National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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



Case Details (Reverse Sorted by Onset Date)

This is page 160 out of 6,867

Result pages: prev   61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259   next


VAERS ID: 1558311 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Chills, Headache, Hyperhidrosis, Muscle spasms, Pain, Pulmonary pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: COQ10/Fish Oil/Esomeprazole/Vitamin D/Atenolol/Duloxetine/Buprpion/Methocarbomol/Gabapentin/Atorvastatin/Quetiapine/Trazodone/Prazosin/Hydroxyzine/Lortab/Calcium, Magnesium,Zinc
Current Illness:
Preexisting Conditions: Anemia/High Blood Pressure/High Cholesterol/PTSD
Allergies: Nsaids
Diagnostic Lab Data: No treatment
CDC Split Type:

Write-up: Headache, body aches, , cramping , a 101-degree fever that lasted 24 hours. Sweating profusely, chest/lung pain, 72 hours. Chills 48 hours. Did not seek treatment


VAERS ID: 1558336 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dyspnoea, Fatigue, Headache, Injection site irritation, Joint stiffness, Muscle spasms, Muscular weakness, Musculoskeletal stiffness, Nausea, Pain in extremity, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: chronic back pain
Allergies: mosquito bites
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Irritation at injection site, arm hurt, 1st day 2nd day headache, fever of 100.2, sharp stabbing pains in arms and legs, left arm elbow, other random spots extreme fatigue, muscle weakness, nausea, short of breath, day 3 & 4 , joints tight , stiff spine, neck & back charlie horse. Headache, can''t sleep Treatment: taking Tylenol, drinking extra fluids, rest


VAERS ID: 1558358 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Fatigue, Nausea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine, Symbicort
Current Illness: none
Preexisting Conditions: Asthma, Allergy, hyperlipidemia, Chronic back pain, intervertebral disc degeneration
Allergies: Naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: dyspnea, chills, body pain, dizziness,, fatigue, nausea


VAERS ID: 1558421 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Fibrin D dimer increased, Pleuritic pain, Pulmonary embolism, Scan with contrast abnormal, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: morbid obesity
Allergies: none
Diagnostic Lab Data: elevated d-dimer, CT scan of chest with contrast showing pulmonary emboli, venous duplex ultrasound showing DVT, all tests performed on 8/13/21
CDC Split Type:

Write-up: symptoms included pleuritic chest pain and shortness of breath; diagnosed with bilateral subsegmental pulmonary emboli and popliteal deep venous thrombosis, currently being treated with lovenox with plan to bridge to warfarin


VAERS ID: 1558438 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-08-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Private       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Modafini, tramadol, trapdoor paxel
Current Illness: None
Preexisting Conditions: Lung disease , COPD , lymphoma, heart disease , emphysema
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Lymph nodes on left side of neck total 6


VAERS ID: 1558464 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-05
Onset:2021-08-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Chest tightness/pain


VAERS ID: 1559252 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta
Current Illness:
Preexisting Conditions: Hashimoto''s thyroiditis Chronic migraine with aura
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache similar to headache when I had covid-19 in January 2021, nausea and dizziness that has persisted for the last 3 days with increasing severity.


VAERS ID: 1559253 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-26
Onset:2021-08-11
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19 pneumonia, Cerebrovascular accident, Condition aggravated, Hypoxia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inh, alendronate, amlodipine, atorvastain, azithromycin, breo ellipta inh, vitamin d3, clopidogrel, vitamin b12, docusate, fasenra inj, ferrous sulfate, furosemide, lactobacillus, losartan, methadone, metoprolol ER, montelukast,
Current Illness:
Preexisting Conditions: CAD status post stent x3 (2018), right MCA embolic stroke (2016), chronic pain on methadone, chronic eosinophilic pneumonia, and hypertension
Allergies: Ibuprofen, cephalexin
Diagnostic Lab Data: COVID status positive 8/11/21.
CDC Split Type:

Write-up: Patient receive COVID vaccine Pfizer 2 dose series on 3/5/21 and 3/26/21. On 8/11/21, patient presented to our facility with 2 days history of fever and generalized weakness. He was admitted for acute stroke with hypoxia due to COVID pneumonia. Patient discharged home on 8/13/21 in stable condition.


VAERS ID: 1559263 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-27
Onset:2021-08-11
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Chronic respiratory failure, Hypoxia, Malaise, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen PRN, albuterol inh PRN, Advair disk inh, levetiracetam, levothyroxine, lisinopril, oxybutynin, phenazopyridine PRN, revastigmine, simvastatin, trazodone, venlafaxine XR, Ocuvite
Current Illness:
Preexisting Conditions: Advanced COPD and chronic respiratory failure supposed to be on home O2 4L/min but only using as needed every few hours, moderate Alzheimer''s dementia, chronic systolic and diastolic CHF EF 35-39% 2017, seizure disorder, HTN. Patient resides in assisted living.
Allergies: Zolpidem
Diagnostic Lab Data: COVID status positive on 8/11/21.
CDC Split Type:

Write-up: Patient received COVID vaccine Moderna series on 2/1/21 and 2/27/21. On 8/11/21, patient was admitted to our facility Hospital for COVID virus infection (mildly symptomatic, chest x-ray w/out signification findings of PNA), chronic respiratory failure with hypoxia (on home O2 therapy for COPD). Patient was discharged back to assisted living facility on 8/13/21 in good condition.


VAERS ID: 1562805 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 3 LA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1569040 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Back pain, Blood pressure increased, Chest X-ray, Chest discomfort, Chest pain, Diarrhoea, Gaze palsy, Injected limb mobility decreased, Laboratory test, Pain in extremity, Pyrexia, Ultrasound Doppler, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Ocular motility disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Zithromax, nuts, carrots, gluten, soy Sensitivity to Penicillin
Diagnostic Lab Data: On 8/12/21 numerous tests and lab work were performed in the emergency room by Dr. at Hospital.
CDC Split Type:

Write-up: Vaccine rec''d on 8/10/2021(2nd Pfizer). Symptoms began the next morning 8/11/2021. Severe arm, shoulder, chest, back and armpit pain. Sensation of "being on fire" in back and chest. Hives on face. Low grade temp (100), severe headache, diarrhea. Inability to move arm where shot was given. Emergency room visit became necessary on 8/12/21 as symptoms were so severe. No relief from Tylenol from start of symptoms. ER discovered acute extremely high blood pressure (207/118), no prior issues. Gave IV fluids, pain meds, ran multiple scans, ultrasounds, chest x-ray. Pt was discharged the evening of 8/12/21 only because she had a previously scheduled appt with an endocrinologist on 8/13/21 who could do additional testing and follow up exam.


VAERS ID: 1569075 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002121A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Feeling cold, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norgee birth control and Magnesium
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type: 002121A

Write-up: Both arms and hands went numb, started to tingle, then felt like they started to burn and then felt cold. Did this for a couple of hours. Started at 4:13pm


VAERS ID: 1569160 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Nausea
SMQs:, Acute pancreatitis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tachyarrhythmia terms, nonspecific (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: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she experience heart flutters 3 hours after getting the vaccine which only lasted that evening. She woke up in the morning with no heart flutters but only nausea. She reported no other side effects since then.


VAERS ID: 1569194 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dysphagia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Allergy to insect venom (bee), Allergy to codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives on neck, trouble swallowing, tightness in chest, cough


VAERS ID: 1569210 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-21
Onset:2021-08-11
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Computerised tomogram thorax abnormal, Laboratory test, Musculoskeletal chest pain, Pulmonary embolism
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Multiple pulmonary emboli. Pt had symptoms start, mild lower rib, upper abdominal pain start 1 week after first dose, worsening after second dose prompting her to seek care. Multiple PE diagnosed later in the day on 8/11


VAERS ID: 1569211 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Gastrooesophageal reflux disease, Hypersomnia, Hypoaesthesia, Immediate post-injection reaction, Impaired work ability, Migraine, Nausea, Pain in extremity, Paraesthesia, Photophobia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), 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: None.
Current Illness: None.
Preexisting Conditions: I am overweight, aside from that I have no chronic or long-standing health conditions.
Allergies: I have a latex allergy, and pineapple allergy.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I have experienced: ? pain/discomfort in my joints (knees, elbows, shoulders, fingers.) - I am still currently experiencing pain/discomfort in my joints. ? extreme fatigue - The extreme fatigue lasted roughly 4 days, I was lucky enough to be able to take off work and therefore had the ability to sleep for literally 74 hours straight aside from waking up to use the restroom. ? light sensitivity followed by a migraine - The light sensitivity and migraine were my immediate reaction following the vaccine and lasted until the morning after my initial dose. ? numbness and a tingling sensation in both of my arms and hands. - I am still currently experiencing numbness and tingling in my arms and hands. ? nausea - I had nausea the day after my vaccination and it lasted throughout the day, I was able to eat small things like crackers and water. ? acid reflux. - Acid reflux for around 4 days, despite a limited diet. *I did not use any OTC medication to treat any of these symptoms.*


VAERS ID: 1569930 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-04
Onset:2021-08-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OSOC21A / 1 LA / SYR

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: none
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I have had a really bad rash that comes and goes over various parts of the body, legs, arms, stomach, back hands, feet etc. started day 7 after vaccine and is still here day 10. Seems to be the worst these last two days.


VAERS ID: 1571083 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-08-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207AZ1A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Electrocardiogram, Head discomfort, Headache, Hypoaesthesia, Nasal congestion, Oropharyngeal pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 2 EKGs, Chest x-ray, Blood work, vitals checked multiple times, temperature check, IV
CDC Split Type:

Write-up: Numbness/Loss of feeling in fingertips, continued headache, sore throat, running and congested nose, chest pain/pressure, back of head pressure/


VAERS ID: 1571215 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Feeling abnormal, Headache, Lymphadenopathy, Pain in extremity
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Very sore arm(right) , sore swollen underarm gland, no enegry, headache, in bed all day feeling terrible, Same symptoms second day and underarm more swollen, sick in bed again second day, Third day woke up with headache, took tylenol and started to feel better.


VAERS ID: 1573798 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-22
Onset:2021-08-11
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, Infection, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (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), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: eliquis, astelin nasal=, vit D, B12, clobetasol oint, hydrocortisone lotion, imipramine, lisinopril, melatonin, omeprazole, quetiapine, simvastatin, temazepam
Current Illness: no
Preexisting Conditions: PVD, afib, GERD, HTN, HLD, SSS s/p pacemaker
Allergies: no
Diagnostic Lab Data: Covid + 8.11.2021
CDC Split Type:

Write-up: breakthrough case requiring hospitalization and supplemental O2,


VAERS ID: 1573885 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dysphagia, Eye pruritus, Eye swelling, Immediate post-injection reaction, Night sweats, Pain in extremity, Pyrexia, Sensation of foreign body, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Apple Cider Vinegar Complex (Paleovalley brand, 3 capsules every morning) I Am Myself Again - Phase It Up Supplements
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Erythromycin
Diagnostic Lab Data: No tests have been taken to date.
CDC Split Type:

Write-up: Started with extremely sore arm right away. As day went on, I started getting the chills, and shakes, then a low grade fever. About 15 hours after vaccination, my eyes became itchy and swelled up. I also then started feeling like I had a lump in my throat and it was a little hard to swallow. I then had my husband take me to ER because it was 4:30 am. I took Benadryl while waiting to be seen (I was there about 4 hours waiting). Once seen, they prescribed Prednisone twice a day; Famotidne, twice a day. They also told to continue to take the Benadryl that I bought over the counter. I then followed up with Dr. but was only able to see the PA. She said to continue with ER gave me but prescribed Cetrizine HCL, once a day. She said it worked better than Benadryl so I stopped taking Benadryl and switched to the Cetrizine. My next appointment is via zoom on Wednesday, 8/18/21. To date, my eyes are still slightly swollen but almost back to normal. Night sweats continued since vaccination. Last night 8/16/21 was first night not having them.


VAERS ID: 1573922 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-08-11
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine 5 mg daily, lisinopril 40 mg daily, simvastatin 40 mg daily, metformin 500 mg BID, levothyroxine 150 mcg daily, glimepiride 4 mg daily, insulin glargine 60 units BID, indapamide 2.5 mg daily, gabapentin 300 mg TID, omeprazole 20
Current Illness: Patient reports he had a "cold" (congestion and slight cough) in Feb 2021
Preexisting Conditions: Hypertension, hyperlipidemia, hypothyroidism, type 2 diabetes, obesity, GERD
Allergies: codeine
Diagnostic Lab Data: Positive Covid 19 swab on 8/14/21
CDC Split Type:

Write-up: Patient has contracted Covid-19.


VAERS ID: 1573985 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2020-12-30
Onset:2021-08-11
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Ear pain, Headache, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: sulfa,erythromycin
Diagnostic Lab Data: 8/11/21 tested positive for COVID
CDC Split Type:

Write-up: symptoms started 8/2/21 was tested negative for COVID but got progressively worse with symptoms. Nasal drainage, ear pain, headache, cough


VAERS ID: 1573986 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea exertional, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol, allopurinol, diclofenac gel, gabapentin, hydrocodone-APAP, ibuprofen, losartan-HCTZ, magnesium oxide, metoprolol succinate, multivitamin, rivaroxaban, rosuvastatin, vitamin D
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia, pre-diabetes, history of pulmonary embolism, paroxysmal atrial fibrillation
Allergies: lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed fever (101.5), fatigue, headache, and dyspnea on exertion within a day of vaccination and symptoms continued until admission to hospital 4 days later


VAERS ID: 1573994 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-12
Onset:2021-08-11
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL140 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 4000 iu daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: +PCR
CDC Split Type:

Write-up: COVID developed on 8/11/2021


VAERS ID: 1574039 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-11
Onset:2021-08-11
   Days after vaccination:61
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO150 / 2 AR / 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID positive after vaccination


VAERS ID: 1574065 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Crying, Dizziness, Headache, Malaise, Mobility decreased, Pyrexia, Screaming, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: My Child started feeling ill around 3;30pm the day after. Her stomach started to hurt she became light headed and threw up twice. She also could not pick up her arm that the shot was given. Around 5pm she began screaming crying of her head hurting (pain 10 on pain scale) and projectile vomiting due to the pain of her head. She then began to run a fever of 103.5. She could not function due to her pain in her head and high fever. Tylenol and Ibprofureon did not break the fever. Her fever finally broke Thursday am around 6am and was 101. By Thursday afternoon 3pm she was all better no complaints, head did not hurt nor did she have a fever or vomiting.


VAERS ID: 1574089 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint contracture, Motor dysfunction, Muscle spasms, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: 400 mg ibuprofen two hours prior to vaccination
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Symptoms began 14 hours after vaccination (~4:00 a.m.). Symptoms begin with high fever (101 - 102 degree fever). Shortly following identification of high fever a possible carpopedal spasm occurred. Hands started to curl in, were painful, and there was a loss of motor control. This also occurred in the feet. Spasm response resolved within 30 minutes to 1 hour. Fever ranging from 99 - 101 lasted another 24 hours and was treated with tylenol.


VAERS ID: 1574106 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-22
Onset:2021-08-11
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Magnetic resonance imaging head normal
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: multiple myeloma,
Allergies:
Diagnostic Lab Data: MRI brain: 8/12 negative
CDC Split Type:

Write-up: Dizziness. MRI negative for stroke. Patient felt better after 1 day.


VAERS ID: 1574112 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-08-11
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Hospital 8/11/21


VAERS ID: 1574124 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: I am reporting the fact that pt was given his second dose of Pfizer vaccine a week early. The second dose was to be administered on 08/18/2021, but instead got his second dose on 08/11/2021. Pt notified.


VAERS ID: 1574141 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SCE180 / 1 LA / IM

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

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

Write-up: short of breath, and having chest pain


VAERS ID: 1574146 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dysstasia, Immediate post-injection reaction, Mobility decreased, Nodule, Oral herpes, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin/ acyclovir
Current Illness: RA/ hypo Thyriod
Preexisting Conditions: Shingles/ hypothyroid/ RA
Allergies: Bactrim penicillin microbid latex
Diagnostic Lab Data: I haven?t had a chance to see a doctor yet! I?m going tomorrow. I know what took place with my body.
CDC Split Type:

Write-up: Immediately after I felt out of it! Then the pain in my arm started. Then I was in severe pain all over and couldn?t stand or turn in bed. I had to crawl around my house to care for my child. Then mild chest pains and shortness of breath. Then my period came on early. Then a painful small lump came back in my neck where I first had cancer at. Then my cold sore came back on my face even though I take medication and never have breakouts! This all happened in a matter of three days. This vaccine is horrible for people with existing conditions!! I feel like I was poisoned. Now I have to worry if I have cancer again!


VAERS ID: 1574163 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Pt w/ hx of allergies to salmon, milk, eggs, shrimp.
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt w/ hx of allergies to salmon, milk, eggs, shrimp. No other medical info available at the time of vaccination. P/t c/o hives on bilateral legs and itchy throat 10mins post vaccination. Vitals @15:45 BP 130/78, HR 76, RR 16, SpO2 100% -- $g 16:55 122/78, 87, 16, 100% -- $g @17:16 124/79, 88, 16, 100% Pt given Benadryl 50mg PO @16:53 and 0.3mg Epi into the Left Thigh @17:17. 911 was called @17:18 and the patient was taken to the Emergency Room. Disposition is unknown to this writer. Allergy noted in pt chart and 2nd dose Pfizer vaccine appt canceled."


VAERS ID: 1574182 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Heart rate increased, Nausea, Nervousness, Respiratory rate increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 5mins post vaccination, pt c/o dizziness, Nausea, and Anxiety. Vitals BP 117/71, HR 103, RR 22, SpO2 99% RA. Pt reported having anxiety and nervousness pre-vaccination. VS Stable and pt felt better after 15mins in med bay. Pt stable and released from the vaccination site.


VAERS ID: 1574189 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

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

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

Write-up: Client came to office to explain adverse events. Client''s upper lip started swelling late in the evening. This has happened to client before from allergic reaction and from stress. Client took Benadryl and did not help swelling. Client also had couple hives on arms. Instructed client to go to walk-in or call primary care physician.


VAERS ID: 1574263 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-30
Onset:2021-08-11
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 UN / IM

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

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

Write-up: Covid positive


VAERS ID: 1574392 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient indicated that he wished to receive the vaccine and denied having received a previous Covid vaccine. Staff utilized the state covid vaccine management system to identify inmates who may have already received a Covid vaccine; this inmate may have been added to list after checks were completed. The patient received the Janssen Covid vaccine; vaccine administration was entered into the Covid vaccine management system and at that time it was found that the patient had received Covid vaccine, Moderna, at another correctional institute on 3/25/21. The nursing director was notified on 8/13/21 and was advised to monitor inmate for vaccine reactions.


VAERS ID: 1574405 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: Patient indicated that he wished to receive the vaccine and denied having received a previous Covid vaccine. Staff utilized the state Regulatory Authority system to identify patients who may have already received a Covid vaccine; this patient may have been added to list after checks were completed. The patient received the Janssen Covid vaccine; Regulatory Authority was entered into the Regulatory Authority management system and at that time it was found that the patient had received Covid vaccine, Pfizer, at another location on 3/25/21. The nursing director was notified on 8/13/21 and was advised to monitor patient for vaccine reactions.


VAERS ID: 1574497 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Discomfort, Impaired work ability, Injection site erythema, Injection site pain, Injection site swelling, Migraine, Mobility decreased, Neck pain, Pain
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Divalproex, Quetiapine, antacids, tizanidine, Buspar, Bupropion
Current Illness: sinus infection about one month from first dose of Moderna. Was told to wait until better to get second dose.
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Patient stated no tests or labs were conducted.
CDC Split Type:

Write-up: The patient experienced a burning pain at site of injection and within an hour the pain spread up to neck, down back, and down to wrist and began to feel heavy. The pain triggered her migraine headaches. The shoulder and arm of the injection side was red and swollen. She called a doctor, and was told to come in for a visit. The Doctor thought a nerve was hit when injected. The following day, upon visualization of the injection site, the redness and swelling resolved itself. The patient was prescribed Gabapentin to help with the burning pain in arm. The pain is no longer in entire arm after using gabapentin for a few days, but still in pain. She is missing work due to inability to list heavy objects.


VAERS ID: 1574525 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-08-11
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Cellulitis, Full blood count, Influenza, Metabolic function test, Nausea, Pyrexia, Respiratory syncytial virus test, SARS-CoV-2 test, Urine analysis, 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), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC, BMP, glucose POC, flu, RSV, COVID, urinalysis
CDC Split Type:

Write-up: nausea, vomiting, fever, cellulitis


VAERS ID: 1574584 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not known: Patient would not answer phone calls to get more information
Current Illness: Not Known
Preexisting Conditions: Tobacco Smoker
Allergies: Penicillin and Sulfa
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Pt called on 08/13/2021 to cancel the @nd dose. Said she had an anaphylactic reaction and "just got out of the hospital". Pt did not give any details and did not respond to 3 attempts to contact by phone.


VAERS ID: 1574606 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Erythema, Lymphadenopathy, Skin warm
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: red arm, swollen lymph gland right arm, golf ball size, warm to touch, started 2 days after administration, subsided 4 days after start date. patient stated he experienced a burning sensation in lower abdomen area, kidney area.


VAERS ID: 1574633 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dyspepsia, Fatigue, Feeling hot, Flushing, Headache, Hyperhidrosis, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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: inflamed gallbladder after MMR booster in 2018
Other Medications: Multi-vitamin, Milk Thistle, Dandelion Root
Current Illness: None
Preexisting Conditions: Celiac Disease
Allergies: Celiac, lactose intolerance, demerol, tetracycline, erythromycin, preservatives
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2:00am - Chills 5:00am - Flushing, heat, sweating Muscle soreness, headache, excessive fatigue Still having upper chest discomfort and pressure, consistent heartburn


VAERS ID: 1574638 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Inadvertent dose given to patient under the age of 12.


VAERS ID: 1574656 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-09
Onset:2021-08-11
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Magnetic resonance imaging, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Potassium, Folic Acid, Levetiracetam, Sidenafil, Levothyroxine, Prednisome, Famotidine, Triamterene, Nadolol, Letairus, Women''s One a Day, Vitamin C, Vitamin D3, Systane Eye Drops, Mupirocin, Triamcinolone Acetonide Ciclopirox, Omeprozale,
Current Illness: Systemic Erythemus Lupus, Pulmonary Hypertension Liver Cirrhosis
Preexisting Conditions: Lupus Pulmonary Hypertension Liver Cirrhosis High Blood Pressure
Allergies: Sulfur, Penicillin & Sulfur
Diagnostic Lab Data: MRI - 08/11/2021
CDC Split Type:

Write-up: Blood clot


VAERS ID: 1574866 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-08
Onset:2021-08-11
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Exposure to SARS-CoV-2, Pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: 8/16, EE called to EHS that Sx, chills, runny nose, fever and bodyache since 8/11. Son was pos last wk. The last day worked was 7/12. EE was tested. Fully vaccinated.


VAERS ID: 1574869 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-01-13
Onset:2021-08-11
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

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

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

Write-up: 8/16, EE called that Sx, runny nose, nasal congestion, and HA since 8/11. Her husband was pos and EE tested on 8/9(-). The last day worked was on 8/3. 2/3 kids are Pos.


VAERS ID: 1577487 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Limb discomfort, Oropharyngeal pain, Pain assessment, Pain in extremity
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hypertension (anti-hypertensive medications.); Hypothyroidism (thyroid hormone replacement); Latex allergy; Non-smoker; Sleep apnea (uses CPAP with moist air.)
Preexisting Conditions: Comments: The patient was not pregnant at the time of vaccination, no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210811; Test Name: Pain scale; Result Unstructured Data: 9/10; Comments: Sore left Arm; Test Date: 20210812; Test Name: Pain scale; Result Unstructured Data: 4/10; Comments: Sore throat; Test Date: 20210812; Test Name: Pain scale; Result Unstructured Data: 2-3/10; Comments: Sore left Arm
CDC Split Type: USJNJFOC20210826091

Write-up: SORE THROAT WITHOUT REDNESS OR WHITE PATCHES; SORE LEFT ARM WITHOUT REDNESS AND SWELLING; ARM FELT HEAVY; This spontaneous report received from a patient concerned a 68 year old female. The patient''s weight was 145 pounds, and height was 66 inches. The patient''s concurrent conditions included: hypothyroidism, hypertension, sleep apnea, latex allergy, non-alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient was not pregnant at the time of vaccination, no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, expiry: 21-OCT-2021) dose was not reported, administered on 11-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-AUG-2021, the patient experienced sore left arm without redness and swelling. On 11-AUG-2021, the patient experienced arm felt heavy. Laboratory data included: Pain scale (NR: not provided) 9/10. On 12-AUG-2021, the patient experienced sore throat without redness or white patches. Laboratory data included: Pain scale (NR: not provided) 2-3/10, 4/10. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from sore left arm without redness and swelling, had not recovered from sore throat without redness or white patches, and the outcome of arm felt heavy was not reported. This report was non-serious.


VAERS ID: 1577506 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Bipolar disorder; Smoker (Smokes marihuana once a day)
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210826568

Write-up: BRUISES ON MIDDLE OF FOREHEAD, EYEBROWS AND LEFT EYE WHICH HURTS; This spontaneous report received from a consumer concerned a 26 year old male. The patient''s weight was 180 pounds, and height was 75 inches. The patient''s concurrent conditions included: smoker, non-alcohol user, and bipolar, and other pre-existing medical conditions included: The patient had no known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: UNKNOWN) dose was not reported, administered on 09-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-AUG-2021, the patient experienced bruises on middle of forehead, eyebrows and left eye which hurts. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from bruises on middle of forehead, eyebrows and left eye which hurts. This report was non-serious.


VAERS ID: 1577531 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling hot
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210830326

Write-up: FELT WARM; This spontaneous report received from a patient 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 (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-AUG-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-AUG-2021, the patient experienced felt warm. Treatment medications included: paracetamol. The action taken with covid-19 vaccine was not applicable. The outcome of felt warm was not reported. This report was non-serious.


VAERS ID: 1577624 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain oedema, Dyspnoea, Fatigue, Headache, Nasal congestion, Pallor
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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: Chiari Malformation
Allergies: Penicillin
Diagnostic Lab Data: None Just stopped in to see his doctor to get a bit of advice on the next vaccine dose and to let her know what transpired. I didn?t bring him with.
CDC Split Type:

Write-up: He sat for 15min in pharmacy when we got out to the car, he started talking and was really nasally and he sounded different. Got home 2 min away and he walked in pale white and you knew he had a headache, told him to lay down, Then he tells me he feels out of breathe, elevated his feet, ready to call 911. Then that passed, still had headache . Then he got up , went to the bathroom and came out yelling and said he felt really awnry. Told him to lay down. All this within a 1/2 hour of getting vaccine, one right after the other. Then 45 min after all this he ate and showered . I gave him a Tylenol and he later went to bed at 9 , I checked on him all night and he woke up super tired and said he?s a weird tired to this day. The doctor told me he may have had slight swelling of the brain and it?s up to me about the 2nd dose but we are very nervous as to what could happen. The doc did say he at least as a bit of protection from the first one . He does attend a large high school so definitely a concern.


VAERS ID: 1577637 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: vasovagal response
Other Medications: FLUoxetine (PROzac) 10 mg tablet lamoTRIgine (LaMICtal) 25 mg tablet
Current Illness:
Preexisting Conditions:
Allergies: Prednisone - unspecified
Diagnostic Lab Data: Within 5 minutes pt became faint, asked to be placed on floor - then placed on stretcher - 5:05 B/P 113/75, heart rate 86, O2 Sat 97 5:10 B/P 110/75, heart rate 89, O2 Sat 98. 5:15 B/P 108/72, heart rate 89, O2 Sat 98
CDC Split Type:

Write-up: Pt came to vaccine clinic requesting J&J vaccine. Reviewed checklist that was completed by pt in clinic, on said checklist pt checked NO in response to "Have you ever received a dose of COVID-19 vaccine?" Pt''s name clicked in system, notice flashed in red that pt not due for vaccine of J&J due to inappropriate at this time. ?Pt. Questioned by me, states this is first vaccine. ?Pt states she gets vasovagal response and fainting feeling to needles and shots in the past, pt placed into blue easy chair in the clinic to prevent injury in the event pt has vasovagal response as described. ?J&J vaccine administered with second RN in attendance. ?Within 5 minutes pt became faint, asked to be placed on floor - then placed on stretcher - Vitals B/P 113/75, heart rate 86, O2 Sat 97 at 5:05. ?Public response called at 5:03 PM, evaluated by ED team and found to be stable. ?Pt. Questioned about receiving a prior covid vaccine, pt first stated today''s vaccine was her first; upon further questioning pt states she received a pfizer vaccine months ago but could not remember when. ?Pt. States she took the vaccine today because she was afraid that she would have to restart pfizer vaccine series again and would not have it in time to get into school classes, so she decided to get J&J vaccine today. Pt advised by Staff on possible side effects of vaccine and to go to ED if experiences same. ?Pt advised Staff will call her via phone tomorrow 8-12-21 and 8-13-221 to check on her and how she is feeling. ?Pt agreeable to same. 5:10 B/P 110/75, heart rate 89m O2 Sat 98. 5:15 B/P 108/72, heart rate 89. ?O2 Sat 98 Pt discharged via WC with friend who will drive her home.


VAERS ID: 1577642 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased appetite, Diarrhoea, Full blood count, Headache, Nausea, Pain, SARS-CoV-2 test negative, Urine analysis, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone Propionate 50 MCG/ACT Suspension 1 spray in each nostril Nasally Once a day, Notes: prn. Diclofenac Sodium 1 % Gel apply 4 gram to affected area on shoulder and knee Transdermal BID PRN. Omeprazole 40 MG Capsule Delaye
Current Illness: none
Preexisting Conditions: I10 Essential hypertension G62.9 Neuropathy G89.29 Other chronic pain K21.9 GERD without esophagitis I25.2 History of MI (myocardial infarction) J30.2 Seasonal allergic rhinitis, unspecified trigger E78.2 Mixed hyperlipidemia
Allergies: NKDA
Diagnostic Lab Data: 8/16/2021: SARS-COV-2 Antigen (negative) ; CBC (WBC 12.1); UA (without infection)
CDC Split Type:

Write-up: symptoms started a few hours after vaccination. symptoms consist of body aches, chills and rigors, HA (at the back of head), decreased appetite, nausea, and diarrhea; symptoms have persisted x 5 days at time of visit


VAERS ID: 1577891 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #FC3180 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysphagia, Erythema, Oral pruritus, Peripheral swelling, Pruritus, Skin warm, Throat irritation, Tinnitus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazodone 50 mg at Bedtime, Montelukast SOD 10 mg at Bedtime
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish, Vicodin
Diagnostic Lab Data: Benadryl, and dexamethasone
CDC Split Type:

Write-up: Itchy mouth, ears, throat, back, forearms and ankles. Warmth to skin and redness in face, and arms and swelling in the hands. difficulty swallowing . Ringing in ears


VAERS ID: 1577897 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip dry, Lip swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Approximately 12 hours post vaccination, patient experienced a mild fever (~100 degrees F) and swelling of the lips. Patient stated that lips swelled to a size approximately 25% larger than normal. Symptoms mostly resolved the following day without treatment. Six days later the lip still seems a little swollen and dry but is not noticeable to the casual observer.


VAERS ID: 1577904 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-20
Onset:2021-08-11
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1577922 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-14
Onset:2021-08-11
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breast operation, COVID-19, Cancer surgery, SARS-CoV-2 test positive
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: Patient states that she has breast cancer and underwent surgery in May of 2021.
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested positive for Covid 19 on 8/11/2021


VAERS ID: 1577936 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-06
Onset:2021-08-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Injection site induration, Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth, Lymph node pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Aug 6. Got vaccination, had arm pain at shot site in the evening Aug 7. Pain in upper arm at shot site Aug 8. Little less pain in upper arm at shot site Aug 9. No symptoms Aug 10. No symptoms Aug 11. Swelling of lymph node in armpit. Pain & tightness in upper arm & armpit area Aug 12. More swelling and painful lymph node, very swollen and painful Aug 13. Little less swelling and pain in lymph node in armpit. Tender at shot site again, feels irritated. Aug 14. Bullseye rash around shot site, painful and tender, itchy, feels hot and hard. Little less pain and swelling in lymph node in armpit. Sharp shooting pain in my lymph node a few times. Aug 15. Bullseye rash spread larger, still hot & hard, painful, tender & itchy. Lymph node still swollen and painful. Sharp shooting pain in lymph node a few times. Aug 16. Bullseye rash spread larger, not as hot & hard or painful, itchy around the edges. Lymph node little less swollen and painful, still uncomfortable. Aug 17. Bullseye rash spread larger, much less painful, little less hard and hot feeling. It has a defined edge around the circle of the rash and the edges are itchy. Lymph node a little less swollen and painful.


VAERS ID: 1577997 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-08-11
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

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

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

Write-up: Patient has been fully vaccinated by moderna on 4/8/21. She has tested positive and is symptomatic as of 8/11


VAERS ID: 1578021 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-21
Onset:2021-08-11
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 2 UN / SYR

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

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

Write-up: Covid positive


VAERS ID: 1578023 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dizziness, Heart rate increased, Hypersensitivity, Paraesthesia
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: moderna vaccine EUA within 5 minutes of receiving vaccine, had elevated heart rate to 140-150s, lightheadedness, chest burning, tingling in legs. Was taken to ER immediately and given IV steroids, IV Benadryl for severe allergic reaction.


VAERS ID: 1578085 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-08-11
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 1 - / -

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

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

Write-up: Patient contracted COVID-19 post-vaccination


VAERS ID: 1578090 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: rash over body including the hand and feet , red and itchy


VAERS ID: 1578094 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-22
Onset:2021-08-11
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Myalgia, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: LORazepam (ATIVAN) 0.5 mg tablet sertraline (ZOLOFT) 25 mg tablet(Expired)
Current Illness: None
Preexisting Conditions: Nervous Elbow pain, right Circulatory Hemorrhoids Mitral valve prolapse Raynaud''s disease Genitourinary Irregular periods Musculoskeletal Acne Other jaw asymmetry Lateral epicondylitis of right elbow Other Anxiety Depression Chronic fatigue
Allergies: Lexapro [escitalopram Oxalate]
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Muscle or body aches, Headaches, and Congestion or runny nose


VAERS ID: 1578227 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-01-21
Onset:2021-08-11
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: many
Current Illness: none
Preexisting Conditions: Brain tumor
Allergies: none
Diagnostic Lab Data: CT Scan on 8/11/21
CDC Split Type:

Write-up: On Aug 11, 2021, I was taken to an ER for pain on my right side. After my scan, the ER Dr and radiologist said I had severe appendicitis and removed my appendix that afternoon.


VAERS ID: 1578267 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Carbon dioxide normal, Chest X-ray, Chest discomfort, Cough, Dyspnoea, Electrocardiogram, Full blood count, Gait disturbance, Haematocrit decreased, Haemoglobin normal, Headache, Hypoaesthesia, Hypoaesthesia oral, Metabolic function test, Muscular weakness, Neutrophil count decreased, Pain, Paraesthesia, Platelet count normal, Pyrexia, Sinus bradycardia, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Disorders of sinus node function (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine asteline glucosamine condrotion
Current Illness: sinus/allergies congestion
Preexisting Conditions: allergies hypothyroidism
Allergies: bactrim flagyl latex wool ppd
Diagnostic Lab Data: 8/17/2021 emergency room visit cbc wbc 4.6, hgb 12.4, hct 36.9,plt 152, anc 1.9, all wnl bmp sodium 141,potassium 4.1, chloride 106,co2 26, bun 12., creat 0.83 glu 98 cxr no acute cardiopulmonary abnormalities observed ekg sinus bradycardia c
CDC Split Type:

Write-up: numbness of lips, cough- fever chills, severe body aches pain, numbness in legs on right side , muscle weakness, difficulty walking, right sided facial numbness, headache, parasthesia, chest tightness


VAERS ID: 1578271 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-29
Onset:2021-08-11
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Report completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/08/21 pfizer,Lot#EL3248 2nd dose: 01/29/21 Pfizer,Lot# EN5318 Diagnosed covid positive:08/10/21 Symptom onset:08/11/21 Exposure:Travel Symptoms:Fever, cough, fatigue, loss of smell/taste, sore throat , runny nose ,headache.


VAERS ID: 1578293 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none at time of vaccination one month prior unknown
Preexisting Conditions: unknown
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine given 7 days too early - no adverse event


VAERS ID: 1578321 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-16
Onset:2021-08-11
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pfizer on 3/16 and 4/6. Positive on 8/11 admitted on 8/11-current


VAERS ID: 1578322 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-11
Onset:2021-08-11
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood glucose decreased, COVID-19, Chest X-ray, Chest pain, Hypophagia, SARS-CoV-2 test positive, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medication on Admission to hospital: allopurinol 300 mg oral tablet, 300 mg/ 1 tab(s), Oral, Daily Aspirin Low Dose, Oral, Daily carvedilol 3.125 mg oral tablet, 3.125 mg/ 1 tab(s), Oral, BID clopidogrel 75 mg oral tablet, 75 mg/ 1 tab(s
Current Illness: Unknown
Preexisting Conditions: Arthritis Asthma Diverticulitis Glaucoma Gout Sleep apnea
Allergies: Anectine Cipro Contrast Dye ZyrTEC codeine penicillin
Diagnostic Lab Data: Positive Covid PCR 08/08/21 Chest x-ray: EXAM: XR Chest 1 V Portable CR REASON FOR STUDY: Chest pain DATE OF PROCEDURE: 8/11/2021 FINDINGS: A portable frontal view the chest is performed. Comparison made to previous study of 08/21 and prior. Lung fields appear to be clear of infiltrates. Sternal wires are noted. Left chest pacemaker device is in place. The cardiac silhouette size is stable.
CDC Split Type:

Write-up: 79-year-old male multiple medical problems who presents with complaint of generalized weakness. Per ER report patient said generalized weakness for the past 10 days. Patient was recently seen in the emergency department approximately 3 days ago for similar complaint. Patient found to be Covid positive. Patient not eating or drinking at home. EMS was called patient was found to have a glucose of 52. Amp of D50. Patient was given another amp of D50 in the emergency department. At this time patient denies headache or acute visual change. Patient drowsy but improving. There is no chest pain shortness of breath or palpitations. There is no abdominal pain, nausea vomiting. No history of fever chills or rigors. Patient has no other concerns. Patient to be admitted for further evaluation.


VAERS ID: 1578324 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-19
Onset:2021-08-11
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Janssen on 7/19. Positive on 8/4 admitted on 8/11-current


VAERS ID: 1578334 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-06
Onset:2021-08-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Cough, Fatigue, Influenza, Myalgia, Nausea, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

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

Write-up: It started with the flu, cough, severe muscle pain, nause since Thursday and it remained the same until Saturday when he started with temperature. Went to the hospital for emergencies and they tested him for Covid and it came out negative. He is tired and severe stmach pain. Only paracetamol for treatment, Ibuprofen and medication for nausea.


VAERS ID: 1578365 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

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

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

Write-up: Patient received 2nd dose 1 week too early


VAERS ID: 1578378 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-28
Onset:2021-08-11
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medications Prior Authorizations aspirin 81 mg tablet calcium carbonate-vitamin D3 600 mg(1,500mg) -400 unit per tablet metoprolol succinate XL (TOPROL-XL) 25 mg 24 hr tablet omega-3 fatty acids (FISH OIL) 300 mg capsule rosuvastatin (CR
Current Illness:
Preexisting Conditions: Respiratory Allergic rhinitis Circulatory Coronary artery disease involving native coronary artery of native heart without angina pectoris Essential hypertension Musculoskeletal Degeneration of cervical disc without myelopathy Sebaceous cyst Localized, primary osteoarthritis Derangement of knee Endocrine/Metabolic Hyperlipidemia Other Former smoker Overweight(278.02)
Allergies: MetronidazoleNausea Only
Diagnostic Lab Data: COVID-19 PCR
CDC Split Type:

Write-up: Cough Headache Congestion Runny nose


VAERS ID: 1578391 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Heart rate irregular, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiac arrhythmia terms, nonspecific (narrow), Dehydration (broad)

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

Write-up: EMPLOYEE WAS VACCINATED ON 8/11/21 AND DEVELOPED irregular heart beats, and tachycardia. PATIENT WENT TO HOSPITAL DUE TO IRREGULAR HEART BEAT AND TACHYCARDIA. PATIENT HAS A MEDICAL HISTORY OF PVS''S AND IRREGULAR HEART BEAT.


VAERS ID: 1578469 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7874 / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Dyspnoea exertional, Electrocardiogram, Supraventricular tachycardia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Supraventricular tachyarrhythmias (narrow), Pulmonary hypertension (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC MVI and Flonase
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG and PCP Office Visit with subsequent ER visit requiring repeat cardiac workup and hydration.
CDC Split Type:

Write-up: Paroxysmal SVT x 24 hours. Exertional dyspnea. Dehydration.


VAERS ID: 1578520 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-28
Onset:2021-08-11
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Dyspnoea, Fatigue, Headache, Myalgia, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS COV-19 Nasopharyngeal swab and PCR, positive 13 AUG 2021.
CDC Split Type:

Write-up: SARS COV-19 Infection. Cough, congestion, runny nose, fever, loss of taste, loss of smell, headache, shortness of breath, sore throat, fatigue, chills, muscle aches.


VAERS ID: 1578587 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-16
Onset:2021-08-11
   Days after vaccination:87
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Feeling abnormal
SMQs:, Dementia (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methylphenidate ER 27 MG at the time of vaccine. Increased to 36 MG the following month
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 8/11/2021 ER Visit with examination by multiple RN. CT Scan to rule out other diagnosis read by MD radiologist.
CDC Split Type:

Write-up: Bell''s Palsy and Mental fog


VAERS ID: 1578630 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-08
Onset:2021-08-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OSIC21A / UNK - / -

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

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

Write-up: Rash boils hives on neck chest arms belt line genitals legs buttocks started 3-4 days after 1st Modern?s shot


VAERS ID: 1578668 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, 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? Yes
Hospitalized? No
Previous Vaccinations: HPV vaccine-she fainted
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted following 1st covid vaccine. We did call 911 -when first responders came they recommend she go to ER b/c her bp was so low. After callng 911 mom said pt had fainted at her last vaccine too. Mom said she came around just fine and they left the ER before being seen.


VAERS ID: 1578716 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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

Write-up: Pt received Pfizer vaccine. In observation, developed a rash on lower extremities (feet and calf). Called provider over, gave patient 50 mg Benadryl. Vital signs are stable. Pt complains of itchy throat, O2 sat 100%. No s/s of wheezing or SOB. 30 minutes passes by and rash starting to develop on thighs. Provider advised to give epinephrine IM. Educated patient regarding medication. Ambulance called.


VAERS ID: 1578991 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood creatinine increased, COVID-19, Cough, Dyspnoea, Hepatic enzyme increased, Hypoxia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Atrial fibrillation, hypertension, hyperlipidemia, obesity, diabetes
Allergies: No allery
Diagnostic Lab Data: AST peaked at 2231 U/L and ALT peaked at 1330 U/L Serum creatinine 3.1 mg/dL
CDC Split Type:

Write-up: COVID-19 infection with cough, shortness of breath, hypoxia 1 day after vaccination. Elevated liver enzymes with AST peaked at 2231 U/L and ALT peaked at 1330 U/L in addition to acute kidney injury


VAERS ID: 1580087 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-08-11
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, 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: Test Date: 20210811; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210822713

Write-up: COVID-19 TEST POSITIVE; This spontaneous report received from a patient 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 not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-AUG-2021, the patient experienced covid-19 test positive. Laboratory data included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of covid-19 test positive was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case is assessed as non-serious.


VAERS ID: 1581680 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-20
Onset:2021-08-11
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, SARS-CoV-2 test
SMQs:, 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: acetaminophen (TYLENOL EXTRA STRENGTH) 500 mg tablet ACIDOPHILUS PROBIOTIC 100 million cell-10 mg capsule albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler benzoyl peroxide 5 % external liquid clindamycin (CLINDAGEL) 1 % gel cloNIDine (
Current Illness: Non-seasonal allergic rhinitis, unspecified trigger
Preexisting Conditions: Nervous Abnormal neurological findings Migraine without aura Tic disorder Respiratory Mild intermittent asthma Allergic sinusitis Digestive Bile reflux gastritis Chronic constipation Dyspepsia GERD (gastroesophageal reflux disease) Musculoskeletal Acne Keratosis pilaris Skin lesion of foot Callus of foot Other At risk for polypharmacy Autism Episodic mood disorder (CMS/HCC) Medication side effect NSAID long-term use Obsessive compulsive disorder Other long term (current) drug therapy Staring spell Attention deficit hyperactivity disorder (ADHD), combined type Seasonal allergies Mild intellectual disability Bipolar disorder (CMS/HCC) Oppositional defiant disorder PDD (pervasive developmental disorder)
Allergies: Red Dye Saphris [Asenapine Maleate] Cat DanderOther (document details in comments) Lithium CarbonateOther (document details in comments) Valproic AcidOther (document details in comments)
Diagnostic Lab Data: COVID-19 (SARS CoV-2,RNA Molecular Amplification) COVID-19 PCR
CDC Split Type:

Write-up: Fatigue


VAERS ID: 1582112 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       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: Prevacid
Current Illness:
Preexisting Conditions:
Allergies: Shellfish allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever started at 11am and lasted 24 hours, going up to 103 at some points.


VAERS ID: 1582145 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Heart palpitations, chest tightness


VAERS ID: 1582347 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-08-11
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 - / -

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

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

Write-up: Dose 1 Pfizer 5/3/2021 lot EW0168 Pt has Covid 19 8/11/2021


VAERS ID: 1582349 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient got really sweaty moments after vaccine, and has been getting dizzy ever since


VAERS ID: 1582352 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-08-11
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

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

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

Write-up: dose 1 pfizer 3/4/2021 EN6198 Has Covid 19 8/11/2021


VAERS ID: 1582363 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-26
Onset:2021-08-11
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

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

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

Write-up: Dose 4/5/2021 Pfizer EW0151 Pt has Covid 19 8/11/2021


VAERS ID: 1582381 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-11
Onset:2021-08-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Pruritus, Stomatitis, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: propranolol, singular, flonase, fish oil, calcium, d3, b12, glucosamine, magnesium, multi vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: pennicillen, zpak, demerol, cipro, tree nuts, msg, red dye, fake sugar
Diagnostic Lab Data: called primary care and reported, did not have me come in.
CDC Split Type:

Write-up: started with hives around 7pm, followed by difficulty breathing. next 4 days itching from heat to toe and chest feeling like an elephant was sitting on it, sores in my mouth.


VAERS ID: 1582462 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Nasal congestion, Pulmonary congestion, Rhinorrhoea
SMQs:, Cardiac failure (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Infective pneumonia (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: Zinc-day of shot vitamin C -Emergen C-after shot 8 days Mucinex Cold and Flu-after shot 8 days
Current Illness: none
Preexisting Conditions: none
Allergies: Codiene
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Day 1 after injection-numbness of left arm for 1 day Day 7 after injection-runny/stuffy nose, chest congestion, headache, numbness of left arm returned


VAERS ID: 1582566 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-08-07
Onset:2021-08-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia, Petechiae
SMQs:, Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fish oil, coenzyme q10, finasteride
Current Illness: no
Preexisting Conditions: no
Allergies: nkda
Diagnostic Lab Data: none. will not change a thing
CDC Split Type:

Write-up: neuropathic pain in left arm for over a week, petechial type rash


VAERS ID: 1582582 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-09
Onset:2021-08-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estarylla Armor thyroid Multi-vitamin Zinc Vit D Magnesium Testosterone Cream
Current Illness: none
Preexisting Conditions: Hypothyroidism (not from autoimmune disease - from Thyroiditis that came on sporadically). I was tested for autoimmune disease and had none.
Allergies: none
Diagnostic Lab Data: None - had a dr visit and she said to wait it out and come back if it gets worse. She isn''t'' sure why it is happening.
CDC Split Type:

Write-up: Slight numbness - more tingling like it is falling alseep - in left arm and hand. Also tingling in left leg/foot . These are constant and don''t go away. I get a slight tingling in left cheek but not constant - every day though - a few times a day.


VAERS ID: 1582631 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Gynaecological examination, Heavy menstrual bleeding, Muscle spasms, Pelvic pain, Thrombosis, Urine analysis, Uterine haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Leflunomide, Diclofenac, Losartan, Atorvastatin, Escitlopram, Buspiroine, Turbafine, daily vitamin
Current Illness: n/A
Preexisting Conditions: Rheumatoid Arthritis, anxiety, depression
Allergies: Lisinopril
Diagnostic Lab Data: Pelvic exam, catheter urine sample, blood work,
CDC Split Type:

Write-up: Extreme sudden onset of clotted uterine bleeding. Clots were fist size and coming every fifteen minutes along with pelvic cramping. Pads/tampons were useless and overflowing. Bleeding continued from 3:30am until about 10pm when the Tranexamic Acid finally helped slow it. abnormal heavy bleeding persisted for three days after the extreme bout.


VAERS ID: 1582634 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-30
Onset:2021-08-11
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pain in extremity, Thrombophlebitis superficial
SMQs:, Embolic and thrombotic events, venous (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armor thyroid B-12; Vitamin D3 2000mcg;
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: PCN
Diagnostic Lab Data: Physician evaluation
CDC Split Type:

Write-up: Onset of right foot pain on 8/11/21, Diagnosed with blood clot dorsum right foot. "superficial" . Has not started treatment at this time. Meds awaiting at pharmacy


VAERS ID: 1582650 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER I / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Magnetic resonance imaging
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: None
Preexisting Conditions: Ankylosing Spondylitis & Irritable Bowel Syndrome
Allergies: NSAIDS, Stadol, Tordol, Zofran
Diagnostic Lab Data: MRI, Blood Test and Physical Therapy and Treatment With Medications
CDC Split Type:

Write-up: None stated.


VAERS ID: 1582657 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-04
Onset:2021-08-11
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL MAALOX VENTOLIN ASCORBIC ACID ASPIRIN TESSALON COREG VITAMIN D3 FUROSEMIDE HUMULIN LISINOPRIL METFORMIN ZOFRAN
Current Illness:
Preexisting Conditions: DIABETES HTN DIVERTICULITIS CHF
Allergies:
Diagnostic Lab Data: COVID POSITIVE TEST
CDC Split Type:

Write-up: A WEEK AGO STARTED FEELING TIRED, BODY ACHES, WEAKNES


VAERS ID: 1582659 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-10
Onset:2021-08-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER I / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Magnetic resonance imaging
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: None
Preexisting Conditions: Ankylosing Spondylitis & Irritable Bowel Syndrome
Allergies: NSAIDS, Stadol, Tordol, Zofran
Diagnostic Lab Data: MRI, Blood Test and Physical Therapy and Treatment With Medications
CDC Split Type:

Write-up: None stated.


Result pages: prev   61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=160&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166