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

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



Case Details (Reverse Sorted by Onset Date)

This is page 152 out of 6,867

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VAERS ID: 1574186 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-05
Onset:2021-08-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Vaginal discharge
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 800 mg magnesium daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I''ve been experiencing a lot of vaginal discharge that I haven''t had before. I''m also experiencing random cramping similar to the start of my period but my period isn''t for 2 more weeks. Nothing else except the vaccine has changed in my day-to-day or my medication. I am not pregnant.


VAERS ID: 1574196 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 80777027315 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Erythema, Hypoaesthesia, Paraesthesia, Skin warm, Vitamin supplementation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: I was still inside my car inside the parking lot when the left side of my face started tingling then went numb. I recall having the exact sensation years before when I got Bells Palsy, so I looked in my purse for my liquid B-12 supplement that I take on a daily basis and had one droplet and waited in the car(I was by myself). 20 minutes later the affected side started to move again. Immediately after the numbness was over, my left warm got red(I cannot tell whether it was rash or just redness)


VAERS ID: 1574208 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-07-21
Onset:2021-08-12
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiomegaly, Chest X-ray abnormal, Dyspnoea, Illness, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown.
Preexisting Conditions: Heart Failure, COPD, AFIB, BPH, DM, Hyperlipidemia, Hypothyroidism.
Allergies: ANTIHISTAMINES Codeine DOXYCYCLINE; shuts kidneys down Metoprolol Tartrate; Not Specified Plavix
Diagnostic Lab Data: Covid Positive. CXR showed cardiomegaly with mild congestion
CDC Split Type:

Write-up: Pt received 1st Dose of Moderna Vaccine 7/21/21. Became ill on 8/12/21, runny nose, SOB. tested positive for covid. received monoclonal antibodies on 8/13/21 and then presented back to the ER later that evening for SOB and was given supplemental oxygen. DC home on 8/15/21 in stable condition


VAERS ID: 1574212 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-08-12
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 UN / IM

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

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

Write-up: PATIENT HOSPITALIZED


VAERS ID: 1574234 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-04
Onset:2021-08-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Dizziness, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol HFA 2 puffs every 6 hours as needed
Current Illness:
Preexisting Conditions:
Allergies: none noted
Diagnostic Lab Data:
CDC Split Type:

Write-up: presents with abdominal pain, vomiting, dizziness. Reports vomiting for 2 days. Felt some dizziness on her way to work in the uber today. Reports epigastric pain, constant, burning, non-radiating.


VAERS ID: 1574277 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 4 LA / IM

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

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

Write-up: Patient received a 4th dose of Moderna. 1st dose on 1/4/21, 2nd dose on 2/1/21, 3rd dose on 6/17/21, and 4th dose on 8/12/21.


VAERS ID: 1574280 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-12
Onset:2021-08-12
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / UNK - / -

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

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

Write-up: Patient admitted 8/12/21 with + Covid Diagnosis


VAERS ID: 1574297 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL 3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lethargy, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Hives all over body, itching, lethargic, headache


VAERS ID: 1574377 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dysphagia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg PO QD Bupropion 75mg PO BID Cetirizine 10mg PO QD Cholecalciferol 5,000units PO QAM Furosemide 40mg PO PRN Multivitamin QD Phentermine 37.5mg PO QD Enbrel 50mg SQ Aleve 2 tablets PO QD
Current Illness: None
Preexisting Conditions: Anemia Anti-phospholipid antibody syndrome anxiety arthritis clotting disorder fibromyalgia lupus obesity
Allergies: Nickel Shellfish Soy Sulfa Taltz autoinjector Darvocet Hydrocodone Iodine Proxyphene Napsylate Gadavist Humira
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received PFIZER COVID vaccine #1 at approximately 11:30AM. Developed symptoms (coughing, shortness of breath at 11:55AM. 12:02PM placed in exam room, O2 applied HR: 121 Pulse Ox: 99% 12:03PM continued coughing, difficulty swallowing, EpiPen administered right thigh. HR: 123 Pulse Ox: 100% 12:06PM 50mg Benadryl administered R deltoid BP 146/100 12:07PM BP 178/116 HR 110 Pulse Ox 99% 12:10PM HR 107 Pulse Ox 99% 12:11PM BP 149/96 HR 105% EMS called, patient transported to medical facility


VAERS ID: 1574382 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, novolog, treshiba, ropinorole, ranolazine, prasugrel, sacubitril-valsartan, Jardiance
Current Illness: None
Preexisting Conditions: CAD, CHF, Type 2 Diabetes, asthma, sleep apnea, pacemaker defibrillator, obesity.
Allergies: Plavix
Diagnostic Lab Data: Tested positive for COVID19 with rapid test one week after receiving shot. Started COVID19 treatments and medications, including monoclonal antibody treatment.
CDC Split Type:

Write-up: Headache, runny nose, congestion, cough, body aches, fatigue. Scratch throat and cough started 3 days after receiving shot, runny nose, congestion, body aches and fatigue started 5 days after shot.


VAERS ID: 1574406 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-16
Onset:2021-08-12
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL6200 / 1 RA / IM

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

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

Write-up: Pt received Pfizer vaccine x2 doses. Pt admitted for COVID on 8/12/21 and being currently treated with remdesivir and dexamethasone


VAERS ID: 1574414 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 LA / 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: Age at time of vaccine < 18


VAERS ID: 1574424 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-30
Onset:2021-08-12
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic 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 PCR positive for COVID 8/12/21 after being fully vaccinated. Asymptomatic.


VAERS ID: 1574427 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-18
Onset:2021-08-12
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

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

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

Write-up: Pt received Pfizer x2. Admitted to the hospital on 8/12 for COVID. Being treated with remdesivir, tocilizumab and dexamethasone.


VAERS ID: 1574449 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: Patient sat in the waiting room after receiving her shot. After a few minutes, she fainted and fell out of her chair. I was able to awaken her quickly and have her remain on the floor for a few minutes. She then sat in the waiting area for about 10 more minutes and left without further incident.


VAERS ID: 1574460 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 1 - / 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: age < 18 at time of vaccination


VAERS ID: 1574461 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Crying, Loss of consciousness, Malaise, Paraesthesia, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NKDA, NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 12:15PM Moderna #1 vaccine administration 12:20PM Called to assess patient who "wasn''t feeling well" after vaccine, reported tingling in hands and feet, assisted x 2 to patient exam room, patient passed out and was assisted to floor 12:25PM Synocpal episode, patient unresponsive, spontaneous breathing and pulse, BP: 118/78, HR 88, PulseOx 99 12:30PM Patient responsive, feels weak, assisted to sitting position, BP: 120/76, HR 74, PulseOx 98 12:32PM Patient assisted to wheelchair 12:35PM Cool compress to back of neck 12:37PM BP: 122/82, HR 66, PulseOx 98% 12:40PM HR 77, O2 100, HGB 13.2, Glucose 108 with continued tingling in hands, some in arms 12:44PM BP 120/76, HR 67, O2 100, feels weak, aware that she "passed out, felt like I was dreaming" 12:52PM stable condition, talking with husband, crying 1:00PM Provider in to review treatment options, including discharge home, transfer to ED via ambulance, personal transport to ED 1:18PM Transferred to personal vehicle in wheelchair, stable condition


VAERS ID: 1574477 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-28
Onset:2021-08-12
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02520A / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 - / SYR

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

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

Write-up: Positive Covid19 case


VAERS ID: 1574529 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM

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

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

Write-up: PT RECEIVED VACCINE AT 3 WEEKS INSTEAD OF 4 WEEKS


VAERS ID: 1574534 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-07
Onset:2021-08-12
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydralazine 25mg, Gabapentin 300mg, Aspirin 81mg, Levothyroxine 125mg, Insulin Lispro, Ezetimide 10mg, Allopurinol 300mg, Biotin 300mg, Bumex 1mg, Tresiba FlexTouch 55units, Calcium/Vitamin D Tablet, Omega-3 2 Cap
Current Illness: Diabetes mellitus, Hypercholesterolemia, Hypertension, Hypothyroidism, Neuropathy
Preexisting Conditions:
Allergies: Lobster, Crestor, Niacin, Iodine topical
Diagnostic Lab Data: SARS COV2 Covid-19 PCR
CDC Split Type:

Write-up: Fully vaccinated with a Covid-19 positive test, severe symptoms.


VAERS ID: 1574535 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event
SMQs:

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

Write-up: No reaction


VAERS ID: 1574577 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-19
Onset:2021-08-12
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac failure congestive, Hypoxia
SMQs:, Cardiac failure (narrow), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalization secondary to hypoxia secondary to CHF/Covid 19.


VAERS ID: 1574579 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Laboratory test, Sensation of foreign body, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: Unknown what medical test or laboratory test patient received.
CDC Split Type:

Write-up: Patient received Janssen Covid shot on 8/12/21 around 1:30pm and stated she noticed hives started to appear later that night. She claims when she was younger she used to get hives from unknown causes. She stated she didn''t think too much about it. The next day around 8 pm she said she noticed that the hives had gotten much worse. She also described a feeling of having a "ice cub" stuck in her throat and she was experiencing chest pain. She got worried and headed to Hospital Friday night (8/13/21). Prior to going to the hospital patient had administered claritin and ibuprofen before going to the hospital. At the hospital patient received prednisone, benadryl and famotidine. Patient was seen by practitioner which was supervised by Doctor.


VAERS ID: 1574620 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Feeling cold, Feeling hot, Laboratory test normal, Loss of consciousness, Malaise, SARS-CoV-2 test
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), COVID-19 (broad)

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

Write-up: Once getting the shot, approximately 2 mins after receiving it I felt this heat wave come across my body and I passed out and was taken to the er, which they ran some tests and said I was fine, but the the next day I started feeling sick had chills and was dizzy when I stood up or walked around and felt that way for 5 days, I went yesterday to urgent care where they gave me a covid test and no awaiting test results


VAERS ID: 1574625 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-01-07
Onset:2021-08-12
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID PCR positive in ED on 8/12/2021
CDC Split Type:

Write-up: COVID PCR positive in ED on 8/12/2021


VAERS ID: 1574882 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-08
Onset:2021-08-12
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asymptomatic COVID-19
SMQs:, 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: Asymptomatic


VAERS ID: 1575073 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Dizziness, Musculoskeletal stiffness
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache with the flu shot annually. Age 59.
Other Medications:
Current Illness:
Preexisting Conditions: essential hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Low back stiffness and pain within 20 minutes of the shot. Continued mild to moderate low back pain...taking Naproxen daily to manage the pain. 3 days of vaccine site(R arm) moderate pain. Dizziness 20 minutes after taking the shot. The dizziness lasted for about 20 minutes.


VAERS ID: 1575266 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Cough, Dyspnoea, Electrocardiogram, Feeling jittery, Heart rate increased, Hypersensitivity, Laboratory test, Sensation of foreign body, Tachycardia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin Zyrtec
Current Illness: No
Preexisting Conditions: No
Allergies: NKA
Diagnostic Lab Data: EKGs and labs on 8/12 Cardiologist appointment is 8/18. Allergist appointment is 8/19.
CDC Split Type:

Write-up: 3 hours after I got it, my HR shot up to 178. I was SOB and tight chest and had a lump in my throat and coughing. I was super jittery!! EMS called to take me to the ER. The ER doc said ?I don?t *think* it was anaphylaxis, but an allergic reaction can cause all of your symptoms.? So he?s sending me to an allergist. Since I?ve been home, I keep having episodes of chest pain and SOB and tachycardia mainly upon standing and worse with any kind of exertion- walking, talking, etc. I also now have a referral for a cardiologist. I see both this week.


VAERS ID: 1577501 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210812; Test Name: Body temperature; Result Unstructured Data: 103 F
CDC Split Type: USJNJFOC20210826432

Write-up: FEVER OF 103 F ALL DAY; This spontaneous report received from a consumer concerned a male of unspecified age. 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: Unk) dose was not reported, administered on 11-AUG-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-AUG-2021, the patient experienced fever of 103 f all day. Laboratory data included: Body temperature (NR: not provided) 103 F. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from fever of 103 f all day. This report was non-serious.


VAERS ID: 1577507 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maine  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210826589

Write-up: VACCINATION FROM VIAL THAT WAS PUNCTURED LONGER THAN 6 HOURS (25 HOURS); VIAL WAS KEPT IN REFRIGERATOR FOR MORE THAN 6 HOURS AFTER PUNCTURE; This spontaneous report received from a health care professional concerned a 66 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: 1808982 and expiry: 21-SEP-2021) dose was not reported, administered on 12-AUG-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced vaccination from vial that was punctured longer than 6 hours (25 hours). On 12-AUG-2021, the patient experienced vial was kept in refrigerator for more than 6 hours after puncture. The action taken with covid-19 vaccine was not applicable. The outcome of the vaccination from vial that was punctured longer than 6 hours (25 hours) and vial was kept in refrigerator for more than 6 hours after puncture was not reported. This report was non-serious.


VAERS ID: 1577522 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient have No known allergies and no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210829047

Write-up: RUNNY NOSE; SORE THROAT; HEADACHE; This spontaneous report received from a patient concerned a 31 year old male. The patient''s weight was 250 pounds, and height was 69 inches. The patient''s concurrent conditions included: non-smoker, and non alcohol user, and other pre-existing medical conditions included: The patient have No known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, expiry: UNKNOWN) dose was not reported, administered on 19-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-AUG-2021, the patient experienced runny nose. On 12-AUG-2021, the patient experienced sore throat. On 12-AUG-2021, the patient experienced headache. The action taken with covid-19 vaccine was not applicable. The outcome of the runny nose, headache and sore throat was not reported. This report was non-serious.


VAERS ID: 1577646 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-05
Onset:2021-08-12
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, SARS-CoV-2 test
SMQs:, 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: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler ibuprofen 200 mg capsule mv-min/iron/folic/calcium/vitK (WOMEN''S MULTIVITAMIN ORAL) sertraline (ZOLOFT) 25 mg tablet
Current Illness: None
Preexisting Conditions: Nervous Abnormal hearing test Dysmenorrhea Genitourinary Polycystic ovarian syndrome Other Blood pressure elevated without history of HTN Overweight School physical exam
Allergies: PromethazineNausea and Vomiting
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: COVID exposure


VAERS ID: 1577650 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-10
Onset:2021-08-12
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Streptococcus test, Tonsillitis
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin (AMOXIL) 875 mg tablet aspirin-calcium carbonate 81 mg-300 mg calcium(777 mg) tablet CONTOUR NEXT TEST STRIPS strip escitalopram (LEXAPRO) 5 mg tablet glucagon, human recombinant, (glucagon) 1 mg injection HumaLOG U-100 Insulin
Current Illness: nONE
Preexisting Conditions: Digestive Adult-onset obesity Musculoskeletal Lipodystrophy due to insulin Endocrine/Metabolic Hypercholesterolemia Type 1 diabetes mellitus with hypoglycemia Adult onset hypothyroidism Hypoglycemic unawareness associated with type 1 diabetes mellitus Hematologic Anemia Other Fitting and adjustment of insulin pump
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR POCT Strep A, PCR
CDC Split Type:

Write-up: 1. Sore throat 2. Fever, unspecified fever cause 3. Tonsillitis


VAERS ID: 1577919 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-19
Onset:2021-08-12
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / -

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

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

Write-up: Covid19


VAERS ID: 1577925 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-22
Onset:2021-08-12
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Chills, Cough, Dyspnoea, Exposure to SARS-CoV-2, Headache, Laboratory test, Nausea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 8/12/2021- symptoms began as stated below 8/16/2021- ED arrival with increased SOB, cough, headache, fever, chills, nausea- "Covid outbreak at work/church" Covid swab in ED which was positive J&J vaccine on 5/22/2021per patient


VAERS ID: 1577947 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Insomnia, Mucosal inflammation, Rash, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Severe sore shoulder and minor rash by that evening. intensity of shoulder and rash lasted 3 days, loss of sleep those days. On day 2 post injection I developed sores in my mouth and one in my right nostril, all but one have healed at this point. morning of day 3 i woke up to complete numbness on the right side of my face, didnt notice if I had facial droop. numbness resolved several hours after waking. So almost a week after the injection all that remains is one sore in my mouth.


VAERS ID: 1577950 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dry mouth, Fatigue, Hypoaesthesia oral, Rhinorrhoea, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Got extreme dry mouth and numb upper lip within 5 min of injection, extremely tired about an hr after shot, running nose, chills. 2 days after shot my right leg had 2 different leg trimmers lasting a couple of seconds long. Dry month is still ongoing. Numb upper lip went around in about 3 days. Energy came back around day 3.


VAERS ID: 1577969 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-08-12
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 UN / IM

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

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

Write-up: Covid positive


VAERS ID: 1578054 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-19
Onset:2021-08-12
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Fatigue, Oxygen saturation decreased, Pyrexia, Respiratory distress, Speech disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine, Protonix, Albuterol, Symbicort, Brilinta, Lasix Gabapentine, Hydralazine, Norco 10, Amlodopine, Duloxetine, Iron, Tizanidine
Current Illness: Unknown
Preexisting Conditions: CAD, COPE, GERD, MI, Hip fx, Heart failure, Fusion of lumbar spine, HTN, hypercholesteremia, PVD, Pacemaker, CKD, CVA, Coronary stents, Thyroid disease
Allergies: Latex, Venofer, Penicillin, Sulfa drugs
Diagnostic Lab Data: SARS COV2 COVID 19 PCR 08/13/2021
CDC Split Type:

Write-up: The patient presents with shortness of breath. 90 year old presents to ED from other area with concerns over sob. Per EMS, the pt''s o2 saturation dropped to 85% PTA and the pt became noticeably exerting herself to breathe. Pt received steroids by EMS, with no significant relief. The onset was just prior to arrival. Risk factors consist of coronary artery disease, congestive heart failure and hypertension. The patient is a 90-year-old female with a history of Chronic Obstructive Pulmonary Disease, CHF, coronary artery disease, chronic kidney disease that presented to the emergency department with complaints of shortness of breath. Patient states she has had increased weakness, fatigue and shortness of breath over the past 3 days. States she began running a fever yesterday and thought she may have COVID-19 so she was sent to the ED by her nursing home. Notes cough and shortness of breath. COVID-19 swab was not completed in the ED. currently resting in bed. In respiratory distress. On 4 L via nasal cannula with respiratory rate of 30. She is on chronic home O2 at 2 L. moderate distress. Unable to complete full sentences. Respiratory distress


VAERS ID: 1578064 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A2JA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Feeling warm, sweating, hypotension, feeling lightheaded over course of 40 min


VAERS ID: 1578076 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002021A / UNK LA / IM

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

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

Write-up: Vaccine given at 21 days rather than 28 days


VAERS ID: 1578095 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-08
Onset:2021-08-12
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EL1283 / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EN5318 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal hernia, Abdominal pain, Condition aggravated, Cough, Hernia pain, Nausea, SARS-CoV-2 test, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, Atorvastatin, Pepcid, ascorbid acid, benzonatate,
Current Illness: Unknown
Preexisting Conditions: CAD s/p CABG, Abd. hernia, hypercholesteremia, HTN
Allergies: Contrast dye, shellfish, NSAIDS, anaphylactic to eggs
Diagnostic Lab Data: SARS COV2 Covid 19 PCR 08/13/2021--incidental finding
CDC Split Type:

Write-up: The patient presents with abdominal pain. 77 year old male presents to ED complaining of abdominal pain. He states he has a chronic ventral hernia located in his central abdomen. He notes he had a cough last week that aggravated the hernia, along with an episode of vomiting 3 days ago. He currently complains of soreness to the area of the hernia and nausea.


VAERS ID: 1578101 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-05
Onset:2021-08-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Body temperature fluctuation, Chest X-ray, Chills, Differential white blood cell count, Dizziness, Dyspepsia, Full blood count, Headache, Hypoaesthesia, Metabolic function test, Neck pain, Night sweats, SARS-CoV-2 test negative, Urine analysis, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Urinalysis Covid test twice (both negative) Chest X-ray CBC (complete blood count) White blood cell differential Basic metabolic panel
CDC Split Type:

Write-up: Headache all 6 days. Body temp shifts between 105.3 and 92. Sweat all night for 4 nights in a row now. Heart burns and while this I had blurry vision while pumping. Lower back pain. Right arm numbs. Energy shifts between 80% and goes down to 10%. Can?t lift my body. Chills everyday. I shiver quite often. Just like the covid, symptoms come and go. Now neck pain. Muscles feel contracted. Lymph node under opposite arm of injection No vomiting. No diarrea. Dizziness when heart was burning. Numb fingers sometimes, like a thunder strike on the fingers. Too many days in a row now.


VAERS ID: 1578104 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-16
Onset:2021-08-12
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute sinusitis, Cough, Dyspnoea, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test, Sinus congestion, Suspected COVID-19
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: azithromycin (ZITHROMAX) 250 mg tablet buPROPion XL (WELLBUTRIN XL) 150 mg 24 hr tablet cholecalciferol, vitamin D3, 125 mcg (5,000 unit) tablet cyanocobalamin 2,000 mcg tablet immune globulin (FLEBOGAMMA DIF) 10 % solution immune globulin
Current Illness: None
Preexisting Conditions: Nervous Otitis media Brachial neuritis Circulatory Essential hypertension Digestive Gastroesophageal reflux disease Alternating constipation and diarrhea Musculoskeletal Multiple benign melanocytic nevi Peroneal tendinitis, right leg Other History of malignant melanoma History of colonic polyps Ganglion cyst
Allergies: Iodine And Iodide Containing Products Latex Latex, Natural Rubber RifaximinRash
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: 1. Cough 2. Suspected COVID-19 virus infection 3. Nasal congestion with rhinorrhea 4. Shortness of breath 5. Sinus congestion 6. Acute non-recurrent frontal sinusitis


VAERS ID: 1578132 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-11
Onset:2021-08-12
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A21A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: CSF glucose normal, CSF protein decreased, Culture negative, Cytomegalovirus test, Enterovirus test, Gram stain negative, Guillain-Barre syndrome, Herpes simplex test, Imaging procedure abnormal, Immunoglobulin therapy, JC polyomavirus test, Lumbar puncture abnormal, Nucleated red cells, Peripheral sensory neuropathy, Varicella virus test, Viral test, West Nile virus test
SMQs:, Peripheral neuropathy (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Morbid obesity; Type 2 diabetes mellitus; factor 7 deficiency
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Guillain Barr? syndrome: HOSPITAL COURSE: The patient was admitted to the general medicine service for management of acute ascending sensory neuropathy c/w atypical GBS variant vs autoimmune process. Neurology was consulted. Every 2 hr vital signs in combination with every 2 hr vital capacity, inspiratory force. The patient did not develop motor symptoms. Neurology felt her syndrome was most c/w a GBS variant versus an autoimmune process based on imaging, symptoms. The patient received a total of 110 grams of IVIG; plasmapheresis was avoided to hypercoagulable state. An LP was performed via radiology with 5 nucleated cells, a glucose of 50, and protein of 18. Gram stain and culture with no growth to date. A paraneoplastic panel, JC virus, Varicella Zoster PCR, arbovirus, west nile virus, HSV, enterovirus, CMV labs are pending at the time of discharge, but felt an encephalitis without encephalopathy or other concerning s/sx is very unlikely. On the day of discharge she was symptom free. Told her to come back if she developed shortness of breath or new weakness, but neuro feels this is very unlikely at this time with her lack of disease progression.


VAERS ID: 1578137 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Chest pain, Chills, Decreased appetite, Haematemesis, Hypoaesthesia oral, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Chills, chest pain, stomach pain, weakness, site pain, nausea, loss of appetite, numbness of the tounge, throwing up blood


VAERS ID: 1578145 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-15
Onset:2021-08-12
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet amoxicillin (AMOXIL) 500 mg capsule aspirin 81 mg tablet blood sugar diagnostic strip docusate sodium (COLACE) 100 mg capsule DULoxetine (CYMBALTA)
Current Illness: None
Preexisting Conditions: Nervous Peripheral neuropathy Benign familial tremor Controlled type 2 diabetes mellitus with diabetic polyneuropathy, without long-term current use of insulin Acute confusional state Respiratory Asthma exacerbation attacks Intermittent asthma Chronic cough Community acquired pneumonia of left lower lobe of lung Obstructive sleep apnea Circulatory Essential hypertension Paroxysmal atrial fibrillation Digestive Adenocarcinoma of esophagus Obesity GERD (gastroesophageal reflux disease) Diarrhea Small bowel obstruction Nausea Iron deficiency Genitourinary Benign prostatic hyperplasia Musculoskeletal Arthritis Artificial knee joint present, left Rosacea Osteoarthrosis, localized, primary, knee, left Dermatitis Squamous cell carcinoma in situ of skin Non-healing skin lesion Endocrine/Metabolic Hypothyroidism Pure hypercholesterolemia Hematologic Microcytic hypochromic anemia Iron deficiency anemia Other Anxiety Panic disorder without agoraphobia Depression Change in voice Memory deficits Lactose intolerance
Allergies: Ferrous SulfateSwelling
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Tested positive for COVID-19


VAERS ID: 1578165 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-15
Onset:2021-08-12
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: benzonatate (TESSALON PERLES) 100 mg capsule blood sugar diagnostic (FREESTYLE LITE STRIPS) strip blood-glucose meter (glucose monitoring kit) kit celecoxib (CeleBREX) 200 mg capsule(Expired) cholecalciferol, vitamin D3, (VITAMIN D3) 125 mc
Current Illness: None
Preexisting Conditions: Nervous Chronic pain of right knee Circulatory Hypertension Digestive GERD (gastroesophageal reflux disease) Constipation Diarrhea Musculoskeletal Arthritis of right knee Endocrine/Metabolic Diabetes mellitus (CMS/HCC) Hematologic Iron deficiency anemia Microcytosis Other Chronic fatigue History of chicken pox
Allergies: FamotidineItching
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough


VAERS ID: 1578222 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: It was discovered after administering the vaccine to the patient (discovered at approximately 4PM---Unsure of exact time) that the vial had been opened on 8/11/21 and was due to "time out" and be thrown away at 6PM on 8/11/21. Vaccine was given at 1:25PM on 8/12/21 The patient has suffered no unusual side effects at this point State CDC was consulted and recommended that patient return and be re-vaccinated, as dose thought to be ineffective


VAERS ID: 1578255 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-06
Onset:2021-08-12
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Adrenal insufficiency, Factor V Leiden mutation, homocysteinemia, asthma, hypertension, HfrEF with recovered EF (2016 TTE showe EF 60-65%), T2DM, Fibromyalgia, GERD, hypercholesterolemia; on home steroid
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per patient, she was vaccinated at an outside facility on 3/6/2021 and 4/3/2021 both with Moderna COVID-19 vaccines. Patient recently returned from another locale visiting her daughter who was COVID positive. Patient did home COVID tests twice on 8/12/21 and were both positive. Patient presented to hospital on 8/16/2021 where another COVID test was performed on 8/16/2021 and was also positive.


VAERS ID: 1578302 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: I had extremely bad head aces, I threw up and was extremely nauseas, I also had blurred vision. This all occurred 24 hours of receiving the vaccine. I went to the emergency room and I was given an IV, and gave me anti nausea, and I was given something else but I can''t remember the name.


VAERS ID: 1578326 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Hyperhidrosis, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: pt received first dose of Pfizer COVID vaccine and approximately 10 minutes later became pale and diaphoretic. He complained of nausea and feeling lightheaded. He was given two orange juices and 500cc normal saline administered . He was given 2cc(10mg) of ephedrine IV per Dr. Routine vital sign monitoring and an EKG were performed. The patient and his mohter declined EMS transport and decided to go to Hospital. He was seen there and dismissed to home that same day.


VAERS ID: 1578331 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-08-12
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna on 1/26 and 2/19. Positive on 8/3 admitted 8/12-8/13


VAERS ID: 1578366 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 LA / IM

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

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

Write-up: Two days following vacciantion patient developed pink slightly raised rash to stomach, hip and under breast area.PAtient using over the counter costisone cream for treatment with much improvement. Rash present today.


VAERS ID: 1578395 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trintellix 20 mg daily Synthroid 112 mcg daily
Current Illness: none
Preexisting Conditions: hypothyroidism, depression
Allergies: Keflex, rice, persimmon, pistachios
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Itchiness at the palms of hands x 6 days starting the date after the injection


VAERS ID: 1578451 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-08
Onset:2021-08-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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: None
Current Illness: Hemorrhoids
Preexisting Conditions: Hemorrhoids
Allergies: None
Diagnostic Lab Data: Rectal examination
CDC Split Type:

Write-up: Bloody stools and diarrhea


VAERS ID: 1578456 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-01
Onset:2021-08-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Bedridden, Blood creatinine increased, Blood sodium decreased, COVID-19, Chest X-ray abnormal, Dyspnoea, Full blood count abnormal, Hyponatraemia, Lung infiltration, Lymphopenia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medications taking at time of hospitalization: allopurinol 100 mg oral tablet, 100 mg/ 1 tab(s), Oral, Daily Bumex, 1 mg, Oral, BID, Not taking: Has not taken in a while Colace, 200 mg, Oral, Daily at Bedtime Dexilant 30 mg oral delaye
Current Illness: Unknown
Preexisting Conditions: Anxiety Cirrhosis CKD (chronic kidney disease), stage III Depression, major, in remission Diabetes DM (diabetes mellitus), type 2 Esophageal varices Fibromyalgia Gastroparesis GERD (gastroesophageal reflux disease) Hepatic encephalopathy HTN (hypertension) Hypercholesteremia Hyperlipidemia Hypothyroidism IBS (irritable bowel syndrome) Kidney disease MRSA Sleep apnea Splenomegaly Historical Cellulitis DDD History of colon polyps History of Helicobacter pylori infection History of pancreatitis Hyperammonemia Hypotension Parkinson disease
Allergies: Cipro (anaphylaxis) Lyrica (anaphylaxis) Neurontin (anaphylaxis) Septra (anaphylaxis) sulfa drugs (Anaphylactic reaction) tetanus toxoid (anaphylaxis) mirtazapine Darvocet-N 100 (abd pain) Latex (rash, itching) Tape (blisters, rash) codeine (Nausea)
Diagnostic Lab Data: Covid PCR 8/12/21 ============== REPORT============= EXAM: XR Chest 1 V Portable CR REASON FOR STUDY: Cough DATE OF PROCEDURE: 8/12/2021 FINDINGS: A portable frontal view the chest is performed. There is made to previous study of 06/17/2021. The cardiac silhouette size is upper normal limits. There is mild diffuse radiating infiltrates throughout the central lung fields suggesting central vascular congestion and congestive failure. The peripheral lung fields are clear. There is an obese body habitus.
CDC Split Type:

Write-up: patient is a 58 y old female with h/o HTN , dyslipidemia , hypothyroidism , Dm2, CKD 3 , chronic liver disease secondary to NASH among others who currently is established with hospice and is a DNR refers that for the last couple of days has been bedbound and weak . Refers that is unable to get out of bed . Also describes subjective fevers and worsening sob . Refers that husband has similiar symptoms suggestive of covid 19 . Refers having 2 doses of covid 19 vaccine - Pfizer back in April 2021 . Due to worsening weakness came to er . seems that initially was requiring 02 non rebreather with pulse ox 89 % . At time of exam patient is not febrile , not having cough and is currently on 6 liters 02 per nc . Patient is a poor historian and doesnt know what meds she takes though says that took water pills this am . Refers that regarding code status wants to have some things done if able to be kept alive but doesnt want to prolong her life either. On admission her cbc reveals no leukocytosis . Has lymphopenia . Patient has evidence of hyponatremia and AKI with creatinine 1.7 probably reflective of use of bumex and spironolactone at home . CXR reveals b/l infiltrates consistent with possible pneumonia . ER has requested admission for eval and treatment of covid 19 . Patient at this time is not tachypneic and is not coughing actively . Is requiring 02 and is at risk for progression and worsening disease.


VAERS ID: 1578494 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Product administered to patient of inappropriate age
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine, Singulair, Fluticasone, Flonase, and Pro Air HFA
Current Illness: N/A
Preexisting Conditions: asthma, bilateral undescended testicles
Allergies: Amoxicillin
Diagnostic Lab Data: N/A.
CDC Split Type:

Write-up: Covid-19 vaccine was given to patient 9 years old. As per parent symptoms are pain in the injection site.


VAERS ID: 1578521 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-04
Onset:2021-08-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thyroid mass
SMQs:

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: No.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Thyroid nodules


VAERS ID: 1578557 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: Within 18 hours of Covid vaccine, patient developed quarter size hives on B/L arms, and torso. No angioedema. No SOB. Hives have been continuous since the vaccine. Patient is on a daily Claritin and Benadryl. When Claritin and Benadryl are discontinued, the hives return. Patient has NKDA or Food Allergies.


VAERS ID: 1578603 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-27
Onset:2021-08-12
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Chest discomfort, Cough, Dyspnoea, Headache, Pain, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritalin; Concerta; Escitalopram, Zofran; Naratriptan; Propranolol; Ibuprofen
Current Illness: none
Preexisting Conditions: allergic rhinitis; OSA; excessive daytime sleepiness; major depression; migrane with and without aura; leukopenia, impaired fasting glucose
Allergies: Sulfa; Imitrex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Starting on 8/12/21 tightness in her breathing making it difficult to take a deep breath, low energy and body aches, headache. fever, loss of taste, loss of smell, dyspnea, sore chest, unable to sleep, cough.


VAERS ID: 1578606 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Upper arm swelling and redness


VAERS ID: 1578646 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-11
Onset:2021-08-12
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Diarrhoea, Productive cough, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; doxazosin; Furosemide; xarelto; Allopurinol; Protonix
Current Illness: none
Preexisting Conditions: hypertension; mixed hyperlipidemia; chronic kidney disease, stage 3a; anemia of chronic disease; thrombocytopenia; lumbar degenerative disc disease; Raynaud''s BPH; elevated PSA; history of PE; impaired fasting glucose
Allergies: Amlodipine
Diagnostic Lab Data: chest xray
CDC Split Type:

Write-up: started on 8/12/21, cough (productive); diarrhea, fever 101.7


VAERS ID: 1578656 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Diplopia, Dyspnoea, Haemoptysis, Headache, Hyperhidrosis, Pain
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Ocular motility disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Protonix, cetirizine
Current Illness: None
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Has not been to the doctor for these symptoms
CDC Split Type:

Write-up: Felt clamy and had headache soon after vaccination. Felt achy all over. Headache has continued until 8/16. Double vision started 6/16 and lasted approx. 1/2 hr. Diaphoretic 8/16/21 while at and sweated through shirt. 8/17/21 coughed up bright red blood in the AM one time. He describes it as more bright red in the AM and has not happened since. He is short of breath.


VAERS ID: 1578688 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Hypersomnia, Rash, Taste disorder
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: RASH ON TRUNK OF BODY, SEVERE HEADACHE, LACK OF APPETITE, TASTE PERVERSION, SEVERE FATIGUE ("SLEPT FOR A DAY AND A HALF")


VAERS ID: 1578706 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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

Write-up: woke up on 8/12/21 with " itchy rash over body" Denies any SOB, chest pain . PT advised to go to urgent care for evaluation.


VAERS ID: 1578740 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

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

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

Write-up: MODERNA BRAND WAS INADVERTENTLY ADMINISTERED TO A 13 YEAR OLD. NO ADVERSE REACTION PER MOTHER.


VAERS ID: 1579614 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache
SMQs:

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

Write-up: Headache & fatigue, lasted about 4 days, not sure what treatments were used


VAERS ID: 1580098 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspepsia, Eye pain, Feeling hot, Headache, Oedema peripheral, Pain, Pain assessment
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210812; Test Name: Pain scale; Result Unstructured Data: 8/10 PAIN; Test Date: 20210812; Test Name: Pain scale; Result Unstructured Data: 5/10 PAIN OVER EYES
CDC Split Type: USJNJFOC20210828117

Write-up: SWOLLEN CALVES AND FEET; FEELING HOT AT CALVES AND FEET; HEARTBURN; ABOUT A 5/10 PAIN OVER EYES; 8/10 PAIN; TIGHTNESS ON CHEST; CHEST PAIN; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-AUG-2021, the patient experienced swollen calves and feet. On 12-AUG-2021, the patient experienced feeling hot at calves and feet. On 12-AUG-2021, the patient experienced heartburn. On 12-AUG-2021, the patient experienced about a 5/10 pain over eyes. On 12-AUG-2021, the patient experienced 8/10 pain. On 12-AUG-2021, the patient experienced tightness on chest. On 12-AUG-2021, the patient experienced chest pain. On 12-AUG-2021, the patient experienced headache. Laboratory data included: Pain scale (NR: not provided) 5/10 PAIN OVER EYES, 8/10 PAIN. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, swollen calves and feet, feeling hot at calves and feet, heartburn, about a 5/10 pain over eyes, 8/10 pain, tightness on chest, and chest pain. This report was non-serious.


VAERS ID: 1580105 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest pain, Chills, Dizziness, Dysstasia, Fatigue, Gait inability, Headache, Hot flush, Insomnia, Movement disorder, Neck pain, Pain, Vision blurred
SMQs:, 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient was healthy, Patient was not diagnosed with COVID previously.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210829301

Write-up: HEADACHE/MILD COMES AND GOES HEADACHE; LIGHT-HEADED FEELINGS; PAIN; UNABLE TO SLEEP; BLURRED VISION; SLIGHT CHEST PAIN; NECK PAIN; CANNOT MOVE; HOT FLASHES; COULD NOT WALK; COULD NOT STAND WITHOUT ASSISTANCE; CHILLS; INTENSE JOINT PAINS IN THE GROINS, KNEES, ANKLES, ELBOWS; FATIGUE; WEAKNESS/SEVERELY WEAK; This spontaneous report received from a consumer concerned an 18 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient was healthy, Patient was not diagnosed with COVID previously. 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 12-AUG-2021 11:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-AUG-2021, the patient experienced light-headed feelings. On 12-AUG-2021, the patient experienced pain. On 12-AUG-2021, the patient experienced unable to sleep. On 12-AUG-2021, the patient experienced blurred vision. On 12-AUG-2021, the patient experienced slight chest pain. On 12-AUG-2021, the patient experienced neck pain. On 12-AUG-2021, the patient experienced cannot move. On 12-AUG-2021, the patient experienced hot flashes. On 12-AUG-2021, the patient experienced could not walk. On 12-AUG-2021, the patient experienced could not stand without assistance. On 12-AUG-2021, the patient experienced chills. On 12-AUG-2021, the patient experienced intense joint pains in the groins, knees, ankles, elbows. On 12-AUG-2021, the patient experienced fatigue. On 12-AUG-2021, the patient experienced weakness/severely weak. On 13-AUG-2021, the patient experienced headache/mild comes and goes headache. Treatment medications (dates unspecified) included: melatonin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from slight chest pain, and headache/mild comes and goes headache, and the outcome of light-headed feelings, weakness/severely weak, fatigue, blurred vision, chills, intense joint pains in the groins, knees, ankles, elbows, neck pain, cannot move, hot flashes, could not walk, could not stand without assistance, unable to sleep and pain was not reported. This report was non-serious.


VAERS ID: 1580110 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (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: SEROQUEL; CLONIDINE
Current Illness: Alcohol use (Very rare maybe a glass of wine a month if that.); Cigarette smoker (Cigarette smoking 8 per day.)
Preexisting Conditions: Medical History/Concurrent Conditions: Opioid abuse, unspecified use; Comments: The patient had no known allergies. Patient reported drug abuse for heroin then fentanyl on and off for 9 years. Patient reported that no taking fentanyl from 1 month ago.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830364

Write-up: METAL STUCK AT INJECTION SITE; SORE ARM; This spontaneous report received from a patient concerned a 30 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: opioid dependency, and concurrent conditions included: cigarette smoker, and alcohol use, and other pre-existing medical conditions included: The patient had no known allergies. Patient reported drug abuse for heroin then fentanyl on and off for 9 years. Patient reported that no taking fentanyl from 1 month ago. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. Concomitant medications included clonidine for drug used for unknown indication, and quetiapine fumarate for sleep disorder therapy. On 12-AUG-2021, the patient experienced sore arm. On 14-AUG-2021, the patient experienced metal stuck at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore arm, and metal stuck at injection site. This report was non-serious. This case, from the same reporter is linked to 20210830342.


VAERS ID: 1580119 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Nebraska  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Disturbance in attention, Fatigue, Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: Abstains from alcohol; Cigarette smoker (Heavy 1 pack per day smoker)
Preexisting Conditions: Comments: The patient had no known allergies, no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832747

Write-up: REGULAR REACTIONS; CANNOT CONCENTRATE; TINGLING IN FEET, MOVED UP THE LEGS, UPWARDS INTO THE FACE AND REST OF THE BODY; TIRED; BRAIN FOG; This spontaneous report received from a patient concerned a 56 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: cigarette smoker, and non-alcohol user, and other pre-existing medical conditions included: The patient had no known allergies, no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A and expiry: UNKNOWN) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced brain fog. On 12-AUG-2021, the patient experienced cannot concentrate. On 12-AUG-2021, the patient experienced tingling in feet, moved up the legs, upwards into the face and rest of the body. On 12-AUG-2021, the patient experienced tired. On an unspecified date, the patient experienced regular reactions. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from regular reactions, and had not recovered from tired, tingling in feet, moved up the legs, upwards into the face and rest of the body, brain fog, and cannot concentrate. This report was non-serious.


VAERS ID: 1582370 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-23
Onset:2021-08-12
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 - / -

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

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

Write-up: Has Covid 19 8/12/2021


VAERS ID: 1582376 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-09
Onset:2021-08-12
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

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

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

Write-up: Dose 1 Pfizer 5/19/2021 EW0187 Pt has covid 19 8/12/2021


VAERS ID: 1582384 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-11
Onset:2021-08-12
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, General physical health deterioration, Hypophagia, Malaise, Nausea, Pain, Productive cough, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: The patient is a 59-year-old male with history of Parkinson''s disease, anxiety, bipolar disorder, hypertension, and type 2 diabetes who presents to the emergency department with 6 days of feeling unwell. The patient reports generalized malaise, body aches, nausea, decreased oral intake. He has a cough that is slightly productive and actually was started on antibiotics at the urgent care center a few days ago. His symptoms worsened and he went to a different urgent care center and had a Covid test yesterday which was positive. Patient did not get treatment and left on the same day.


VAERS ID: 1582387 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-12
Onset:2021-08-12
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 - / -

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

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

Write-up: dose 1 12/22/2020 pfizer EL0140 lot Pt has covid 19 8/12/2021


VAERS ID: 1582392 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-18
Onset:2021-08-12
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / -

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

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

Write-up: Dose 1 1/29/2021 Pfizer EL9264 lot Covid 19 positive 8/12/2021


VAERS ID: 1582398 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-06
Onset:2021-08-12
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 - / -

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

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

Write-up: has covid 19 8/12/2021


VAERS ID: 1582399 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Paperwork was incorrectly filled out saying the child was 12. After further investigation, the child turned out to only be 11.


VAERS ID: 1582406 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-08-12
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / -

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

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

Write-up: p[t has covid 19 8/12/2021


VAERS ID: 1582412 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO217 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle twitching, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (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: Daily multi vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Left arm, hand, shoulder, boob, and under arm numb for 3 days. Left shoulder & under arm twitches with shooting, painful tingles down my arm on the 3rd day after vaccination.


VAERS ID: 1582505 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: 44 year old female who has completed a 15-minute observation period with the following signs and symptoms of an adverse reaction: sensation of throat swelling or throat closure. Pfizer-BioNTech COVID-19 vaccine # 2 in series administered. o Action(s) taken: Epinephrine administered


VAERS ID: 1582553 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-02-26
Onset:2021-08-12
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax, Plavix, Protonix, Ambien
Current Illness:
Preexisting Conditions: Migraines
Allergies: NKDA
Diagnostic Lab Data: COBAS-Sars-Cov2 PCR
CDC Split Type:

Write-up: Breakthrough COVID19 infection


VAERS ID: 1582731 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Condition aggravated, Dizziness, Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Neck pain, Pain, Pyrexia, Sinus arrhythmia, Troponin increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: On 8/14 Troponin elevated at 4.7, EKG with NSR, no ST elevation. ECHO normal. EKGs for the 1st 3 days of hospitalization showed sinus arrhythmia.
CDC Split Type:

Write-up: He had had COVID-19 in November 2020. His father was also ill with COVID at that time. He had fever, headache, fatigue, cough, and diarrhea then. His symptoms lasted one week and then resolved .He received his first Pfizer COVID vaccine on 7/21/21. He developed fever, dizziness and headache after the vaccine. Symptoms improved after one day. He recalled some slight chest pain then. On 8/11, he received his second dose. On 8/12, he developed fever, dizziness and chest pain. On 8/14, his chest pain worsened and became severe. He reports associated SOB and radiation to his neck. He was taken to an outside facility. He was transferred to ED for further management He was admitted to the telemetry floor on the cardiology service. He was started on tylenol and motrin as needed for pain. The morning of 8/15 he developed chest pain. He denies any chest pain thereafter. He will not be cleared to return to football until a stress test is done in three months.


VAERS ID: 1582778 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-22
Onset:2021-08-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 6780 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling abnormal, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular 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: escitalopram oxalate (for anxiety)
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data:
CDC Split Type:

Write-up: extreme tiredeness, headache, body aches, dizzy, brain fog. worst 2 and 3 days after second dose. First dose had very little side effects.


VAERS ID: 1582945 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-08-12
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Condition aggravated, Continuous positive airway pressure, Respiratory distress, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALLOPURINOL, ASCORBIC ACID, GABAPENTIN, ZINC GLUCONATE, APIXABAN, BUMETANIDE, DOCUSATE, LOSARTAN, INSULIN, VELPHORO, LANTUS, DILTIAZEM, TERAZOSIN, D3.
Current Illness:
Preexisting Conditions: A-FIB, BPH, CATARACT, COLECTOMY, DM, ESRD, GERD, GOUT, HF, HTN, NEUROPATHY, SLEEP APNEA, STROKE
Allergies: AZITHROMYCIN
Diagnostic Lab Data: COVID POSITIVE RESULT 08/13/2021 1543
CDC Split Type:

Write-up: ADMITTED TO HOSPITAL ON 08/12/2021 FOR + COVID, RESPIRATORY DISTRESS WITH O2 SATURATION 75% ON CPAP, ALSO TRANSPORTED WITH A-FIB.


VAERS ID: 1583048 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-01
Onset:2021-08-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 10 mg tablet balsalazide (COLAZAL) 750 mg capsule cyclobenzaprine (FLEXERIL) 5 mg tablet(Expired) lisinopriL (ZESTRIL) 40 mg tablet omeprazole (PriLOSEC) 20 mg capsule psyllium (METAMUCIL SMOOTH TEXTURE) 3.4 gram pack
Current Illness:
Preexisting Conditions: Nervous Neck pain Respiratory Nasal congestion Cough Circulatory Hypertensive disorder Digestive Gastroesophageal reflux disease without esophagitis Ulcerative pancolitis without complication Irritable bowel syndrome Chronic ulcerative rectosigmoiditis without complications Endocrine/Metabolic Hyperlipidemia Impaired fasting glucose Other Screening for thyroid disorder PND (post-nasal drip) Insomnia Encounter for immunization Family history of colonic polyps Personal history of colonic polyps
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Fever Cough Aches


VAERS ID: 1583338 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Immediate post-injection reaction, Pruritus, Rash, Throat irritation
SMQs:, Anaphylactic reaction (broad), 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? Yes
Office Visit? No
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: None
CDC Split Type:

Write-up: Rash & pruritis to back immediately following 1st dose of Pfizer COVID-19 vaccine. While in the ED, rash continued to spread & itching of the throat developed. Treated with oral Benadryl 25mg, Oral Pepcid 20mg, I.M. Decadron 2mg, I.M. Epinephrine 0.15mg. Condition improved & she was discharged home with her mother. Given prescriptions for Benadryl and Pepcid.


VAERS ID: 1583345 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-04
Onset:2021-08-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthritis, Blood uric acid normal, Laboratory test normal
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow), Immune-mediated/autoimmune 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: warfarin, 5 mg daily
Current Illness: none
Preexisting Conditions: venous stasis
Allergies: none
Diagnostic Lab Data: chemistries, uric acid, all wnl.
CDC Split Type:

Write-up: acute monoarthritis, left ankle


VAERS ID: 1583383 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AVH / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Limb discomfort, Paraesthesia, Poor quality sleep, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Tingling and numbness started in left leg and then in both legs, lasted for 2 hours and then went away. There was a rash on my left upper leg several days later. Both hands are very achy, joint pain. Sleep has been very restless since 8/12/21, tossing and turning all night - heavy legs.


VAERS ID: 1583391 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-08-08
Onset:2021-08-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, lamictal
Current Illness: none
Preexisting Conditions: htn, high triglycerides, prediabtes, fatty liver, obesity, mood disorder
Allergies: dust mite, aripiprazole.
Diagnostic Lab Data: ER on 8/12/21 no labs or other tests.
CDC Split Type:

Write-up: hives all over body, throat closing up 4 days after vaccination


VAERS ID: 1583397 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Condition aggravated, Gait disturbance, Hypoaesthesia, Joint stiffness, Pain, Paraesthesia, Pruritus, Walking aid user
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none at the time of vaccine
Current Illness: recovering from total knee replacement surgery on left knee, and partially numb left foot, nerve damage from surgery
Preexisting Conditions: sciatica, migraines, vertigo, high blood pressure
Allergies: sulphur, I told the person giving the vaccine that
Diagnostic Lab Data: I am going to primary care doc tomorrow (8/19/21) for some blood work . I call the surgeon that did the TKR (8/16/21) and his office replied, if I don''t have a fever and the incision is not red then it probably not infected and to call my primary care doc. The great pass off
CDC Split Type:

Write-up: about 20 minutes aft shot, nurse had just left, my operated left knee began to sting and burn, a lot, then the knee became very stiff. the burning continues and knee became very painful sore even while laying down. My surgery was 3months ago and i was doing very well, only had pain if i over did exercise, i had some nerve damage and my left foot was partially numb, but i was recovery well and my foot was almost back to normal prior to the shot. Now my foot is back to being almost entirely numb with tingly sensations, it effective I have regressed back to month 1 of my surgery. Hours before i got the shot, I went to store and forgot my cane, meaning I was walking un assisted, Now I have such pain I need my cane again. I works so hard to make progress with this surgery, it is a fight against scare tissue, and now since my PT sessions are drawing to an end, i fear i mayn''t have he support to get back to where i was prior to the shot. today, 8/18/21 I am experiencing slight itching on my arms and neck, something new.


VAERS ID: 1583605 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Erythema, Headache, Joint swelling, Myalgia, Pain, Pyrexia, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Muscle pain, high fever 101,body pain,chills,headaches. Swollen, red,hot shoulder for 5 days. Stomach pain due hight does of Tylenol and Ibuprofen Still taking Omeprozole


VAERS ID: 1583619 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: At about noon I started getting itchy all over my body. It got worse and until I started taking Benadryl. I took a bunch of Benadryl and was still getting itchier and itchier. the itchiness went up to my throat and I just rode it out taking a lot of Benadryl.


VAERS ID: 1584203 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

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

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

Write-up: Patient collapsed within 15 minutes of receiving the vaccine. Emergency services was called and emergency services came.


VAERS ID: 1584206 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C2IA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue, Headache
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Zyrtec
Current Illness: None
Preexisting Conditions: Poly cystic ovarian syndrome
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stomach pain, chills and fatigue were experienced after about 16 hours. After a few more hours, a headache set in. These symptoms lasted about 24 hours.


VAERS ID: 1584223 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-21
Onset:2021-08-12
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: I got Bells Palsy. Although the doctor thought I was exposed to a virus, he believed it wasn''t vaccine related due to the time which passed since my final vaccine. I however have not been ill. The only virus I?ve been exposed to is with the vaccine. I am currently taking Prednisone (60 mg) once a day and Valacyclovir HCL (1 GM) three times a day. I have since went to the Kaiser emergency room for worsening Bells Pasly symptoms and am waiting to follow up with my primary doctor. Up until this incident, I have been in good health.


VAERS ID: 1586357 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-17
Onset:2021-08-12
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 8731 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 10 mg tablet ascorbic acid (VITAMIN C ORAL) aspirin 81 mg tablet carvediloL (COREG) 6.25 mg tablet(Expired) cholecalciferol, vitamin D3, 50 mcg (2,000 unit) tablet tablet fluticasone propionate (FLONASE) 50 mcg/actuatio
Current Illness:
Preexisting Conditions: Nervous Neck pain Low back pain Lumbar radiculopathy Shoulder joint pain Chest pain, atypical Bilateral leg paresthesia Respiratory Mild intermittent asthma without complication Circulatory Essential hypertension CAD (coronary artery disease) Vascular insufficiency of intestine Digestive Obesity Vitamin D deficiency Gastroesophageal reflux disease without esophagitis BMI 50.0-59.9, adult Musculoskeletal Other specified disorders of tendon, left shoulder Localized, primary osteoarthritis Granuloma annulare Endocrine/Metabolic Hyperlipidemia Hyperglycemia Other Depression Risk factors for obstructive sleep apnea Health care maintenance
Allergies: Contrast [Iodinated Contrast Media]Anaphylaxis LevofloxacinShortness of breath / Dyspnea, Nausea Only Ace InhibitorsSwelling AtorvastatinMyalgia / Muscle Pain Shellfish DerivedSwelling BenactyzineNausea and Vomiting Nsaids (Non-steroidal Anti-inflammatory Drug)Nausea and Vomiting
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Tested positive for COVID-19


VAERS ID: 1586367 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-18
Onset:2021-08-12
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Oropharyngeal pain, SARS-CoV-2 test, Sinus disorder, Streptococcus test
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen 200 mg capsule lamoTRIgine (LaMICtal) 100 mg tablet predniSONE (DELTASONE) 10 mg tablet
Current Illness:
Preexisting Conditions: Nervous Low back pain Acute suppurative otitis media of left ear without spontaneous rupture of tympanic membrane, recurrence not specified Respiratory Sleep apnea Upper respiratory tract infection, unspecified type Digestive Obesity Musculoskeletal Right ankle strain, initial encounter Other Bipolar 2 disorder (CMS/HCC) Fall from slip, trip, or stumble, initial encounter
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR POCT Strep A, PCR
CDC Split Type:

Write-up: Sinus Problem Cough Sore Throat


VAERS ID: 1586604 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Nausea, Pain, Paranasal sinus discomfort, Pyrexia, Rash, Swelling, Swelling face, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Moderna 1st Injection Left arm but not as severe,very mild
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: LATEX, SHELLFISH, SILICONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face and neck swelling, Nausea, Headache, Fever, Chills, Uncontrollable Full Body Shakes, Foggy Brain, Fatigue, Body Aches, Redness and Swelling at Injection Site with Hot to Touch, Rash. Took Tylenol 1000mg, Benadryl 25mg and Ibuprofen 800mg every 4 hours rotating for 5 days. Still having Headache, Fatigue and Feeling of Sinus Pressure with Minor Facial Swelling


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