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From the 10/8/2021 release of VAERS data:

Found 781,870 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 163 out of 7,819

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VAERS ID: 1725329 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: MULTIVITAMINS [VITAMINS NOS]
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: fever; Chills; Body ache; arm is really sore; fatigue; severe headache triple this time, much worse; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (fever), CHILLS (Chills), MYALGIA (Body ache), PAIN IN EXTREMITY (arm is really sore) and FATIGUE (fatigue) in a 68-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 11-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Sep-2021, the patient experienced PYREXIA (fever), CHILLS (Chills), MYALGIA (Body ache), PAIN IN EXTREMITY (arm is really sore), FATIGUE (fatigue) and HEADACHE (severe headache triple this time, much worse). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) for No adverse event, at an unspecified dose and frequency. At the time of the report, PYREXIA (fever), CHILLS (Chills), MYALGIA (Body ache), PAIN IN EXTREMITY (arm is really sore), FATIGUE (fatigue) and HEADACHE (severe headache triple this time, much worse) outcome was unknown. Patient received first dose on 01-FEB-2021 intramuscularly (batch no: 004M20A) and second dose on 02-MAR-2021 (batch no: 025A21A) Patient''s side effects from 3rd dose is much worse than from the 2nd dose.


VAERS ID: 1725337 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling abnormal, Pain in extremity
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: little pain in right foot''s toes/ pain in toes, pain has been going up through the calf; does not feel good; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (little pain in right foot''s toes/ pain in toes, pain has been going up through the calf) and FEELING ABNORMAL (does not feel good) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Sep-2021, the patient experienced PAIN IN EXTREMITY (little pain in right foot''s toes/ pain in toes, pain has been going up through the calf) and FEELING ABNORMAL (does not feel good). At the time of the report, PAIN IN EXTREMITY (little pain in right foot''s toes/ pain in toes, pain has been going up through the calf) and FEELING ABNORMAL (does not feel good) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication and treatment information was reported. Patient called asking for recommendation and did not have any intentions on reporting the AE. Patient received first dose of Moderna COVID-19 vaccine on 10Sep2021. Next day patient started to experience a little pain in right foot''s toes. The pain has been going up through the calf. Patient felt that the symptom was related to blood circulation because when patient puts leg up, pain stops and when places foot down again, pain continues hence the patient was afraid called to ask what medication should the patient take and how long should the patient wait to start taking it and also stated that the patient does not feel good. Reporter did not allow further contact


VAERS ID: 1725339 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Adverse reaction, Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Really bad, painful muscle spasms; Right big toe is still sore; Had a bad reaction; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE SPASMS (Really bad, painful muscle spasms), PAIN IN EXTREMITY (Right big toe is still sore) and ADVERSE REACTION (Had a bad reaction) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Sep-2021, the patient experienced MUSCLE SPASMS (Really bad, painful muscle spasms), PAIN IN EXTREMITY (Right big toe is still sore) and ADVERSE REACTION (Had a bad reaction). The patient was treated with Physical therapy (massaged) for Muscle spasms. At the time of the report, MUSCLE SPASMS (Really bad, painful muscle spasms) and ADVERSE REACTION (Had a bad reaction) outcome was unknown and PAIN IN EXTREMITY (Right big toe is still sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication and treatment information was reported. Patient stated that she had a bad reaction to the initial vaccination. On 11-Sep-2021, she developed really bad, painful muscle spasms in her right leg and stated that she massaged it to try and get it to reduce. Patient stated she has never had this happen before and was afraid she will have more of a reaction with the second shot and patient doesn''t think she will get a second shot.


VAERS ID: 1725388 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Hair injury, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: 20210911; Test Name: fever; Result Unstructured Data: fever ( 102.7 F )
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: hair hurting; fever ( 102.7 F ); chills; body ache; This spontaneous case was reported by a consumer and describes the occurrence of HAIR INJURY (hair hurting), PYREXIA (fever ( 102.7 F )), CHILLS (chills) and MYALGIA (body ache) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Sep-2021, the patient experienced HAIR INJURY (hair hurting), PYREXIA (fever ( 102.7 F )), CHILLS (chills) and MYALGIA (body ache). At the time of the report, HAIR INJURY (hair hurting), CHILLS (chills) and MYALGIA (body ache) outcome was unknown and PYREXIA (fever ( 102.7 F )) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Sep-2021, Body temperature: 102.7 (High) fever ( 102.7 F ). The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were not reported. No treatment medications were not provided.


VAERS ID: 1726007 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 2 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cardiac function test, Dizziness, Dyspnoea, Hypertension, Laboratory test, Pain, Sluggishness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrolazine 100 mg- TID ; Lasartin qd; HTCZ qd; Busprin 7.5mg TID; Multi Vitamin; Tumeric; Fish Oil; Liver restorer that he got off line; Ibup prn;
Current Illness: None
Preexisting Conditions: BP issues treated with medication
Allergies: NKA
Diagnostic Lab Data: Lab tests, cardiac work ups,
CDC Split Type:

Write-up: Reports on 9/11/21, one day after 2nd vaccination given, has been having SOB, Dizziness, dyspnea at times, sluggish, body ache. HBP that had been controlled with medications prior to injections. Today: 9/23/21, continues with same adverse events BP 180/100 HR 110 O2 @ 96% on RA. presents with SOB, Dizziness


VAERS ID: 1726169 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Injection site bruising, Injection site erythema, Injection site joint pain, Joint range of motion decreased, Mobility decreased, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: None, a doctor would have told me to do just what I did. There was no point in having someone tell me once again that my idea was the best course of action.
CDC Split Type:

Write-up: Initial affects of the shot (first 2 days): Cascading joint pain which started at the injection site. An elliptical bruise approximately 4 square inches in size formed around the injection site. Lone term: Intense pain in left shoulder, similar to a football injury from throwing a football all day with an injury. I am right handed and I have not thrown a football within the last few months. I was unable to light my arm up in a chicken wing motion without immense pain. No medication was taken for the pain. Motion was restricted/limited for for duration of pain (up to 2 weeks after shot). No sleeping position or other situation can be connected to the random intense pain. At the 2 week point: Bruise is indistinguishable but injection point is still able to be found due to the lingering light red dot. Shoulder mobility has been restored to normal range of motion and I am working on exercising the shoulder to strengthen the socket once again.


VAERS ID: 1726231 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-28
Onset:2021-09-11
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 2 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Hypoxia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID positive on admission for hypoxia.


VAERS ID: 1726284 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-20
Onset:2021-09-11
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Pyrexia, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote, Levothryroxine, Premarin, Women''s over 65 multi-vitamin, Glucosamine & Chnodroitin
Current Illness:
Preexisting Conditions: Bipolar II, Hypothyrodism
Allergies: Sulfa
Diagnostic Lab Data: Antigen Rapid Test on 09/12/21
CDC Split Type:

Write-up: Extreme fatigue, shortness of breath, dry cough, diarrhea, chills, and low grade fever (100).


VAERS ID: 1726301 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-08
Onset:2021-09-11
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Spoke with PUI caregiver who confirmed that PUI was discharged last night and brought back home by an Ambulance. Caregiver stated that PUI symptom onset was on 9/11 with chills and body aches. On 9/13 PUI complained of shortness of breath and was transported to the hospital. Patient is fully vaccinated.


VAERS ID: 1726390 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Blood test normal, Chest X-ray normal, Chest pain, Computerised tomogram thorax, Dyspnoea, Pain
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto 20 mg by mouth daily
Current Illness: none
Preexisting Conditions: left popliteal deep venous thrombosis
Allergies: none
Diagnostic Lab Data: 9/21/21 - tests performed including CT pulmonary angiogram, chest x-ray, blood tests. . No evidence of pulmonary embolism, deep vein thrombosis nor myocardial infarction.
CDC Split Type:

Write-up: Patient experienced chest pain, shortness of breath and diffuse body pain for 2 weeks following vaccination with Pfizer vaccine on 9/10/21. Seen in outside hospital ED on 9/21/21. No evidence of pulmonary embolism, deep vein thrombosis nor myocardial infarction.


VAERS ID: 1726423 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-25
Onset:2021-09-11
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 UN / UN

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

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

Write-up: ED visit for COVID symptoms, COVID positive test 9/11/21. Fully vaccinated Feb 2021. Received monoclonal antibodies in ED.


VAERS ID: 1726499 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood creatinine increased, Blood urea increased, Blood urine present, Chromaturia, Full blood count, Heavy menstrual bleeding, Hyperhidrosis, Lethargy, Metabolic function test, Nausea, Pain, Pyrexia, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa
Diagnostic Lab Data: U/A, CBC, CMP done on 09/07/2021. Large amt of blood in U/A, High Creatinine level 1.46, BUN of 24.5
CDC Split Type:

Write-up: I started urinating rust colored urine 8 hrs after receiving my second covid vaccine. I also had fevers of 101, sweats, body aches, lethargy, nausea. Also a week after getting 2nd covid vaccine had severe menstrual bleeding.


VAERS ID: 1726575 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Chills, Dyspnoea, Fatigue, Illness, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sick with chills, nausea, bone aches, fever, breathing issues (down to 92% for a couple days). Lasted 9 days. Could barely get out of bed. Still feel fatigued nearly two weeks later


VAERS ID: 1726735 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rybellus, Unithroid,Sertraline
Current Illness: none
Preexisting Conditions: Hashimoto''s Disease
Allergies: Latex adhesive
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual Cycle has lasted so far 12 days longer than normal Originally started on 9/4/21 before the shot on 9/9/21. Normal cycles last 5 to 7 days previously before the shot


VAERS ID: 1726766 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, broke out in little white bumps, maybe 6 years ago
Other Medications: losartan, aspirin, zopodiem, zrytec,
Current Illness: none
Preexisting Conditions: high blood pressure, type 2 diabiets. allergies.
Allergies: codien, linsinapro, predison,coconut, milk
Diagnostic Lab Data: going to the dr next week. hard to get in.
CDC Split Type:

Write-up: felt like I had covid again. then had swelling in my face and hands, and then got a bloody nose for a few days


VAERS ID: 1726821 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-09-11
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Headache, Nausea, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:09/14/21 Symptom onset:09/11/21 Exposure:Home Symptoms:HA,NAUSEA,DIARRHEA


VAERS ID: 1726897 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Fatigue, Influenza like illness, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Arthritis (broad)

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

Write-up: flu-like symptoms, fatigue, nausea, joint/bone pain


VAERS ID: 1726924 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-23
Onset:2021-09-11
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chest wall haematoma, Computerised tomogram thorax abnormal, Laboratory test, Muscle spasms, Muscle swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin; B complex vitamin; valacyclovir HCL; pregabalin; propranolol ER; XARELTO; trazodone; DAYVIGO; CONVENT respiratory inhalant; 3L of oxygen at night; 4.5 to 2 Liters of oxygen during the day; C-PAP at night
Current Illness: Covid
Preexisting Conditions: Lung Issues - COPD
Allergies: Sulfa Drugs
Diagnostic Lab Data: CT Scan - 09/12/2021; Lab work - 09/12/2021 - 09/16/2021
CDC Split Type: vsafe

Write-up: Without anything that preceded I had a pain in my right chest pectoral muscle, like a cramp and it was very painful after a Saturday morning breakfast. It continued to build throughout the day and it continued to swell. It swelled up bigger than a softball and I went to the hospital. They said it was a Hematoma between my chest wall and pectoral muscle. I was hospitalized for pain management. They were giving me narcotics to manage the pain. They started me on fentanyl then Dilantin and Noyco. They were giving me Dilantin in the vein, it was 1mg every 2 hours. I was released on 09/16/2021. On 09/24/2021 I am going back to the hospital to have it drained. Drugs given while in the hospital; Hydro Morphine 1mg per liter injected - Dilaudid GEQ 1mg IV every 2 hours; Norco5 hydrocodone.


VAERS ID: 1726946 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site reaction, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Large red ?rash? on same arm as vaccine but NOT directly at injection site. Warm to the touch and very sore like a bruise. Continued to get larger covering most of upper arm over a few days. About 5 days later started to dissipate and was itchy as it was going away.


VAERS ID: 1727064 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Diarrhoea, Fatigue, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Physical exam Covid 19 test- negative
CDC Split Type: vsafe

Write-up: Repeated vomiting and diarrhea Stomach cramps Stomach aches Chills Fatigue I called the doctor on the phone. They recommended for her to go to Urgent Care. She was given a prescription of Zofran.


VAERS ID: 1727362 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Conjunctivitis, Culture stool positive, Dermatitis exfoliative generalised, Diarrhoea, Escherichia test positive, Haematochezia, Haemolytic uraemic syndrome, Hypotension, Tachycardia
SMQs:, Haemolytic disorders (narrow), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Conjunctival disorders (narrow), Renovascular disorders (broad), Ocular infections (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 9/9. Diagnosed with COVID-19 9/11. Developed abdominal pain and diarrhea 9/14. Developed hematochezia 9/16. Also with erythroderma and conjunctivitis. Presented to the hospital 9/16. Became hypotensive and tachycardic. Stool studies obtained. Treated as MIS-C while labs pending. Stool culture resulted positive for E. coli on 9/20. Now with HUS.


VAERS ID: 1727367 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-03
Onset:2021-09-11
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fatigue, Lethargy, SARS-CoV-2 RNA, SARS-CoV-2 test positive
SMQs:, Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole tamsulosin tumeric generic PreserVision multivitiman
Current Illness:
Preexisting Conditions:
Allergies: PCN
Diagnostic Lab Data: POC Covid 14 Sept negative SARS COV 2 RNA Sept 14 Detected
CDC Split Type:

Write-up: diarrhea for 3 plus days Sept 11-14 Tired and letharigic one day Sept 13 Sought care on the 14th


VAERS ID: 1728743 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Chills, Disorientation, Dizziness, Dyspnoea, Fatigue, Headache, Heart rate increased, Hot flush, Lymphadenopathy, Muscle twitching, Nausea, Pain in extremity, Pruritus, Pyrexia, Sensory disturbance, Throat irritation, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), 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: None
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Will be done next week
CDC Split Type:

Write-up: Day 2: 102 fever lasted 20 hours, chills, body twitches, arm pain, headache severe (1-10 scale at 10) vision blurriness, extreme fatigue .. The weekend after the shot : random feeling of what felt like a rush of cold water or air over head, followed by dizziness and nausea, followed by vision blur. Swollen lymph nodes, moderately swollen on neck, random episodes of shortness of breath lasting 5-10min and increased heart rate. Also noticed heat flashes at random times, itchiness at lymph node sites, itchy throat, (avoided inhaler due to increased Heart rate) Following week same things but occurring more often, disorientation and short term memory loss . Contacted primary MD to screen for more info . Never had any of these problems or symptoms ever in my life , EVER. My vision has always been 2020, it?s my pride, my memory has always been excellent I take great pride in that too, I haven?t been SICK in years?my immune system is strong and I have had no need for my inhaler or any other meds in several years. This may sound small but is very abnormal for me which makes it an extremely huge deal


VAERS ID: 1729045 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Gait disturbance, Muscular weakness, Pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone HCL 30 mg/day
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Bloodwork was normal. Doctor not able to explain cause of adverse events
CDC Split Type:

Write-up: Extreme weakness in legs and thighs (for approximately 7 days after vaccine) Unable to walk for short periods of times (for approximately 6 days after vaccine) Difficulty walking (13 days after vaccine and ongoing) Shooting pain in legs, thighs, and arms (for approximately 12 days after vaccine) Tingling feeling throughout body (for approximately 12 days after vaccine) Dizziness and lightheadedness (for approximately 9 days after vaccine)


VAERS ID: 1729062 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-21
Onset:2021-09-11
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 UN / UN

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

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

Write-up: Patient treated in ED for COVID symptoms and positive result. Vaccinated in April 2021.


VAERS ID: 1730194 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-09-11
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: COUMADIN
Current Illness: Primary pulmonary hypertension
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210943918

Write-up: ADVERSE EVENT NOS; FEVER; This spontaneous report received from a patient concerned a 78 year old female. The patient''s weight was 72.7 kilograms, and height was not reported. The patient''s concurrent conditions included: primary pulmonary hypertension. The patient received macitentan (tablet, oral, batch number: ZE023B0301 expiry: 30-APR-2025) 10 mg, 1 time every 1 day, therapy dates were not reported for an unspecified indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included warfarin sodium. On 11-SEP-2021, the patient experienced adverse event nos. On 11-SEP-2021, the patient experienced fever. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and dose of macitentan was not changed. The outcome of the adverse event nos and fever was not reported. This report was non-serious.


VAERS ID: 1730271 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-01
Onset:2021-09-11
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L(Z)0A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Erythema, Headache, Malaise, Myalgia, Pain, Peripheral swelling, Pruritus, Pyrexia, Vaccination site reaction
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL; TIMOLOL; B12 [CYANOCOBALAMIN]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: malaise; covid arm; low grade fever/low grade temperature/normal temperature is 97.8, on sunday he recorded 100.2; body aches; (arm) swollen; (arm) it had redness; headache; chills; joint pain; pain that night/still sore to the touch; itch; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (malaise), VACCINATION SITE REACTION (covid arm), PAIN (pain that night/still sore to the touch), PRURITUS (itch) and PERIPHERAL SWELLING ((arm) swollen) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A, 003AZ1A and 030L(Z)0A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included METOPROLOL, TIMOLOL and CYANOCOBALAMIN (B12 [CYANOCOBALAMIN]) for an unknown indication. On 01-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 02-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced PAIN (pain that night/still sore to the touch) and PRURITUS (itch). On 12-Sep-2021, the patient experienced PERIPHERAL SWELLING ((arm) swollen), ERYTHEMA ((arm) it had redness), HEADACHE (headache), CHILLS (chills) and ARTHRALGIA (joint pain). On an unknown date, the patient experienced MALAISE (malaise), VACCINATION SITE REACTION (covid arm), PYREXIA (low grade fever/low grade temperature/normal temperature is 97.8, on sunday he recorded 100.2) and MYALGIA (body aches). At the time of the report, MALAISE (malaise), VACCINATION SITE REACTION (covid arm), PAIN (pain that night/still sore to the touch), PRURITUS (itch), PERIPHERAL SWELLING ((arm) swollen), ERYTHEMA ((arm) it had redness), PYREXIA (low grade fever/low grade temperature/normal temperature is 97.8, on sunday he recorded 100.2), HEADACHE (headache), CHILLS (chills), ARTHRALGIA (joint pain) and MYALGIA (body aches) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment medication was provided. Patient was taking vitamins and supplements. Patient received the 3rd dose. It was not clarified if the caller was immunocompromised or not.


VAERS ID: 1730368 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-18
Onset:2021-09-11
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Coronavirus test, Drug ineffective, Head discomfort, Hypersensitivity, Nasal congestion, Pulmonary congestion
SMQs:, Cardiac failure (broad), Angioedema (broad), Lack of efficacy/effect (narrow), Taste and smell disorders (narrow), Hypersensitivity (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: Test Date: 20210912; Test Name: swab test for COVID-19; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Mild COVID-19 disease after 2nd vaccine; Lack of drug effect; Thought it was allergies after 2nd vaccine; Mild Congestion Lungs after 2nd vaccine; Mild Congested Head after 2nd vaccine; Mild Stuffy Nose after 2nd vaccine; Lost sense of taste after 2nd vaccine; Lost sense of smell after 2nd vaccine; This spontaneous case was reported by a consumer and describes the occurrence of PULMONARY CONGESTION (Mild Congestion Lungs after 2nd vaccine) in a 63-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045A21A and 003B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced PULMONARY CONGESTION (Mild Congestion Lungs after 2nd vaccine) (seriousness criterion medically significant), HEAD DISCOMFORT (Mild Congested Head after 2nd vaccine), NASAL CONGESTION (Mild Stuffy Nose after 2nd vaccine), AGEUSIA (Lost sense of taste after 2nd vaccine), ANOSMIA (Lost sense of smell after 2nd vaccine) and HYPERSENSITIVITY (Thought it was allergies after 2nd vaccine). On 12-Sep-2021, the patient experienced COVID-19 (Mild COVID-19 disease after 2nd vaccine) and DRUG INEFFECTIVE (Lack of drug effect). At the time of the report, PULMONARY CONGESTION (Mild Congestion Lungs after 2nd vaccine), COVID-19 (Mild COVID-19 disease after 2nd vaccine), HEAD DISCOMFORT (Mild Congested Head after 2nd vaccine), NASAL CONGESTION (Mild Stuffy Nose after 2nd vaccine), AGEUSIA (Lost sense of taste after 2nd vaccine), ANOSMIA (Lost sense of smell after 2nd vaccine), DRUG INEFFECTIVE (Lack of drug effect) and HYPERSENSITIVITY (Thought it was allergies after 2nd vaccine) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Sep-2021, Coronavirus test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was not applicable. Concomitant medications was not provided by the reporter. Treatment information was not provided. Company comment: This case concerns a 63-year-old male subject who experienced the serious event of pulmonary congestion and non-serious events of COVID-19, head discomfort, nasal congestion, ageusia, anosmia, drug ineffective and hypersensitivity. The patient''s medical history was not provided. The events occurred approximately 6 months 25 days after the first dose, and 5 months 25 days after the second dose of Spikevax. The rechallenge was not applicable as the patient had already completed the 2 recommended doses of the vaccine. Causality was not provided by the reporter. The benefit-risk relationship of the vaccine is not affected by this report.; Sender''s Comments: This case concerns a 63-year-old male subject who experienced the serious event of pulmonary congestion and non-serious events of COVID-19, head discomfort, nasal congestion, ageusia, anosmia, drug ineffective and hypersensitivity. The patient''s medical history was not provided. The events occurred approximately 6 months 25 days after the first dose, and 5 months 25 days after the second dose of Spikevax. The rechallenge was not applicable as the patient had already completed the 2 recommended doses of the vaccine. Causality was not provided by the reporter. The benefit-risk relationship of the vaccine is not affected by this report.


VAERS ID: 1730450 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLBUTRIN; VITAMIN D [COLECALCIFEROL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (if covid prior vaccination: Yes)
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: fever; Result Unstructured Data: Test Result:Unknown results; Comments: Fever after 24 hours
CDC Split Type: USPFIZER INC202101191972

Write-up: Fever after 24 hours; This is a spontaneous report from non- contactable consumer reported for herself that: A 34-years-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration, administered in Arm Left on 10Sep2021 (at the age of 34-year-old) (Lot number was unknown) as DOSE NUMBER UNKNOWN, SINGLE for covid-19 immunization. Past drug event and Known allergies included: Bactrim and morphine and was diagnosed with COVID-19 before vaccination. The patient was nonpregnant. Concomitant medications included bupropion hydrochloride (WELLBUTRIN) and colecalciferol vitamin d (COLECALCIFEROL). The patient experienced fever after 24 hours on 11Sep2021 with outcome of not recovered. Therapeutic medication was not administrated. It was reported that the patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine and she hasn''t been tested for COVID-19. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1730480 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-09-11
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high
Allergies:
Diagnostic Lab Data: Test Date: 20210913; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101211153

Write-up: positive test result for Covid 19; positive test result for Covid 19; This is a spontaneous report from a contactable consumer. A 71-year-old male patient (father) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; Batch/Lot number was not reported), dose 2 via intramuscular route in right arm on 05Mar2021 at 09:00 as single dose for COVID-19 immunisation. The patient''s medical history included hypertension from an unknown date. There were no concomitant medications reported. The patient''s historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; Batch/Lot number was not reported) dose 1 via intramuscular route in right arm on 15Feb2021 at 10:00 as single dose for COVID-19 immunisation. On 11Sep2021 at 07:00, approximately 190 days after the second dose, the patient had positive test result for COVID-19, first dose was received on 15Feb2021/ second dose was received on 05Mar2021, flu like symptoms, slight fever, feelings of light headedness, cough and runny nose. The adverse events resulted in physician''s office visit. The patient underwent sars-cov-2 test (nasal swab) which was positive on 13Sep2021. The patient was not tested positive for covid-19 prior to vaccination. The outcome of all the events was not recovered. The lot number for the vaccine was not provided and will be requested during follow-up.


VAERS ID: 1731175 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       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: Diovan hct 160/12.5
Current Illness: none
Preexisting Conditions: Hypertension, obstructive sleep apnea
Allergies: lisinopril, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: persistent numbness/tingling in ulnar nerve distribution on left arm (side of injection)


VAERS ID: 1731221 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin Protonix Phentermine Mobic Cymbalta Amlodipine Hydrochlorothiazide
Current Illness:
Preexisting Conditions: Osteoarthritis, fibromyalgia, migraines, cervical spinal stenosis
Allergies: Morphine Toradol Cyclobenzaprine Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe joint pain, fever of 102 Diarrhea, nausea Chills Still having severe joint pain Tylenol


VAERS ID: 1731248 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Influenza like illness, Loss of personal independence in daily activities, Pain
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: The day after the vaccine I experienced flu like symptoms. I was prepared for this and rested/ stayed in bed. Along with my chills, aches and fatigue, diarrhea developed. I wasn?t too concerned, since I was clearly having immune response to the vaccine. But now, two weeks later, I have very bad diarrhea still. It?s honestly hard to carry on with normal life. It?s very unusual for me and not any symptom I?ve ever experienced for this long.


VAERS ID: 1731459 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-03-03
Onset:2021-09-11
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized and diagnosed with COVID


VAERS ID: 1731495 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Pain, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sore arm, chills/aches, lack of energy (very tired all the time), no treatment yet


VAERS ID: 1731749 (history)  
Form: Version 2.0  
Age: 0.33  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-11
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1004321A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood glucose, Blood pressure fluctuation, Blood test, Chest X-ray, Computerised tomogram, Discomfort, Electrocardiogram, Fatigue, Flank pain, SARS-CoV-2 test, Syncope, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levroxin
Current Illness:
Preexisting Conditions: Auto-immunity Graves? disease with thyroidectomy 1994
Allergies:
Diagnostic Lab Data: Sugar levels 9/11, 9/19, 9/22, 9/23 EKGs 9/11, 9/19, 9/22, 9/23 General blood work (same) Urinalysis 9/19, 9/23 Chest x-ray 9/19, 9/22 Ct abdomin 9/22 Covid tests 9/19 ( inconclusive) 9/23
CDC Split Type:

Write-up: 1 week after vaccination I became weak, faint, had episodes of increased blood pressure then sudden drops. Also abdominal pressure and pain left flank. Weakness and periods of extreme fatigue have continued.


VAERS ID: 1731881 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK - / IM

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

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

Write-up: Patient''s parent misrepresented age on consent and again when verbally asked


VAERS ID: 1732029 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (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: Zoloft, Zyrtec, Wellbutrin, Bupropion
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness all day and all night since the second day of receiving the vaccine. I''m on day 14 and am still very dizzy!!!


VAERS ID: 1732126 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-02-01
Onset:2021-09-11
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012A20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Type II DM, CKD stage 5, HTN, Hyperlipidemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After being fully vaccinated patient contracted the COVID-19 virus and was hospitalized.


VAERS ID: 1732187 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-25
Onset:2021-09-11
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aspartate aminotransferase, Blood albumin, Blood bilirubin, Blood calcium, Blood chloride, Blood creatine, Blood electrolytes, Blood glucose, Blood potassium, Blood sodium, Blood test, Blood urea, C-reactive protein, Carbon dioxide, Culture throat, Differential white blood cell count, Epstein-Barr virus antibody, Full blood count, Liver function test, Oral mucosal blistering, Oropharyngeal pain, Pyrexia, Red blood cell sedimentation rate, SARS-CoV-2 test, Stomatitis, Streptococcus test, Urine analysis
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: sesame seeds
Diagnostic Lab Data: SARS-COV-2 (COVID-19) URINALYSIS URINE CULTURE URINALYSIS ELECTROLYTES (SODIUM, POTASSIUM, CHLORIDE, CARBON DIOXIDE) CREATININE BLOOD UREA NITROGEN (BUN) GLUCOSE BLOOD CULTURE EPSTEIN BARR VIRUS ANTIBODY PANEL WHITE BLOOD CELL DIFFERENTIAL ALBUMIN ASPARTATE AMINOTRANSFERASE CBC (COMPLETE BLOOD COUNT) WITH DIFFERENTIAL C-REACTIVE PROTEIN ERYTHROCYTE SEDIMENTATION RATE LIVER FUNCTION PANEL CALCIUM DIRECT BILIRUBIN THROAT CULTURE GROUP A STREPTOCOCCUS SCREEN
CDC Split Type:

Write-up: High Fever, mouth blisters, mouth sores, sore throat


VAERS ID: 1732201 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram; Asmanex; omeprazole; Prolia; methotrexate
Current Illness: no acute illnesses (rotator-cuff tendinitis for months)
Preexisting Conditions: cough-variant asthma, depression, GERD, osteoporosis, and RA
Allergies: sulfa, zithromax
Diagnostic Lab Data: None
CDC Split Type:

Write-up: approx. 4 days following this 3rd dose of the Moderna vaccine, an itchy rash appeared at the injection site (upper right arm) which had been painful/swollen for 3-4 days. Shortly thereafter, the rash appeared on my upper right thigh (inner and outer) as well as right buttock. It also appeared to a lesser extent on my right ankle, as well as on my lower back. The rash also occurred on my outer and inner left thigh. Saw the dermatologist today and he suggested either a shot of Kenalog (which i declined) or topical cream to apply 2X/day. I don''t know the cream name, but will pick it up tomorrow. Note: i''ve had no changes to diet, supplements, or lotions. . On 08/26/21, recvd cortisone shot in left shoulder joint


VAERS ID: 1732220 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Exam and EKG done. EKG within normal limits. Reassurance that not highly suspicious for myocarditis. Discussed resolution of any possible side effects.
CDC Split Type:

Write-up: Patient reported during immunization screening on Sept 22 when in clinic to receive Varicella vaccine that he was worried he had myocarditis from Covid19 vaccination received 9/10/21 and wanted to know if he should get dose 2. He stated he had an elevated heart rate of 80-100 bpm and had called an ask a nurse line at the clinic after the vaccination. He received the Varicella vaccine without inicdence. Upon checking records, doctor from facility had tried to call patient back on 9/11/21 but patient didn''t have voicemail and didn''t return call to clinic. Patient called clinic on 9/24/21 and had experienced chest pain again and asked to see a provider. He was examined by NP that day.


VAERS ID: 1732403 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Electrocardiogram normal, Flank pain, Red blood cell sedimentation rate increased
SMQs:, Retroperitoneal fibrosis (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: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Ekg Normal CRP abnormal High 21.0 Esr range 39
CDC Split Type:

Write-up: Chest pain, left side pain.


VAERS ID: 1732820 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Endometriosis
Allergies: Ciprofloxacin, Trace Metals (hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complains of left arm numbness, shortness of breath with exertion and at rest, and chills after 2nd dose of Pfizer vaccine.


VAERS ID: 1733873 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-08-26
Onset:2021-09-11
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site anaesthesia, Vaccination site erythema, Vaccination site pruritus, Vaccination site rash, Vaccination site warmth
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: a rash on her arm/rash was about 4 inches long/the rash is resolving on its own; her left arm was warm and fairly red; doesn''t itch too much; still feels a little sensation; her left arm was warm and fairly red/the color is already reducing; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE RASH (a rash on her arm/rash was about 4 inches long/the rash is resolving on its own), VACCINATION SITE WARMTH (her left arm was warm and fairly red), VACCINATION SITE PRURITUS (doesn''t itch too much), VACCINATION SITE ANAESTHESIA (still feels a little sensation) and VACCINATION SITE ERYTHEMA (her left arm was warm and fairly red/the color is already reducing) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced VACCINATION SITE RASH (a rash on her arm/rash was about 4 inches long/the rash is resolving on its own), VACCINATION SITE WARMTH (her left arm was warm and fairly red), VACCINATION SITE PRURITUS (doesn''t itch too much), VACCINATION SITE ANAESTHESIA (still feels a little sensation) and VACCINATION SITE ERYTHEMA (her left arm was warm and fairly red/the color is already reducing). At the time of the report, VACCINATION SITE RASH (a rash on her arm/rash was about 4 inches long/the rash is resolving on its own), VACCINATION SITE WARMTH (her left arm was warm and fairly red), VACCINATION SITE PRURITUS (doesn''t itch too much), VACCINATION SITE ANAESTHESIA (still feels a little sensation) and VACCINATION SITE ERYTHEMA (her left arm was warm and fairly red/the color is already reducing) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Treatment informations were reported.


VAERS ID: 1733879 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-03-11
Onset:2021-09-11
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Insomnia, Muscle swelling, Myalgia, Neck pain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: swollen muscle; feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit; cannot sleep at night; feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit; feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit; throbbing pain / feeling throbbing pain in different parts of his right arm from neck to big muscle of his arm,; tender and swollen muscle/from neck to big muscle of his arm; This spontaneous case was reported by a patient and describes the occurrence of MUSCLE SWELLING (swollen muscle), AXILLARY PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), INSOMNIA (cannot sleep at night), NECK PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit) and PAIN IN EXTREMITY (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit) in a 67-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 046C21A, 002C21A and 031A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 11-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced MUSCLE SWELLING (swollen muscle), AXILLARY PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), INSOMNIA (cannot sleep at night), NECK PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), PAIN IN EXTREMITY (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), PAIN (throbbing pain / feeling throbbing pain in different parts of his right arm from neck to big muscle of his arm,) and MYALGIA (tender and swollen muscle/from neck to big muscle of his arm). At the time of the report, MUSCLE SWELLING (swollen muscle) and MYALGIA (tender and swollen muscle/from neck to big muscle of his arm) outcome was unknown and AXILLARY PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), INSOMNIA (cannot sleep at night), NECK PAIN (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit), PAIN IN EXTREMITY (feeling throbbing pain of his right arm from neck to big muscle of his arm, including armpit) and PAIN (throbbing pain / feeling throbbing pain in different parts of his right arm from neck to big muscle of his arm,) had not resolved. No concomitant medication reported. No treatment medication reported On day 3 to 4, he developed a tender and swollen muscle in his right arm. Caller said he was feeling throbbing pain in different parts of his right arm from neck to big muscle of his arm, including armpit, and due to which he could not sleep at night. This case was linked to MOD-2021-320310 (Patient Link).


VAERS ID: 1733922 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Chills, Erythema, Headache, Hyperhidrosis, Nail discolouration, Pain in extremity, Pallor, Peripheral coldness, Peripheral swelling, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atypical angina (She has a history of atypical angina (20 years ago) with coronary vasospasm.); Bowel ischemia; Clot blood (She does have a history of blood clots with ischemic bowel.); Norovirus infection
Allergies:
Diagnostic Lab Data: Test Date: 202106; Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Took 20 minutes to get out of bed; Hands were completely white and the nail beds were completely white.; She pressed on it and got a linear line of pink but her arms felt cold as ice; Chest discomfort; Lather up in a sweat; Chest pain; Feverish; Had a headache like a nail driving up in her brain stem; Arm was sore as a boil; Face turned beet red then became pale; Arm swole up from the top of her shoulder to the bottom of her elbow and around across to deltoid muscle; Face turned beet red; Chills in the evening time; Runny nose; This spontaneous case was reported by a consumer and describes the occurrence of RHINORRHOEA (Runny nose), PERIPHERAL SWELLING (Arm swole up from the top of her shoulder to the bottom of her elbow and around across to deltoid muscle), ERYTHEMA (Face turned beet red), ASTHENIA (Took 20 minutes to get out of bed) and PALLOR (Face turned beet red then became pale) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 058E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Atypical angina (She has a history of atypical angina (20 years ago) with coronary vasospasm.) in 2001, Clot blood (She does have a history of blood clots with ischemic bowel.), Bowel ischemia and Norovirus infection in June 2021. Concomitant products included METOPROLOL for Heart rate abnormal. On 11-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 11-Sep-2021, the patient experienced RHINORRHOEA (Runny nose) and CHILLS (Chills in the evening time). On 12-Sep-2021, the patient experienced PERIPHERAL SWELLING (Arm swole up from the top of her shoulder to the bottom of her elbow and around across to deltoid muscle) and PAIN IN EXTREMITY (Arm was sore as a boil). 12-Sep-2021, the patient experienced ERYTHEMA (Face turned beet red), PALLOR (Face turned beet red then became pale) and HEADACHE (Had a headache like a nail driving up in her brain stem). 12-Sep-2021, the patient experienced PYREXIA (Feverish). On 13-Sep-2021, the patient experienced ASTHENIA (Took 20 minutes to get out of bed), NAIL DISCOLOURATION (Hands were completely white and the nail beds were completely white.), PERIPHERAL COLDNESS (She pressed on it and got a linear line of pink but her arms felt cold as ice), CHEST DISCOMFORT (Chest discomfort) and HYPERHIDROSIS (Lather up in a sweat). 13-Sep-2021, the patient experienced CHEST PAIN (Chest pain). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) on 13-Sep-2021 for Adverse event, at an unspecified dose and frequency. At the time of the report, RHINORRHOEA (Runny nose), PERIPHERAL SWELLING (Arm swole up from the top of her shoulder to the bottom of her elbow and around across to deltoid muscle), ERYTHEMA (Face turned beet red), ASTHENIA (Took 20 minutes to get out of bed), PALLOR (Face turned beet red then became pale), NAIL DISCOLOURATION (Hands were completely white and the nail beds were completely white.), PERIPHERAL COLDNESS (She pressed on it and got a linear line of pink but her arms felt cold as ice), CHEST DISCOMFORT (Chest discomfort), HYPERHIDROSIS (Lather up in a sweat), PAIN IN EXTREMITY (Arm was sore as a boil), CHEST PAIN (Chest pain), PYREXIA (Feverish), HEADACHE (Had a headache like a nail driving up in her brain stem) and CHILLS (Chills in the evening time) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In June 2021, SARS-CoV-2 test negative: negative (Negative) Negative. Patient heart rate sometimes goes up to 165, but was found to be 75 at the time of reporting. This case was linked to MOD-2021-321068.


VAERS ID: 1734156 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Heart rate, Heart rate increased, Loss of consciousness, Nausea, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes); Latex allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Heart rate; Result Unstructured Data: Test Result:148bpm; Comments: heart rate was at 148bpm; Test Date: 20210911; Test Name: Heart rate; Result Unstructured Data: Test Result:Resting heartbeat never dropped below the 120s bpm
CDC Split Type: USPFIZER INC202101194916

Write-up: My vision was going black and I passed out; I had severe ringing in my ears/ Throughout the rest of the day my ears were ringing; Light headed /Dizzy; My heart rate was at 148bpm/ my resting heart beat never dropped below the 120s bpm.; Nausea; Bad headache; This is a spontaneous report from a contactable other health care professional (patient). A 24-year-old female patient received BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right arm on 10Sep2021 17:00 (at the age pf 24-year-old) (Lot Number: Fc3183) as dose 1, single for COVID-19 immunization. The patient was not pregnant at the time of vaccination. Medical history included latex allergy. Concomitant medication included topiramate (TOPAMAX) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. On 11Sep2021 10:30, the patient woke up and got up to brush her teeth and shower and had severe ringing in her ears, was light headed, dizzy, vision was going black and passed out. The patient''s heart rate was at 148bpm when she regained consciousness. Throughout the rest of the day her ears were ringing, had a bad headache, nausea, and reported that her resting heart beat never dropped below the 120s bpm. The patient did not receive any treatment for the events. The outcome of the events was recovering.; Sender''s Comments: Based on the reported information ,a causal relationship between the event loss of consciousness and suspected drug cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate


VAERS ID: 1734505 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Electrocardiogram, Heart rate increased, Myocarditis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel FE 1.5/30
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ECG resulted in high heart rate
CDC Split Type:

Write-up: Sever body aches, high fever, chills, elevated heart rate, myocarditis


VAERS ID: 1734557 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Contusion, Haemorrhage, Macule, Papule, Pruritus, Rash maculo-papular, Skin plaque
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Raised maculopapular rash, burning, plaques starting on upper extremities, eventually spreading to the legs, then to the trunk. Plaques eventually coalesced together forming larger plaques and raised macules. Started on the inner arms, then was noted on the outer thighs, which spread to the buttock, then up the back. As plaques began to heal, new raised papules and plaques would surface in other areas of the body. Plaques and raised papules caused Itching, burning, bleeding, which caused scratching so bad there was bruising and bleeding noted around the affected areas. Resolved with time, 14 days, and antihistamine as needed.


VAERS ID: 1734958 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-09-11
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E11685 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Extra dose administered, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (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: VtD/E/B/zinc
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pain in shoulder/deltoid in left arm that persisted weeks after shot. Pain with movement and at rest. Did Active PT with physical therapist for 3 months. Now resolved.


VAERS ID: 1735052 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-09-11
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ezetimibe 10mg, Fenofibrate 160mg, Losartin 10mg, Metoprolol Tart 50mg
Current Illness: None
Preexisting Conditions: High Cholesterol, High Blood Pressure
Allergies: None
Diagnostic Lab Data: I have an appointment with an ENT specialist on October 4, 2021.
CDC Split Type:

Write-up: I have developed severe Tinnitus since receiving the vaccine. I have a constant, loud hum in both ears. It is extremely irritating in normal and quiet environments. Loud noise drowns it out. The sound is high pitched like circadia bugs.


VAERS ID: 1735554 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-09-11
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative, Taste disorder
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 112 mcg and Linzess 72mcg
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: 3 rapid tests 2 Covid tests all negative
CDC Split Type:

Write-up: Severe headache fatigue change of taste in mouth sore throat runny nose


VAERS ID: 1735746 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Pyrexia, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
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: I am employed and was coerced under threat to take these experimental vaccines, even though I already had natural immunity from prior infection. So, after I took it, some time at night after receiving the injection, I proceeded to have high fever, violent shivering and projectile vomiting. It lasted all night and me and my wife were not certain I''d make it through the night. The 2 weeks proceeding just left me drained and feeling like a cancer patient. I am now starting to slowly feel like my normal self. That is if no long-term side effects develop because these vaccines are experimental.


VAERS ID: 1735776 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Hyperthyroidism, Ultrasound thyroid
SMQs:, Hyperthyroidism (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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 tests, ultrasound of thyroid
CDC Split Type:

Write-up: Hyperthyroidism


VAERS ID: 1737098 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Insomnia, Irritability, Pain in extremity
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: arm pain, very irritable for three days, some loss of sleep the first night


VAERS ID: 1737165 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-01
Onset:2021-09-11
   Days after vaccination:253
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Echocardiogram, Pericardial effusion, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Testosterone cypionate Percocet Meloxicam Asprin
Current Illness:
Preexisting Conditions:
Allergies: Peanuts
Diagnostic Lab Data: CT scan and echocardiogram
CDC Split Type:

Write-up: Pericarditis with pericardial effusion


VAERS ID: 1737495 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-23
Onset:2021-09-11
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Herpes zoster, Pruritus, Rash papular, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Prevnar- about 2017 I had a drop in blood pressure with a high heart rate and a near passing out and it just lasted for about a
Other Medications: Magnesium Turmeric Vitamin D Macuhealth
Current Illness:
Preexisting Conditions: Mast Cell Activation Syndrome
Allergies: Neosporin ointment
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: On Saturday September 11th I had itching and a burning sensation on the left side toward my back around my waist. I though it was a spider bite, but when I felt it I didn''t feel anything. At noon I noticed a lot of little red bumps that extended towards my spine on my back. I went to urgent care and they told me I had shingles. I was prescribed an anti viral medication for it which I took immediately. The medication that was prescribed was Valacyclovir 1000mg 3xday for 10 days by mouth. On the 7th day everything started to clear up. The day before I found out I had shingles, I had a venom shot against yellow jackets, wasp, and hornets. I get the venoms shots just incase if I ever get stung the reaction would be milder because of my mast cell activation that I have. I have been getting those venom shots for five months without any issues.


VAERS ID: 1738057 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Discomfort, Dizziness, Electrocardiogram normal, Hyperhidrosis, Limb discomfort, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan (50 mg), Probiotic, Vitamin D and Magnesium
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Severe abdominal pain w/ Bactrim, Cipro & Levaquin
Diagnostic Lab Data: EKG on 9/27/2021 was normal, no heart issues.
CDC Split Type:

Write-up: Wave of discomfort, pins and needles in arms & hands and lower legs & feet, sweaty palms, feel like going to pass out, episode lasts for approximately 3 hours at a time, has occurred 4 times since shot, most recent being 9/26/21. PCP recommended B12. Also had chest pain starting 4 days after the shot and still continues. Intensity varies and lasts majority of the day. Dull pain mostly but some sharp stabbing pains.


VAERS ID: 1738506 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Chills, Fatigue, Headache, Oropharyngeal pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: swelling of arm after DTAP
Other Medications: Smarty Pants Multi-Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Bee stings
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Started feeling weak, tired, sore throat, and headache in the morning after getting his second dose. Then he threw up. He laid down and started getting a fever in the afternoon, reaching 103.0 at one point. We started giving him Tylenol which reduced the fever, but it kept fluctuating the rest of the day. He had chills, and his left armpit hurt. He took over five naps that day, and more the next day with headaches continuing, but no more fever. After the first two full days, his only remaining symptom was the pain in his left armpit. It subside four days later.


VAERS ID: 1739980 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-11
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210949968

Write-up: SORE ARM; This spontaneous report received from a patient concerned a 72 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 11-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-SEP-2021, the patient experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sore arm on 24-SEP-2021. This report was non-serious.


VAERS ID: 1740139 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dysmenorrhoea, Pain in extremity, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL; SERTRALINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Menopause; Tiredness
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191862

Write-up: menstrual cycle with cramps/have not had a menstrual cycle in about a year; menstrual cycle with cramps; severe back pain with it that is shooting down my leg; severe back pain with it that is shooting down my leg; This is a spontaneous report from a contactable consumer (patient). A 46-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: FC3182), via an unspecified route of administration in the left arm on 10Sep2021 at 18:30 (at the age of 46-year-old), dose 2, single for COVID-19 immunisation. Medical history included staying tired but expected on that, going through menopause and have not had a menstrual cycle in about a year. Concomitant medications included amfetamine aspartate, amfetamine sulfate, dexamfetamine saccharate, dexamfetamine sulfate (ADDERALL) and sertraline. The patient had no known allergies. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: FC3181) administered via an unspecified route of administration in the left arm on 16Aug2021 at 15:00 (at the age of 46-year-old), dose 1, single for COVID-19 immunisation. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive other vaccines four weeks prior. The patient was not pregnant at the time of vaccination. On 11Sep2021 at 08:00, the patient had menstrual cycle with extreme cramps. The patient stated she was going through menopause and have not had a menstrual cycle in about a year. The patient also had severe back pain with it that was shooting down her leg. No treatment was received for the events. The patient had not been tested for COVID-19 since vaccination. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1740548 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Limb discomfort, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (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: Multiple myeloma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Difficulties in the arm; Difficulties in the shoulder; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (Difficulties in the arm) and MUSCULOSKELETAL DISCOMFORT (Difficulties in the shoulder) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Multiple myeloma. On 09-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Sep-2021, the patient experienced LIMB DISCOMFORT (Difficulties in the arm) and MUSCULOSKELETAL DISCOMFORT (Difficulties in the shoulder). At the time of the report, LIMB DISCOMFORT (Difficulties in the arm) and MUSCULOSKELETAL DISCOMFORT (Difficulties in the shoulder) outcome was unknown. No concomitant product was provided by the reporter. No adverse events after the first two vaccinations. The patient experienced "Difficulties in the arm" and "Difficulties in the shoulder" after third dose. The patient was in treatment (unspecified) for multiple myeloma.


VAERS ID: 1740935 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Cold sweat, Dizziness, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Heart rate increased, Palpitations, Peripheral coldness, Tremor, Troponin, Tunnel vision
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (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: None
Current Illness: None- Had active COVID infection in Mid June 2021
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: EKG was done. Do not see evidence of troponins done on SM work-up.
CDC Split Type:

Write-up: Soldier started having chest pain approx 1 day after vaccination. Chest pain has been intermittent since vaccination but increased significantly on 9/27. SM was in class and started having lightheadedness, heart palpitations, increased chest pain, tunnel vision, shaky, cold clammy hands and increased heart rate and SM was brought to ER for work-up. SM states that his sx''s feel a little better with leaning forward and also laying down at times. ER basically told SM that everything was ok and to follow up at clinic. EKG done at MISC. Shows some ST elevation in V3-V6 which is consistent with possible pericarditis.


VAERS ID: 1741065 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-20
Onset:2021-09-11
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Congestive heart failure, hypertension
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Fever, SOB, fainting


VAERS ID: 1741155 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Joint swelling, Mobility decreased, Musculoskeletal chest pain, Nasal congestion, Neck pain, Pain, Pain in jaw, Paraesthesia, Paraesthesia oral, Pyrexia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Magnesium with zinc and vitamin D3
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Epinephrine, NSAIDS, Sudafed, Clindamycin, Keflex, Lorcet, Lortab, Liquid red dye, Steroids, Cefprozil, Cyclabenzaprine, Prednisone
Diagnostic Lab Data: Knee drained
CDC Split Type:

Write-up: Breathing changed (was more labored) for about 48 hours. Inside of my nose felt swollen, my tongue felt swollen, my lips were tingly, and my finger tips were tingly for about 4 hours. Left side of my body hurts from the top of my head to the tips of my toes. For about 4 days I could not tough my neck because the pain was so intense. I had a hard time eating because my jaw hurt to chew. My rib cage hurts to breathe. Can''t lay on my left side because the pain is so severe. On day 7 my knee swelled up and had to be drained. Can''t bend my knee because the swelling is so much. After a week the swelling has started to go down, but still swollen and very concerning. I have felt feverish everyday but only had a fever the first two days. I get waves of feeling weak and dizzy every day.


VAERS ID: 1741385 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myalgia, Nausea, Pyrexia, SARS-CoV-2 test negative, Sensitive skin
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: COVID Rapid Detection Test 8/13: neg
CDC Split Type:

Write-up: Diffuse muscle aches, skin sensitivity, nausea, fever


VAERS ID: 1741556 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site mass, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: Patient called us 9/28/21 to report that she had developed a lump and bruise at the injection site shortly after administration. About a week later the bruise went away, but a lump was still present and the lump was painful with sharp shooting pains, so she went to her primary care doctor. She said her doctor instructed her to wait and watch. She says as of 9/28/2021 she hadn''t improved and was messaging her doctor about the situation.


VAERS ID: 1741729 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Discomfort, Grip strength decreased, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (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: Employee calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 9/11/2021 Is this your first or second dose- 2nd Date of symptom onset - ? 9/11/2021 Symptoms - ? heavy feeling, pain all over, joint pain in big joints all over the body, parasthesia of hands and feet (so bad she drops objects), employee states she can still walk and do things but it is hard. employee also stated that she has psoriatic arthritis and takes biologics for it but it was a month before the first dose COVID-19 vaccine as recommended. Last day of work and shift - ? NA Home remedies-Employee stated she has been taking 1 gram of Tylenol twice a day for pain Any improvement- Tylenol helps the pain only Recommendation- Advised employee to follow treatment plan of phycisian. Employee voiced understanding Employee of information ? Yes Employee voiced any concerns ? No Employee?s questions answered to employee?s satisfaction -Yes


VAERS ID: 1742758 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acne, Chest pain, Dyspnoea, Headache, Lymphadenopathy, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe acne hives swollen lymph nodes headache chest pain difficulty breathing


VAERS ID: 1743002 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Musculoskeletal chest pain, Pain, Pulmonary 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Serious burning lung pain. Lasting about 12 hours. Feeling like ribs are broken.


VAERS ID: 1744305 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Chest X-ray normal, Computerised tomogram head abnormal, Contusion, Dizziness, Exercise tolerance decreased, Eye contusion, Full blood count, Head injury, Leukocytosis, Metabolic function test, Myocardial necrosis marker normal, Nausea, Skin laceration, Soft tissue swelling, Suture insertion, Syncope, Troponin normal, White blood cell count increased, X-ray limb normal
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: CT scan (20 Sept 2021): Sot tissue swelling/contusion along the inferior frontal and left periorbital region extending into the nasal soft tissues; No fracture; Chest XR (same): NACP Left shoulder XR: no fracture Troponin (same date): negative CMP (Same): Elevated AST to 58; elevated ALT to 59 CBC: (same): Leukocytosis to 11.7
CDC Split Type:

Write-up: He noted that for days after receiving COVID 19 J&J vaccine, patient developed dizzy spells with nausea and decreased exercise tolerance. On Sept 20th, he noted that the symptoms worsened and he developed a syncopal episode and hit his head. He was seen in the Emergency Department. He had head trauma which resulted in imaging (negative) but resulted in a head laceration requiring stitches. He had cardiac enzymes screening accomplished which was negative.


VAERS ID: 1744324 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-16
Onset:2021-09-11
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Headache, Respiratory tract congestion, 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: Rapid Test done on 9-15-2021, resulted positive
CDC Split Type:

Write-up: Headache and congestion


VAERS ID: 1744409 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-28
Onset:2021-09-11
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Diarrhoea, Fatigue, Headache, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: PCR collected on 9-14-2021 and resulted positive on 9-15-2021
CDC Split Type:

Write-up: Fever, chills, body aches, runny nose, cough, wheezing, cough, headache, fatigue, diarrhea, loss of taste and smell.


VAERS ID: 1744422 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaemia, Chromaturia, Dizziness, Fall, Haemoglobin decreased, Transfusion
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Muscular dystrophy; scoliosis
Allergies: Cats; bees; iodine; weather in general
Diagnostic Lab Data: Hemoglobin levels were supposed to be like 14-15, but went I went to the hospital it was like .5.
CDC Split Type: vsafe

Write-up: The same day I got the shot I fell walking up the stairs. I was not able to get up for a couple of minutes. I was dizzy. It was like 30 hours after the shot that my urine was changing color. I went to the doctor and they told me to go to the hospital. They told me I had a rare form of anemia that was basically like my immune system was attacking itself and killing my blood cells. I had like 14 or 15 blood transfusions. They did a whole bunch of tests. I am still going back to get blood tests because I have the anemia. I am on a steroid called prednisone to treat that. I had to be hospitalized from 9/11/2021 to 9/20/2021.


VAERS ID: 1745267 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood glucose increased, Dizziness, Hypoaesthesia, Joint swelling, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1st vaccine in March. Same side effects
Other Medications: Glimepiride 4mg 2 time daily , enalapril 10mg , hydrochlorothiazide 25 mg, furosemide 20mg ,alopurinol 300mg
Current Illness:
Preexisting Conditions: diabetic high blood pressure ,gout
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Toes and feet tingling and hurting . Glucose was over 300 . Still feeling dizzy. Feet sometimes goes numb . Ankles swelling and painful.


VAERS ID: 1745964 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-27
Onset:2021-09-11
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/11/2021: Right facial droop. Emergency room visit diagnosis: Bell''s palsy. Dose 1: Exp. 08/09/2021. Dose 2: Exp. 9/6/2021.


VAERS ID: 1747646 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-25
Onset:2021-09-11
   Days after vaccination:229
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pyrexia, Vaccination site erythema, Vaccination site hyperaesthesia, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
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: ATENOLOL; FELODIPINE; LEXAPRO; FISH OIL; DOXAZOSIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Heart disease, unspecified; Renal disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: very warm; it became very sensitive; I had a fever for 2 days; my arm swelled up/it was the size of a golf ball; it was very red; it was painful; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (very warm), VACCINATION SITE HYPERAESTHESIA (it became very sensitive), PYREXIA (I had a fever for 2 days), VACCINATION SITE SWELLING (my arm swelled up/it was the size of a golf ball) and VACCINATION SITE ERYTHEMA (it was very red) in an 87-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030L20A, 013M20A and 037F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Renal disease and Heart disease, unspecified. Concomitant products included ATENOLOL, FELODIPINE, ESCITALOPRAM OXALATE (LEXAPRO), FISH OIL and DOXAZOSIN for an unknown indication. On 25-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced VACCINATION SITE WARMTH (very warm), VACCINATION SITE HYPERAESTHESIA (it became very sensitive), PYREXIA (I had a fever for 2 days), VACCINATION SITE SWELLING (my arm swelled up/it was the size of a golf ball), VACCINATION SITE ERYTHEMA (it was very red) and VACCINATION SITE PAIN (it was painful). On 13-Sep-2021, PYREXIA (I had a fever for 2 days) had resolved. On 18-Sep-2021, VACCINATION SITE WARMTH (very warm), VACCINATION SITE HYPERAESTHESIA (it became very sensitive), VACCINATION SITE SWELLING (my arm swelled up/it was the size of a golf ball), VACCINATION SITE ERYTHEMA (it was very red) and VACCINATION SITE PAIN (it was painful) had resolved. The treatment medication was unknown.


VAERS ID: 1749467 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 202F21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dehydration, Headache, Myalgia, SARS-CoV-2 test, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Dehydration (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, thyroid NR
Current Illness: none
Preexisting Conditions: attention-deficit disorder, hypothyroidism, polycystic ovarian syndrome
Allergies: penicillin, azithromycin
Diagnostic Lab Data: COVID-19 testing, unknown blood tests
CDC Split Type:

Write-up: vomiting with dehydration, myalgia, headache


VAERS ID: 1749539 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Hypoaesthesia, Influenza like illness, Injected limb mobility decreased, Injection site discolouration, Injection site erythema, Injection site warmth, Joint swelling, Lymphadenopathy, Musculoskeletal stiffness, Myalgia, Pain, Paraesthesia, Peripheral swelling, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: That evening around 9pm, I started to feel achy, muscle aches, chills, shivering, fatigue and low grade fever, I woke up the next morning with the same flu like symptoms. These symptoms resolved after 2 days but still feeling fatigue. On 9/14/2021, the injection site was red, hot and purple hue and growing larger. My left arm all the way down to my fingers was swollen. My left hand- pinky, ring and middle finger lost sensations and they felt numb and tingling and this lasted over 2 days and slowly the symptoms did improved. On 9/15/2021 I also had tingling in my left foot, tingling toes and my ankles were swollen. I also had a swollen lymph node on the left side of my arm pit. It was large enough that it was protruding into my chest. It was bigger than my fist. I did consult with my doctor and they recommended to take Benadryl and ibuprofen. Currently, I am still having brain fog, stiffness and soreness around my neck/shoulder, and decreased mobility of my left arm,


VAERS ID: 1749565 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Insomnia, Nausea, Pain, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: I had pretty bad nausea. I contacted a doctor online. I was prescribed some medication. The nausea went away after about 2 days. That was followed by paresthesia, which was tingling sensation in different areas of my body. I still have tingling in my back and groin area. I let the doctor know about that but they did not have any treatment for that. I have sparks of pain in different areas. They did not have any treatment for that either. I went to my cardiologist because I had a little bit of fluttering in my heart, this was before the vaccine. They did an echocardiogram, and it came back normal. I am supposed to go back for some additional tests. I also had insomnia the first night of the vaccine. I had some of the sparks of pain in my chest area and that lasted for about a week and it was not a continuous pain. The tingling sensation has not gone away.


VAERS ID: 1749669 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristiq
Current Illness:
Preexisting Conditions: Hashimoto disease diagnosed in 2011
Allergies: All seasonal allergies; dog hair; tree; palms; very chemically sensitive to cleaning products; eat fruit with a pesticide also have a reaction
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: After my second dose vaccine I feel extremely exhausted, unable to really start get through a day without having to go to bed. My days have been extremely short. I am having hard time, fatigue and achiness are really bad. I also had a low grade fever after my vaccine. I still have the symptoms today.


VAERS ID: 1749721 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Shot every Year since 2000. Whatever they give us at the Hospital for Employees.
Other Medications: Levothyroxine, Spironolactone, Singulair, Meloxicam
Current Illness: None
Preexisting Conditions: Thyroid
Allergies: Latex, Lisinopril, All Contrast Media Dyes for CT Scans & MRI Scans...
Diagnostic Lab Data: Labs done 9/30/2021 CT to be Scheduled.
CDC Split Type:

Write-up: Swollen Lymph Nodes in Neck and Armpit. Won''t go away.


VAERS ID: 1749923 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-18
Onset:2021-09-11
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J4J / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram abnormal, Extremity necrosis, Peripheral arterial occlusive disease, Peripheral coldness, Poor peripheral circulation, Scan with contrast abnormal, Sensory loss, Skin discolouration, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, Nexium 40mg, Hydroxyzine 25mg, Phentermine, cont..
Current Illness: None
Preexisting Conditions: Obesity, GERD, Anxiety, Migraines, Hyperlipidemia
Allergies: Codeine, Duloxetine
Diagnostic Lab Data: 09/20/2021 - US upper extremity arteries right - peripheral artery disease 09/30/2021 - CTA upper extremity right with and without contrast - No significant flow is visualized to
CDC Split Type:

Write-up: 4 weeks after receiving Janssen vaccine, patient''s thumb and pointer fingers on her right hand became necrotic. She has no feeling, they are turning black and they are cold. Ultrasound and Cat Scan were done. Patient had blood clot in in her right arm that the doctors told her had broken apart and ended up in her fingers, causing them to lose circulation. Patient was recently told by hand surgeon that fingers will need to be amputated.


VAERS ID: 1752062 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-23
Onset:2021-09-11
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bell''s palsy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101224498

Write-up: I received the Pfizer vaccination in April and I recently have been diagnosed with Bell''s Palsy; This is a spontaneous report. A 63-year-old male patient received BNT162B2 (COMIRNATY; Lot number and expiration date were not reported), via an unspecified route of administration in left arm in the early afternoon on 23Apr2021 (at the age of 63-years-old) as dose 2, single for COVID-19 immunization in a hospital. Medical history included bell''s palsy. Family medical history relevant to events was reported as none. No history of all previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available). There were no concomitant medications/other products reported. Historical vaccination included BNT162B2 (COMIRNATY; Lot number and expiration date were not reported), via an unspecified route of administration on 02Apr2021 (at the age of 63-years-old) as dose 1, single for COVID-19 immunization. The patient received the vaccination in Apr2021 and recently had been diagnosed with bell''s palsy on 11Sep2021. The patient understood that this might be a possible side effect. The patient requested to provide any information regarding the event. It was reported that there was no investigation assessment and no relevant tests performed. These events didn''t led to emergency room and physician''s office visit. The outcome of the event was not recovered at the time of report. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1752121 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC5184 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal faeces, Axillary pain, Diarrhoea, Groin pain, Monoplegia, Oropharyngeal pain
SMQs:, Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Osteonecrosis (broad), Noninfectious diarrhoea (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: USPFIZER INC202101229993

Write-up: Temporary paralysis in right hand (happened two different times); Daily diarrhea with a very odd foul smell; Daily diarrhea with a very odd foul smell; Sharp severe pains in left and right groin; Sharp severe pains in right armpit; Severe sore throat; This is a spontaneous report from a contactable consumer (patient). A 35-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right arm on 09Sep2021 18:00 (at the age of 35-year-old) (Lot Number: FC5184) as dose 1, single for COVID-19 immunization. The patient medical history was not reported. The patient was not pregnant at the time of vaccination. There were no concomitant medications. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. On 11Sep2021, the patient had daily diarrhea with a very odd foul smell, temporary paralysis in right hand (happened two different times), sharp severe pains in left and right groin, sharp severe pains in right armpit and severe sore throat lasting for days. The events resulted in doctor/HCP/clinic office visit. The patient did not receive treatment for the events. The outcome of the events was not recovered. The events were assessed as non-serious by the reporter. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752838 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Medication errors (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg daily; Atorvastatin 20 mg daily; Losartan-HCTZ 50-12.5 daIly; Lumigan 0.01% 1 drop in left eye daily; Melatonin 5 mg daily; Timolol maleate 0.5% 1 drop daily in left eye; Tamsulosin 0.4 mg daily; Turmeric 1500 mg daily; Magnes
Current Illness: None
Preexisting Conditions: Hypertension, glaucoma, hypercholesterolemia, BPH.
Allergies: None
Diagnostic Lab Data: COVID PCR test, September 14, 2021.
CDC Split Type:

Write-up: Sore throat, fatigue. This began 2 days after the injection; I woke up with the sore throat.


VAERS ID: 1753310 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Eye pruritus, Fatigue, Night sweats, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Itchy eyes, congestion, night sweats, extreme fatigue for 1 week, loss of taste, and smell on 9/18/21.


VAERS ID: 1753834 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-09-11
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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: History of RA on chronic steroids
Allergies:
Diagnostic Lab Data: Cycle threshold 19.8 on admission.
CDC Split Type:

Write-up: Patient admitted to the hospital for COVID 19. Reporting per Moderna COVID vaccine EUA.


VAERS ID: 1753845 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-09-11
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: CLL on Imbruvica
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted to the hospital for COVID 19. Reporting per Moderna COVID vaccine EUA.


VAERS ID: 1754016 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 - / -

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

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

Write-up: Upper eye lid began to swell.


VAERS ID: 1754317 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Sciatica
SMQs:, Retroperitoneal fibrosis (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: Chronic lower back pain. Sciatica


VAERS ID: 1754737 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain
SMQs:, 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: CALCIUM; FISH OIL; METAMUCIL; MULTIVITAMIN
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Three days after the vaccine was administered, the patient began to experience severe upper sternal chest pain. It did not radiate, and he said that taking deep breaths seemed to cause more pain. He did not seek any medical care for this, and by the next day, the pain was significantly improved, with the pain completely resolving by the 3rd day.


VAERS ID: 1755925 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-13
Onset:2021-09-11
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023D / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Dyspnoea, Fatigue, Feeling abnormal, Headache, Hypoaesthesia, Nausea, Palpitations, Pyrexia, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USMODERNATX, INC.MOD20213

Write-up: I have numbness from my elbows down to my hands, numbness from my knees down to my feet; Feels strange; Rapid heartbeat; shortness of breath; Joint aches; A massive headache; Fever (unknown temp); Nausea; Felt super super tired; Injection site pain; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (I have numbness from my elbows down to my hands, numbness from my knees down to my feet), FEELING ABNORMAL (Feels strange), PALPITATIONS (Rapid heartbeat), DYSPNOEA (shortness of breath) and ARTHRALGIA (Joint aches) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 023D) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced HYPOAESTHESIA (I have numbness from my elbows down to my hands, numbness from my knees down to my feet), FEELING ABNORMAL (Feels strange), PALPITATIONS (Rapid heartbeat), DYSPNOEA (shortness of breath), ARTHRALGIA (Joint aches), HEADACHE (A massive headache), PYREXIA (Fever (unknown temp)), NAUSEA (Nausea), FATIGUE (Felt super super tired) and VACCINATION SITE PAIN (Injection site pain). At the time of the report, HYPOAESTHESIA (I have numbness from my elbows down to my hands, numbness from my knees down to my feet) and FEELING ABNORMAL (Feels strange) had not resolved and PALPITATIONS (Rapid heartbeat), DYSPNOEA (shortness of breath), ARTHRALGIA (Joint aches), HEADACHE (A massive headache), PYREXIA (Fever (unknown temp)), NAUSEA (Nausea), FATIGUE (Felt super super tired) and VACCINATION SITE PAIN (Injection site pain) outcome was unknown. No Concomitant medications were reported. No Treatment details were reported.


VAERS ID: 1756707 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, C-reactive protein normal, Chest X-ray normal, Chest pain, Costochondritis, Echocardiogram, Electrocardiogram normal, Pain, Palpitations, Pruritus, Pulmonary calcification, Pulmonary valve stenosis, Troponin normal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 50mg 1 tab PO daily x 5 days, Famotidine 20mg 1 tab PO BID, Benadryl 25mg 1 cap PO q6hr prn allergies, PRN epi-pen =$g all prescribed by Emergency Department. Patient is also on Vitamin D3 5000 1 cap PO daily
Current Illness: Hypertension, vitamin D deficiency, UTI, CKD2
Preexisting Conditions:
Allergies: BenzaClin, Spironolactone, Scented lotions detergents
Diagnostic Lab Data: pls see #18
CDC Split Type:

Write-up: 9/20/2021: 27-year old female who was seen in our clinic after her ED visit at Medical Center ED on 9/11/2021 for chest pain s/p her 1st shot of pfizer covid vaccine. Was sent to ER from the vaccine clinic. 12-lead ekg =$g NSR. CXR =$g no acute cardiopulmonary disease. Patient was d/c home from the ED with prednisone 50mg 1 tab PO daily for 5 days, diphenhydramine 25mg 1 cap PO q6hr PRN itching, famotidine 20mg 1 tab PO BID and epinephrine (epipen) 0.3mg/0.3mL inject 0.3mL into the muscle as needed for allergic emergencies (anaphylaxis). States, "At night, I feel like my heart is coming out of my chest". When bending her back backwards, it worsens the pain. Resting or leaning forward help to relieve the pain. Denies any dyspnea, dizziness, lightheadness, palpitations, abdominal pain, n/v. 9/30/2021: Patient feels better after taking OTC ibuprofen PRN pain. No chest pain at this time. Has been taking OTC ibuprofen PRN pain with full relief of chest pain. CXR and 12-lead EKG in the ED were normal. Labs were ordered and reviewed. Trop - neg, CRP - stable, TSH - stable, ESR - normal. Echocardiogram =$g normal EF 65%. There is mild pulmonic stenosis with calcification. Patient''s cardiac workup is unremarkable. Patient''s chest pain is most likely costochondritis. Patient to take OTC tylenol BID PRN pain or OTC ibuprofen PO BID with food PRN pain. Patient may take her 2nd Pfizer vaccine completion. Patient saw Cardiology Dr a few days ago Patient to f/u with Cardio for pulmonic stenosis follow-up.


VAERS ID: 1756934 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Impaired driving ability, Muscle tightness, Pain
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt stated that he started to have neck muscle tightness ( at 7 on scale 1-10) day after Covid 19 Pfizer. On going for 21 days. Gets knots in the neck . His driving is limited due to difficulty turning his neck ( pain when turning). Constan
Current Illness:
Preexisting Conditions:
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that he had on going pain for 21 days , starting day after covid shot. He has neck muscle tightness ( 7 on scale 1-10). He gets knots in the neck. His driving is limited due to pain in the neck when turning. He has to take OTC Advil for his constant pain when in it is unbearable, happens later part of the day. He has headache toward the back of his head.


VAERS ID: 1757195 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-28
Onset:2021-09-11
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Ear pain, Headache, Lymphadenitis, Pain, Respiratory tract congestion, SARS-CoV-2 test negative, Skin mass, Upper-airway cough syndrome
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Honey
Diagnostic Lab Data: Physical exam, ear exam, CT scan without contrast, blood draw, Covid rapid test all done on 9.12.2021 at ER visit. Ct scan showed that it was negative for mastoiditis. Covid test came back negative. Blood work came back normal. Diagnosed with lymphadenitis by the left ear.
CDC Split Type:

Write-up: 9/11/2021 began to have Congestion, ear pain, , post nasal drip and painful lumps on left side of ear all around. Felt throbbing of ear pain and head pain. 9/12/2021 Went to urgent care and was directed to go to ER to rule out mastoiditis.


VAERS ID: 1757253 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-08-30
Onset:2021-09-11
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute coronary syndrome, Arterial catheterisation, Electrocardiogram, Myalgia, Myocarditis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3, 5000 IU, every other day Fexofenadine, OTC, one daily Multivitamin, One-A-Day Men''s
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NSAID medications Tylenol Aspirin Nightshade food group
Diagnostic Lab Data: EKG (multiple), 09/22 - 09/23 Radial Artery Catheterization, 09/22
CDC Split Type:

Write-up: Myopericarditis, extreme fever (105+ degree), muscular soreness, acute coronary syndrome


VAERS ID: 1757357 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Dizziness, Fatigue, Formication, Mobility decreased, Muscle spasms, Muscle twitching, Paraesthesia, Pruritus, Somnolence, Tremor, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: benazepril 40mg in the morning every day zoloft 200mg in morning every day
Current Illness: none
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: none yet. I will be scheduling blood work with my primary doctor soon.
CDC Split Type:

Write-up: LOT FC3184 was my 2nd pfizer shot. the day after i was very tired, could not get out of bed and body joint pain all over body. It was painful to have the sheets on top of me while asleep. This minimized over the next few days. during the next 2 weeks, I struggled to stay awake during the work weeks and constantly taking over the counter pain relievers to reduce the body joint pains but unsuccessful. Starting September 24 to now I have been suffering random joint pains, pins and needles from my fingers down to my toes, I feel I have bugs crawling on me with itching from my legs and back to my arms, I feel dizzy at times and get very fatigued and tired, my hands legs and feet get spasms or twitching and shaking, I feel overall weak and feels like my vision gets cloudy. Since September 24th it has not changed or has not gotten any better.


VAERS ID: 1757399 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Colorado  
Vaccinated:1951-09-08
Onset:2021-09-11
   Days after vaccination:25571
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Confusional state, Decreased appetite, Dizziness, Fatigue, Gait disturbance, Laboratory test normal, Lethargy, Pyrexia, Somnolence, Weight decreased
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg, atrovastatin 40 mg, metoprolol 25 mg, omega-3.
Current Illness: Non_Hohgkin''s Lymphoma
Preexisting Conditions: Non-Hodgkin''s Lymphoma
Allergies: None
Diagnostic Lab Data: All tests performed in the hospital did not show the source of the fever and above symptoms.
CDC Split Type:

Write-up: Fever above 100F for five days, chills, weakness, dizziness, inability to walk without support, low appetite, some mental confusion, sleepiness, lethargy. After a week, very slow improvement. As of the time of this report, 10/03/2021, still very weak, easily fatigued, lost 12 lbs.


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