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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 159 out of 6,867

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VAERS ID: 1549969 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Periorbital swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: patient received vaccine @ 3:10pm on 8/11/21, approximately 7pm that night hives began to appear all over her body and her face swelled around her eyes, she reports she had a little difficulty breathing that night but her throat/tongue did not swell, the next day late afternoon/evening she went to clinic for treatment, afterwards she came to the pharmacy to let us know what happened


VAERS ID: 1549991 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Agitation, Crying, Dyspnoea, Hypoaesthesia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Patient in postobservation area compliant of "face feeling numbed and agitated". BP 130/68, SOB and swollen tongue was noted. Pulse 135 BPM. No rash or skin changes. 911 Called, Epinephrine .5 ml administered to R area, Albuterol puff x 2 via mouth. Client comforted to stop crying and depleting self of air. EMT transported client to ER. Client released on 8/11/21 at 10 pm. Contacted client on 8/12/21 to follow up. State was given IV fluids and released feeling well. Client denies any other problems at this time.


VAERS ID: 1550002 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Storage and handling excursion- Patient was given a dose of pfizer vaccine past BUD time of 6 hours- with labeled expiration time of 3:00PM of 8/11/2021 dose was given at 3:45PM .


VAERS ID: 1550011 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / UNK - / -

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

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

Write-up: Shortness of breath, chest pain, nausea, vomiting, headache


VAERS ID: 1550014 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Storage and handling excursion- Patient was given a dose of Pfizer vaccine past BUD time of 6 hours described in EUA - with labeled expiration time of 3:00PM of 8/11/2021 dose was given at 6:03PM 8/11/2021 . No adverse events reported, extra dose not required at this time


VAERS ID: 1550016 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Flushing, Head discomfort, Immediate post-injection reaction, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100 mg daily Lyrica 50 mg/ 4x daily Buprenorphine 7 mg daily Ibuprofen 600 mg every 8 hours Acetaminophen 500 mg/ 2x daily
Current Illness: Nerve pain in right foot. Lower right back pain.
Preexisting Conditions: Chronic Pain/Nerve Pain History of food and environmental allergies.
Allergies: Peanuts-anaphylaxis Soy-anaphylaxis Corn-stomach upset
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Shortness of breath, itching, head congestion, flushed feeling that progressed immediately following injection. Patient took 75 mg diphenhydramine and symptoms resolved after 2 hours.


VAERS ID: 1550018 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (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: multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I got my 1st Moderna vaccine, I had no side effects. When I got my 2nd Moderna vaccine, I had mild aches and pains. Now, after my 3rd Moderna vaccine, I have had a fever of 100 degrees Fahrenheit and aches and pains and felt tired. After taking 1000 mg of acetaminophen my fever went down to 98 degrees, but after 6 hours the fever of 100 degrees Fahrenheit came back.


VAERS ID: 1550019 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: glucose check
CDC Split Type:

Write-up: Pt is at the clinic to get J&J covid vaccination today. @1620 Rapid response was called. Pt shook for less than a minute after receiving vaccine and lost consciousness. Dr. and rapid response team on scene. Dr. assessed pt. Pt AOx4 breathing even and unlabored, was not in distress. Estimated time less than 2 minutes of losing consciousness. Pt is coherent, color is back to of skin patients regular skin color after regaining consciousness, temp: warm/WNL, R and L eyes PERL. Pt denies the following: pain, CP, palpitation, and c/o nausea. See vitals: WNL, Pt''s glucose today 100 mg/dl. Per Dr. observation for 30 minutes. Pt taken to ER per Dr. via boyfriend.


VAERS ID: 1550157 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Storage and handling excursion- Patient was given a dose of Pfizer vaccine past BUD time of 6 hours- with labeled expiration time of 3:00PM of 8/11/2021 dose was given at 4:11PM . No adverse event report, no additional dose required at this time.


VAERS ID: 1550163 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Storage and handling excursion- Patient was given a dose of pfizer vaccine past BUD time of 6 hours- with labeled expiration time of 3:00PM of 8/11/2021 dose was given at 4:34PM . No adverse event was reported, no additional dose was given.


VAERS ID: 1550167 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Storage and handling excursion- Patient was given a dose of pfizer vaccine past BUD time of 6 hours- with labeled expiration time of 3:00PM of 8/11/2021 dose was given at 6:33PM . No adverse event reported, no additional required.


VAERS ID: 1550410 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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

Write-up: Patient inform pharmacist that he needed a dose 2 shot. Patient is disable and patient stated it was difficult to go get his card upstairs. Pharmacist gave Patient Moderna Shot but patient stated that his Dose 1 Shot was Pfizer. Pharmacist advised patient not to go for the second dose of Pfizer.


VAERS ID: 1550652 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pain, Pleuritic pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None that I am aware of
Diagnostic Lab Data: Pending, none yet.
CDC Split Type:

Write-up: Developed chest pain 2 days after first dose of covid-19 vaccine. Pain when trying to breathe deep, pain when moving right side of torso.


VAERS ID: 1550657 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Heavy menstrual bleeding
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None, I held off from taking anything the entire day of vaccination.
Current Illness: PCOS, VITAMIN D DEFICIENCY
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Adominal pain & cramping on first day of second dose. Pain stopped and returned more intensely on day 5 after receiving the second dose. Menstrual bleeding has also returned intensely after a 5 month absence.


VAERS ID: 1550664 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-04
Onset:2021-08-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       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: B12
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: After 7 days from the jhonson and jhonson vaccine, I had the worse headache that had in my life with a pain level to a 8 level of 10 it last for 6 hrs. I took Excedrin to help relive the pain.


VAERS ID: 1550876 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0110214 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling hot, Headache, Influenza like illness
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: None yet
CDC Split Type:

Write-up: Headache and fatigue , extreme feeling of heat with no fever . Feel like I have the flu with no other symptoms.


VAERS ID: 1550880 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-03
Onset:2021-08-11
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctivitis, Injection site rash
SMQs:, Severe cutaneous adverse reactions (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (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: Rhogam shot, flu shot
Other Medications: Synthroid, Cytomel, Prenatal Vitamin, vitamin D, calcium carbonate, aspirin
Current Illness: Cesarean birth two weeks before
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash developed at the injection site more than a week after receiving the shot. Conjunctivitis developed the next day.


VAERS ID: 1552822 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-03-11
Onset:2021-08-11
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Audiogram, Deafness neurosensory
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: None
Current Illness: None
Preexisting Conditions: Chronic Lyme disease
Allergies: None
Diagnostic Lab Data: Audiology and medical examination.
CDC Split Type:

Write-up: Sudden Sensorineural Hearing loss in left ear; 100% loss, on August 11, 2021. I feel the vaccine was associated with this apparent anti immune and very serious event. Took dose one on February 11, 2021 and second on March 11, 2021.


VAERS ID: 1553432 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, 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: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild


VAERS ID: 1553434 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 AR / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Medium, Additional Details: Grandmother called, said that patient had red streaks on arm and swelling night of 08/11/2021. today was better. was concerned because she said immunizer had hard time getting needle to go in and arm hurt. She said felt immunizer was unsure how to give vaccine.


VAERS ID: 1553444 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Site: Pain at Injection Site-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: "electrical pulses across his arm"


VAERS ID: 1553457 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

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

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

Write-up: DOSE ADMINISTERED WAS USED FROM A VIAL IN THE FRIDGE THAT WAS 6 DAYS PAST EXPIRATION


VAERS ID: 1553643 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety
SMQs:, Hypoglycaemia (broad)

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

Write-up: I have had more anxiety than usual. ALmost a resurgence of anxiety I had as a child.


VAERS ID: 1553652 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 214016 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Headache, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Intensive headache muscle pain joint pain chills nausea and vomiting fever loss of appetite


VAERS ID: 1553657 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Tooth abscess, Tooth infection, Toothache
SMQs:, Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen (800mg), MegaKrill dietary supplement (500mg), Centrum Silver multivitamin
Current Illness: None
Preexisting Conditions: Lower back pain
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tooth abscess appeared approximately 2 days after getting vaccination shot for COVID-19. The tooth affected had a root canal completed late June 2020. I have had low-level pain since the root canal. It''s possible I had a mild infection around the tooth after the operation and, after receiving my COVID-19 shot on Monday, the infection flared up because my immune system was activated by the vaccination shot.


VAERS ID: 1553680 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-08-11
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / UNK - / -

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

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

Write-up: pregnant at time of vaccination Vaginal bleeding


VAERS ID: 1553708 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Injection site swelling, Lymphadenopathy, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Ibuprofen 200mg; Excedrin Migraine extra strength 500mg; hemp ointment, 3 bottles of Pedialyte; 3 gallons of H2O
Current Illness: N/A
Preexisting Conditions: Thyroid hypotension; mild anemia
Allergies: Allergic to Cipro
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever, dizziness, aches in joints, swollen arm at injection site, swollen lymphatic glands, rash on lymphatic surface


VAERS ID: 1553711 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Dyskinesia
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Hearing impairment (broad)

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

Write-up: Bell''s Palsy, left sided facial involvement


VAERS ID: 1553717 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: Patient reported that injection site area became hard, swollen, red, and warm. area was 3 and 1/2 inches in diameter. The patient reported that she went to urgent care and was told she had cellulitis. She was given an prescriptionfor bactrim ds.


VAERS ID: 1553766 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspepsia
SMQs:, Gastrointestinal nonspecific dysfunction (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: Klonopin 1mg daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Consistent and extreme heartburn since receiving the vaccine on 08/11.


VAERS ID: 1553804 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Lip swelling, Rash, Rash pruritic
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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Duricef
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Complaint of rash on left arm and itching. BP at 4:22 was 134/76 HR 74. Benadryl elixir 50mg given 4:32 pm. BP 4:42 140/82 HR 71, itching subsiding. 4:54 complaint of left upper lip swelling, was not visible. 4:58 advised patient and mom to go to urgent care for evaluation and that Benadryl 50mg could be given every 4-6 hrs. At discharge swelling sensation was resolving. Spoke with mom on 8/12/2021 informed that patient went to urgent care but no other treatment was recommended and doctor advised not to give dose #2 of Pfizer.


VAERS ID: 1553811 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Chest pain, Chills, Cough, Headache, Injection site pain
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Extreme chills constantly, mild chest pains, headaches, cough, upset stomach, soreness at injection site.


VAERS ID: 1553858 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Dyskinesia, Feeding disorder, Gait inability, Head discomfort, Hypoaesthesia, SARS-CoV-2 test negative, Vertigo
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ozimpic, Lipitor, Priolsec
Current Illness: None
Preexisting Conditions: T-2 Diabetic, mild HBP
Allergies: penacillin, darvon, streptomayacin
Diagnostic Lab Data: 8/12/2021 -CT to rule out stroke; bloodwork-All came back clear- Covid swab- NEGATIVE - Sent home because the hospital was full and he was considered "non Life threatening" 8/13/2021 - Returned to different hospital specializing in neurology for further evlauation
CDC Split Type:

Write-up: Facial numbness, right side uncontrollable movements, cant walk, cant feed himself, severe pressure on right side of head(migraine like) Vertigo,


VAERS ID: 1553862 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide-Lisinopril 12.5-20 mg daily
Current Illness: None reported
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data: T 36.6 HR 96 BP 136/96 Pulse ox 98% Covid Screening Negative
CDC Split Type:

Write-up: Headache, body aches, fatigue, shortness of breath


VAERS ID: 1553903 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: no adverse reaction but patient said it was first dose but it was actually 3rd dose


VAERS ID: 1553937 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-08-11
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, 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), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: erithromycin, Tylox
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 73 y/O female with hx of oxygen dependent COPD presents with cough and SOB. she was noted to be febrile in ER. She desaturated on room air however she has $g 90% sat on 2 lit oxygen. She has Hx of COPD,HTN,HLD, GI bleeding, RA, VTE, Anxiety 8/11/2021 tested positive


VAERS ID: 1553951 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Sudden and severe tinnitus


VAERS ID: 1553954 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-08-11
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: He presented to the ED on 8/11/2021 for cough, shortness of breath and fatigue. No prior COVID-19 infections.


VAERS ID: 1553978 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-24
Onset:2021-08-11
   Days after vaccination:109
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Computerised tomogram normal, Palpitations, Sinus rhythm, Supraventricular tachycardia
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: He presented to the ED on 8/11/2021 for palpitations and upper abdominal pain. He was noted to be in SVT and received medication which converted him back to a normal sinus rhythm. CT scan was negative for PE. Remained in sinus rhythm and was able to be discharged back home with follow-up to see PCP.


VAERS ID: 1553988 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

Write-up: Patient received expired dose of Moderna#1 No known adverse reactions reported.


VAERS ID: 1553993 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-08-11
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1050 / 2 LA / IM

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

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

Write-up: Presented to the ED on 8/11/2021 for painful back mass. She did not have any covid symptoms but tested positive. No prior positive test results for COVID-19 documented.


VAERS ID: 1553999 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-01
Onset:2021-08-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKDA
Diagnostic Lab Data: EMT ADMINISTERED GLUCOSE TEST AND EKG, PUPIL RESPONSE, AND INNER EAR.
CDC Split Type:

Write-up: PATIENT FAINTED. RECOVERED IMMEDIATELY. EMT WAS CALLED AND ALL VITALS WERE TAKEN. PATIENT''S MOTHER REFUSED ER VISIT. MOTHER AND PATIENT WALKED OUT OF STORE WITHOUT ANY FURTHER INCIDENT.


VAERS ID: 1554019 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078L21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Chills, Decreased appetite, Emotional distress, Extra dose administered, Fatigue, Headache, Interchange of vaccine products, Lymph node pain, Lymphadenopathy, Malaise, Myalgia, Nausea, Oropharyngeal pain, Pain of skin, Pyrexia, Wrong product administered
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I took my 17 year old daughter to the pharmacy for her HEP B shot - and she was ACCIDENTIALLY injected with the Moderna COVID vaccine, WHICH WAS INTENDED FOR ANOTHER PATIENT. This error took place because the pharmacists ''wanted to save time'' by bringing syringes for 2 patients into the consultation room. NOTE: She was already fully vaccinated with the Pfizer vaccine. This was an UNAUTHORIZED 3rd vaccine for which I did not give consent. My daughter has been ill with vaccine side effects for 3 days. These have included: fever, loss of appetite, nausea, extreme fatigue, muscle pain, joint pain, skin painful to the touch. chills, sore throat, headache. swollen, painful lymph nodes and general malaise. She has also experienced severe anxiety and distress, as have we, as parents.


VAERS ID: 1554023 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

Write-up: Patient received expired dose of Moderna.


VAERS ID: 1554037 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-08-11
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood culture, Cerebral amyloid angiopathy, Cerebral atrophy, Chest X-ray, Computerised tomogram, Confusional state, Differential white blood cell count, Encephalopathy, Full blood count, Hallucination, Headache, Hypertension, Hypomagnesaemia, International normalised ratio, Magnetic resonance imaging, Metabolic function test, Paranoia, Prothrombin time, Seizure, Troponin, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI, CT, urinalysis, blood cultures, chest xray, troponin, cbc with differential, bmp, PT/INR,
CDC Split Type:

Write-up: Headache, confusion, hypomagnesemia, cerebral amyloid angiopathy, expressive aphasia, hypertension, increasing frequency of seizure activity, acute encephalopathy, paranoia, hallucinations, brain atrophy,


VAERS ID: 1554049 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

Write-up: Patient received expired dose of Moderna


VAERS ID: 1554056 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-08-11
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood alcohol, Blood lactic acid, Brain natriuretic peptide, Chest X-ray, Computerised tomogram head, Culture stool, Differential white blood cell count, Fall, Full blood count, Influenza virus test, Major depression, Metabolic function test, Respiratory syncytial virus test, SARS-CoV-2 test, Troponin, Urine analysis, X-ray of pelvis and hip
SMQs:, Psychosis and psychotic disorders (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (narrow), Arthritis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: fecal testing, chest xray, CT head, xray pelvis, urinalysis, troponin, BNP, CBC with diff, BMP, lactic acid, blood alcohol flu, RSV, COVID,
CDC Split Type:

Write-up: Multiple falls, left hip pain, severe episode of recurrent major depressive disorder


VAERS ID: 1554060 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

Write-up: Patient received expired dose of Moderna


VAERS ID: 1554066 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: misreport of administration of vaccine or potential error stated by patient on 01/11/2021.


VAERS ID: 1554092 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

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

Write-up: Patient received expired dose of Moderna dose #1


VAERS ID: 1554094 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-26
Onset:2021-08-11
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Brain natriuretic peptide increased, Chest X-ray, Computerised tomogram thorax, Cough, Dyspnoea, Fibrin D dimer increased, Fluid retention, Full blood count, Hypertension, International normalised ratio, Metabolic function test, Prothrombin time, Pulmonary oedema, Respiratory syncytial virus test, SARS-CoV-2 test, Troponin increased, Urine analysis
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: troponin, urinalysis, cta chest, chest xray, cbc, BMP, PT/INR/D-dimer, RSV, COVID,
CDC Split Type:

Write-up: SOB, fluid retention, htn, atrial fibrillation, pulmonary edema, elevated D-Dimer, elevated BNP, elevated troponin, cough


VAERS ID: 1554101 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Chills, Confusional state, Dizziness, Flushing, Hyperhidrosis, Hyperventilation, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Chills-Severe, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Medium, Additional Details: Patient fainted within a minute of receiving vaccine. I was able to get her to the floor with assistance of a customer. Advised tech to call EMS. Took 2-3 minutes for her to rouse. Patient was still extremely confused and started complaining of abdominal pain and other symptoms so I administered an epipen in case any allergic symptoms were developing that she was not explaining. I told patient i was administering epipen and why and she consented. Paramedics took her to ER. Recovered fine.


VAERS ID: 1554123 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-08-11
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2316 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, Chest X-ray, Dizziness, Full blood count, International normalised ratio, Palpitations, Prothrombin time, Troponin increased
SMQs:, Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC, BNP, chest xray, pt/INR
CDC Split Type:

Write-up: dizziness, palpitations elevated troponin,


VAERS ID: 1554159 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), 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: Methotrexate
Current Illness: none
Preexisting Conditions: Psoriasis and Psoriatic Arthritis
Allergies: Lamosil
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had an Anaphylactic reaction almost immediately. The pharmacist had to give me 50mg of Benadryl for it.


VAERS ID: 1554170 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, apixaban, atorvastatin, canaglifozin, beclomethasone, cyclobenzaprine, diphenhydramine, furosemide, glipizide, sitagliptin, amitriptyline, doxepin, fluoxetine, Victoza, metoprolol tartrate
Current Illness: None
Preexisting Conditions: History of clots in legs, hypertension, diabetes, anxiety, arthritis, migraine
Allergies: meloxicam- hives, topiramate-hives, amoxicillin-rash, aspirin-rash, nausea, contrast dye- itching, iodine-itching, latex-rash, penicillins- anaphylaxis, vomiting, pravastatin-diarrhea, Macrobid-nausea and makes her sick, tape- rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports a rash at site of injection and on back of right leg and arm. It is itchy and the site has a knot now.


VAERS ID: 1554173 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-11
Onset:2021-08-11
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: lot and site of administration information not available. Dates were 6/11 and 7/2


VAERS ID: 1554182 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral atrophy, Computerised tomogram abnormal, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anemia High Cholesterol Prediabetes
Allergies: Gelatin Morphine Cephalexin Sulfamethoxazole-Trimethoprim
Diagnostic Lab Data: I was not told that the CT scan is related to the vaccine and the CT scan was taken because of the headache. Neurologist visit is scheduled for October 1, 2021.
CDC Split Type:

Write-up: Blurred vision and headache on 8/11/21. Went to Hospital. CT Scan findings show Moderate to severe diffuse cerebellar volume loss. Severe headache at home the night of 8/12/21 and ongoing as of today 8/13/21.


VAERS ID: 1554187 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-04
Onset:2021-08-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Lymphadenopathy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Swelling/pain/redness at the effected site. Muscle pain. Swollen lymph-nodes.


VAERS ID: 1554232 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-31
Onset:2021-08-11
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: contracted covid


VAERS ID: 1554235 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-01-19
Onset:2021-08-11
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Illness, SARS-CoV-2 test negative
SMQs:, COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hepatitis series x 2 never converted to positive. Found leukemia following the second series
Other Medications: Chemo pills
Current Illness: None
Preexisting Conditions: Leukemia
Allergies: None
Diagnostic Lab Data: Covid PCR tests
CDC Split Type:

Write-up: 8/8/21 Exposure to grandson who was covid + 8/9 Covid PCR neg test 8/11 ill 8/13 + Covid PCR test 8/24 potential to RTW


VAERS ID: 1554251 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 621B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Injection site rash, Injection site warmth
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPROAZOLE 20MG 1 A DAY/ TOPRIAMATE 50MG 1 DAILY
Current Illness: NA
Preexisting Conditions: GERD/IRON DEFICIENCY ANEMIA
Allergies: CEPHALEXIN
Diagnostic Lab Data: NONE ORDERED
CDC Split Type:

Write-up: ON 8/11/21 HAD AN EPISODE OF DIZZINESS LASTING 10 MINUTES, FOLLOWED BY BREAKING OUT IN A COLD SWEAT. A RASH THEN DEVELOPED ON LEFT UPPER ARM, 9 X 5 CM AREA OF ERYTHEMA WITH PROMINENT BORDER, HOT TO TOUCH,NOT TENDER TO LIGHT TOUCH.


VAERS ID: 1554276 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hypersensitivity, Injection site pain, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 2nd shot at 9:00 am, approximately 5:00 pm - injection sight was painful, gave 220 mg-1 tablet (NSAID) - a medicine that patient had prior times without side effects. At 5:40 * patients throat was closing up and having difficulty breathing - taken to ER for evaluation. It was determined to be an allergic reaction. Given a single dose of prednisone, benadryl, and pepsid. Released after approximately 3 hours.


VAERS ID: 1554297 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest pain, Dizziness, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Hypoaesthesia, Loss of consciousness, Paraesthesia, Swelling
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Falmina (28) 0.1mg-20mcg tablet daily - birth control
Current Illness: none
Preexisting Conditions: mitral valve disorder
Allergies: morphine - heart racing
Diagnostic Lab Data: EKG, CXR, and blood work (including d-dimer) normal in the ER
CDC Split Type:

Write-up: Pt states that yesterday she was in a conference and she started feeling lightheaded and having tingling in the arms. She states that she was driving home with a coworker and she was having trouble breathing and passed out momentarily. Her arms felt numb and she was having chest pain as well. She states that she went to the ER and they did a work-up. They did a EKG, CXR and BW which included a D-dimer. She was told it all was normal and they sent her home. Pt states that she is not feeling any better. She currently has chest pain and she feels swollen around the neck and her arms felt tingly. Pt denies any heartburn, wheezing, trouble breathing or swallowing. Pt denies this being anxiety- she states feels nothing like it. Pt states that she did get the J and J vaccine on Monday and unsure if any of this is related.


VAERS ID: 1554299 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Mobility decreased, Muscular weakness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: HAVE LIMITED MOVEMENT OF MY LEFT HAND, VERY, VERY WEEK. SOMETIMES SHAKES VILANTLY


VAERS ID: 1554312 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 621B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Injection site erythema, Injection site rash, Injection site warmth
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPROAZOLE 20MG 1 A DAY/ TOPRIAMATE 50MG 1 DAILY
Current Illness: NA
Preexisting Conditions: GERD/IRON DEFICIENCY ANEMIA
Allergies: CEPHALEXIN
Diagnostic Lab Data: NONE ORDERED
CDC Split Type:

Write-up: ON 8/11/21 HAD AN EPISODE OF DIZZINESS LASTING 10 MINUTES, FOLLOWED BY BREAKING OUT IN A COLD SWEAT. A RASH THEN DEVELOPED ON LEFT UPPER ARM, 9 X 5 CM AREA OF ERYTHEMA WITH PROMINENT BORDER, HOT TO TOUCH,NOT TENDER TO LIGHT TOUCH.


VAERS ID: 1554330 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-01-09
Onset:2021-08-11
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 2 RA / IM

Administered by: Work       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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: mini pill-birth control, vit D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid PCR test
CDC Split Type:

Write-up: 12/19/20 Covid Pfizer 01/9/2021 Covid Pfizer 8/11/21 ill 8/12/21 + Covid PCR test


VAERS ID: 1554354 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Arthralgia, Blood test, Bloody discharge, Condition aggravated, Exposure during pregnancy, Fatigue, Headache, Human chorionic gonadotropin normal, Myalgia, Nausea, Progesterone decreased, Pyrexia, Thrombosis, Ultrasound foetal, Urinary tract infection, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (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: Tirosint 125mcg
Current Illness: None
Preexisting Conditions: Hashimoto''s Thyroiditis. History of Endometriosis. Heart palpitations-PVCs diagnosed by cardiologist -unknown cause
Allergies: Allergy to Bactrim- experienced joint pain with is medication. Allergy to Ortho Tri Cyclen birth control- developed rash on chest from this medication. Gluten/Dairy/Soy intolerant.
Diagnostic Lab Data: They performed ultrasound. Found I am approximately 5 weeks pregnant. There was a gestational sac but no fetal pole or heartbeat. They told me that was normal since I am so early. They didn''t see any signs of what would have caused the bleeding on ultrasound. They did do a urinalysis which they found I had a UTI. They also did bloodwork to check my HCG and Progesterone levels. HCG was in normal range but my Progesterone was mildly low. They prescribed me an antibiotic for my UTI and Progesterone 200mg to supplement until 13 weeks of pregnancy.
CDC Split Type:

Write-up: Had my J&J Covid-19 vaccine on Tues. Aug. 10th. I was recommended by my OB to get the vaccine while pregnant. I am around 5 weeks pregnant. Estimated birth date is April 2, 2022. That evening of the vaccine, I had 2 fevers that I controlled with Tylenol (one 500mg rapid release capsule at time of fever)as instructed by my OB. Along with the fevers, I had headache, muscle/joint ache and pains, nausea and extreme fatigue. I only got out of bed to use the restroom. Next day, Aug. 11th I had one fever and took one dose of Tylenol. After that most of my symptoms seemed to subside. I then went to the restroom at 11am to find a nickel to quarter size bright blood spot on my underwear. I then passed a nickel size blood clot while urinating. It was not painful but the blood scared me to call the OB in case I was having a miscarriage. I continued to have another spotting incident before I saw my OB''s NP at 2pm for the abnormal bleeding. Prior to the vaccine I had small implantation bleeding (light pink discharge occasionally), but had not had as much blood as I saw after getting the vaccine which made me call my doctor''s office. As of today Aug. 13th, I am still having light pink discharge, very little spotting. It is not as frequent as it was and not as much as it was day after getting the vaccine.


VAERS ID: 1554384 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: xyzal, flonase, magnesium
Current Illness: n/a
Preexisting Conditions: depression, mood disorder, anxiety
Allergies: tramadol
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Itching all over body. No rash, bites or bumps. Only itching.


VAERS ID: 1554388 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Hypoaesthesia, Hypotension, Paraesthesia, Presyncope, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Dehydration
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 8/11/2021 blood sugar and blood pressure in pharmacy waiting area
CDC Split Type:

Write-up: Patient complained of light-headed and dizziness almost immediately after administration. Patient was asked to stay seated and remain in observation area for 15 minutes. Patient then complained of numbness and tingling of extremities and was not responding to commands or instructions. Patient never appeared to lose consciousness, however pharmacist suspected vasovagal syncope/response. EMS was dispatched and arrived in 10 minutes. Blood sugar was tested and was normal, Blood pressure was low. Patient taken to Medical Center for observation/IV fluids and released a few hours later.


VAERS ID: 1554414 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-08-11
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

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

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

Write-up: Patient was vaccinated 3/31/21 and was diagnosed 8/11/21 with COVID-19


VAERS ID: 1554418 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UKN
Current Illness: UKN
Preexisting Conditions: UKN
Allergies: CITRUS
Diagnostic Lab Data: RAPID RESPONSE CODE WAS CALLED FOR PT. (FATHER) OF PT. REFUSED ANY FURTHER TREATMENT
CDC Split Type:

Write-up: PT. PASSED OUT POST VACCINE ADMINISTRATION


VAERS ID: 1554465 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: takes a blood pressure medication, but he does not know the name
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the vaccine at 9:40 am on 08/11/2021. That evening, he experienced some shortness of breath when lying down to go to sleep. He has the same experience the following evening. He thought it was anxiety, so he took a valium. He did sleep a little better, but he still felt like it was difficult to take a deep breath. He returned to Clinic on 08/13/2021 for evaluation and advice. At his visit, it was discovered that his heart rate was 150-160 bpm. He was referred to hospital.


VAERS ID: 1554469 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bacterial infection, Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Mobility decreased, Nausea, Pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cephalexin 500 mg 1 cap every 8 hours Bactrim DS 800 mg-160 mg 1 twice a day PRN Melatonin 20 mg Omega 3 Oral Twice a day Omeprazole 20 mg 1 cap twice a day Trazodone 50 mg 1 tab QHS
Current Illness: No
Preexisting Conditions: Obesity
Allergies: no
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Redness, Body Aches, Nausea, tired, arm pain around injection site. Next day: arm war to the touch, redness, unable to raise arm, arm pain. Took Tylenol 500 mg (2times), Swollen under armpit, PCP said it was a bacterial infection.


VAERS ID: 1554520 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-08
Onset:2021-08-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Fatigue, Headache, Pain
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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

Write-up: dizziness, body aches, severe fatigue, headache, chills, diarrhea x 5 days (onset started 3 days post vaccine)


VAERS ID: 1554542 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05E21A / 1 RA / IM

Administered by: Senior Living       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: non no adverse reaction
CDC Split Type:

Write-up: The pt was given the vaccination accidentally he, is 13 and the moderna is not approved for thirteen spoke to health dept. and was told we should give the second in the series according to CDC there has been no adverse reaction with this pt.


VAERS ID: 1554548 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: High sugar, treating with insulin, sugar still running high wont go below 400.


VAERS ID: 1554569 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-06
Onset:2021-08-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: none nknown
Preexisting Conditions: n/a
Allergies: nkda or food allergies
Diagnostic Lab Data: none at this time; pt will follow up if persists
CDC Split Type:

Write-up: feeling swollen in throat multiple days after the vaccine (3-5 days)


VAERS ID: 1554764 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Dyspnoea, Neck pain, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Day after vaccination 8/11 developed frequent but intermittent chest pain and shortness of breath. 8/12 developed tingling in palms and finger left hand and pain in shoulder into neck on the left side. Also continued to have the chest pain and shortness of breath, but not as often.


VAERS ID: 1554767 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 LISTED
Current Illness: NONE LISTED
Preexisting Conditions: NONE LISTED
Allergies: NONE LISTED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: VACCINE DOSE ADMINISTERED WAS 6 DAYS EXPIRED. NO ADVERSE EVENTS RECORDED.


VAERS ID: 1554793 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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: UNKNOWN
Current Illness: NONE
Preexisting Conditions: DIABETIC
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: ADMINISTERED SECOND DOSE OF COVID 19 PFIZER VACCINE FROM A BATCH 6 DAYS OUT OF DATE. NO ADVERSE EVENT.


VAERS ID: 1554801 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 LISTED
Current Illness: NONE LISTED
Preexisting Conditions: NONE LISTED
Allergies: NONE LISTED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: DOSE 2 OF COVID 19 PFIZER VACCINE ADMINISTERED WAS 6 DAYS EXPIRED, NO ADVERSE EVENTS AS A RESULT


VAERS ID: 1554965 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

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

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

Write-up: DOSE ONE OF THE COVID 19 PFIZER VACCINE ADMINISTERED WAS 6 DAYS EXPIRED


VAERS ID: 1554970 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired product administered, No adverse event
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 LISTED
Current Illness: NONE LISTED
Preexisting Conditions: NONE LISTED
Allergies: NONE LISTED
Diagnostic Lab Data:
CDC Split Type:

Write-up: DOSE ONE OF THE VACCINE ADMINISTERED WAS 6 DAYS OUT OF DATE, NO ADVERSE EVENT


VAERS ID: 1554975 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C2119 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Eye swelling, Fatigue, Feeling hot, Headache, Injection site pruritus, Nasopharyngitis, Neck pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril HCL 20mg, Atorvstatin, cetalopram,flonase
Current Illness: No illnesses. I am having an aortic valve replacement in a few weeks. i only use the Glipiside if my blood sugar is over 145. My latest A1c was 6.2
Preexisting Conditions: heart and high blood pressure, pre-diabetes
Allergies: pennicillan, sulfa drugs. Grass,trees,especially pine. Dust, mold Glipiside
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Came on gradually. I felt like it was an additional symptom of Covid 19 about once every hour. Started with headache, then a neck ache. Then my eye balls felt swollen and hot in the back . Next was total body aching and fatigue. The fever started and within about 1.5 hours it was up to 102.6. after about 103 I had chills really bad. Of course in that time I took Tylenol.I laid under 3 blankets until morning. By the next morning the fever broke. And little by little the symptoms started to go away Today is the third day and I don''t feel symptomatic any more. But I feel like I''m coming down with a terrible head cold and cough. And the injection sit itches something awful


VAERS ID: 1554976 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: MMr
Other Medications: Zoloft Xanax Multi vitamin Lipitor Seasonique
Current Illness: Anxiety
Preexisting Conditions: Anxiety
Allergies: Vincomycin
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Heavy menstral bleeding 5 days before period was due. Heavy clots passed


VAERS ID: 1555007 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-18
Onset:2021-08-11
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

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

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

Write-up: Covid Positive


VAERS ID: 1555208 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

Administered by: Other       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: DID NOT DISCLOSE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s daughter came in at drop off asking for first dose of Moderna for her dad, she told our technician that she made appointment online for Moderna vaccine and answered questions for her Dad already. And our technician asked the daughter that is it the first dose of Covid vaccine and daughter said yes. Then we processed, gave patient vaccines and appointment card for the next dosage while the daughter went shopping. When patient was waiting for 15 minutes and pharmacist gave him his CDC card for first dosage of Moderna, patient told pharmacist that this is the second dose not the first dose, then we asked and he said he got Covid vaccines Pfizer begin of 2021 and he did not get the second dose because they had to wait for 4 hours and his daughter didn''t like it so they left . Then when daughter came back to pick him up today, our pharmacists and technician went out to verify which her. And she told her dad that " why you told them that?". And she admitted that she didn''t told us earlier , she just wanted her Dad to get another vaccine and she told rudely to our both pharmacists that " It doesnt matter which Covid vaccines, I don''t care" . Then the daughter asked about second dose of Moderna Covid vaccine, so we told patient that 3rd dose of Covid vaccine is not approved yet, pay attention to her Dad next couple days for any reactions. We watched patient for over 30 minutes and no reaction.


VAERS ID: 1555211 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Paramedics checked his blood pressure, heart rate, and pulse ox. All where within normal limits.
CDC Split Type:

Write-up: Patient started having a seizure and fell out of his chair 10 mins after getting the vaccination. The pharmacist called 911 and attended to him. Got him back in the chair and then the patient had a second seizure. The paramedics came and checked him out and said he did not need to go to the hospital if he didn''t want to and the patient declined.


VAERS ID: 1555590 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Patient received undiluted 0.3 mL of Pfizer COVID vaccine during hospital stay. Patient did not experience any side effects at the time of this report. Patient remains hospitalized for co-morbidities.


VAERS ID: 1555603 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cardiac flutter, Cough, Dizziness, Dyspnoea, Eye pruritus, Eye swelling, Fatigue, Feeling abnormal, Flank pain, Headache, Nausea, Nervousness, Ocular hyperaemia, Pain in extremity, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olly The Women''s Multivitamins
Current Illness: was ill for a few days about 3 and a half weeks before receiving the vaccine, might have just been because of the smoke in the area.
Preexisting Conditions: Digestive issues, suspected IBS Had vertigo issues as a teenager
Allergies: gluten, kale, penicillin, prilosec, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red swollen/itchy eyes- first symptom started before I left the clinic. Brain fog, pain in lower right side, throwing up, dizziness- all these symptoms began within an hour after receiving the vaccine. Went to bed, woke up at 1 in the morning with a feeling like I was shaking so badly that I couldn''t fully expand my lungs to breathe, extreme dizziness, and a weak, fluttery heartbeat. Went back to bed, awoke with a pounding headache, dizziness still present but not as extreme, very nauseous, had strange heartbeat episodes throughout the day, coughing, dizziness subsided about 24 hours after vaccination, headache lessened but took longer to mostly go away, one more shaking incident happened at 9:30 am 8/13 lasted about fifteen minutes but without the breathing issues and dizziness,48 hours after vaccination heartbeat episodes have stopped and most issues are gone expect for fatigue, nausea, and the sore arm.


VAERS ID: 1555778 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (beer, liquor (amount varies)); Arthritis; Asthma; Smoker (4 cigarettes/day)
Preexisting Conditions: Comments: The patient is taking pro-air inhaler for unknown indication.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210822480

Write-up: ADMINISTRATION OF A FILLED SYRINGE THAT WAS STORED IN REFRIGERATOR FOR 12-18 HOURS; ADMINISTRATION OF A FILLED SYRINGE THAT WAS STORED IN REFRIGERATOR FOR 12-18 HOURS; This spontaneous report received from a pharmacist concerned a 65 year old female. The patient''s weight was 210 pounds, and height was 67 inches. The patient''s concurrent conditions included: asthma, arthritis, alcohol user and smoker and other pre-existing medical conditions included: The patient is taking pro-air inhaler for unknown indication. The patient was previously experienced hives and skin rash when treated with ciprofloxacin for drug used for unknown indication, and drug dependence when treated with aripiprazole, colchicine, fluticasone propionate, escitalopram oxalate, naproxen, omeprazole, paracetamol and diclofenac for drug used for unknown indication, drug dependence when treated with gabapentin and oxybutynin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 11-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-AUG-2021, the patient experienced administration of a filled syringe that was stored in refrigerator for 12-18 hours. On 11-AUG-2021, the patient experienced administration of a filled syringe that was stored in refrigerator for 12-18 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of a filled syringe that was stored in refrigerator for 12-18 hours and administration of a filled syringe that was stored in refrigerator for 12-18 hours was not reported. This report was non-serious.


VAERS ID: 1555781 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Pain, SARS-CoV-2 test, Sensory disturbance, Throat irritation
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210811; Test Name: SARS-CoV-2 test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210822868

Write-up: HIT LIKE A TON OF BRICKS; ACHY FEELING; SCRATCH IN THROAT; COLD CHILLS; TIREDNESS AND FATIGUE; This spontaneous report received from a patient concerned a 42 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: 204B21A, expiry: UNKNOWN) dose was not reported, administered on 10-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-AUG-2021, the patient experienced hit like a ton of bricks. On 11-AUG-2021, the patient experienced achy feeling. On 11-AUG-2021, the patient experienced scratch in throat. On 11-AUG-2021, the patient experienced cold chills. On 11-AUG-2021, the patient experienced tiredness and fatigue. Laboratory data included: SARS-CoV-2 test (NR: not provided) Negative. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hit like a ton of bricks, tiredness and fatigue, achy feeling, cold chills, and scratch in throat. This report was non-serious.


VAERS ID: 1558095 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Contusion, Decreased appetite, Dry mouth, Fatigue, Feeling abnormal, Immediate post-injection reaction, Musculoskeletal chest pain, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily immune response
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in left shoulder immediately after shot that persisted. Severe chills causing uncontrollable shaking starting at 10:30pm 8/11/21 lasting through the night until 5am 8/12/21 Fever 100-101 from 10:30pm 8/11/21 to 9am 8/13/21 Extreme fatigue and muscle aches starting morning of 8/12/21 persisting through 8/13/21 Brain fog and severe Lower back and mid back/rib pain starting morning of 8/13/21 to current Bruising on top of my left foot starting 8/13/21 noticed in the morning Dry mouth and loss of appetite since morning of 8/12/21 to current Aches in knee and hip joints starting 8/12/21 to current


VAERS ID: 1558101 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-04
Onset:2021-08-11
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / UNK - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Had Aortic Heart Valve replaced summer of 2020
Allergies:
Diagnostic Lab Data: Antigen Rapid Test
CDC Split Type:

Write-up: Tested Positive for Covid 8/13/221


VAERS ID: 1558103 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature decreased, Chills, Fatigue, Headache, Pyrexia, Rash, Sleep disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pain in arm at sight, then umusual sensation in fingers. Headache 3 days. Fever of 101 the afternoon of injection, cold chills, fatigue, inability to sleep. Temperature the following morning was 93. Developed rash/hives over entire body on the third night. Mostly resolved after taking antihistamine.


VAERS ID: 1558116 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-04
Onset:2021-08-11
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: positive COVID had a positive contact. Having moderate symptoms, that seem to be getting worse


VAERS ID: 1558120 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Feeling abnormal, Hyperhidrosis, Muscle spasms, Nausea, Tinnitus, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Dizziness, profuse sweating, cold chills, ear ringing, light headedness, uncontrollable shaking, and nausea 5 minutes after first dose of Pfizer vaccine. Subsided after 25 minutes. Dizziness continues 3 days after vaccination. Muscle spasms in left thigh muscle, brain fog, and tiredness continue.


VAERS ID: 1558147 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-04
Onset:2021-08-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye inflammation, Heavy menstrual bleeding, Photophobia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Changes in period- I started my period 3 days after getting my first short of Pfizer. I have noticed that my period has lasted 10 days (usually always lasts 4-5), with unusual spotting. I have also noticed inflammation of my eyes about a week after my first short. They have felt strained and have been sensitive to light. I have had to schedule an appointment with my eye doctor.


VAERS ID: 1558186 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Per patient, on 8/13/21 all test performed in ER came back normal.
CDC Split Type:

Write-up: Within 10 minutes of receiving vaccine the patient began having excessive itching with an ascending rash beginning from finger tips and moving up hand/arm. He was given Benadryl x2. 30 minutes later the patient started developing splotchy rash on chest. There was no shortness of breathe/dyspnea or heart palpitations. Patient was instructed to take Zyrtec and continue Benadryl every 6 hours. Patient was able to work the next day, but the day after that he presented to the emergency room due to chest pain. All test came back normal.


VAERS ID: 1558256 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-02
Onset:2021-08-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Large, red, itchy rash at vaccination site. Appeared about 1 week after vaccine.


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