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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 153 out of 6,867

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VAERS ID: 1586605 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-30
Onset:2021-08-12
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Fatigue, Headache, Nausea, Neck pain, Paranasal sinus discomfort, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Patient tested positive for COVID-19, symptoms: Neck pain, sinus pressure, loss of smell, headache, fatigue, nausea


VAERS ID: 1586669 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-08-12
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, COVID-19, Chest X-ray abnormal, Condition aggravated, Cough, Fatigue, Hypoxia, International normalised ratio, Lethargy, Lung opacity, Malaise, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler cetirizine (ZYRTEC) 10 MG tablet dexamethasone (DECADRON) 6 MG tablet diphenhydrAMINE (BENADRYL ALLERGY) 25 MG capsule ketotifen (ZADITOR) 0.025 % ophthal
Current Illness: Respiratory Unspecified chronic bronchitis Circulatory DVT of lower extremity (deep venous thrombosis) Chronic thromboembolism of deep veins of proximal leg, unspecified laterality Chronic deep vein thrombosis of proximal vein of lower extremity Chronic embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity Digestive GI bleed Infectious/Inflammatory MRSA infection COVID-19 Genitourinary Stage 3 chronic kidney disease Other Elevated blood pressure reading without diagnosis of hypertension Angioedema, initial encounter History of DVT (deep vein thrombosis)
Preexisting Conditions: Respiratory Unspecified chronic bronchitis Circulatory DVT of lower extremity (deep venous thrombosis) Chronic thromboembolism of deep veins of proximal leg, unspecified laterality Chronic deep vein thrombosis of proximal vein of lower extremity Chronic embolism and thrombosis of unspecified deep veins of unspecified proximal lower extremity Digestive GI bleed Infectious/Inflammatory MRSA infection COVID-19 Genitourinary Stage 3 chronic kidney disease Other Elevated blood pressure reading without diagnosis of hypertension Angioedema, initial encounter History of DVT (deep vein thrombosis)
Allergies: LemonHives, Swelling, Other OrangesHives, Swelling, Other PineappleHives, Swelling Bactrim [Sulfa Drugs]Other PenicillinsHives PrednisoneAnxiety, Other
Diagnostic Lab Data: COVID19 PCR-Positive 8/12/2021
CDC Split Type:

Write-up: Patient is an 80-year-old man with past medical history of RLE DVT on Coumadin who is fully vaccinated with Pfizer SARS-COV-2 Vaccination in 02/2021, presented with 7 days history of generalized fatigue, malaise and lethargy as well as cough. Patient was seen in urgent care where he tested positive for COVID-19. Patient was found to be hypoxemic saturating 87% on room air, with temp of 39.3?. Chest x-ray was patchy opacification of the right lung base. Given hypoxemia, patient was admitted and started on Decadron. Patient''s respiratory status significantly improved and remained stable off oxygen. Patient was able to ambulate in his room without any difficulty. Patient was provided with dexamethasone prescription at discharge. Patient received dexamethasone during the hospital stay but was discontinued at the time of discharge. INR was therapeutic and patient was advised to resume warfarin per home regimen. Patient was discharged to Home without services in stable condition.


VAERS ID: 1586715 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-03
Onset:2021-08-12
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Headache, Respiratory tract congestion, Rhinorrhoea, 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: cetirizine (ZyrTEC) 10 mg tablet clobetasol-emollient 0.05 % cream fluticasone propionate (FLONASE) 50 mcg/actuation nasal spray ibuprofen (MOTRIN) 400 mg tablet multivit-minerals/ferrous fum (MULTI VITAMIN ORAL) Saccharomyces boulardii (FL
Current Illness:
Preexisting Conditions: Digestive Colitis, acute Other Bulimia
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Headache Congestion or running nose


VAERS ID: 1586749 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-02
Onset:2021-08-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Streptococcus test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: None
Current Illness:
Preexisting Conditions: Musculoskeletal Non-neoplastic nevus
Allergies: No Known Allergies
Diagnostic Lab Data: POCT COVID-19 PCR POCT Strep A, PCR
CDC Split Type:

Write-up: Fever Sore throat


VAERS ID: 1586836 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-13
Onset:2021-08-12
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH N/A / 2 AR / IM

Administered by: Unknown       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: PCR COVID + TEST
CDC Split Type:

Write-up: CONTRACTED COVID DESPITE BEING FULLY VACCINATED AT TIME OF EXPOSURE AND PCR + TEST. CURRENTLY ASYMPTOMATIC. POSITIVE PCR TEST 8/12/21


VAERS ID: 1586857 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Contusion, Fatigue, Somnolence, Ultrasound scan normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine,
Current Illness: None or possibly Lyme though not confirmed by lab results.
Preexisting Conditions: none
Allergies: penicillin, doxycycline Soy
Diagnostic Lab Data: I was instructed to go to the ER to be sure the bruise was not the result of a blood clot. After five hours in the ER and conducting an ultrasound it was determined there was no clot. I am currently awaiting result of blood work to check for platelet levels. I will state here that the person who saw me today does not connect this to the vaccine but I absolutely do. I am not trying to mislead anyone but I do want some answers. I do not trust my doctor''s assessment and wanted to report this as an adverse event.
CDC Split Type:

Write-up: Two days after receiving the vaccine I woke with a large bruise on my right arm 4"x3" across with a flesh colored center. There were two rings of color, one dark blue and an outer ring which started out as light blue and turned very dark red. I have a picture but nowhere to upload it. I had done nothing the day prior but sleep as I was exhausted from the vaccine. When I awoke there was this scary looking bruise like nothing I''ve ever seen.


VAERS ID: 1586950 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Wyoming  
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 019B21A / 1 RA / IM

Administered by: Private       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? 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: NKDA no known food allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: There were no adverse reaction per his mom.


VAERS ID: 1586973 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Wyoming  
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 019B21A / 1 RA / IM

Administered by: Private       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: There were no adverse reaction


VAERS ID: 1586992 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Wyoming  
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 019B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site lymphadenopathy, Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: This boy had a fist size bump at the injection site and slightly swollen lymph nodes on the side of injections.


VAERS ID: 1587028 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-01
Onset:2021-08-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mood altered, Neurological examination normal, Staring, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (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), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Intuniv 2 mg, Concerta 54 mg
Current Illness: None
Preexisting Conditions: ADHD, autism spectrum disorder, abnormal EEG in 2014, facial tic
Allergies: kiwi
Diagnostic Lab Data: Came in for follow up a few days later, neuro check came back completely clear. No imaging completed at the time.
CDC Split Type:

Write-up: Patient''s teacher observed that he was staring and unresponsive for around 5 minutes, was altered and not himself for 25 minutes, no memory of the event. Mom felt he was sleepy and "out of it" until dinner time that night.


VAERS ID: 1587040 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-22
Onset:2021-08-12
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Cough, Dyspnoea, Headache, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), 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), 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: Chronic conditions include rheumatoid arthritis, on immunosuppression.
Allergies:
Diagnostic Lab Data: SARS-CoV-2 positive test result by PCR from specimen collected 8/18/2021
CDC Split Type:

Write-up: Patient presented with fever, cough, body aches, chills, weakness, headaches, SOB.


VAERS ID: 1587050 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-03
Onset:2021-08-12
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Nausea, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/12/21Lot#EL3248 2nd dose 02/03/21,lot#EN5318 Diagnosed covid positive:08/13/21 Symptom onset:08/12/21 Exposure:Home Symptoms:Cough, fatigue, head ache,sore throat, nausea, congestion.


VAERS ID: 1587053 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-22
Onset:2021-08-12
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Fatigue, Myalgia, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/30/21Lot#EL0142 2nd dose01/22/21 ,lot#EL3247 Diagnosed covid positive:08/13/21 Symptom onset:08/12/21 Exposure:Home Symptoms:fever, fatigue,muscle aches,congestion.


VAERS ID: 1587054 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-16
Onset:2021-08-12
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis, Coreg, Nifedipine, Olanzapine, Clonidine
Current Illness:
Preexisting Conditions: Renal failure, congestive heart failure), History of DVT (deep vein thrombosis), Anemia, unspecified type, Dyspnea, unspecified type, Depression, unspecified depression type, Bipolar 1 disorder (HC code), Encephalopathy, Prolonged Q-T interval on ECG, Hungry bone syndrome
Allergies: CEPHALOSPORINS GROUP, NYSTATIN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was given a pfizer vaccination in April 2020, came to our office last week and told us they needed their 2nd dose and that it was Moderna. After leaving the office we discovered she had one of both vaccines. No side effects reported.


VAERS ID: 1587103 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-06-13
Onset:2021-08-12
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: AFTER FOOTBALL PRACTICE HEART BEGAN TO BEAT 205-215 BPM. MEDICATION WAS ADMINISTERED THROUGH HIS IV AND HIS HEART RETURNED TO A NOMAL RYTHUM.


VAERS ID: 1587121 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
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 - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chest X-ray, Chest pain, Gait disturbance, Muscle spasms, Pruritus, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Novocaine/ Cephelexin
Diagnostic Lab Data: Chest x Ray 08/13/2021
CDC Split Type:

Write-up: Muscle spasms, difficulty walking, chest pain, burning, itching, tenderness


VAERS ID: 1587211 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
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 FC3180 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Computerised tomogram thorax, Dyspnoea, Impaired driving ability, Inflammation, Pain, Pyrexia, Scan brain, Vertigo, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations: headache and fever
Other Medications: metformin
Current Illness: none
Preexisting Conditions: none
Allergies: nikel, food dye
Diagnostic Lab Data: blood work, chest xray and ct scan, brain scan.
CDC Split Type: vsafe

Write-up: So within the first three hours i had vertigo and blurry vision and a day later had a fever and the same weekend was short of breath and it was really painful. My chest was heavy nd at the night it got really bad and I had to go the emergency room and they gave me Toradol and checked my lungs and gave me steroids. I had a pdine when they ran the tests they did the CT scan and X-ray and blood work. Then they sent me home with steroids and by Monday. My eye sight was still blurry and shortness of breath. I went to the eye doctor and they said that I have inflammatory reaction and it was triggering my nerves. because of the inflammation they sent me back to the ER and they had a brain scan and did a scan again to see the inflammation. it was just the inflammation so they sent me back home and gave me a couple of medicines. my breathing is a little bit better and my vision is still blurry a lil bit but I am not comfortable driving. At the end of the day I had a allergic reaction.


VAERS ID: 1587219 (history)  
Form: Version 2.0  
Age: 54.0  
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 - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Injection site erythema, Nausea, Paraesthesia, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever X 2 days (as high as 102.4), swelling X 4 days, nausea X 2 days, diarrhea X 2 days, redness at injection site X 4 days, tingling in extremity that still continues as of today (ongoing)


VAERS ID: 1587291 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling hot, Pruritus, Skin mass
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), 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: Multi Vitamin, Calcium, Vitamin B, Vitamin C, Vitamin D, Omega/CQ10 & Red Yeast Rice
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulphur Drugs
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Red/Hot area & extreme itching for 1 week 2 days so far. Lump under skin has increased in size x''s 3. Never had severe pain with moving arm.


VAERS ID: 1587299 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
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 043A21A / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Trokendi, Onfi,Madazolam, CBD oil
Current Illness:
Preexisting Conditions: Seizure disorder
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: light headed, anxious


VAERS ID: 1587339 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Nausea, Pain, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID Test Negative 8/18/21
CDC Split Type:

Write-up: Diarrhea, nausea, fatigue, body aches, chills, vomiting


VAERS ID: 1587411 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-08-12
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: 12/20/2020- 1st dose Moderna COVID-19 vaccine 01/28/20201- 2nd dose Moderna COVID-19 vaccine. 08/05/2021 - date of symptom onset 08/12/2021- patient tested positive for COVID-19.


VAERS ID: 1587425 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-08-12
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Inappropriate schedule of product administration, Malaise, SARS-CoV-2 test positive
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 03/16/2021- 1ST DOSE MODERNA COVID-19 VACCINE 04/14/2021- 2ND DOSE MODERNA COVID-19 VACCINE 08/11/2021 - ONSET OF COVID-19 SYMPTOMS 08/12/20201- PATIENT TESTED POSITIVE FOR COVID-19, PCR TEST.


VAERS ID: 1587457 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
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 002F21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Heart rate decreased
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: Multi Vitamin & Probiotic not consistent
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st night my heart felt like it was flipping out, my watch health monitor could not determine if it was afib, but was not sinus rhythm (undetermined). Additionally it is showing Lower than average heart rate and I have the feeling of heaviness in my chest making it harder to breath. I have shortness of breath from normal walking, normal activities.


VAERS ID: 1588580 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody increased, Arthralgia, Arthritis, Gait disturbance, Muscular weakness, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (narrow), Hypoglycaemia (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: Synthroid Celebrex Lamictal Metformin Trintellix Ambien Black seed oil Vitamin D Osteo Tri flex Adderall PRN
Current Illness: None
Preexisting Conditions: Hypothyroidism RA Depression Anxiety Metabolic obese syndrome Insomnia
Allergies: None
Diagnostic Lab Data: Elevated ANA
CDC Split Type:

Write-up: Severe joint pain, difficulty walking ,sleeping, holding items. Exacerbation of arthritis . Elevated ANA blood test. The pain is worsening day by day since day 2 after receiving the vaccine


VAERS ID: 1588581 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Erythema, Feeling abnormal, Inflammation, Pain, Pruritus, Skin lesion, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dementia (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Naproxen Acyclovir Sertraline Tretinoin Clyndamycin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Doctor ordered blood work today, will complete on Monday 8/23/21.
CDC Split Type:

Write-up: Received first dose of vaccine on 8/6/21. By 8/12/21, I noticed lesions on my left elbow as well as lesions on the palm-side of my fingers, bottoms of feet and toes. These became increasingly painful, enlarged and additional sores appeared over the course of the next few days, on my right elbow, both knees, both thigh/buttocks regions, and tops of hands followed. Sores/lesions are red, inflamed, tender to touch, blistered feeling, burning sensation, and mild itchiness.


VAERS ID: 1588918 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-02-22
Onset:2021-08-12
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19 pneumonia, Cough, Decreased appetite, Mental status changes
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: mechanical aortic valve, complete heart block status post pacer, paroxysmal atrial flutter, hyperlipidemia, hypertension, CKD stage III, chronic indwelling Foley .No history of prior COVID infection
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted to med/surg with moderate COVID + pneumonia. Pt was discharged 8/18/21 with O2. Presentation: AMS, Cough, poor appetite


VAERS ID: 1590944 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027D21A / 2 LA / IM

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

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

Write-up: Error: Booster Given Too Early.


VAERS ID: 1590958 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-08-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Nausea, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Lung disease, former smoker, Lou Gehrig''s disease
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR 8/16/21 = Positive
CDC Split Type:

Write-up: Upon Disease Investigation 8/19/21 - case reported symptom onset of 8/12/21 which included fever, runny nose, headache, fatigue, cough and nausea.


VAERS ID: 1590982 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-08-12
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray abnormal, Cough, Decreased appetite, Dyspnoea, Electrocardiogram abnormal, Fatigue, Olfactory nerve disorder, Pneumonia, Rhinorrhoea, SARS-CoV-2 test positive, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension, Cardiovascular disease, COPD, hyperlipidemia, anemia, AFIB, Bradycardia, IBS, Dyspnea, Former smoker and CAD
Allergies: Unknown
Diagnostic Lab Data: Covid 19 PCR 8/16/21 = Positive Chest X-Ray 8/16/2021 = Abnormal EKG 8/16/2021 = Abnormal
CDC Split Type:

Write-up: Upon date of Case Investigation of 8/19/2021 case wife reported onset of symptoms as 8/12/21 which included Runny nose, new olfactory disorders, fatigue, cough, wheezing, shortness of breath and loss of appetite. Case wife reports that he is hospitalized due to an abnormal EKG and Pneumonia.


VAERS ID: 1591163 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-05
Onset:2021-08-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 LA / IM

Administered by: Senior Living       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: 8/6/21 UTI
Preexisting Conditions: Heart failure, COPD, cardiomyopathy
Allergies: Cipro
Diagnostic Lab Data: 08/12/2021 Abbott binax rapid COVID-19 test 08/12/2021 (results 08/14/2021) Capstone PCR COVID-19 test
CDC Split Type:

Write-up: Resident tested positive with a rapid test 08/12/2021. No symptoms present so PCR collected and sent to Capstone. PCR returned 08/14/2021 and was positive. Resident has remained without symptoms currently.


VAERS ID: 1591197 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

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

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

Write-up: developed a rash about a week after the shot on the left side that turned out to be shingles


VAERS ID: 1591316 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-08-12
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, OSA
Allergies: KNDA
Diagnostic Lab Data: positive covid pcr on 8/12
CDC Split Type:

Write-up: PT RECEIVED PFIZER VACCINE X 2 DOSES ON 3/4/21 AND 3/27/21. Patient found down in hotel room on 8/12. Patient tested positive for covid pcr on 8/12. breakthrough covid vaccine case


VAERS ID: 1591573 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Fatigue, Feeding disorder, Headache, Impaired work ability, Migraine, Myalgia, Pericarditis, Pyrexia, Swollen tongue, Urticaria, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Vaccine (given once a year and hives/fever occur after each time.
Other Medications: daily morning prescriptions: Nifedipine, hydroxyzine. daily evening prescriptions: Fluoxetine, lev0cetirizine
Current Illness:
Preexisting Conditions:
Allergies: Idiopathic Urticaria
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives from head to toe, fever, chills, diarrhea, vomiting, migraine, tongue swelling, sore muscles, dizziness and very fatigued. On Saturday signs of Pericarditis returned and therefore I began taking the prescribed medication from prior episode (colchicine). Missed 2 days of work (Friday and Monday). Had to utilize epi pen, and also took regular doses of Benedryl. Could not eat or drink for three days. A week later and the headache is still slightly there and hives are slowly diminishing.


VAERS ID: 1591590 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradykinesia, Condition aggravated, Confusional state, Decreased appetite, Depersonalisation/derealisation disorder, Diarrhoea, Dizziness, Fatigue, Hyperhidrosis, Malaise, Migraine, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan 8/11/21 Tylenol 8/12/21 Travatan Z 98/11/21 Rizatriptan 8/11/21 Omerprazole 8/11/21 Medroxyprogestrone Metformin
Current Illness:
Preexisting Conditions: Chronic Migraines Asthma anxiety and depression bleeding hemmorrhoids Restless leg syndrome GERD H. Pylori Glaucoma PCOS
Allergies: Tramadol Ketorolac Nickel Adhesive Ciprofloxacin Lorazepam Codeine
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Got my vaccine on 8/12/21 felt fine after then roughly 3 hours after started feeling very sick. I was told it would last 1-3 days. It is now 8/20/21 I have had a migraine since given the vaccine. I have chronic migraines and I had not had one in months. I have been puking, very tired, dizzy, not able to eat much. I have not been feeling myself. I have been confused and super slow to do things. I have had diarrhea and sweats. I have had these symptoms since 3 hours after getting the vaccine on 8/12/21


VAERS ID: 1591600 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT REVEALED TO US
Current Illness: UNKNOWN
Preexisting Conditions: ASTHMA
Allergies: OPOIDS IV CONTRAST DYE
Diagnostic Lab Data: NOT REPORTED TO US AT THE PHARMACY LEVEL
CDC Split Type:

Write-up: SAID TONGUE FELT COLD. SMALL RED, ITCHY RASH COVERING BOTH FEET AND PROGRESSING UP BOTH ANKLES. LARGE HIVES ON FOREHEAD. CHEST TIGHTNESS. HIVES LATER APPEARED ON NECK, CHEST AND STOMACH. PATIENT WENT TO EMERGENCY DEPARTMENT. WAS TREATED AND RELEASED


VAERS ID: 1591656 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-13
Onset:2021-08-12
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, COVID-19, COVID-19 pneumonia, Chest pain, Condition aggravated, Cough, Hypertension, Hypovolaemia, Imaging procedure, Lung opacity, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prior to Admission Medications Outpatient Home Medications Taking? Allopurinol (ZYLOPRIM) 100 mg Oral Tab Takes Regularly Sig: Take 3 tablets by mouth daily Colchicine (COLCRYS) 0.6 mg Oral Tab Takes Regularly Sig: Take 1 tablet by mouth da
Current Illness: Gout, weakness
Preexisting Conditions: h/o diverticulosis, asthma/COPD overlap, BPH, DM2, Afib on Pradaxa, OSA, HTN, CKD, tobacco smoking, gout and recent admission for COVID pneumonia 8/6-8/8
Allergies: Amlodipine, HCTZ
Diagnostic Lab Data: 84 years old, CHEST PAIN ** TECHNIQUE **: 1 view of the chest acquired. COMPARISON: Radiograph 8/6/2021 ** FINDINGS **: LUNGS: Patchy opacities in the right mid and lower lung suspicious for infiltrate/pneumonia (including COVID-19 pneumonia). No pleural effusion. MEDIASTINUM/OTHER: Normal cardiomediastinal silhouette
CDC Split Type:

Write-up: 84 Y male with history of asthma/COPD overlap syndrome, obstructive sleep apnea, tobacco smoking, type 2 diabetes, atrial fibrillation, hypertension, chronic kidney disease, gout, who re-presented to the ED on 8/6 with increased generalized weakness after tested positive for COVID 8/5 and was admitted for further management of COVID pneumonia. Patient had increased dry cough on 8/3 which improved with albuterol. He was evaluated in the ED on 8/5 and found to be COVID-positive. He had no hypoxia with ambulation and was subsequently discharged home. He re-presented to the ED on 8/6 with worsening generalized weakness. Last fever on 8/6. He was treated with remdesivir (8/6 to 8/8). He continued to show symptomatic improvement without hypoxia at rest or with ambulation. Hospital course was also significant for acute kidney injury 2/2 hypovolemia. Renal function returned to baseline with IV hydration. Patient was briefly hypertensive during this hospitalization, requiring increase of PTA hydralazine from QHS to BID. Patient was clinically stable for discharged on 8/9 with COVID kit. Patient will continue to remain in self-isolation until 8/15. Primary Procedures: None Secondary Procedures: None Reason for Hospital Admission (Admitting Diagnosis): COVID-19 PNEUMONIA


VAERS ID: 1591696 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster, Injection site hypoaesthesia, Rash, Rash papular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: I had a rash that started to itch underneath my right breast. About 2.5 inches width by 1 inch height. This rash got worse and the bumps were raised/blistered. I went back to the same clinic I received the vaccine to see a doctor on site. She was able to see me that day within the hour. She did confirm that I had a mild shingles outbreak and prescribed me antiviral to take for a week. Since taking the medication the outbreak has not worsened and is very, very slowly getting a little better. I am experiencing numbness at the site now as well which has started just yesterday (08/19/2021). I understand that the vaccine does not CAUSE shingles, but that factors can contribute to an outbreak of shingles such as stress or immune conditions (my system was potentially weakened by the vaccine which allowed this outbreak??) I have never had a shingles outbreak before in my life, so I would say this is indeed an adverse event related to the vaccination I received.


VAERS ID: 1591709 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Nodule, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood pressure - Calcium Cholesterol Gabapentin Aspirin
Current Illness:
Preexisting Conditions: Diabetic Hypertension Nerve issue Cholesterol
Allergies: Penicillin Sulfa
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Developed a know on left arm with pain and itching. She put ice pack and took ibuprofen and hydrocortisone cream to area.


VAERS ID: 1591713 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 6 LA / IM

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

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

Write-up: Patient developed hives and bumps. Her skin was pink, red and itchy


VAERS ID: 1591717 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-25
Onset:2021-08-12
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: Woke up with rash all over back, less severe on arms and chest. Most likely molluscum contagiosum.


VAERS ID: 1591872 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM

Administered by: Pharmacy       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started cymbalta around the same time.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called to inform us that she still has redness, swelling and warmth in the right arm red 9 days after vaccination. She is not currently having any systemic issues.


VAERS ID: 1591946 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: constant ringing in both ears. began shortly after shot and has not stopped or weakened since. have never had this issue before


VAERS ID: 1592026 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-30
Onset:2021-08-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

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

Write-up: Muscle spasms and twitching in legs non stop


VAERS ID: 1592101 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Lymphadenopathy, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: cetirizine 10 mg daily, fluoxetine 20 mg daily
Current Illness: none
Preexisting Conditions: anxiety
Allergies: Sulfa, egg
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Adenopathy and hives


VAERS ID: 1592128 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests normal, Ear discomfort, Ear pain, Otitis media, Tinnitus
SMQs:, Hearing impairment (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: Prenatal, magnesium, probiotic, digestive enzyme
Current Illness: Cold and sore throat a few weeks before. Resolved before vaccination
Preexisting Conditions: Infertility
Allergies: None
Diagnostic Lab Data: Ear Check by MD family doctor: said there was fluid built up ear. Steroids given. Ear check by ENT, ears found normal. Audiologist tested my hearing and found no hearing loss. Pressure and ringing continues in ears.
CDC Split Type:

Write-up: Ringing in ears and clogged ear feeling, pressure in ears, ear pain


VAERS ID: 1593225 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anal incontinence, Balance disorder, Disorientation, Dizziness, Mobility decreased, Myalgia, Neck pain, Pain, Pruritus, Skin warm, Somnolence, Swelling, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Ibuprofen over counter
Current Illness:
Preexisting Conditions: Chronic bronchidis
Allergies: Pennecillian and zyban
Diagnostic Lab Data:
CDC Split Type:

Write-up: 30 min-swollen warm arm. 2hrs-muscle aches and pains, could not lift arm all the way up. Vertigo began Day2-vertigo and neck pain began increasing, muscle pain about the same, arm swelling went down. Itching torso Day7-vertigo and neck pain extreme. Vertigo happens bending over, turning head, looking down. Neck too stiff to move much. Itching continues along with muscle soreness. Sleepy lightheaded and loss of balance Day 8- took Benadryl. It helped temporarily with itching and eased neck pain and vertigo some. Went to sleep. As day continued, vertigo and neck pain as well as all other symptoms increased again along with shortness of breath and uncontrollable bowel .movements. Neck pain is from behind lower ear to inside collar bone. Disoriented, unbalanced, walking to the bathroom feels like a five mile run afterwards.


VAERS ID: 1594194 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE8236 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling of body temperature change, Migraine, Photopsia, Vertigo, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Inability to regulate temperature (hot to cold in a matter of seconds), vertigo, flashes of light, blurred vision, severe migraine headaches. Sporadic vertigo and headaches persist 8 days later.


VAERS ID: 1594310 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210812; Test Name: COVID-19 virus test; Result Unstructured Data: Positive.
CDC Split Type: USJNJFOC20210826496

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via social media concerned a patient of unspecified age, sex, race and ethnicity. 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: Unknown and expiry : UNKNOWN) dose was not reported, 1 total, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 12-AUG-2021, the patient tested positive for COVID-19 (suspected clinical vaccination failure) as the patient experienced generalised aching, sore throat, fever and was sick as a dog . The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210826496-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS.


VAERS ID: 1594346 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Diarrhoea, Feeling abnormal, Gastrointestinal disorder, Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PNEUMOVAX; LISINOPRIL; HYDROCHLOROTHIAZIDE
Current Illness: Abstains from alcohol; Heart disorder; Narcolepsy; Non-smoker; Penicillin allergy; Sulfonamide allergy
Preexisting Conditions: Comments: The patient had no history of drug abuse or illicit drug use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210832326

Write-up: LOWER BACK PAIN; GASTROINTESTINAL ISSUES; DIARRHEA; PAIN AT INJECTION SITE; NAUSEA; HEADACHE; FELT YUCKY; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: narcolepsy, heart issues, penicillin allergy, non alcohol user, non-smoker, and sulfonamide allergy, and other pre-existing medical conditions included: The patient had 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: 1820095, expiry: UNKNOWN) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. Concomitant medications included hydrochlorothiazide for heart issues, lisinopril for heart issues, and pneumococcal vaccine polysacch 23v. On AUG-2021, treatment medications included: naproxen sodium. On 12-AUG-2021, the patient experienced felt yucky. On 12-AUG-2021, the patient experienced pain at injection site. On 12-AUG-2021, the patient experienced nausea. On 12-AUG-2021, the patient experienced headache. On 14-AUG-2021, the patient experienced gastrointestinal issues. On 14-AUG-2021, the patient experienced diarrhea. On 15-AUG-2021, the patient experienced lower back pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from gastrointestinal issues, diarrhea, pain at injection site, nausea, and headache on 15-AUG-2021, was recovering from felt yucky, and had not recovered from lower back pain. This report was non-serious.


VAERS ID: 1594373 (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: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Skin adhesion
SMQs:, 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: CLONIDINE; SEROQUEL; SUBLOCADE
Current Illness: Opioid use disorder; Sleep disorder
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210833182

Write-up: METALS ARE STICKING TO THE ADMINISTRATION 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 concurrent conditions included: opioid dependency disorder, and sleep disorder, and other pre-existing medical conditions included: The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. Concomitant medications included buprenorphine for opioid dependency disorder, quetiapine fumarate for sleep disorder, and clonidine. On 12-AUG-2021, the patient experienced sore arm. On 14-AUG-2021, the patient experienced metals are sticking to the administration site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from metals are sticking to the administration site, and sore arm. This report was non-serious.


VAERS ID: 1594406 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Non-smoker; Penicillin allergy (After taking penicillin patient got reaction included fever of 100 degree F, body aches, head burning and very tired which lasted for 36 hours.); Social alcohol drinker (moderate social)
Preexisting Conditions: Comments: The patient had no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210835195

Write-up: BODY ACHES; CHILLS; FEVER; HEADACHE PERSISTENT (ON BACK OF THE SKULL AND FOREHEAD); This spontaneous report received from a consumer concerned a 23 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: social alcohol user, non-smoker, and penicillin allergy, and other pre-existing medical conditions included: The patient had 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: 202A21A, expiry: 21-SEP-2021) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced body aches. On 12-AUG-2021, the patient experienced chills. On 12-AUG-2021, the patient experienced fever. On 12-AUG-2021, the patient experienced headache persistent (on back of the skull and forehead). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, chills, and fever on AUG-2021, and had not recovered from headache persistent (on back of the skull and forehead). This report was non-serious.


VAERS ID: 1594427 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Pyrexia, SARS-CoV-2 test
SMQs:, 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210812; Test Name: Body temperature; Result Unstructured Data: 101.2 F; Test Date: 20210817; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210836071

Write-up: FEVER; This spontaneous report received from a patient concerned a 23 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 21-SEP-2021) dose was not reported, administered on 12-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.2 F. On 17-AUG-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever. This report was non-serious.


VAERS ID: 1594440 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-08-12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Oral pain, SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Dementia (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? 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: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210837418

Write-up: SUSPECTED COVID-19 INFECTION; REALLY SORE MOUTH; NOT FEELING RIGHT; SUSPECTED CLINICAL VACCINATION FAILURE; This spontaneous report received from a patient concerned a 32 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: not reported) dose was not reported, 1 total, administered on 09-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 12-AUG-2021, the patient was tested positive for coronavirus disease (Covid-19) (suspected clinical vaccination failure). Patient''s only symptoms were sore mouth and he was not feeling right. Patient''s primary care physician (PCP) was aware of the complaint. On an unknown date, patient experienced suspected covid-19 infection. Patient''s wife (who had received the first dose of Moderna) and children (unvaccinated) were tested negative for COVID-19. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected clinical vaccination failure, suspected covid-19 infection, really sore mouth and not feeling right was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210837418-Covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1595215 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

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

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

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1602553 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNS 052E21A / 7+ LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Heart rate increased, Hypertension, Immediate post-injection reaction, Oropharyngeal discomfort
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Hypersensitivity (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, birth control, Wellbutrin
Current Illness: None
Preexisting Conditions: POTS
Allergies: Latex and adhesives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right after I received the shot my whole entire body started to burn. My face my tongue, my eyes even my toes burned it felt like a fire inside my body. My heart rate and bp were high. My throat started to feel funny. I was at the er within 15 mins.


VAERS ID: 1602655 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood gases, Full blood count, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture abnormal, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Metabolic function test, Muscular weakness, Paraesthesia, Pulmonary function test, Scan with contrast
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: 23 flu unknown, gi effects
Other Medications: Melatonin Topamax Vitamin D,C,B,E Magnesium Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: Clindamycin Tape adhesive Flu vaccine
Diagnostic Lab Data: Hospitalized 8/14/21-8-18-21. Multiple breathing test performed at least twice a day during stay to assess paralysis progression was not effecting my diaphragm. Lumbar puncture 8/14. ABG 8/14. MRI Spine WITH contrast 8/15, MRI brain with contrast 8/16. Daily CBC and BMP while hospitalized. Received IVIG treatment = 5 doses of Privgen.
CDC Split Type:

Write-up: Numbness and tingling of arms within hours of vaccine, progressed to legs . Two days later in the Emergency room with leg weakness. Lumbar puncture with high protein confirmed GBS. I was in the ICU for 3 days and medical unit another 2 days receiving treatment.


VAERS ID: 1602675 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Headache, Pyrexia, Swelling face, Thirst
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: On 2 or 3 occasions, I became severely sick with the flu at exactly 7 days after receiving the vaccine. This, I do not normally
Other Medications: Vitamins, B complex, C, Ca + Mg + Zinc complex
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 4 hours after the vaccine I started to feel feverish and very thirsty. I took my own temperature and it was normal. About 5 days after vaccine I started to feel a few random heart jabs in the heart area. This occurred randomly during the day and now, 14 days later, seems to have slowed down in frequency. On 8/16 & 17 I also felt very strong jabs on the left side of my head, internally. On 8/18, I woke up with my entire face swollen especially my left side. There was no other swelling on my body.


VAERS ID: 1602714 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-29
Onset:2021-08-12
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / UNK - / -

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1602764 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-31
Onset:2021-08-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Dyspnoea, Fibrin D dimer increased, International normalised ratio normal, Pulmonary embolism, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, losartan, HCTZ
Current Illness: none
Preexisting Conditions: Hypothyroidism: dx''d in 1984 ; etiology is idiopathic ; Hypertension: dx''d in 2001 ; controlled ; with associated none ; Irritable Bowel Syndrome Endometriosis: dx''d in 1960s ; Osteoarthritis: primarily affecting the knees ; Obesity ECHO 2018 done for murmur, showed trace mitral and tricuspid regurgitation L2-4 trauma s/p horse accident age 22
Allergies: none
Diagnostic Lab Data: CTA showed showed PE''s as above. D-dimer elevated to 1.13 mg/L. INR 1.08. Negative PCR for COVID-19.
CDC Split Type:

Write-up: Patient with difficulty breathing around 10-12 days after second dose of vaccine . 2 days later in the ER, patient found to have definative segmental and subsegmental pulmonary emboli in the left lower lobe. Treated with admission, heparin drip, anticoagulation.


VAERS ID: 1602851 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OO8C21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Dizziness, Dyspnoea, Eye irritation, Fatigue, Feeling abnormal, Hypoaesthesia, Hypoaesthesia oral, Injection site pain, Migraine, Muscle fatigue, Musculoskeletal stiffness, Nausea, Paraesthesia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (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 meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Vestibular disorders (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motri
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1. Burning behind the eyeballs. Lasted for 2 days. 2. Face went completely numb. Mouth went numb. Lasted the whole day of vaccination date. 3. Fever. Lasted for 3 days. 4. Brain fog. Still continuing. 5. Fatigue. Still continuing. 6. Chest pain. Still continuing. 7. Shortness of breath. Still continuing. 8. Dizziness. Still continuing. 9. Unusual migraines. Still continuing. 10. Extreme burning pain attention injection site in left arm. Still continuing. 11. Left arm goes tingly and completely numb. Still continuing. 12. Extreme stiff neck. Can barely move my neck. Still continuing. 13. Body felt like it was burning fire on the inside. Lasted 3 days. 14. Muscle fatigue and pain. Lasted a week. 15. Nausea. Lasted 3 days.


VAERS ID: 1603059 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site discharge, Injection site pain, Injection site swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl
Current Illness: Asthma since an infant, but no current flare
Preexisting Conditions: Possible undiagnosed autoimmune disease Asthma Severe allergies
Allergies: Keflex, severe environmental allergies
Diagnostic Lab Data: Reported to urgent care on day 9 due to injection site being severely swollen & uncomfortable. Hives were continuing to come & go throughout body. Prescribed azithromycin & prednisone.
CDC Split Type:

Write-up: Hives throughout body within 1-2 hours after shot, continued for about 3 days consistently. Arm also swelled about 2 inches around injection site within 2 hours, it continued to swell to about 3.5 inches around injection site over the next 36hours. Hives continued on & off about 3 more days. Injection site stayed swollen. On day 7-8 hives & swelling seemed to lessen, but on day 9, swelling/pain/discomfort got much worse & hives returned on & off throughout body. I then went to our local urgent care.


VAERS ID: 1603822 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Capillary fragility
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: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: Tree nuts food allergy.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: A few days after I recieved the vaccine I noticed something on my finger. The more I looked at it I noticed it was under the skin. It appears to be a popped blood vessel. It is very small and is not going away. Then I started to notice in the same day, more of them over my entire body (areas including belly, arms, and legs). They still have not gone away, or even faded, or seem like they will go away soon.


VAERS ID: 1617389 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-08-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 8077727399 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial spasm
SMQs:, Dystonia (broad)

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

Write-up: Facial spasms


VAERS ID: 1617436 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Eye swelling, Fatigue, Headache, Lymphadenopathy, Nausea, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantroprazole 20 mg
Current Illness: none
Preexisting Conditions: gerd
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, fatigue,swollen lymph nodes in neck, under arms. Face and eyes swollen. Queasy and slight uneasiness in chest.


VAERS ID: 1617500 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-25
Onset:2021-08-12
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011DZIA / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, mega red krill oil (Omega-3), vitamin D, Vitamin C with Zinc
Current Illness: None
Preexisting Conditions: Osteoarthritis in finger knuckles
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Got my period 2.5 weeks after first vaccination shot. I have not had a period since December 27, 2020.


VAERS ID: 1617528 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Eye haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retinal 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: Atorvastatin, Lamictal, Cymbalta, amlodipine, lisinopril, hydrochlorithiazide, modafinil, Ambien, clonazepam, Amitiza, 81 mg aspirin
Current Illness: No
Preexisting Conditions: Depression, hypertension
Allergies: Shellfish- clams, scallops, etc
Diagnostic Lab Data: CT scan for blood clots or brain bleeds
CDC Split Type:

Write-up: Ruptured blood vessel in right eye


VAERS ID: 1617586 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, Fall, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (narrow)

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

Write-up: After I gave the vaccine in his left arm, he walked to the waiting area about 15 feet away. He sat down, then appeared to faint, and fell on the floor. His brother helped him back into his chair by the time I was able to run over to him. He seemed pale. We gave him a glucose tablet to eat to raise his blood sugar and he immediately threw it up. We ended up calling the ambulance, and when they arrived they checked his blood sugar and pupils and he said that he had not eaten that AM. His blood sugar was low and his pupils were reactive and they advised him to get something to eat but did not take him to the hospital.


VAERS ID: 1617621 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-02
Onset:2021-08-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008021A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Erythema, Fatigue, Hot flush, Hyperhidrosis, Malaise, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu vaccine gives me overall body aches
Other Medications: lisinopril 10 mg po qd
Current Illness: none
Preexisting Conditions: borderline hypertension
Allergies: sulfa, betadine
Diagnostic Lab Data:
CDC Split Type:

Write-up: With initial injection on 8/2/21 I experienced a hot flush over my entire body then broke out in a sweat; this lasted about 1 minute. On 8/3/21, I experienced extreme fatigue and achy joints, a feeling of malaise.; this resolved in 24 hours. I was then asymptomatic until 8/12/21. My left deltoid became swollen, reddened, and very hot to touch. I also ran a low grade temp to 100.5 which was sustained overnight. The next morning I took Benadryl 50 mg po and Ibuprofen 400 mg po at the advice of the pharmacist.


VAERS ID: 1617750 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Dysmenorrhoea, Headache, Insomnia, Lymphadenopathy, Menstruation irregular, Nausea, Paraesthesia, Pyrexia, Visual impairment
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Fertility disorders (broad), Noninfectious diarrhoea (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: Covid 19 Pfizer Shot # 1 (see report)
Other Medications: Daily Multi vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Seclor / cefaclor
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: Insomnia, headache, menstrual like cramps/squishy poop, fever (101.7 from forehead thermometer), swollen lymph node(s) under arm, one instance of dizziness (saw spots/ arms legs tingling), nausea, and started an unexpected 3rd menstrual period (see report from shot # 1) just 2 weeks after the last one. Called doctor who said it should all pass. As of today, everything seems fine except the swollen lymph node(s) under the arm are decreased but not yet gone. We are not sure what will happen with the disruptions to the menstrual cycle.


VAERS ID: 1617849 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-08-12
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Shingles without history of chicken pox (vaccinated against chicken pox in 1996)


VAERS ID: 1618499 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dyspnoea, Fatigue, Hypersensitivity, Immediate post-injection reaction, Injection site erythema, Injection site induration, Injection site nodule, Injection site pain, Injection site swelling, Injection site warmth, Neuralgia, Paraesthesia, Pyrexia, Sensory loss, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Trazadone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood panels, lung X-ray, leg ultrasound on 08/14/21, 48 hours after shot. All negative results. Diagnosed with injection site allergic reaction. Recommend Tylenol Morton and Benadryl and follow up with PCP.
CDC Split Type:

Write-up: Immediately after show injection site pain redness swelling. 6-7 hours after shot fever, chills, shortness of breath, and fatigue began. Day after the shot injection site swelling and redness were worse, it was hot to touch, and constantly burning with pain on a scale of 7/10, and fevers continued. One week after shot arm pain has not had an relief there is hard painful knot at the injection site. I am experiencing ulnar never pain with tingling and loss of feeling in pink and ring finger on left had that comes and goes. Sciatic never pain that radiates down my left leg numbness and tingling in pinky and fourth toes on my left foot. Fevers continue on and off, averaging 101.5, improve with Tylenol.


VAERS ID: 1620494 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa/Bactrim
Diagnostic Lab Data: Seeing GP and neurologist in September
CDC Split Type:

Write-up: Extremity numbness, tingling, pins and needles.


VAERS ID: 1623250 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Pain in extremity, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe dizziness, nausea and vomiting on on two occasions lasting many hours and left hand tingling consistently and pain intermit-ant immediate after injection


VAERS ID: 1623283 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Dizziness, Dyspnoea, Fatigue, Impaired work ability
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: have received the covid test three time''s and all the test were negative
CDC Split Type:

Write-up: received the shot on a Monday in the left arm and and two days after the shot at work at 3:00 AM i started to feel light headed. dizzy, stomach hurt, weak, and very tired. a day after the symptoms stared i begun to have short breaths when returning back to work and wasn''t able to complete a 9 hour work day only made it 4 hours in the workday. haven''t been back to work for a week now.


VAERS ID: 1623292 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C2IA / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Headache, Insomnia, Mobility decreased, Pain
SMQs:, Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bioidentical hormones; Estrodial, Progesterone, Testosterone. Nexium for GERD
Current Illness: No.
Preexisting Conditions: No.
Allergies: No.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Couldn''t move. Body aches, headache, sick to stomach. On a scale of 1-10, my experience was about an 8:10 in aches, pain, couldn''t move, couldn''t sleep. This lasted for 48 hours and began 12 hours after receiving the 1st shot.


VAERS ID: 1623315 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-16
Onset:2021-08-12
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-08-23
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? 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: Positive covid 19 PCR


VAERS ID: 1623381 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Headache evey day


VAERS ID: 1623499 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis 5 mg - twice daily, Toujeo Solostar 300 units/ml - 10 units sub-q at bedtime
Current Illness:
Preexisting Conditions: diabetes, cancer
Allergies: Penicillins
Diagnostic Lab Data: MD appt 8/18/21 - no tests run (as far as I know)
CDC Split Type:

Write-up: Patient experienced itchy, welt-like hives. Her physician''s MA described them as looking like "blood blisters." This reaction began the day after receiving the vaccine on 8/11/21. She saw her physician on 8/18/21 because her condition had not resolved. Her physician advised OTC Benadryl to relieve itching. As of today (8/23/21), she describes the hives as "almost gone."


VAERS ID: 1623627 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-09
Onset:2021-08-12
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: CARDIOVASCULAR DISEASE
Allergies: UNK
Diagnostic Lab Data: POSITIVE PCR ON 8/12/21.
CDC Split Type:

Write-up: TESTED POSITIVE FOR COVID 19, AFTER BEING FULLY VACCINATED.


VAERS ID: 1623646 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-09
Onset:2021-08-12
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: HTN, CARDIOVASCULAR DISEASE
Allergies: UNK
Diagnostic Lab Data: POSITIVE PCR ON 8/12/21
CDC Split Type:

Write-up: TESTED POSITIVE FOR COVID 19, AFTER BEING FULLY VACCINTTAED.


VAERS ID: 1623668 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hallucination, Urine analysis abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports having burning across her chest, hot urine, and hallucinations.


VAERS ID: 1624011 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-05
Onset:2021-08-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: patient stated covid rash appeared on arm 7 days after administration


VAERS ID: 1624158 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia oral, Paraesthesia oral, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pnuemia - Packzier 13
Other Medications: Benadryl; Elberahl Inhaler for asthma; lots of phylum.
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Lots medication please contact for list too long for report. Latex; Polyp Fill Stuffing; nuts; hair dye; Benadryl; Pineapple( requires additional treatment).
Diagnostic Lab Data: 08/12/2021 observation alumetral and Pepside through IV and monitored for an hour and releasedIV Steriod shot Pretazone .08/13/2021 two oral tablets of Pepsids Roof of the month was Tingley and she took Benadryl at home every two to three hours as prescribed . A week for her to recover from the side effects.
CDC Split Type: vsafe

Write-up: 08/12/2021 tongue felt tingle, swollen and numb and numb 06:30 pm two Benadryl that not helping so went to ER at 09:00PM. They looked at it put on Salumetral and Peptide through IV and monitored for an hour and released. 08/13/2021 was noon tip of tongue was tingley contacted the ER and the recommended for come in.


VAERS ID: 1624547 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Eczema
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (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: Seasonal allergies; allergic to sulfa meds
Diagnostic Lab Data:
CDC Split Type:

Write-up: I experienced chest pain, tightness and shortness of breath from 8/12/21-8/16/21. I continue to have sporadic shortness of breath. I had an extreme flare up of eczema of both my hands ?all fingers and each palm beginning on 8/12-finally clearing up with use of hydrocortisone.


VAERS ID: 1624817 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Headaches, daily, mostly in evenings for at least 2 weeks now and continue


VAERS ID: 1625804 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Arthralgia, Chills, Headache, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PVIUS2021001172

Write-up: shaking muscle; abdominal burning; Headache; Nausea; joint pain; fever; chills; This spontaneous case was reported by a consumer and describes the occurrence of TREMOR (shaking muscle), ABDOMINAL DISCOMFORT (abdominal burning), HEADACHE (Headache), NAUSEA (Nausea) and ARTHRALGIA (joint pain) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form once. On 12-Aug-2021, the patient experienced TREMOR (shaking muscle), ABDOMINAL DISCOMFORT (abdominal burning), HEADACHE (Headache), NAUSEA (Nausea), ARTHRALGIA (joint pain), PYREXIA (fever) and CHILLS (chills). At the time of the report, TREMOR (shaking muscle), ABDOMINAL DISCOMFORT (abdominal burning), HEADACHE (Headache), NAUSEA (Nausea), ARTHRALGIA (joint pain), PYREXIA (fever) and CHILLS (chills) had not resolved. No concomitant medications reported. Treatment information not reported. Reporter did not allow further contact


VAERS ID: 1628017 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-06
Onset:2021-08-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Presyncope, SARS-CoV-2 test negative
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (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: Vyvanse 30 mg qd
Current Illness:
Preexisting Conditions: G6PD deficiency
Allergies: NKA
Diagnostic Lab Data: 07/17-Normal EKG 08/12-Neg COVID
CDC Split Type:

Write-up: Patient had episode of palpitations for one day following the first dose. He reports ongoing fatigue after the 2nd dose. He experienced near syncope on post vaccine day 6. No other cause could be found for the episode.


VAERS ID: 1628047 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Lip swelling, Pain in extremity, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 & Calcium tablets
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness in left arm for the first day (August 12th) into all of the next day (August 13th), finally ebbing on the 14th. Pronounced upper lip swelling occurred on August 16th, and pronounced lower lip swelling occurred on August 18th into the 19th. Minor nose swelling on August 23rd, treated by taking 2 Benedryl to mitigate swelling. Between these swelling incidents, I also experienced itchiness and red patches on various body parts, but especially on left wrist.


VAERS ID: 1628173 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Diarrhoea, Dizziness, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Pain in Left arm, heart start was twitching often. diarrhea, dizzness


VAERS ID: 1628282 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
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, Malaise
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: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: SECOND DOSE OFCOVID-19 MODERNA VACCINE WAS ADMINISTERED 10 DAYS AFTER FIRST DOSE. ( 18 DAYS TOO EARLY) PATIENT RECALLS FEELING ILL DUE TO THIS.


VAERS ID: 1628307 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Vital Signs: B/P 143/94, HR 78, O2 98%, P 70.
CDC Split Type:

Write-up: Pt. presented to walk to get the COVID-19 vaccine. Stated he was nervous. After shot, pt. sat down in the observation area. Pt. stated he was going to pass out. Nurse advised to sit on floor. Pt. vitals were taken and pt. put his feet up. After a while he stated he was ok and left with his wife.


VAERS ID: 1628363 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-02-04
Onset:2021-08-12
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram pulmonary, Asthenia, Blood test, COVID-19, Chest X-ray abnormal, Cough, Electrocardiogram, Fatigue, Flushing, Hypoxia, Pneumonitis, Pyrexia, Respiratory symptom, SARS-CoV-2 test positive, Urinary tract infection
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tramadol 50mg PO Q12H PRN, Prednisolone acetate 1 drop OP BID, Nirtofurantoin macrocrystal 1 cap PO Q12H, lisinopril 20mg PO BID, ondansetron 1 tab PO Q8H PRN, levothyroxine 112mcg PO ACBREAKFAST, latanoprost 0.005 ophth soln 1 drop OP BEDT
Current Illness: UTI
Preexisting Conditions: hypothyroidism, elevated cholesterol, HTN, incontinence, osteoarthritis, obesity, anticoagulation therapy
Allergies: NKDA
Diagnostic Lab Data: SARS COV1-PCR-Positive8/12/21, blood testing 8/12/21 and 8/16-8/22, chest angiogram 8/16, CXR 8/16 and 8/19, EKG 8/14, CXR 8/14,
CDC Split Type:

Write-up: 8/14-patient tested in the facility ED for fatigue, weakess and cough. at that time it was also found that she had a UTI, but was not exceedingly ill with COVID related to respiratory issues. Patient presented on 8/16 with worsening weakness, flushing of face and cough, new pneumonitis on imaging. patient was hypoxic into the low 80s. fever of 101F. patient then hospitalized and treated for COVID-19 with remdesivir 200mg x1day and remdesivir 100mg x4days.


VAERS ID: 1628426 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1069 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Liver function test abnormal, Pain, Pruritus, Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acyclovir, aripiprazole, buspirone, vitamin D3, cyclobenzaprine, dicyclomine, duloxetine, hydroxyzine, lactobacillus, levocetirizine, levonorgestrel, meclizine, methylprednisolone, nortriptyline HCI, ondansetron, simethicone, ursodiol
Current Illness: None
Preexisting Conditions: Lumbar Disc Herniation with radiculopathy, sleep disorder breathing, Anxiety associated with depression, elevated Liven Enzymes, vertigo, PTSD, Herpes simplex, IBS, Macular degeneration, Obesity, GERD,
Allergies: Latex, adhesive tape, propoxyphene, gabapentin, herbal Drugs, Thimerosal, Covid 19 vaccine.
Diagnostic Lab Data: Liver labs, Mildly elevated
CDC Split Type:

Write-up: 8/12-Fever 100.6, body aches, chills x1 day 8/13 itchiness day 2 to current VA RX''d hydroxyzine 25mg PRN and Chlorpheniramine 4mg PRN


VAERS ID: 1628506 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Dysphagia, Dysphonia, Ear discomfort, Ear pain, Hypoaesthesia, Lethargy, Malaise, Oropharyngeal pain, Paraesthesia oral, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin SR 150 mg once daily Claritin 10 mg once daily Benadryl 25 mg one hour prior to vaccine
Current Illness: none
Preexisting Conditions: Mitral Valve Prolapse with regurgitation
Allergies: mustard- and anything related hazelnut- and anything related sesame- and anything related
Diagnostic Lab Data: none at present
CDC Split Type:

Write-up: I received my first dose of the Moderna Vaccine on 8/12/2021 at Hospital. I have multiple allergies, although none listed on the Moderna Vaccine sheet in the identified ingredients. I experienced some reactions minutes to hours post vaccine after leaving hospital; Right sided facial numbness, lip tingling on the right side Felt like mild to moderate Sore Throat & sensation of difficulty swallowing Pain between my ears that is similar in my experience to anaphylaxis that was heavy and lingered. I experienced no hives. Lethargy- slept for over 13 hours on the first day. The facial numbness subsided within 24 hours. The below symptoms continued for more than 7 + days. Sore Throat & difficulty swallowing Pain between my ears similar to anaphylaxis Lethargy and simply just not feeling well. I experience an episode of a completely occluded Airway on Monday 8/16/2021. Chest tightness at multiple times over the next 7 days post vaccine. I had to take Benadryl and Motrin twice daily for the pain and swelling during the 7 days. This aided in both sore throat, swallowing and pain between ears discomfort with great effect. I did not go to the doctor. I considered urgent care on the morning of 8/20 if the symptoms did not subside. The symptoms slowly improved. It took more than 7 days for some of these symptoms to subside and am still left with a hoarse throat and difficulty swallowing. My PCP office has been notified. I have not heard back from them at this time.


VAERS ID: 1628610 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Heavy menstrual bleeding, Hypertension, Lung disorder, Menstruation irregular, Muscle spasms, Palpitations
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Fertility disorders (broad)

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

Write-up: PATIENT CALLED ON 8/24/21 AND STATED THAT ON 8-12-21 SHE STARTED HER MENSTRIAL CYCLE 2 WEEKS EARLY AND BLEED HEAVY FOR 7 DAY AND THEN STARTED BLEEDING MORE THAN NORMAL, ON DAY 3, 8-13-21, SHE HAD HIGH BLOOD PRESSURE 150/115 AND IT IS USUALLY ON THE LOW SIDE, HER O2 WAS 91, SHE STATED THAT SHE HAD A MUSCLE SPASEM IN HER RIGHT LUNG AND HEART PALPITATIONS, CHEST WAS HEAVY AND SHORTNESS OF BREATH. TODAY 8/24/21 SHE SAYS HER BP IS STILL HIGH AND STILL A LITTLE SHORT OF BREATH BUT NOT AS BAD AS BEFORE. WE STRONGLY RECOMMENDED THAT SHE SEE A DOCTOR.


VAERS ID: 1628615 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-02-04
Onset:2021-08-12
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, COVID-19, Chest X-ray, Electrocardiogram, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol 300mg PO Daily, alogliptin Benzoate 6.25mg PO daily, artificial tears per dose instructions both eyes Q4H PRN, lisinopril 40mg PO daily, hydrochlorothiazide 12.5mg PO daily, amlodipine 5mg PO Daily, tamsulosin 0.4mg PO Daily, sa
Current Illness: unknown
Preexisting Conditions: high cholesterol, HTN, pacemaker, sleep apnea, BPH, osteoarthritis, osteoporosis, obesity, gout
Allergies: NKDA
Diagnostic Lab Data: ED- EKG 8/14, CRX 8/14.8/20 Bloodwork8/14, 8/20-8/24,
CDC Split Type:

Write-up: patient hospitalized after contracting COVID19 disease for hypoxia


VAERS ID: 1628792 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-11
Onset:2021-08-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chills, Diarrhoea, Influenza like illness, Injection site erythema, Injection site inflammation, Injection site pruritus, Injection site warmth, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: I had COVID infection in April 2021. After the vaccine, 1st dose, around 1am (11 hours later), I started throwing up, diarrhea, chills, body aches and my arm was sore. My left arm was red and inflamed. The next day, I still had flu-like symptom and my arm was red, sore, warm, painful to the touch and itchy. Over the next several days, it started to get worse. It started to spread and move down to my elbow and bicep. It was red, raised, warm to the touch with a burning sensation. I continued to ice it. I saw my doctor on 8/14/2021 who advised that he would prescribed antibiotics if not cleared in a week. My left arm continued to get worse and I continue to ice it and not bother it or irritate it even further. It finally start to resolve around 8/21/2021. The soreness and redness was starting to improve and it no longer itched or burned.


VAERS ID: 1628862 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Dyskinesia, Eyelid function disorder, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to ER and they did CAT scan to rule out stroke. Final diagnosis was Bell''s palsy.
CDC Split Type:

Write-up: 1.5 day after vaccine my mouth didn''t open then by 2nd day couldn''t blink my eyes, and sharp pain in heck.


VAERS ID: 1632285 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-08-03
Onset:2021-08-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Unusual menstruation. Have had the same menstrual cycle for 21+ years 4-5 days light, heavy, regular, light, light.. This cycle was 7 days and spotty. VERY unusual cycle.


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