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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 16 out of 8,753

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VAERS ID: 1853743 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-03
Onset:2021-11-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swollen painful lymph node in left armpit


VAERS ID: 1853773 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-10-22
Onset:2021-11-07
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030BD / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: ECG, possible left ventricular hypertrophy
CDC Split Type:

Write-up: Passed out while taking a shower


VAERS ID: 1853791 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Intolerance to peanuts (not anaphylactic)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea and vomiting approximately 4 hours after receiving the first dose of the vaccine, nausea lasted about an hour, vomited only once


VAERS ID: 1853817 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-10-01
Onset:2021-11-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 3 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 - / IM

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

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

Write-up: tested positive, asymptomatic


VAERS ID: 1853865 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: My lymph nodes under my left arm pit swelled to the size of a golf ball and was extremely painful for about 24 hours then began to subside. I called my physician because it was so painful and spoke to the nurse over the phone about my symptoms and we made an appointment for the following day to have the doctor do an examination but I did cancel it because I was seeing improvement.


VAERS ID: 1853891 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-22
Onset:2021-11-07
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nasopharyngitis, Pain, Respiratory tract congestion
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Naltrexone HCl 50 MG Tablet TAKE ONE TABLET BY MOUTH EVERY DAY Oral ?Fluocinonide 0.05 % Cream 1 application to rash area on hand Externally Twice a day ?Cetirizine HCl 10 MG Tablet 1 tablet Orally two times a day, for rash from bee
Current Illness: none
Preexisting Conditions: Anxiety and depression. History of alcohol abuse-sober since 8/2020.
Allergies: Nitrofurantoin: rash - Allergy Betadine: rash - Allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, cold, congestion, body aches x 2 days starting 11/7/21


VAERS ID: 1853916 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / IM

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

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

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


VAERS ID: 1853917 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st dose -03/11/2021 Pfizer EN6199 Swollen lymph nodes
Other Medications: Nifedipine Venlafaxine Baclofen Irbesartan/hctz Spruced Laxis Vitamin D3
Current Illness:
Preexisting Conditions: Chronic myeloid leukemia Multiple sclerosis
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes - neck and under arm Low grade fever -99 Headache Body aches Dizziness


VAERS ID: 1853920 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 3 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Nose bleed two days after receiving the Moderna booster vaccine.


VAERS ID: 1853983 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient experienced very high fever (104-105F) after Moderna booster dose. Kept fever down with Tylenol, fever broke after 24hrs


VAERS ID: 1854016 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Diarrhoea, Injection site pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20 mg, Bupropion 300 mg, MVI, vitamin D supplement, Flonase nasal spray
Current Illness: none
Preexisting Conditions: seasonal allergies, anxiety
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe nausea, vomiting all day, could not keep water or food down for at least 12 hours straight. Mild diarrhea symptoms. Sore arm at injection site.


VAERS ID: 1854054 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-11-07
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: macular degeneration, hearing impairment, prostate cancer, and hypertension
Allergies: NKDA
Diagnostic Lab Data: positive covid PCR 11/6/21
CDC Split Type:

Write-up: Hospitalization after being fully vaccinated for covid


VAERS ID: 1854069 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site pruritus, Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), 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: Sudafed, Claritin
Current Illness: None
Preexisting Conditions: Environmental Allergies
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Between baseball and golfball size itchy red whelt at injection site still present 3 days after vaccine dose administered.


VAERS ID: 1854114 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site mass, Injection site reaction, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), 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: Clairitin, aleve
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfur-based drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: The area around the injection has had a red rash around it that I noticed two days after receiving the vaccine. Its about a 3x3 area. There is also a visible lump that makes it look like I have a really nice shoulder muscle.


VAERS ID: 1854118 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Hypoaesthesia, Injection site pain, Migraine, Neck pain, Pain in extremity, Paranasal sinus discomfort
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: I started out with just typical soreness in my arm, later that night I got a headache and fatigue. Monday I woke up with the same headache which grew into a migraine. Late Monday morning the left side of my neck was sore along with the left arm around the injection site, and I experienced numbness in my left cheek. The numbness in my cheek went away by this morning for the most part and now all that?s left is the migraine and some sinus pressure.


VAERS ID: 1854123 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-11-07
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 UN / UN
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Atrial fibrillation with RVR; COVID-19 virus infection; Acute hypoxemic respiratory failure due to COVID-19;


VAERS ID: 1854134 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Lymph node pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Muscle, joint pain. The worst is the pain in my lymph nodes. I had nodes removed for cancer screening in the location of the pain. this is day three of the painful lymph nodes.


VAERS ID: 1854139 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-01
Onset:2021-11-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Insomnia, Joint range of motion decreased, Pain
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, jardiance, clopidogrel, isosorbide, metoprolol, losartan, amlodipine, carbamazapine, atorvastatin, montelukast, Clonazepam, lamotrigine, lomotil
Current Illness:
Preexisting Conditions: Diabetes, COPD, heart problems, previous heart attacks and Tia, possible Celiac, neuropathy, bipolar, asthma, hypothyroid
Allergies: Gabapentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pain. Unable to move arm most times and unable to sleep for 2 nights due to pain and unable to position arm


VAERS ID: 1854146 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F63527 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Trigeminal neuralgia
SMQs:, Demyelination (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: Trileptal (600 mg 3 times daily)
Current Illness:
Preexisting Conditions: Trigeminal Neuralgia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 5-6 hours after receiving the booster, I felt an increase in the symptoms/sensations associated with trigeminal neuralgia (increased facial pain, sensitivity to touch and wind). These symptoms/sensations have been well-controlled for several months.


VAERS ID: 1854230 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / UNK AR / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1854233 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Left armpit lump and pain. Started next day after COVID-19 Booster injection shot.


VAERS ID: 1854256 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA5127 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Nausea followed by vomiting beginning around 12AM Sunday November 7. Repeated bouts of vomiting approximately every hour from 12AM until 7AM Sunday November 7. Unable to tolerate food or water from 12AM to 7 AM. No medication given. Symptoms resolved during the day on November 7 although appetite suppressed. Water and light meals (mostly carbohydrate) tolerated. Patient ate soup at approximately 6:30 PM on November 7 and became nauseous and vomited approximately an hour later. No nausea or vomiting during the night or during the following day Monday November 8, diet normal. On Tuesday morning again became nauseous and vomited approximately an hour following eating graham crackers and milk. No fever was recorded and no other symptoms were reported.


VAERS ID: 1854280 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Dizziness, Flushing, Headache, Hyperhidrosis, Insomnia, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Mild, Systemic: Nausea-Mild, Additional Details: Stayed in waiting area for approximately 15-20 minutes - provided her with ice pack - she was clammy, dizzy, lightheaded and nauseous within 5 minutes of administration - called to check on her the following day and she was having headaches and trouble sleeping but feeling somewhat better


VAERS ID: 1854330 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30155BA / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Extreme shaking, chills, fever, difficult getting breathe, entire body aches, temp has been between 101 and 103


VAERS ID: 1854334 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-10-27
Onset:2021-11-07
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Extra dose administered, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl orally; Hydrocortisone topically
Current Illness: None
Preexisting Conditions: None
Allergies: Lactose
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am 4 ? months pregnant, due to deliver 4/29/2022. I received my COVID-19 booster on 10/27/2021 and started getting hives and being very itchy in various places all over my body developing welts and rashes. I have been taking Benadryl orally every 4-6 hours and applying hydrocortisone topically which seems to help but it keeps returning 4-6 hours post Benadryl. My sister had her COVID-19 booster (Moderna) on 10/22/2021 and experienced these exact same symptoms, including hives/rash/welts starting on 11/1/2021. She is not pregnant and able to take steroids for the itch/rash and experienced these symptoms for a few days.


VAERS ID: 1854365 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 3 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Oxybutynin, Pantoprazole, Synthroid, Venlafaxine
Current Illness:
Preexisting Conditions:
Allergies: Pen G, Amoxicillin, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receving the 3rd additional dose of Moderna patient presented to emergency department with syncope. Patient was discharged next day.


VAERS ID: 1854368 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-11-07
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: HTN, CKD, dementia, OSA, osteoporosis, history of stroke
Allergies: cymbalta, triamterene-Hctx, trospium
Diagnostic Lab Data:
CDC Split Type:

Write-up: admitted to hospital for covid


VAERS ID: 1854394 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-13
Onset:2021-11-07
   Days after vaccination:298
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/8/21 SARS/COV-2. NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1854425 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram normal, Extra dose administered, Interchange of vaccine products, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Exam and EKG normal 11/9/21
CDC Split Type:

Write-up: vasovagal syncope the morning after Moderna booster. Patient received J&J in April 2021 x 2 and contracted COVID from her children in May 2021.


VAERS ID: 1854433 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Extra dose administered, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (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: Warfarin, Metropalol, Temazepam, Pantoprazole, Vitamin Supplements
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Omentins'', Bacterium, Pennicillin, Arithamicine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 3rd dose of Moderna 11/06/2021, started experiencing symptoms 11/07/2021 of swelling in the left arm (Cellulitis). Primary visit 11/09/2021, recommendation for Follow-Up of Prednisone.


VAERS ID: 1854448 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Diplopia, Magnetic resonance imaging head normal, Magnetic resonance imaging neck
SMQs:, Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Metropolol, crestor, wellbutrin, sertaline, amolodipine
Current Illness: none
Preexisting Conditions: hypertension,depression, elevated cholesterol
Allergies: NKA
Diagnostic Lab Data: MRI of head and neck were negative and all bloodwork was within normal limits
CDC Split Type:

Write-up: Approximately 36 hours after vaccination patient woke up with double vision in right eye.


VAERS ID: 1854451 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, 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: Allegra Flonase Sudafed Benedryl Meloxicam Melatonin Zinc Singulair Magnesium
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm around the injection site became very painful, red, swollen, and warm to the touch. This has continued for 3 days, with itching beginning on the 3rd day.


VAERS ID: 1854479 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / UN

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

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

Write-up: Headache


VAERS ID: 1854493 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-23
Onset:2021-11-07
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/8/21 SARS/COV-2, NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1854587 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Jugular vein thrombosis, Vertebral artery stenosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow)

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

Write-up: severe headaches post vaccination, found to have severe vertebral artery stenosis and jugular vein thrombosis


VAERS ID: 1854609 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-11-03
Onset:2021-11-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Glaucoma (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: Bright Red Eyes -


VAERS ID: 1854644 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-11-07
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA #031M20A, #040A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fall, Pelvic fracture, X-ray abnormal
SMQs:, Accidents and injuries (narrow), Osteoporosis/osteopenia (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: unknown
Current Illness: unknown
Preexisting Conditions: Osteoporosis, hypothyroid.
Allergies: No known allergies
Diagnostic Lab Data: X-rays show nondisplaced fractures of the left superior and inferior pubic. This patient with orthopedics who are coming to evaluate her. XR Femur Left AP + Lat, XR Pelvis AP Only,
CDC Split Type:

Write-up: Left hip pain/fall,


VAERS ID: 1854765 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Severe fever, chills, body ache and headache until Tuesday 11/9 at 2pm. From that point on lingering severe headache


VAERS ID: 1854771 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-10-01
Onset:2021-11-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, lisinopril, diltiazem, vit D, carvedilol, warfarin
Current Illness: cardiomyopathy, DM 2, obesity, hyperlipidemia, HTN, Vit D deficiency, abnormal liver function test
Preexisting Conditions: per#11
Allergies: Sulfa, adhesive
Diagnostic Lab Data: Vital signs stable
CDC Split Type:

Write-up: 2 weeks after receiving Moderna booster at left deltoid(third moderna injection), patient had onset of pronounced swelling of bilateral hands with associated sense of itching. Also return of pain at injection site, sense of itching at abdomen and back of head, swelling of left ear


VAERS ID: 1854813 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Eye swelling started the night after receiving the vaccine. It was more prominent the next morning. Was seen in our office 11-8-21


VAERS ID: 1854864 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplopia, Ophthalmological examination, Retinal migraine, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Ocular motility disorders (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: Guanfacine and Concerta for ADHD, Clonidine for insomnia
Current Illness: None
Preexisting Conditions: ADHD
Allergies: None
Diagnostic Lab Data: Medical eye and vision exam on Nov. 9, 2020
CDC Split Type:

Write-up: Within an hour of her Covid shot on the way home, she began experiencing vision problems in her left eye, which have continued for the past two days but are slowly improved. Symptoms include intermittent double vision, blurring and dimming. Symptoms temporarily improve with an anti-inflammatory pain medication like ibuprofen. Eye dr. concluded she is having ocular migraines as a side effect of her Covid vaccine.


VAERS ID: 1855048 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-16
Onset:2021-11-07
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD7204 / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Aphthous ulcer, Blood test, Chills, Fatigue, Feeling of body temperature change, Oropharyngeal pain, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Fuchs Iridocyclitis in one eye
Allergies: Shrimp only known allergy
Diagnostic Lab Data: Blood tests taken do not have the results. Dr is reporting that he is seeing a rise of viruses with similar symptoms. He said my symptoms reminded him of the disease Roseola in young children. Gave a steriod and Benadryl
CDC Split Type:

Write-up: The vaccine I had was the second shot of two doses. First I would like to report that my mouth was full of canker sores approx 5 weeks ago from the time of this report. Would get the odd cankersore before but not like the last time. On Nov 2nd I noticed I was starting to become fatigued. On Nov 4th felt temperature starting to rise. on Nov 5th felt temperature starting to rise again and had chills plus mild sore throat. On Nov 6 had high temperature approx 101 degrees and severe chills and mild sore throat. On Nov 7th around 7 pm temperature 100.3 no chills no sore throat. By 11:15 pm no temperature no chills no sore throat. Before I went to bed at 11:30 pm I noticed that my left foot was itchy. Scratched ankle turned on light saw that the lower half of my body was in a full rash starting from the ankles working its way up. My legs were itchy. Took a single Benadryl of 25 mg. By morning Nov 8th did the same took another Benadryl but it did not seem to work. Went to the emergency room of the Hospital for diagnosis.


VAERS ID: 1855093 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / 3 LA / IM

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

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

Write-up: Patient presented with pain, swelling, and redness Sunday night. Monday morning the symptoms continued to get worse and Tuesday the arm was very swollen and the patient went to her PCP. PCP was suspecting cellulitis


VAERS ID: 1855300 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Feeling cold, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: This was a booster shot. I had J&J back on March. I felt fine when I first came home but the next day around noon I started feeling really cold. Got a fever and headache. I went to bed. When I woke up an hour later I was in agony. Every joint (most especially my hips) felt like I had been stabbed. I could not get up at all. It was so excruciating, I could only lay there until the next day. I thought I was better, but I tried to work and had a relapse. I hurt so bad I had to go home.


VAERS ID: 1855325 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pain in jaw, Pyrexia, Urinary tract infection, Urine analysis abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Osteonecrosis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I took my normal medications - Geodon, Gabapentin, Synthroid, Wellbutrin, Melatonin, and Ativan.
Current Illness: UTI
Preexisting Conditions: Hypothyroidism
Allergies: Depakote, Zyprexa, and Bee Stings
Diagnostic Lab Data: Urinalysis - Showed a UTI
CDC Split Type: vsafe

Write-up: I experienced fever, sever jaw pain and headaches. I took 600mg of Ibuprofen which did not help resolve my symptoms. The fever has returned to normal but the other symptoms are continuing. When I went to Urgent Care, they diagnosed me with a UTI.


VAERS ID: 1855550 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular, Secretion discharge, Thrombosis, Vaginal odour
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Fertility disorders (broad)

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

Write-up: Two days after injection, my period started. I had just finished my period the week before. This discharge is thick and mucousy like the lining of my uterus and my blood is red not dark and clotty. it is not a typical cycle for me. My cycles are regular and consistent. This has a smell that i have never had before.


VAERS ID: 1855575 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 1 LA / IM

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

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

Write-up: Patient stated DOB as 10/14/2009 on the consent release forms. So we trusted the parent not realize the child is under 12


VAERS ID: 1855745 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Photopsia, Vitreous floaters, X-ray
SMQs:, Retinal 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I visited an Ophthalmologist 1pm the next day. I had a series of x-rays, no retinal tears.
CDC Split Type:

Write-up: 5 hours after injection. I started having flashes of white lights and floater in my right eye.


VAERS ID: 1855750 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-10-29
Onset:2021-11-07
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Chest pain, Echocardiogram normal, Enterovirus test positive, Human rhinovirus test positive, Myocarditis, Oropharyngeal pain, Pain, Painful respiration, Pyrexia, Respiratory viral panel, Streptococcus test negative, Troponin increased
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol PRN- not used recently
Current Illness: PCR positive for rhino/enterovirus (nasal swab). Asymptomatic outside of chest pain and pain with deep breathing.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Early october: first pfizer covid vaccine administered 10/29: second pfizer covid vaccine administered 11/7: patient began having chest pain (better with sitting up, worse with lying down or deep breathing) 11/8: Had first and only fever to 38.0. Went to PCP who was concerned about vaccine induced myocarditis so called cardiology team who ultimately recommended coming to ED for further evaluation 11/8 PM: admitted to hospital. BNP 96 pg/ml, Trop 6.33 ng/ml. CRP 140 mg/L. Patient treated with Toradol/acetaminophen. 11/9: Worsening BNP 130, troponin 7.23. Respiratory pathogen panel sent to evaluate for other possible viral causes of myocarditis and resulted positive for rhinovirus/enterovirus. Patient and family deny recent cough, congestion, rhinorrhea, headaches. Patient did have a sore throat 1-2 days after vaccine was given (10/30 or 10/31) which self resolved but he was tested for strep at that time (negative). He has been afebrile throughout hospitalization. Echo normal. Remains admitted for pain control and monitoring of labs at this time.
CDC Split Type:

Write-up: Early october: first pfizer covid vaccine administered 10/29: second pfizer covid vaccine administered 11/7: patient began having chest pain (better with sitting up, worse with lying down or deep breathing) 11/8: Had first and only fever to 38.0. Went to PCP who was concerned about vaccine induced myocarditis so called cardiology team who ultimately recommended coming to ED for further evaluation 11/8 PM: admitted to Hospital. BNP 96 pg/ml, Trop 6.33 ng/ml. CRP 140 mg/L. Patient treated with Toradol/acetaminophen. 11/9: Worsening BNP 130, troponin 7.23. Respiratory pathogen panel sent to evaluate for other possible viral causes of myocarditis and resulted positive for rhinovirus/enterovirus. Patient and family deny recent cough, congestion, rhinorrhea, headaches. Patient did have a sore throat 1-2 days after vaccine was given (10/30 or 10/31) which self resolved but he was tested for strep at that time (negative). He has been afebrile throughout hospitalization. Echo normal. Remains admitted for pain control and monitoring of labs at this time.


VAERS ID: 1855765 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: h e had headaches and started throwing up. He had fever for 24 hours. His fever was around 101.5 for 12 hours.


VAERS ID: 1855770 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, 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: Omeprazole, Levothyroxine, Vit D2 (Ergo) , Ibuprofen, Optivar,
Current Illness: None
Preexisting Conditions: None reported
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received their second moderna vaccine shot and reported "a red, warm and painful to the touch" reaction to their injection site. They didn''t receive any treatment.


VAERS ID: 1856909 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus
SMQs:, 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: Shingles vaccine. Soarness, swelling, redness. September 2021.
Other Medications: Arimidex
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 11/8/2021 noticed redness below injection site. Became very itchy. Redness travelling down arm.


VAERS ID: 1856916 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-11-07
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Appendicitis, Computerised tomogram abdomen abnormal
SMQs:, Retroperitoneal fibrosis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan 11/7/2021.
CDC Split Type:

Write-up: I don''t necessarily know if my adverse event was vaccine-related but since the number 1 serious adverse event reported in clinical trials was appendicitis, I figured I should notify you. The COVID-19 vaccine is so new. It''s hard to know if appendicitis is truly a consequence of the vaccine. The only way you will ever know is if people report the adverse event and you see there is a trend of increased incidence of appendicitis in vaccinated individuals. Once again I don''t know if the appendicitis was truly related to COVID-19 vaccine, but I figured I would report my case and you can use the information. I figure the more information you get the better for these new vaccines.


VAERS ID: 1856613 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-07
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211118830

Write-up: FEEL LIKE STIR FRIED CRUD TODAY; HUGE RED SPOT ON THE TOP OF HIS FOOT; This spontaneous report received from a consumer via a company representative concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 06-NOV-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 07-NOV-2021, the patient experienced feel like stir fried crud today. On 07-NOV-2021, the patient experienced huge red spot on the top of his foot. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the feel like stir fried crud today and huge red spot on the top of his foot was not reported. This report was non-serious.


VAERS ID: 1856946 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Lymphadenopathy, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Common cold
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 101.3 fever, chills, nausea, severe fatigue next day, moderate to significant fatigue subsequent days, muscle aches, loss of appetite, swollen lymph nodes on right side in neck area and armpit area, congestion, very severe headache particularly day after and 2nd day after.


VAERS ID: 1857133 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea, Fatigue, Headache, Hot flush, Immediate post-injection reaction, Lymphadenopathy, Night sweats, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer COVID vaccine (2nd dose)
Other Medications: Vitamin D, probiotics, and Miralax
Current Illness:
Preexisting Conditions: IBS, Interstitial cystitis
Allergies: Dairy, gluten, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm almost immediately. Almost 24 hours later, presented with swollen lymph node in neck, soreness, fatigue, feeling feverish/hot flashes, and headache. 36 hours later presented with night sweats and episode s of feeling feverish/hot flashes. 48 hours diarrhea and upset stomach. Night sweats, feeling feverish/hot flashes, and upset stomach have continued for the next two nights/days so far


VAERS ID: 1857177 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Lymphadenopathy, Tinnitus
SMQs:, Hearing impairment (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: Crab
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lymph node swelling, ear ache, tinnitus


VAERS ID: 1857362 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, pantapraeozole, Lexapro
Current Illness: Sinus infection
Preexisting Conditions: Fatty liver, high blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever - 12 hours post injection onset, continuing at least 72 hours Body aches severe - 14 hours post injection lasting 72+ hours Diarrhea severe - 48 hours post injection lasting 72+ hours


VAERS ID: 1857365 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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


VAERS ID: 1857410 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: uknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: patient found to have low blood pressure when evaluated by EMS
CDC Split Type:

Write-up: Patient fainted after receiving the immunization


VAERS ID: 1857411 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast tenderness, Injection site bruising, Injection site pain, Injection site swelling, Lymphadenopathy, Musculoskeletal chest pain, Tenderness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: swelling and tenderness in armpit/left side of breast/ left side of ribs-Medium, Systemic: Lymph Node Swelling-Medium, Additional Details: pt stated rxn started about 48 hours after receiving third booster of pfizer, previous 2 doses were pfizer, she states tenderness and swelling in left armpit area, on side of left breast and down left side of her ribs. She states no worsening of symptoms ( since 11/07/2021) and that ibuprofen helps with the pain. no limitation in mobility but tender/ and feels swollen. counselled pt to reach out to MD to look at, especially if symptoms worsen.


VAERS ID: 1857460 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Pt states she developed a rash all over her body


VAERS ID: 1857467 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-01
Onset:2021-11-07
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood lactic acid decreased, C-reactive protein increased, Computerised tomogram thorax normal, Dizziness, Dyspnoea, Fibrin D dimer, Pyrexia, Urine analysis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Vitals, D-dimer, CT PE protocol (negative for PE) UA Lactate 1.4 CRP 6.3 from 6.2
CDC Split Type:

Write-up: Pt received COVID vaccine 1st of June at the clinic; presented to Hospital ED on 11/8 with c/o dizziness and fever with weakness, SOB received fluids, IV decadron, tylenol and Albuterol inhaler; discharged also with home 02 and oral dexamethasone. Returned to ED on 11/9 with continued SOB, lung CT obtained, given IV bolus, albuterol neb discharged to home with Azithromycin and duonebs for q 6 hrs prn. to continue home 02, dexamethasone and instructed on proning positioning and isolation requirements.


VAERS ID: 1857488 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Client received the first dose of Pfizer COVID-19 vaccine and about a minute later, he threw up, as he walked away. His mother stated that he has a history of passing out after blood draws and shots. He was lain on a cot and offered some juice to sip slowly. He was chatting throughout and stated "I''m fine- I don''t know why I threw up." After 30 minutes of observation had passed, his mother said that he was fine and they were ready to leave. BP was 108/70, pulse was 88bpm and respiration was 18 per minute.


VAERS ID: 1857513 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Fall, Feeling cold, Loss of consciousness, Palpitations
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), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Client received his Pfizer vaccine and 30 seconds after that, he felt faint and fell to the floor per client''s mother. Mother stated he did not hit his head when he fell. Client regained consciousness a few seconds later and insisted on getting up and stated " I am fine." Client was assessed for pain, bleeding, bruising, client stated "I am fine." Client was transferred to the cot and assisted in lying position with feet elevate. Client stated " I feel better" and asked if he can sit up, client was given water, juice and crackers. After eating, client was transferred to a chair, client''s mother went to check on him and put a mask on him. Client''s eyes rolled back and started falling, client was lowered to the ground and regained consciousness a few seconds after. He complained of feeling cold and stated that his heart was racing. The EMT was called and arrived in less than 5 minutes. BP was 128/78 Heart rate was 90. Client was cleared by the EMT personnel to go home and client stated that he felt "fine."


VAERS ID: 1857583 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-15
Onset:2021-11-07
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / UNK LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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: HYDROCHLORIZIDE, SAXENDA,MAGNISUM
Current Illness: FLU VACCINE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: SWELLING IN LYMPH NODE ON LEFT SIDE OF NECK


VAERS ID: 1857645 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site pruritus, Injection site warmth, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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: lisinopril-hydrochlorothiazide, l-thyroxine, D-3, B-complex, venlefaxine
Current Illness: none
Preexisting Conditions: hypothyroid; hypertension, anxiety
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Covid injection #3 "booster": expected side effects 12 hours after injection: headache, muscle pain, sweating, nausea side effect day 3-current day 5 after injection: injection site pain, bright red, hard lump, heat, itching. 4 inch diameter area right deltoid


VAERS ID: 1857661 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Nausea, Pain in extremity, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: COVID-19; Moderna; 03/2021; could not drive for days due nausea and arm soreness.
Other Medications: None.
Current Illness: Vertigo.
Preexisting Conditions: No.
Allergies: Sulfa Drugs.
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: 11/07/2021 I began having a sore arm that night, a headache, vertigo, nausea, vomiting. All have stopped except nausea, headache and sore arm where the injection was given.


VAERS ID: 1857683 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, 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: Effexor XR, multivitamin, lysine, berberine, fish oil, vitamin D, collagen, glucosamine chondroitin, oral contraceptives
Current Illness: none
Preexisting Conditions: Type 2 diabetes
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: redness, soreness, and diffuse rash at injection site started about 36 hours after injection


VAERS ID: 1857688 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Feeling abnormal, Headache, Speech disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

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

Write-up: Started with a bad headache for a few day (still ongoing). Now I have to focus super hard to do any type of work. During conversations I stumble over my words and I have to correct myself a lot. It''s like a super bad brain fog.


VAERS ID: 1857730 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, 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: Type 2 diabetes, high colestrol, IBS, Prothrombin Gene Mutation
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is the Moderna Booster I received on 11/6/21 and the next day I had swelling of my arm from the elbow to my shoulder. It has been hot to the touch, and itchy. I am on day 4 and the swelling has gone down but still red and itchy. I have taken Benadryl orally, at night and put anti-itch cream on it and icing it a couple times a day. I received my initial Moderna vaccine on 2/12/21, and the second one on 3/12/21 with no problem except a sore arm for a day.


VAERS ID: 1857774 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram QT prolonged, Electrocardiogram abnormal, Fibrin D dimer increased, Full blood count, Inflammation, Lymph node pain, Lymphadenopathy, Metabolic function test, Pleurisy
SMQs:, Torsade de pointes/QT prolongation (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Torsade de pointes, shock-associated conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 11/10/21 CBC CMP DDIMER CHEST XR EKG
CDC Split Type:

Write-up: PT TO ER C/O CHEST PAIN, SHORTNESS OF BREATH, SWOLLEN/PAINFUL LYMPH NODES TO LEFT UNDERARM. SYMTOMS STARTED 1 DAYS AFTER PFIXER BOOSTER SHOT. PT STATES THE FIRST TWO INJECTIONS WERE MODERNA AND SHE HAD FLU LIKE SYMTOMS. EKG SHOWED PROLONGED QT, DDIMER WAS 306, CXR SHOWED POSSIBLE BRONCHITIS. PT WAS DX WITH PLEURITIS AND GIVEN NAPROXEN FOR INFLAMMATION AND A REFFERAL TO CARDIOLOGIST FOR FOLLOW UP. PT WAS TOLD THE SYMPTOMS SHE IS EXPERIENCING ARE NORMAL AFTER COVID VACCINATION...


VAERS ID: 1857804 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Lymphadenopathy, Nausea, Pyrexia, Sinusitis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Injection site pain, all over joint/muscle aches; 31 years of age; 05/1/2021; Pfizer-BioNTech.
Other Medications: Loratadine, Flonase, Afrin, Montelukast sodium
Current Illness:
Preexisting Conditions: Sinus infections around fall time.
Allergies: Red dye, milk product intolerance
Diagnostic Lab Data: Virtual call.
CDC Split Type:

Write-up: Injection site pain. Then overnight (after getting shot), armpit lymph node swelled. Felt a little fatigued and nauseous (11/7/2021-11/8/2021). The next day (11/9/2021), had a slight fever. Treatment: use cold and heat compress. Found out also I had a sinus infection and had to take antibiotics.


VAERS ID: 1857814 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 3 LA / IM
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. P100362826 / N/A RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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 exhibited flu like symptoms the next day then 2 days after vaccine (November 7) she developed a head to toe rash. Somewhat itchy with the scalp being severely itchy. By Tuesday morning November 9 the rash had mostly subsided after patient took benadryl and an oatmeal bath


VAERS ID: 1857854 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033FZ1A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Cough, Dyspnoea, Fatigue, Nasopharyngitis, Pain
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Modafinil, Metformin, Celexa, Vitamin D supplement.
Current Illness: None.
Preexisting Conditions: Anxiety/depression, eczema, interstitial cystitis, polycystic ovarian syndrome, sleep disorder
Allergies: Sulfa, Codeine
Diagnostic Lab Data: November 8 - seen by an urgent care practitioner at a walk-in center who listened to my lungs and said I was getting plenty of oxygen and that my lungs were clear. She prescribed albuterol.
CDC Split Type:

Write-up: Difficulty breathing began two days after receiving the vaccine booster shot. BUT PLEASE NOTE - I (the patient / reporter) often have difficulty breathing after getting a cold and there was a cold going around my daughter''s school the week before I received the booster shot. My daughter and I were both completely healthy the morning I got the shot but it''s possible she got the cold at school that Friday and gave it to me and I showed symptoms two days later. In any event, for the first 48 hours after getting the booster shot I experienced only "normal" vaccine side effects - feeling achy and sore and fatigued. Two days later I started having trouble breathing which worsened over night. On Monday the 8th (third day after getting the booster), I was concerned enough that I tried to reach my primary care doctor and when I couldn''t get through to them, I went to an urgent care walk-in center for treatment. They said that my lungs were clear and I was getting plenty of oxygen so they did not think there was anything serious going on. They prescribed me the inhaler I usually have when I have had bronchitis in the past (Albuterol, two puffs, four times a day). It is now November 10 (five days after the booster) and my daughter has a cold (sniffly, sneezing, congested, no fever) and I have a cough and continued difficulty breathing. No idea at all whether I have a cold or side effects from the booster.


VAERS ID: 1857855 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-02-18
Onset:2021-11-07
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 UN / IM

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

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

Write-up: Fully vaccinated and tested + for COVID 11/09/2021


VAERS ID: 1857878 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-16
Onset:2021-11-07
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Headache, Photosensitivity reaction, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None listed in the record
Current Illness: unknown
Preexisting Conditions: Angina COPD Diabetes mellitus Hypercholesterolemia Hypertension Migraine Neuropathy Stroke/TIA
Allergies: sulfadiazine biaxin
Diagnostic Lab Data: COVID 19 rapid antigen positive 11/7/2021
CDC Split Type:

Write-up: Patient arrived to the ED on 11/7/2021 Complaints of: headache and photosensitivity x 2 days, chilld, congestion, cough


VAERS ID: 1857879 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-10-25
Onset:2021-11-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Exposure during pregnancy, Hepatic enzyme increased, Nausea, Vision blurred, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft; Low Dose Aspirin; Prenatal Vitamins; Iron; Vitamin D3
Current Illness: I had a cold about 3 weeks before the vaccination.
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: bloodwork- elevated liver enzymes (11/7/2021)
CDC Split Type: vsafe

Write-up: I had experienced nauseas, vomiting, and then blurred vison. On 11/7/2021 I contacted my OBGYN office and went to the hospital for monitoring. They said my liver enzymes were elevated. They kept me for 36 hours to monitor my liver enzyme levels that was steadily increasing. I was discharged the next day on 11/8/2021. I follow up with them on 11/11/2021 for repeated lab work. I am recovered from the symptoms of nauseas, vomiting, and blurred vision because I do not experience them anymore, but I am not for sure if my enzymes are back to normal. I have 1 child already, and I am pregnant right now with my 2nd baby. The estimated date of delivery is 2/13/2022.


VAERS ID: 1857920 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330268D / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Arthralgia, Chills, Fatigue, Headache, Loss of personal independence in daily activities, Myalgia, Pyrexia, SARS-CoV-2 test negative, Urinary tract infection, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (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), 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: Vitamin C Motrin 300mg liquid, as needed
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: URINE TEST - UTI Covid test, PCR - negative Note: for item# 20, answer unknown, since fever is still ongoing no more abdominal pain.
CDC Split Type:

Write-up: 8/10 whole lower abdominal pain, constant. The whole day abdomnal pain ranged from 4-8/10 and constant until the 3rd day in the morning. Chills, temp of 103F. Muscle/joints pain. Fatigue. Headache. Treated with Motrin for fever as needed. Absence from school, unable to do routine activities of the day. Seen by MD on the 3rd day because of continued fever, this time on the 3rd day abdominal pain subsided. Urine test done,positive for UTI.


VAERS ID: 1857922 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 3 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Nasal congestion, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril - high blood pressure medicine Hydroclorathorazine
Current Illness: No
Preexisting Conditions: High blood pressure
Allergies: No
Diagnostic Lab Data: Home COVID test on Sunday and on Monday - I went to Urgent Care and they did another Rapid test - positive and I asked for a PCR test for my work - last night, they called with the positive result for that.
CDC Split Type: vsafe

Write-up: My husband was sick the week before and we both tested negative for COVID. On Saturday evening after the vaccine, I had fatigue, slight fever. Sunday, I woke up with a very runny nose and sneezing. I took a home COVID test and it came back positive for COVID. Since then, I followed up with a physician with Monday and my husband tested positive that day, as well. I believe I got it from him. I have had all the symptoms almost - but was just a little feverish on Sunday and that''s it for fever. I have had congestion, sneezing, coughing and fatigue. I do have an appt on Friday for the monoclonal antibodies. I have just taken OTC medicine to help manage some of the symptoms.


VAERS ID: 1857986 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Breast swelling, Oedema peripheral, Rash erythematous, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: N/A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Swelling with fluid buildup from left armpit down to left side of breast and upper side of torso. At day 4 still present and seems to be working it''s way downward. Red rash which appeared at day 2 after injection and subsided at day 3.


VAERS ID: 1858054 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebellar infarction, Magnetic resonance imaging head abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: carvedilol, empagliflozin, furosemide, nicotine lozenge
Current Illness: New onset of congestive heart failure, nonischemic cardiomyopathy
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: 11/7/21 MRI brain : acute right superior cerebellar artery territory nonhemorrhagic infarct
CDC Split Type:

Write-up: Patient received vaccine 11/5/21 and was admitted to the hospital 11/7/21 for an acute right cerebellar infarct


VAERS ID: 1858109 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-03
Onset:2021-11-07
   Days after vaccination:96
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11/10 SARS/COV-2, NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1858111 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-09
Onset:2021-11-07
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg oral enteric coated tablet atorvastatin (LIPITOR) 40 mg oral tablet ergocalciferol (VITAMIN D2) 1,250 mcg (50,000 unit) oral capsule furosemide (LASIX) 80 mg oral tablet gabapentin (NEURONTIN) 300 mg oral capsule insulin aspar
Current Illness:
Preexisting Conditions: Diabetes mellitus type 2 Hypercholesteremia Hypertension Anasarca CHF Acute respiratory failure with hypoxia and hypercapnia Metabolic encephalopathy Suspected COVID-19 infection Hypoventilation syndrome Morbid obesity Dysphagia OSA Physical deconditioning
Allergies:
Diagnostic Lab Data: POSITIVE COVID TEST 11/7/21
CDC Split Type:

Write-up: FALL


VAERS ID: 1858179 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Fatigue, Hypersomnia, Injection site pain, Lethargy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: exact same vaccine slightly milder symptoms
Other Medications: multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data: I have a picture of the thermometer showing the high fever .
CDC Split Type:

Write-up: Severe pain at injection site still ongoing. 101.7 degree fever had photo showing 101.6 chills body aches lasting 2 days. Still feel very weak and tired. Joint pain lethargic. I slept 12+ hours for 3 days so far and drank lots of fluids. What would a doctor have done?


VAERS ID: 1858214 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chest discomfort, Diarrhoea, Dyspnoea, Pain, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol 90MG Loratadine 10MG Amoxicillin 875MG Asiprin 325MG Azithromycin 250MG Pin Needles Benzonatate 200MG Buspirone 5MG Hydromorphone 12MG Novolog Aspart 100 ML 90 units a day Lisinopril 25MG Marcan 4MG as needed Nortriptyline 25M
Current Illness: Bronchitis
Preexisting Conditions: Chronic pain
Allergies: No
Diagnostic Lab Data: Chest Xray Covid test
CDC Split Type: Vsafe

Write-up: Difficulty breathing Chest tightening Body aches Weakness Diarrhea


VAERS ID: 1858284 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Fatigue, Feeling hot, Nodule
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Rosuvastatin Jardiance Lexapro Singulair CoQ10 Amberen peri-menopausal formula Women''s multivitamin
Current Illness: none
Preexisting Conditions: Diabetes, nasal allergies and sinusitis
Allergies: celery phenobarbital sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Significant fatigue for 3 days. Large knot the size of an orange formed on the arm, red and hot to the touch. Bump itself registered 101.5 on infrared thermometer, pt forehead temp was normal.


VAERS ID: 1858300 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012F21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: Versed, Bactrum, Cephalosporins
Diagnostic Lab Data: No tests done. Portal communication with PCP only.
CDC Split Type:

Write-up: Left upper leg numbness and tingling and sensation of twitching intermittently since about 18 hours after the injection. Continues to be ongoing four days since the booster dose.


VAERS ID: 1858748 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-10-17
Onset:2021-11-07
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Differential white blood cell count normal, Drug screen negative, Dyspnoea, Electrocardiogram normal, Foaming at mouth, Loss of consciousness, Metabolic function test, Moaning, Pregnancy test urine negative, Seizure, Seizure like phenomena, Troponin I normal, Urine analysis normal, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Seizure/Seizure-like activity 5 days after Pfizer Covid-19 Vaccine Dose #1
Other Medications: Zoloft
Current Illness:
Preexisting Conditions:
Allergies: Ritalin
Diagnostic Lab Data: CBC with Differential, CMP, Drugs of Abuse, Screen, Urine Pregnancy, Urine, Qual, Troponin I, Urinalysis with Microscopic, ECG 12 lead, XR Chest PA and Lateral All results were Normal/Clear
CDC Split Type:

Write-up: *Seizure/Seizure-like episode 21 days after receiving Dose #2 of Pfizer Covid-19 Vaccine (blurry vision, total loss of consciousness, body convulsions lasting about 2 minutes, gasping, slight moaning, foaming at the mouth, then at least 5+ minutes to regain full consciousness)


VAERS ID: 1858995 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-29
Onset:2021-11-07
   Days after vaccination:282
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Pain, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Cheratussin AC 100-10 MG/5ML Syrup 5 ml Orally every 4 hrs as needed for cough ?Naproxen 250 MG Tablet 1 tablet Orally Twice a day, Notes: PRN
Current Illness: none
Preexisting Conditions: Degenerative joint disease. History of total knee replacements bilaterally . Tubular adenoma of colon-$g last colonoscopy December 2015 (1 polyp removed)-$g repeat in December 2020. Pulmonary nodule, right-$g stable CTs 2015, 2017, 2020 "probably benign", per radiology. Lumbar disc herniation ( w/ central spinal stenosis L4-L5, 2017). Neurogenic claudication. Family hx of colon cancer. diffuse DJD (degenerative joint disease),L ankle and foot/ bil. shoulders. History of tobacco abuse (heavy use between ages 20-37/2 PPD on average-$g quit in 1990
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: scratchy throat, cough, chills, body aches starting 11/7/21


VAERS ID: 1859009 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-22
Onset:2021-11-07
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Nasal congestion, Pain, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Levothyroxine Sodium 75 MCG Tablet 1 tablet on an empty stomach in the morning Orally Once a day ?Sertraline HCl 25 mg Tablet Start 1 tablet in AM once daily for 2 weeks, then increase to 2 tabs in AM thereafter Orally Once a day ?cy
Current Illness: none
Preexisting Conditions: RA. Hypothyroid. Gerd.
Allergies: Penicillin G Benzathine: hives - Allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever-low grade temp, headache-mild, nonproductive cough, body aches, diarrhea-3-4 times a day/no blood in stool, sinus congestion, nasal congestion,. starting 11/7/21


VAERS ID: 1859025 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 320308D / 3 RA / IM
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC. P100369750 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Injection site vesicles, Pain
SMQs:, Anaphylactic reaction (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: The following morning after the shot (11/7/21), the patient woke up with a strange blister that popped on his shoulder in the arm where he received the covid shot. The next day (11/8/21), the patient felt radiating pain from his armpit down the side of his body. In addition, he developed a deep cough. Patient went to his doctor''s office on 11/8/21 to determine if these were complications of the shot.


VAERS ID: 1859041 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-11
Onset:2021-11-07
   Days after vaccination:269
Submitted: 0000-00-00
Entered: 2021-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Feeling hot, Head discomfort, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (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: Fluocinonide 0.05 % Solution to the affected area on ear as needed for psoriasis/eczema Externally Vitamin D daily Aspirin Adult Low Dose 81 MG Tablet Delayed Release 1 tablet Orally Once a day
Current Illness: none
Preexisting Conditions: Adjustment disorder, with depressed mood, treated in 2012
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms started 11/7/21 "felt like she was on fire", did not have fever, body aches, cough, runny nose. Current symptoms: "stuffy head", body aches, runny nose.


VAERS ID: 1860108 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-11-07
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (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: USJNJFOC20211120045

Write-up: FELT LIKE STIR FRIED CRAP; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 06-NOV-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 07-NOV-2021, the patient experienced felt like stir fried crap. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of felt like stir fried crap was not reported. This report was non-serious. This case, from the same reporter is linked to 20211118830.


VAERS ID: 1860488 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-10-27
Onset:2021-11-07
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 32030811 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Asthenia
SMQs:, Guillain-Barre syndrome (broad), Other ischaemic heart disease (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: No
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Heart started hurting 3 days ago. Resting heart rate consistently at 75 (usually 60). Having trouble with my normal cardio exercising without feeling weak.


VAERS ID: 1860515 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, Caesarean section, Exposure during pregnancy, Foetal hypokinesia, Pyrexia, Umbilical cord abnormality
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: PNV, Iron
Current Illness: gestational diabetes, diet controlled. 30 weeks pregnant
Preexisting Conditions: n/a
Allergies: Latex
Diagnostic Lab Data: Baby is in ICU in critical condition. Mom is in stable condition.
CDC Split Type:

Write-up: arrived to hospital 4-5 days after receiving booster with complaints of no fetal movement at 30+6/7 weeks. Received booster on Saturday 11/6 (unknown in chart about which brand booster) and pt developed a fever and high blood sugars over the next few days. Baby had a non reactive tracing over 2 hours (11/11/21) and received an emergency c/s (11/11/2021 at 0217) with a pale baby, no blood noted in umblical cord and required intense resuscitation and blood transfusion. Unknown etiology (no obvious abruption).


VAERS ID: 1860527 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FJ1611 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Wellbutrin, adderall
Current Illness: None
Preexisting Conditions: Hypothyroidism, adhd
Allergies: Penicillin, compazine, macrobid
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red bumps, itching, redness and swelling down upper arm, looks like urticaria


VAERS ID: 1860722 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-11-06
Onset:2021-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Was completing augmentin course
Current Illness: Urethritis, contact dermatitis due to fabric softener exposure, cold 2 weeks prior
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 28 hours post injection painful small vesicular rash on left palm. Like any bites (no exposure to ants). Rash progressed in pain, distribution, and number of bumps ($g80) entire palm only over next 3 days. Possible dx pompholyx eczema?


VAERS ID: 1860739 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-07
Onset:2021-11-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

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

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

Write-up: Vaccine expired 11/5/21 and was given 11/7/21


VAERS ID: 1860785 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-05
Onset:2021-11-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2590 / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, amoxycillin
Diagnostic Lab Data: Urgent care visit on 11/8/21.
CDC Split Type:

Write-up: Widespread hives, itchiness, redness on face, neck, chest, back, legs, arms, hands, and feet. Hives started two days following 3rd dose (booster) of Pfizer vaccine. By third night, hives were so severe that an urgent care visit was needed. Prescribed prednisone, benadryl, zyrtec, and pepcid. Six days post-vaccine and hives are still persistent. They go away for a few hours at a time with medications, but come back all over body. Benadryl not extremely effective and helpful for only 2-3 hours at a time. No exposure to any other allergens.


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