gone, soreness is still with me. Itchiness is overwhelming. I am dealing with exhaustion. Taste has been changed, along with not much of an appetite. --Saturday, May 22, arm is much better, a little sore and arm is itchy. I am still dealing with exhaustion. Taste has been altered, not sure it will come back. --Sunday, May 23, one week after second shot and my covid arm is better. Soreness gone, but still itchy. Still have exhaustion and taste has not come back fully.


VAERS ID: 1351260 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-28
Onset:2021-05-16
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Arteriogram coronary abnormal, Arthralgia, Cardiac vein dissection, Chest pain, Coronary artery occlusion, Echocardiogram, Electrocardiogram, Full blood count, Nausea, Troponin
SMQs:, Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Arthritis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, hydroxyzine HCL, prozac (10mg), Wellbutrin, magnesium, multivitamin
Current Illness: diverticulitis a few weeks prior to vaccination
Preexisting Conditions: reactive airway disease
Allergies: allergic to: certain adhesives adverse reactions to: opioids, promethazine, batrim
Diagnostic Lab Data: 2 angiograms; blood work for troponin levels, CBC; multiple EKGs; echocardiograms
CDC Split Type:

Write-up: Spontaneous cardiac arterial dissection (SCAD): Starting 5/16/2021, patient had chest pain, shoulder pain, and some nausea. She went to the ER just after midnight on 5/17. She was hospitalized, had angiogram which confirmed blockage in artery off of RCA, was put on medications (Plavix, aspirin and a statin), and released later on 5/17. She had a recurrence on 5/21, was hospitalized for 3 nights at the University, repeat angiogram, and her medications modified (statin stopped; a beta blocker and calcium channel blocker started).


VAERS ID: 1351362 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone normal, Chest X-ray normal, Chest pain, Chills, Computerised tomogram abnormal, Dyspnoea, Electrocardiogram normal, Fibrin D dimer, Full blood count normal, Hypoaesthesia, Limb discomfort, Pulmonary embolism, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine
Current Illness: none reported
Preexisting Conditions: anemia of pregnancy, COVID-19 infection, hypothyroidism, kidney stone
Allergies: None reported
Diagnostic Lab Data: At outside ED: d-dimer 523, TSH within normal range, ECG normal At current ED: ECG: sinus rhythm HS troponin, electrolytes: within normal range CBC within normal range including platelets D-dimer: 720 FEU Chest x-ray: no acute radiographic abnormality in the chest CT PE: left lower lobe pulmonary arterial embolism
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: patient presents to emergency department (ED) nauseated with intermittent chest pain and shortness of breath starting three days after vaccination. Initially experienced arms discomfort, throat tightness, chills, and numbness in face and chest that resolved. Seen at another ED three days after vaccination for chest pain and discharged. Followed-up by primary care the next day where vitals were stable and exam was not concerning. In current ED patient''s vital signs within normal ranges and physical exam unremarkable. Patient diagnosed with pulmonary embolism, prescribed anticoagulants, and on follow-up with primary care provider patient reports no new symptoms and vital signs with within normal ranges.


VAERS ID: 1351584 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Disorientation, Dizziness, Head titubation, Magnetic resonance imaging head normal, Nystagmus, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (narrow), Ocular motility disorders (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Ibuprofen
Diagnostic Lab Data: MRI Brain without Contrast- normal
CDC Split Type:

Write-up: 3 days after vaccination patient developed a feeling of disorientation. Also developed nystagmus, and inability to hold his head still (bobbing) when at rest. A week later he developed dizziness, spinning.


VAERS ID: 1351651 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-01
Onset:2021-05-16
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electromyogram, Neuralgic amyotrophy
SMQs:, Immune-mediated/autoimmune disorders (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:
Allergies:
Diagnostic Lab Data: EMG 5/26/21
CDC Split Type:

Write-up: Moderate Left upper trunk brachial plexopathy


VAERS ID: 1351721 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA HRS022C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Feeling abnormal, Myalgia, Pain, Painful respiration, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Ear fullness
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG - 05/20/21
CDC Split Type:

Write-up: Notes from my visit with him: May 17th 2021-- "Got his second dose of Moderna vaccine a week ago. Had some SOB afterwards, and then felt improved. But then yesterday started to have similar symptoms, as well as chest pressure, hurts to breathe all the way in, feels a twinge feeling on the inside. Also noticed a muscular pain as well in the same area, hurts to move down the middle of his chest. Also having pain on the right side. Symptoms are persistent, will wax and wane slightly but doesn''t go away completely. Feels better when he is standing if feels better, has not noticed food triggers, no difficulty eating or swallowing. A few weeks ago also started a higher fat intake diet. No fevers or chills, no diarrhea, no rash, no sore throat, no runny nose. No known muscular injury that he can think of." May 20, 2021-- "Today is feeling some decrease in symptoms, but still feels like he needs to take deep breaths. Feels like "something is erratic" once in a while. Not feeling increased improvement. Laying down does seem to make it worse. One time he was leaning forward and then sitting up made it worse." May 26, 2021 -- "he reports that he is still feeling some chest pain, but overall is feeling better, symptoms are up and down. Feels like a "tiredness" in the chest wall area. The most pain is from twisting. Not worsening with acidic or greasy foods. Feels like pain is mostly in the muscle now. No SOB at all with increased exertion."


VAERS ID: 1351937 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-05-14
Onset:2021-05-16
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Petechiae
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: None
Allergies: Seasonal allergies to pollen and trees
Diagnostic Lab Data: Patient was seen by Dr. on Monday, May 17th. She said she could not confirm or deny it was due to the Covid vaccine.
CDC Split Type:

Write-up: Patient experienced unexplained episodes of petechiae (bleeding under his skin) for starting two days after the vaccine (and continuing since then).


VAERS ID: 1351955 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-12
Onset:2021-05-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: He developed acute chest pain 4 days after the vaccine and presented to the ED. Pain was worse in recumbent position and improved with sitting. ED physician suspected possible pericarditis and he was given ibuprofen. Symptoms resolved within 24 houtrs while taking ibuprofen.


VAERS ID: 1353582 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: School       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021561321

Write-up: armpit swelled up; This is a spontaneous report from a contactable other healthcare professional (patient). A 31-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number and expiry date not reported), via an unspecified route of administration, in right arm on 13May2021 at 12:00 PM (at the age of 31-years-old) as 2nd dose, single for COVID-19 immunization. Medical history included Tylenol allergy. Concomitant medications include release dietary supplements. The patient was not pregnant. No other vaccine was given in four weeks. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination has not been tested for COVID-19. Historical vaccine includes BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number and expiry date not reported), via an unspecified route of administration, on an unspecified date as first dose, single for COVID-19 immunization. The patient''s armpit swelled up in the same side that he got the injection on 16May2021 (reported as three days after 2nd dose). The events were reported as non-serious. The patient did not receive any treatment for the event. The outcome of the event was recovering. Information on the lot/batch number has been requested.


VAERS ID: 1353595 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Headache, Nausea, Pyrexia, Vaccination site pain
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210516; Test Name: Body temperature; Result Unstructured Data: Test Result:103.4
CDC Split Type: USPFIZER INC2021566865

Write-up: Fever (103.4); chills; nausea; injection site pain; fatigue; severe headache; This is a spontaneous report from a contactable consumer (patient). A 33-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0179), dose 2 via an unspecified route of administration in left arm on 15May2021 15:15 (at the age of 33-years-old) as second dose, single for COVID-19 immunization. The patient medical history was not reported. The patient have no known allergies. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0172), dose 1 via an unspecified route of administration in left arm on 25Apr2021 03:30 PM (at the age of 33-years-old) as first dose, single for COVID-19 immunization. The patient''s concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks nor any other medications within two weeks prior. The patient experienced fever (103.4), chills, nausea, injection site pain, fatigue and severe headache on 16May2021 04:00. Since the vaccination, patient has not been tested for COVID-19. No treatment was received for the event. Outcome of the events was resolving.


VAERS ID: 1354409 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-05-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Influenza like illness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Shingles shot, 2 shot regime, major body aches both times
Other Medications: Amitriptyline 75 mg daily
Current Illness: N/A
Preexisting Conditions: vestibular migraine, diagnosed 2 years ago. Medication for the condition in Item #9 above
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 hours after injection, mild flu-like symptoms of nausea and light headedness, slight muscle aches through midnight. Went away in the morning of May 17th, and gone by noon (24 hours after injection).


VAERS ID: 1354426 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-13
Onset:2021-05-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Akinesia, Angiocardiogram, Chest discomfort, Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Fatigue, Gingival erythema, Heart rate increased, Magnetic resonance imaging heart, Myocarditis, Troponin increased, Ventricular hypokinesia
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Gingival disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 325 mg tablet Take 325 mg by mouth every 4 hours as needed for Fever. ibuprofen (ADVIL, MOTRIN) 200 mg tablet Take 200 mg by mouth every 6 hours as needed for Pain.
Current Illness: none reported
Preexisting Conditions: ? Migraines
Allergies: ? Eggs [Albumen, Egg] Other (See Comments) Rash/swelling/upset stomach
Diagnostic Lab Data: Cardiovascular Problem List: Acute combined systolic and diastolic HF o TTE 5/16/21: LVEF 35%, LVIDD 4 cm, global HK with AK in some inferior and inferoapical segments Non-ischemic cardiomyopathy o Coronary angiogram 5/18/21: normal coronary arteries o Cardiac MRI 5/19/21: Areas of T2 signal abnormality and late gadolinium enhancement in a nonischemic distribution, primarily involving the lateral wall of the left ventricle, but with inferior wall and septal involvement also. These changes are compatible with acute myocarditis. No focal wall motion abnormalities on today''s exam. Low normal left ventricular and right ventricular systolic function, ejection fractions 53% and 42%, respectively. Type 2 MI o Peak troponin I (5/16/21) 5,951; coronary arteries normal on angiogram 5/18/21
CDC Split Type:

Write-up: HPI/Subjective: is a 47 year old male with minimal past medical history who presents in consultation. He was hospitalized with myocarditis. The patient presented to PWF 5/16 with CP, fatigue and elevated HR. He had received his second dose of the Moderna COVID-19 vaccine 3 days prior. The initial ECG showed nonspecific ST abnormalities. HS-troponin 1,438 -- $g 5,951. Echo showed ejection fraction of 35% with global hypokinesis, akinesis in inferior and inferoapical segments, and mild right ventricular hypokinesis. He was subsequently transferred to to PPMC and underwent coronary angiogram on 5/18/21 which demonstrated normal coronary arteries. In consultation with Dr. , he was discharged on losartan 25 mg/day and metoprolol succinate 50 mg BID for outpatient follow-up. Cardiac MRI 5/19 showed T2 signal abnormality and LGE involving the subepicardium of the lateral wall, inferior wall, as well as septum c/w acute myocarditis. LVEF 53%. Dr. submitted his case to the VAERS site. reports feeling much improved. He denies fatigue, dyspnea, palpitation, or presyncope. He has noted fleeting chest discomfort. No fevers or chills.


VAERS ID: 1354449 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-11
Onset:2021-05-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

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

Write-up: Heart palpitations occurred four days after injection, went to emergency room on the fifth day. In the emergency room for three hours. Doctors recorded heart rate and I was given two bags of NaCl. Still occurring but are decreasing in frequency.


VAERS ID: 1354644 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Headache, Muscle spasms, Pain in extremity, Urine analysis, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (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: None
Current Illness: None
Preexisting Conditions: Myomyalgia
Allergies: None
Diagnostic Lab Data: Blood test results shows absolute monocytes very Low 104 Still waiting for urine test results and scheduled for a ultrasound on the 10 th of June.
CDC Split Type:

Write-up: I have had heavy vaginal bleeding for 8 days ,now spot bleeding... Also bad cramps in feet?s and pains in legs on and off,besides headaches.


VAERS ID: 1354664 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-26
Onset:2021-05-16
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZERER8737 / 2 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Echocardiogram, Erythema, Pain in extremity, Pericardial effusion, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flue shot
Other Medications: Lasix
Current Illness: Diabetes, Hypertension, heart murmur
Preexisting Conditions: Diabetes Hypertension, Heart murmur
Allergies: Compazine, Neupogen Pineapple
Diagnostic Lab Data: Echocardiogram
CDC Split Type:

Write-up: left arm swelling, redness pain antibiotic x 10 days Pericardial Effusion Lasix daily


VAERS ID: 1354667 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-10
Onset:2021-05-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Audiogram, Deafness neurosensory, Discomfort, Ear discomfort, Headache, Laboratory test, Magnetic resonance imaging, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: atrial fibrillation (intermittent)
Allergies:
Diagnostic Lab Data: Audiogram May 22: Right Ear: 250 Hz = 30 dB; 500 Hz = 40 dB; 1000 Hz = 30 dB, 2000 Hz = 40 dB, 4000 Hz = 50 dB; 8000 Hz = 50 dB
CDC Split Type:

Write-up: Sudden sensorineural hearing loss on the right ear. Symptoms started 1 week after the 2nd dose of the COVID-19 vaccine on Monday 5/17. The hearing loss was accompanied by continuous buzzing sound, static noise, sensation of ear fullness, local discomfort, headache. It progressed over the first week. On saturday 5/22, I performed an online hearing test that confirmed the hearing loss (see section 19 for results). I went to urgent care to get the ear checked and cleaned, with no noticeable improvement in symptoms. On Sunday 5/23 I was started on 30 mg predinsone po. On Monday 5/24, I went to specialist care, she increased dose to 60 mg of prednisone and order additional tests.


VAERS ID: 1355249 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest discomfort, Cough, Dizziness, Fatigue, Imaging procedure, Myalgia, Night sweats
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), 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: Sertraline 100 mg, cetirizine, ibuprofen
Current Illness: none
Preexisting Conditions: depression
Allergies: strawberries, shellfish
Diagnostic Lab Data: tests are pending, including bloodwork and chest imaging
CDC Split Type:

Write-up: second injection 5/15. following day developed weakness, dizziness, myalgias, fatigue. a few days later developed cough and drenching nightsweats and chest pressure.


VAERS ID: 1355357 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-15
Onset:2021-05-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Myalgia, Pyrexia, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Mild aches and pain at injection site
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I experienced a fever 102.4, headache and extreme muscle pain and aches throughout my entire body.. The adverse events lasted approximately 36 to 48 hours.


VAERS ID: 1357019 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-16
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 rapid POC test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210540086

Write-up: SHORTNESS OF BREATH; BODY ACHES; This spontaneous report received from a patient concerned a 31 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, 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 body aches. On 17-MAY-2021, the subject experienced shortness of breath. Laboratory data (dates unspecified) included: COVID-19 rapid POC test (NR: not provided) Negative. The action taken with covid-19 vaccine was not applicable. The patient recovered from body aches on 16-MAY-2021, and had not recovered from shortness of breath. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


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