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From the 6/11/2021 release of VAERS data:

Found 352,386 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 165 out of 3,524

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VAERS ID: 1326659 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 LA / SYR

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

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

Write-up: Shingles: painful itchy rash on back of neck, and right arm.


VAERS ID: 1326702 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo-Provera shot Daily multi-vitamin b-12 supplement
Current Illness: None
Preexisting Conditions: None
Allergies: Clindamycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke during the night with vertigo, then woke in the morning with vertigo. It began to subside later in the day, and completely by Sunday morning, May 16th.


VAERS ID: 1326706 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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 misrepresented age when making vaccine appointment and when asked verbally


VAERS ID: 1326712 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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 misrepresented age when making vaccine appointment and when asked verbally


VAERS ID: 1326719 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

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

Write-up: severe headache causing high blood pressure.


VAERS ID: 1326732 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 RA / IM

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

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

Write-up: Patient given COVID Vaccine 12hours after vial was opened on 05/14/2021. Patient has been contacted to follow up with any allergic or adverse reactions at 08:33 am on 05/18/2021. Patient states he has not had any adverse reactions or any allergic reactions since given the Moderna vaccine. Patient states he is feeling fine.


VAERS ID: 1326803 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: The patient''s father, present the vaccine and repeatedly told this RN that the patient was 12 nearly 13. The patient received her covid vaccine to the left deltoid. The patient had had no reaction and tolerated well. The patient''s father notified staff after the vaccine was given, the patient was 11 nearly 12 years old and he thought since it was so close to the date of the patient''s actual birthday, he thought it was ok for the patient to receive the vaccine. The patient had no adverse reaction while in observation area and left with her father with no issues. The attestation formed was signed.


VAERS ID: 1326809 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: unknown
Current Illness: unknown
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt had been required to wait for 30 mins due to hx of allergy. Pt reported numbness in L upper arm that radiated to the neck and a headache. Vitals were normal and pt denied any other symptoms such as SOB, itching or swelling. Advised pt to wait longer till numbness resolved and to take tylenol or ibuprofen for headache. Numbness did resolve soon after and pt felt well enough to go home. Advised to go to walk in clinic if it did not fully resolve by tomorrow.


VAERS ID: 1326823 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Dizziness, Headache, Hyperventilation, Immediate post-injection reaction, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Pt was very anxious before shot given. Mother had to physically hold pt down for her to receive the shot. Afterwards, pt reported headache, dizziness, and sore throat immediately after the shot. Pt was hyperventilating so I encouraged deep breathing and hydration. HEENT and Pulm exam were normal, as were the vitals. Pt eventually recovered without any other intervention. Pt waited for full 30 minutes after dose.


VAERS ID: 1326841 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Fatigue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: mild intermittent asthma BMI greater than or equal to 95th percentile in childhood
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt screened to wait for 15 mins and when asked if he was feeling okay to leave, reported fatigue and tightness in throat. Father reported hx of asthma. I evaluated him and determined reaction to be anxiety-induced. HEENT and Pulm exams normal. I encouraged hydration, and calmed pt down with casual conversation and held for 40 mins


VAERS ID: 1326842 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Malaise, 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: Norditropin 1.6 mg/day Calcium 600 mg/day Vitamin D
Current Illness: NA
Preexisting Conditions: Idiopathic Pediatric Osteoporosis Idiopathic Short Stature
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low grade fever - 5 days Malaise - 5 days Headache - 5 days


VAERS ID: 1326846 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-05-14
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood lactic acid increased, Malaise, Pneumonia, Pyrexia, Sepsis, White blood cell count increased
SMQs:, Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lamictal
Current Illness: Covid positive 02/18/2021
Preexisting Conditions: Splenectomy
Allergies: Sulfa
Diagnostic Lab Data: WBC 38.99 Lactate 2.5
CDC Split Type:

Write-up: Pt admitted to hospital with Sepsis. Fevers and malaise for 1 day before admission. Extremely elevated WBC. New pneumonia. Requiring oxygen.


VAERS ID: 1326853 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 37A21B / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Decreased appetite, Diarrhoea, Fatigue, Migraine, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Any fruit that has a pit (like apples, peaches, nectarines), walnuts.
Diagnostic Lab Data: Isolated at home, not gone to dr.
CDC Split Type:

Write-up: Migraine, heart palpitations, 5 days of diarrhea so far, lack of appetite, bouts of extreme fatigue, and anxiety (I?m don?t have anxiety so this is very unusual).


VAERS ID: 1326907 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / SYR

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

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

Write-up: headache and fatigue


VAERS ID: 1326934 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Malaise, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Skyrizi
Current Illness: None
Preexisting Conditions: Psoriasis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Really bad headache, arm painful to the touch, whole body pain and achiness, general malaise, tiredness. Lasted about 24 hours. Ibuprofen and a hot shower helped alleviate symptoms. After approx 24 hours only a soreness at injection site remains.


VAERS ID: 1326960 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxcarbazepine, bupropion
Current Illness:
Preexisting Conditions: Bipolar
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Loud, constant ringing in ears; headaches, dizziness


VAERS ID: 1327008 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-17
Onset:2021-05-14
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Infection, SARS-CoV-2 test positive
SMQs:, Arthritis (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, atrial fibrillation, osteoarthritis, sick sinus syndrome, congestive heart failure
Allergies: amoxicillin, penicillin, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted to the hospital on May 5th 2021 with acute on chronic right knee pain, found to have a septic right knee for which she had a washout 5/7. Patient had a negative COVID PCR on admission (5/5). Subsequently on 5/14 she had a repeat COVID PCR for discharge planning which came back positive. On 5/16 patient was noted to have a new oxygen requirement of 4L NC, though her imaging appears more consistent with fluid overload than COVID. She currently remains hospitalized. She is fully vaccinated.


VAERS ID: 1327231 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: No smell or taste, sore throat, positive test day after shot


VAERS ID: 1327274 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient became pale, clammy and light headed for 1-2 minutes while sitting being monitored. Patient given wet cloth to forehead and water to drink. Patient''s symptoms resolved in 3- 5 minutes with additional 15 minutes of monitoring after the first 15 minutes.


VAERS ID: 1327280 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Immunoglobulin therapy, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Platelet count <1 on admission. Patient receiving IVIG and prednisone without significant improvement. patient admitted to hospital on 5/15/2021
CDC Split Type:

Write-up: Thrombocytopenia


VAERS ID: 1327282 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Feeling hot, Hot flush
SMQs:, Hypoglycaemia (broad)

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

Write-up: Hot flashes on and off. Feeling very hot and getting clammy.


VAERS ID: 1327299 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: My arm has been swollen for over 4 days and is very itchy and red. It has been very painful to the touch


VAERS ID: 1327343 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Injection site pain, Nausea, Oropharyngeal pain
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Chills, Sore throat, Nausea, Injection site pain


VAERS ID: 1327354 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Chills, Sore arm, Nausea


VAERS ID: 1327432 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium increased, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood test, Blood urea normal, C-reactive protein increased, Carbon dioxide normal, Cardiac monitoring normal, Chest X-ray normal, Chest pain, Chills, Cytomegalovirus test negative, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment elevation, Epstein-Barr virus antibody positive, Haematocrit normal, Haemoglobin normal, Inflammation, Magnetic resonance imaging normal, Myocarditis, N-terminal prohormone brain natriuretic peptide increased, Pain, Painful respiration, Platelet count decreased, Protein total normal, Red blood cell count decreased, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Tachycardia, Troponin increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hematocrit 43.4 (5/15/2021) Hemoglobin 15.2 (5/15/2021) Platelets 148 (5/15/2021) RBC 4.76 (5/15/2021) WBC 12.83* (5/15/2021) Albumin 4.3 (5/15/2021) Alk Phos 90 (5/15/2021) ALT 56* (5/15/2021) AST 53* (5/15/2021) Bilirubin Total 0.6 (5/15/2021) BUN 13 (5/15/2021) Calcium 9.8 (5/15/2021) Chloride 100 (5/15/2021) CO2 26 (5/15/2021) Creatinine 0.97 (5/15/2021) Glucose Bld 110* (5/15/2021) Potassium 4.1 (5/15/2021) Sodium 137 (5/15/2021) Total Protein 7.6 (5/15/2021) 5/17/2021: Cardiac MRI "Normal biventricular size and function. No evidence of pericarditis. Minimal mid wall enhancement in the inferolateral and lateral left ventricular walls could reflect minimal/resolving inflammation/myocarditis given this patient''s clinical presentation. Repeat cardiac MRI can be considered in 1-3 months." 5/16/2021: Echocardiogram "Technically difficult, suboptimal study. No pericardial effusion. Normal left ventricular systolic function. Normal right ventricular systolic function. Echobright septum."
CDC Split Type:

Write-up: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension. At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care. At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring. CV: Troponins were trended every 12 hours with a max of 4.91. His last troponin checked on the morning of discharge was 0.41. He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis. During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias. Resp: On 2L NC for comfort, no respiratory distress or hypoxia. FENGI: Regular diet Neuro: Ibuprofen scheduled and tylenol PRN for pain. He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately. ID: Myocarditis panel sent with some results still pending. Thus far, he is CMV negative, EBV IgG was positive but not IgM. RVP was negative. This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine. At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.


VAERS ID: 1327473 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-11
Onset:2021-05-14
   Days after vaccination:123
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease Current Smoker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization for 1 day


VAERS ID: 1327474 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-16
Onset:2021-05-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Blood electrolytes normal, Computerised tomogram normal, Dysphagia, Endotracheal intubation, Fall, Full blood count normal, Headache, International normalised ratio normal, Liver function test normal, Lumbar puncture, Magnetic resonance imaging head, Metabolic function test normal, Mobility decreased, Neck pain, Paraesthesia, Prothrombin level normal, Pyuria, Scan with contrast, Speech disorder, Spinal pain, Urine analysis abnormal
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Arthritis (broad), Respiratory failure (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: Sertraline 200 mg daily
Current Illness: Generally healthy
Preexisting Conditions: Anxiety
Allergies: NKA
Diagnostic Lab Data: Pan CTs which were negative as well as basic labs including CBC, PT/INR, and complete metabolic profile with liver enzymes and electrolytes which were normal. Urinalysis showed pyuria and a culture is pending
CDC Split Type:

Write-up: Generally healthy 73-year-old woman transferred from LRGH for weakness. Yesterday she is tripped and fell in the bathroom landing on her tailbone sending a jarring discomfort up through her spine but she was able to feel normal walk around all day and even drive to Rhode Island and back. When she got back she started feeling tired and she noticed when she woke up around 10 or 11:00 at night to go to the bathroom that she had weakness proximally in her upper more than lower extremities and some tingling. She does feel a mild headache, some aching in her neck, aching in her back, and her weakness progressed to the point where she had difficulty getting up. In the emergency department she had increasing weakness, difficulty speaking and swallowing therefore she was intubated for airway protection. She underwent brain MRI with and without contrast. She was briefly extubated on 5/16 however continued to have progressive weakness requiring reintubation. Neurology was engaged and patient underwent lumbar puncture in interventional radiology. Patient is on ventilator 5/18/21.


VAERS ID: 1327634 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

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

Write-up: Passed out about 2 minutes after the shot, about 10 steps from where he got the shot.


VAERS ID: 1327708 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Public       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: Client 11 years old, lied and reported being 12. Accidentally give dose while ineligible.


VAERS ID: 1327712 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Public       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: Client lied and reported being 12 years old. Dose accidentally given to ineligible client.


VAERS ID: 1327803 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm, Dysphemia, Mydriasis, Peripheral coldness, Raynaud's phenomenon, Skin discolouration
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Focalin XR 30mg, Escitalopram 20mg, Focalin 10mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states she received the COVID vaccine on 5/13/2021 at 4:00pm, on 5/14/2021 around 10:30am or 11:00am patient started to have dilated eyes, hands froze and where purple with white Raynaud''s, stuttering, twitching of the left eye. Patient is still having left eye twitching but other symptoms are better.


VAERS ID: 1327816 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

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

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

Write-up: patient was with mom and mom reported an hour after vaccine patient''s hands had red spots around knuckles and red hands. no trouble breathing, patient mom said redness of hands stayed from Friday to Tuesday which is when she called, she did state allergy pill she gave daughter helped the redness go away patient mom says will find a doctor but otherwise patient is experiencing no other symptoms


VAERS ID: 1328017 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Pain, Pyrexia, Rash, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: May 18th: received a steroid shot, oral steroids, and oral hydroxyzine pamoate.
CDC Split Type:

Write-up: Initial symptoms were difficult, but not totally unexpected: chills, fever, body aches, joint pain, headache, and fatigue that started about 10pm on the night of the vaccine (May 14th) and continued through early Sunday (May 16th) afternoon. On Tuesday (May 18th), my legs, buttocks, and arms broke out into a severe rash. Large welts, extremely itchy, and spreading quickly. I went to my doctor the same day to receive treatment after trying topical antihistamine cream and witch hazel, which provided little to no relief.


VAERS ID: 1328023 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient waiting about 30 mins after vaccination reported shortness of breath and wheezing. Team applied O2 and administered EPI Pen to Left Thigh and transported to the ED in stable condition


VAERS ID: 1328262 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-15
Onset:2021-05-14
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Cardiac arrest, Cardiac failure, Computerised tomogram, Fibrin D dimer increased, Intensive care, Lung assist device therapy, Pulmonary embolism, Right ventricular hypertension, Temporary mechanical circulatory support, Troponin I increased
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Cardiomyopathy (broad), Respiratory failure (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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norethin Ace-Eth Estrad-FE 1mg-20mcg
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin G
Diagnostic Lab Data: CT scan 5/14/21, troponin 0.167, BNP 768, Ddimer 3323
CDC Split Type:

Write-up: on 5/14 developed severe bilateral pulmonary embolism with severe right ventricular hypertension and heart failure. Progressed to cardiac arrest requiring mechanical circulatory support (ECMO) in PICU. Managed in the Cardiac ICU


VAERS ID: 1328963 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Nausea, Pain, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: I had severe body aches, tremors, headache, fatigue, fever of 103.4 that was controlled by Tylenol, these symptoms lasted for 30 hours. I still am experiencing vomiting, nausea and diarrhea


VAERS ID: 1329103 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Condition aggravated, Feeling abnormal, Headache, Insomnia, Malaise, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210529914

Write-up: FEELS WORSE; FEELING AWFUL; FEELING SICK; CHILLS; NAUSEA; HEADACHE; BODY ACHES; DID NOT SLEEP WELL; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 14-MAY-2021 13:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-MAY-2021, the subject experienced body aches. On 14-MAY-2021, the subject experienced did not sleep well. On 14-MAY-2021, the subject experienced feeling sick. On 14-MAY-2021, the subject experienced chills. On 14-MAY-2021, the subject experienced nausea. On 14-MAY-2021, the subject experienced headache. On 15-MAY-2021, the subject experienced feels worse. On 15-MAY-2021, the subject experienced feeling awful. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling sick, body aches, headache, nausea, chills, did not sleep well, and feels worse, and the outcome of feeling awful was not reported. This report was non-serious.


VAERS ID: 1329105 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Body temperature, Chills, Headache, Nausea, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (4 times a week (Social drinker)); Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, drug abuse/illicit drug use. The patient was not pregnant at the time of reporting. No pertinent medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: Body temperature; Result Unstructured Data: 99.8 degree F
CDC Split Type: USJNJFOC20210530221

Write-up: BODY ACHE; ARMPIT PAIN; ARMPIT SWELLING; CHILLS; NAUSEA; HEADACHE; FEVER; This spontaneous report received from a patient concerned a 46 year old female. The patient''s weight was 150 pounds, and height was 168 centimeters. The patient''s concurrent conditions included alcoholic, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies, drug abuse/illicit drug use. the patient was not pregnant at the time of reporting. no pertinent medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 13-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced body ache. On 14-MAY-2021, the subject experienced armpit pain. On 14-MAY-2021, the subject experienced armpit swelling. On 14-MAY-2021, the subject experienced chills. On 14-MAY-2021, the subject experienced nausea. On 14-MAY-2021, the subject experienced headache. On 14-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.8 degree F. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, chills, nausea, headache, and fever on 14-MAY-2021, and was recovering from armpit pain, and armpit swelling. This report was non-serious.


VAERS ID: 1329109 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered, Syringe issue, Underdose
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: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530326

Write-up: PHARMACIST UNSURE HOW MUCH OF A DOSE PATIENT RECEIVED DUE TO "SYRINGE EXPLODED"; SYRINGE EXPLODED; UNDERDOSE; This spontaneous report received from a pharmacist concerned a 42 year old female. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and batch number: 207A21A expiry: 23-JUN-2021) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced pharmacist unsure how much of a dose subject received due to "syringe exploded". On 14-MAY-2021, the subject experienced syringe exploded. On 14-MAY-2021, the subject experienced underdose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pharmacist unsure how much of a dose patient received due to "syringe exploded", syringe exploded and underdose was not reported. This report was non-serious.


VAERS ID: 1329111 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530383

Write-up: DOSE GIVEN BEYOND 2 HOURS AT ROOM TEMPERATURE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 14-MAY-2021 14:40 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced dose given beyond 2 hours at room temperature. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of dose given beyond 2 hours at room temperature was not reported. This report was non-serious.


VAERS ID: 1329117 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530654

Write-up: VACCINE STORED AT INAPPROPRIATE CONDITION BEFORE ADMINISTRATION; This spontaneous report received from a health care professional concerned a 20 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, and expiry: 20-JUN-2021) dose was not reported, administered on 14-MAY-2021 10:19 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced vaccine stored at inappropriate condition before administration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine stored at inappropriate condition before administration was not reported. This report was non-serious.


VAERS ID: 1329120 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530792

Write-up: METALLIC TASTE; This spontaneous report received from a consumer concerned a 67 year old male. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced metallic taste. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from metallic taste. This report was non-serious.


VAERS ID: 1329121 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530800

Write-up: PAIN IN THE CALVES OF HER LEGS; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-MAY-2021, the subject experienced pain in the calves of her legs. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from pain in the calves of her legs. This report was non-serious.


VAERS ID: 1329144 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; ATORVASTATIN; LOSARTAN/HYDROCHLOROTHIAZIDE; BREZTRI AEROSPHERE
Current Illness: Chronic obstructive pulmonary disease; Shortness of breath; Smoker (No more than 1/2 pack/day; hasn''t had a cigarette in two days.); Social alcohol drinker (Maybe twice a month- will split a beer)
Preexisting Conditions: Comments: the patient had no known allergies and no known drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210531547

Write-up: INCREASED SHORTNESS OF BREATH; This spontaneous report received from a patient concerned a 65 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included chronic obstructive pulmonary disorder, occasional social alcohol user, smoker, and shortness of breath, and other pre-existing medical conditions included the patient had no known allergies and no known drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, and batch number: 1805025 expiry: UNKNOWN) dose was not reported, administered on 13-MAY-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, atorvastatin, budesonide/formoterol fumarate/glycopyrronium bromide, and hydrochlorothiazide/losartan potassium. On 14-MAY-2021, the subject experienced increased shortness of breath. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from increased shortness of breath. This report was non-serious.


VAERS ID: 1329159 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Eating disorder, Vomiting, Weight, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: Weight; Result Unstructured Data: lost six pounds
CDC Split Type: USJNJFOC20210532469

Write-up: VOMITING; LOST SIX POUNDS; CANNOT EAT; WEAKNESS; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 14-MAY-2021, the subject experienced vomiting. On 14-MAY-2021, the subject experienced lost six pounds. On 14-MAY-2021, the subject experienced cannot eat. On 14-MAY-2021, the subject experienced weakness. Laboratory data included: Weight (NR: not provided) lost six pounds. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from weakness, and the outcome of vomiting, lost six pounds and cannot eat was not reported. This report was non-serious.


VAERS ID: 1329680 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Confusional state, Disorientation, Fatigue, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol, fluoxetine, furosemide, glipizide, janumet, atorvastatin, valsartan, proair
Current Illness: multiple chronic diseases, diabetes type 2, a fib, cerebrovascular disease
Preexisting Conditions: as above
Allergies: lisinopril
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fatigue, myalgia, nausea, shivering, felt confused/disoriented for a couple of days after 2nd vaccine; symptoms self resolved


VAERS ID: 1330329 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Injection site erythema, Injection site pain, Injection site swelling, Muscle spasms, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine HCL 40 mg cap. Estarylla 0.25mg/0.035mg pill Albuterol Sulfate
Current Illness: none
Preexisting Conditions: bicuspid aortic valve asthma obesity
Allergies: None documented
Diagnostic Lab Data: none
CDC Split Type:

Write-up: - Pain/tenderness at injection sight for ~72hrs after vaccination -Small red bump (size of quart) at injection site( was gone after 72hrs.) ***- Abnormal vaginal bleeding, heavy bleeding occured, o clots within blood, cramping*** - General malaise


VAERS ID: 1330437 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Unevaluable event
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: N./A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: N/A


VAERS ID: 1330492 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure during pregnancy, SARS-CoV-2 test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Tested positive 5/14/2021 showing very minimal symptoms, patient is pregnant with C section scheduled for 5/19/2021. At time of reporting patient is currently in OR so no birth weight yet.


VAERS ID: 1330539 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Diarrhoea, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Omeprazole, escitalipram
Current Illness: NA
Preexisting Conditions: Athsma
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Severe headache, vomiting, diarrhea, chills, fever, cold sweats No treatment for health professional Symptoms subsided after 10 hours


VAERS ID: 1330699 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-16
Onset:2021-05-14
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, COVID-19, COVID-19 pneumonia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Infective pneumonia (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: as above
CDC Split Type:

Write-up: Vaccinated for COVID-19 with Pfizer on 3/11/2021 and 4/16/2021, tested positive for Covid-19 by PCR on 5/12/2021. Entered emergency department with complaints of knee pain on 5/14/2021 (knee aspiration done 5/12/2021). Also noted to have Covid-19 pneumonia and hypoxemic respiratory failure and was admitted to hospital.


VAERS ID: 1330781 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: vasovagal reaction


VAERS ID: 1330922 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Inflammation
SMQs:, 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: Sore and inflammed shoulder. Patient has seen a doctor and received a steroid shot in the shoulder.


VAERS ID: 1331055 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Computerised tomogram, Gastrointestinal inflammation, Scan with contrast, X-ray
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: protonix and paxil
Current Illness: None
Preexisting Conditions: Crohns Disease
Allergies: sulfa and pristique
Diagnostic Lab Data: CT scan with contrast, x rays, blood work
CDC Split Type:

Write-up: Extreme abdominal pain and inflammation. Was in the hospital for 3 nights


VAERS ID: 1331304 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK UN / IM

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

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

Write-up: At approximately 1825 a patient fainted over in her seat at the observation area. The EMS transported her to the other side of the gymnasium wherea privacy screen is set up. She was fine to leave around 1835 per the EMT but stayed till 1848 and left on her own will. Patient was 16 years of age, female. Girl has a history of passing out, i.e. when she received novocaine and when she got her ears pierced. Her guardian declined to give a name for the report.


VAERS ID: 1331485 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: Xyzal, OTC acid reflex medication
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: After receiving vaccine, pt had vasovagal event and "fell out of" open car door, waking on ground. Intermittent vomiting x 30 min.


VAERS ID: 1331533 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not that I know of
Current Illness: No known medical conditions
Preexisting Conditions: No known health conditions
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient had the vaccination and waited for 15 minutes, then when he was walking out the store then he felt dizzy and fainted for seconds, Dad was there to catch him when he was falling. he came back to conscious as I was there, we called 911 and paramedics came and checked on pt. then he went home with parents after he was done with the checkup with the paramedics.


VAERS ID: 1331793 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Confusional state, Feeling abnormal, Road traffic accident
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: A Covid long hauler, hospitalized for serious Covid in January 2021
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very severe brain fog and confusion. Left house at 5 am. Confused, left in Jeep with no one knowing. No phone, wallet, shoes. Had an accident ( no one else involved) found laying on ground after 11 hours of searching. Can?t remember what or why it happened, still remains in the hospital at this time. After his first vaccine he got the brain fog for 1 day, but recovered the next day. No incident due to severe confusion.


VAERS ID: 1331836 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / UNK LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest discomfort, Coronary artery occlusion, Myocardial infarction, Stent placement
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi-Vitamin
Current Illness: None
Preexisting Conditions: Smoker
Allergies: Some shellfish alergies
Diagnostic Lab Data: I will release all medical records for this event if needed...I may be one of a very small percentage of this type of adverse effect....and the plaque in my artery may have already been there, but I believe it ruptured due to the vaccine, and at a minimum should Be evaluated! Happy
CDC Split Type:

Write-up: Received first vaccine 4/21/21. Within two days started having tightness in chest, but no other adverse reactions, happened a couple times a day. 5/13/21 received second vaccine....had tightness two more times, then 5/14:22 evening had a heart attack....ambulance to Hospital. 99% blockage in LAD. Hospital inserted stent. Spoke with all of the Cardiologists about my concerns as Heart problems ?Do not? run in my family. I have always had excellent blood pressure and low cholesterol....my father is 86 and was a smoker, and never been on blood pressure medication, same with my late Grandfather. I?ve ?never? had any type of chest pains in my life. Also, I am retired military and have had numerous vaccines, with no issues. The hospital cardiologists said that I could report this, but they believe the Heart attack is due to the fact that I smoke....I just don?t believe that....the Heart Attack occurred 36 hours after my second vaccine!!!


VAERS ID: 1332424 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamins vitamin C, primrose oil, candistat, B12 complex, cranberry
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Heart pain 3-4 hours after injection. Heart pain subsides 13 hours after injection. Chest pain center near sternum, chest tightness in center of chest 8 hours after injection. Chest pain is ongoing since injection and is now day 5. The chest pain worsens when lifting heavy objects, bending over, and laying down.


VAERS ID: 1332431 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Lymphadenopathy, Nausea, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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

Write-up: The lymph nodes in my throat and armpit on the left side started swelling rapidly, I had high fever and nausea. The onset seemed to be sudden and within 1 hour I was feeling very sick. I took 500mg acetaminophen. The next day I felt better but still had to take acetaminophen due to some fever and still swollen lymph nodes. The swelling on my lymph nodes did not fully go away for 3 days. My face was visibly swollen on the left side. I also had bad diarrhea on Thursday and Friday without any change in my diet. I don''t know if that was a side effect too.


VAERS ID: 1332436 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exfoliative rash, Fatigue, Influenza like illness, Pain, Pain in extremity, Rash erythematous, Rash pruritic, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine Hydrochloride (10mg tablet); nightly Vitron C (Iron Supplement); daily
Current Illness: Dental caries--repaired 3days previously Receipt of 1st dose on 04/14--with ISR (pain and swelling ), flu-like feeling, joint pain, and fatigue---and 3 weeks later, pain in the opposite arm
Preexisting Conditions: Seasonal Allergies Asthma Migraines Polyarthralgia Atopic Dermatitis Dishydrotic Eczema Rosacea, inc Occular
Allergies: Iodinated contrast agents (hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: In addition to the expected flu-like and ISR in the R arm, L arm painful, very itchy, scaly rash noticed on day 2--still persisting with cracking and peeling on day 5; fatigue still requiring daytime sleeping after a few hours of being up; R arm rash was a very faint pink but swelling and pain is persisting Symptoms that resolved by day 3 are sharp toe pain, flank pain, and pain with deep breathing


VAERS ID: 1332451 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-18
Onset:2021-05-14
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL EXTRA STRENGTH 500MG
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: SHELLFISH, IBURPROFEN
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: UNEXPLAINED HIVES/RASHES THROUGHOUT BACK AREA, ELBOWS AREA, AND WRISTS. RED, RAISED, WARM TO TOUCH, ITCHY, IRREGULAR SHAPE, AND CLUSTERS. OBSERVES TO OCCUR AFTER NAPS OR SLEEP NO PROFESSIONAL ATTENTION. HOME REGIME OF ZYRTEC ONCE DAILY.


VAERS ID: 1332496 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Cough, Dizziness, Dyspnoea, Fatigue, Headache, Lip dry, Nausea, Oral discomfort, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (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:
Current Illness: Arthritis; Food allergy; Penicillin allergy; Polycystic ovarian syndrome
Preexisting Conditions: Medical History/Concurrent Conditions: Medical device implantation; Comments: Patient confirms she is allergic to almond.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210534881

Write-up: DRY LIPS; BURNING ON THE ROOF OF MOUTH; RUNNY NOSE; COUGH; SHORTNESS OF BREATH; DIZZINESS; KNEE PAIN; JOINT PAIN; FATIGUE; NAUSEA; HEADACHE; This spontaneous report received from a patient concerned a 40 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included metal plate in ankle, and concurrent conditions included arthritis, pcos, penicillin allergy, and peanut/peanuts/garlic/tomatoes/walnuts/almonds allergy, and other pre-existing medical conditions included patient confirms she is allergic to almond. The patient experienced drug allergy when treated with amoxicillin. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A, and batch number: 204A21A) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-MAY-2021, the subject experienced dry lips. On 14-MAY-2021, the subject experienced burning on the roof of mouth. On 14-MAY-2021, the subject experienced runny nose. On 14-MAY-2021, the subject experienced cough. On 14-MAY-2021, the subject experienced shortness of breath. On 14-MAY-2021, the subject experienced dizziness. On 14-MAY-2021, the subject experienced knee pain. On 14-MAY-2021, the subject experienced joint pain. On 14-MAY-2021, the subject experienced fatigue. On 14-MAY-2021, the subject experienced nausea. On 14-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine was not applicable. The patient recovered from runny nose, cough, shortness of breath, and dizziness on MAY-2021, was recovering from headache, and had not recovered from fatigue, nausea, dry lips, burning on the roof of mouth, knee pain, and joint pain. This report was non-serious.


VAERS ID: 1332966 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210530880

Write-up: HEART ISSUES; This spontaneous report received from a pharmacist concerned multiple patients. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 14-MAY-2021, the subject experienced heart issues. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from heart issues. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not needed as per standard procedure since case is assessed as non-serious.


VAERS ID: 1332973 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Fatigue, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HORMONES
Current Illness: Menopause
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210534784

Write-up: DIARRHEA; FELT A LITTLE NAUSEOUS; EXTREME WEAKNESS; DIZZINESS(COULD NOT WALK); WIPED OUT; MUSCLE PAIN; This spontaneous report received from a patient concerned a 64 year old female. The patient''s weight was 120 pounds, and height was 70 inches. The patient''s concurrent conditions included menopause. The patient was previously treated with vitamins nos. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 13-MAY-2021 16:55 for prophylactic vaccination. Concomitant medications included . On 14-MAY-2021, the subject experienced muscle pain. On 16-MAY-2021, the subject experienced dizziness (could not walk). On 16-MAY-2021, the subject experienced extreme weakness. On 16-MAY-2021, the subject experienced wiped out. On 17-MAY-2021, the subject experienced diarrhea. On 17-MAY-2021, the subject experienced felt a little nauseous. Treatment medications (dates unspecified) included: bismuth subsalicylate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt a little nauseous on 17-MAY-2021, and muscle pain, was recovering from diarrhea, had not recovered from extreme weakness, and the outcome of dizziness(could not walk) and wiped out was not reported. This report was non-serious.


VAERS ID: 1333196 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Dizziness, Fatigue, Loss of consciousness, Nausea, Syncope, Vomiting
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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No Known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had a bout of syncope without warning. He awoke less than 3 minutes later disoriented. He felt light-headed and nauseous for several minutes and vomited but produced nothing substantial. Patient was monitored for 30 minutes and felt tired and light-headed for most of that time. He recovered fully and left of his own accord.


VAERS ID: 1333277 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bed rest, Dizziness, Emotional distress, Fatigue, Feeling abnormal, Gait disturbance, Pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin, multivitamin, calcium, glucosamine, fish oil, vitamin D
Current Illness: none
Preexisting Conditions: IBS
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woozy and stumbled that evening. Next day extreme body aches and fatigue requiring bed rest. Same for the day after (Sunday). Bedridden for majority of the two days after second dose of vaccine. Miserable suffering. I''ve experienced the flu with a sinus infection. This felt more than twice as bad.


VAERS ID: 1333317 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, General physical health deterioration, Lethargy, Magnetic resonance imaging head normal, Mental status changes, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: donepizil, coumadin, metformin, famotidine, imdur, tamsulosin
Current Illness:
Preexisting Conditions: NPH s/p VP shunt CAD PE
Allergies: wellbutrin, dilatin, keppra
Diagnostic Lab Data: MRI brain negative
CDC Split Type:

Write-up: Approximately 2 weeks after receiving vaccination, patient developed confusion and lethargy. He presented to the hospital where he was found to be febrile. Alteration mental status continued to worsen, and then had a generalized seizure. Patient was empirically treated for possible meningoencephalitis but diagnosis is not confirmed.


VAERS ID: 1333323 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, Fall, Feeling hot, Head injury, Loss of consciousness, Seizure like phenomena
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No
Diagnostic Lab Data: accucheck at 1130 was normal per EMS.
CDC Split Type:

Write-up: Patient received the Janssen vaccine. Less than 1 minute after receiving the vaccine, passed out and had seizure like activity for 10 sec. When he fell, his hit the right side of his head. When he came to, he knew where he was. Ambulance was called, he refused to go to the hospital. BP was 138/78 and pulse was in the 60''s. Leading up to passing out, reported that he felt warm, then passed out. After waking up and coming to, he was feeling better.


VAERS ID: 1333342 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dizziness, Injection site pain, Malaise, Nausea, Presyncope, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had vasovagal reaction and emesis immediately post vaccine admin. NO ALLERGY to vaccine. Okay to receive 2nd dose. At 1:37PM, 6 min post receiving vaccine, patient told mom that he felt lightheaded and was having pain at injection site left arm. Rn assessed immediately and pt reported feeling "sick". He drank few sips of water. MD called to bedside. I assessed pt at 1:39PM, pt sitting chair, elevated his legs onto the footrests of wheelchair sitting in front of pt. +Facial and lip pallor, and complaining of nausea followed by 1 episode NBNB emesis consisting of what he ate for lunch 1 hour prior. Pt immediately reported feeling better post emesis. Lips appeared pink. Pt brought to triage area, lay supine on stretcher with legs elevated. Nausea and "lightheaded" sensation resolved prior to lying down. BP improved post emesis from 75/39 to 84/46 at 1:48 PM. Stayed lying down for 5 minutes after which time pt wanted to sit up. Upon sitting BP and HR increased 96/64 and 69, stable with no nausea or lightheadedness, only remaining sx "slightly weak". drank 12 oz apple juice and ate 2 graham crackers without any further emesis or symptoms. Observed for 15 more minutes and was ambulating without return of symptoms, discharged home with mom and brother with instructions to seek medical care if symptoms return.


VAERS ID: 1333370 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Pain, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 5/17/2021- rapid PCR covid test, negative 5/19/2011- rapid antigen covid test, negative
CDC Split Type:

Write-up: Disclaimer: I was diagnosed with COVID in December 2020. This may be the reason why my symptoms were out of the ordinary. The first shot gave me a mild chills and pretty bad body pain, however, the second shot gave me a sore throat, nasal congestion, chest congestion, wet cough, body pain, and shortness of breath. In order to tally out a second exposure to Coronavirus, I got tested twice and was negative. These adverse symptoms started 4 hours after the 2nd vaccine and are still the same intensity. I?m taking mucinex and anti histamines but nothing has been helping much. I?m on my 6th day now.


VAERS ID: 1333392 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site discharge, Underdose
SMQs:, Medication errors (broad)

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

Write-up: ADMINISTERED COVID VACCINE (MODERNA 1ST DOSE) TO PT ON 5/14. PT WORKS IN THE STORE AND WAS ON HER WAY TO THE BACK OF THE STORE WHEN SHE NOTICED A CLEAR LIQUID RUNNING DOWN HER ARM FROM THE VACCINE ADMIN SITE. PT THEN TOOK OFF THE INJECT-SAFE BANDAGE AND SAID THERE WAS A CLEAR LIQUID POOLING IN THERE AS WELL. FROM THE DESCRIPTION, IT SEEMED THAT THE MAJORITY OF THE ADMINISTERED VACCINE LEAKED BACK OUT. PER RESEARCH FROM MODERNA/CDC, IT IS ADVISED THAT PT RECEIVE THE DOSE AGAIN, IN THE OPPOSITE ARM. PT WAS INFORMED ACCORDINGLY.


VAERS ID: 1333622 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Palpitations, Vaccine positive rechallenge
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Same reaction to previous (1st) Covid vaccine
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient was transported to the ED
CDC Split Type:

Write-up: Patient received her vaccine and then had a complaint of dizziness and palpitations that did not resolve.


VAERS ID: 1333629 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: C-reactive protein increased, Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram normal, Pericarditis, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 test negative, Troponin T increased, White blood cell count
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG - Diffuse ST elevation consistent with a dx of Acute Pericarditis Echo - Normal - normal function and no effusion - on bedside echo in the ER and normal 2 days later in the cardiology office. ESR and CRP mildly elevated at 18 and 2.4. Normal WBC. Negative RVP and Negative Covid-19. Troponin T slightly elevated at 0.23. CXR - Normal
CDC Split Type:

Write-up: Patient developed sudden onset of chest pain and shortness of breath worse with supine position. Patient went to the ER and ECG was done which was consistent with Acute Pericarditis. Patient was treated with Ibuprofen 600mg PO TID with resolution of his chest pain and SOB. patient was discharge home from the ER with cardiology follow-up 2 days later. Patient continues to have no chest pain or SOB and continues on Ibuprofen 600mg PO TID at this time. Repeat labs are pending.


VAERS ID: 1333708 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Blood fibrinogen increased, Computerised tomogram abdomen abnormal, Fibrin D dimer increased, Haematemesis, Headache, Heparin-induced thrombocytopenia test, Immunology test, Mesenteric vein thrombosis, Myalgia, Nausea, Platelet count decreased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg daily, smokes 1/2 ppd, no ETOH use
Current Illness:
Preexisting Conditions: Heart Failure, asthma
Allergies: Amoxicillin, Sulfamethoxazole
Diagnostic Lab Data: 5/19 CT abdomen indicated large thrombus in superior mesenteric vein. Platelets: 5/19 @ 0920= 226, @1349 = 140, 5/20 @ 0755 = 243; D-Dimer 10.72; Fibrinogen 469; HIT ELISA pending
CDC Split Type:

Write-up: Patient presented to hospital emergency department on 5/19/2021 with complaints of headache, myalgia, nausea, vomiting with hematemesis and severe abdominal pain (rated 8/10) that began on the 5/16. Patient started on argatroban for treatment of mesenteric vein thrombosis. Treatment course pending.


VAERS ID: 1333741 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Oropharyngeal pain, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Covid Test shown negative taken 5/18/21
CDC Split Type:

Write-up: Very sore throat lasting 7+ days and trouble breathing in and out throughout those 7 days


VAERS ID: 1334017 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN,
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: UNKNOWN
Diagnostic Lab Data: WE ARE NOT CURRENTLY AWARE OF ANY ADVERSE EFFECTS. Doctor IS MEETING WITH patient''s mother TO CHECK IN ON the patient AND MAKE AN APPROPRIATE REPORT. ONcE the patient''s fATHER FOUND OUT THAT WE WERE REPORTING HIM "allegedly" HE BECAME ANGRY WITH the patient''s MOTHER. WE WERE NOT ABLE TO ACCESS THE VACCINE RECORDS AND THE PATIENT WAS NOT REGISTERED UNDER THE CORRECT DOB, THE OPERATOR WAS NOT ABLE TO FIND BASED ON THE INFORMATION I WAS PROVIDED.
CDC Split Type:

Write-up: PATIENT''S MOTHER CALLED MY OFFICE TO SET UP AN APPOINTMENT. DURING THIS CALL, THE MOTHER INFORMED ME THAT WHEN the patient WAS WITH HER FATHER LAST WEEKEND HE "allegedly" TOOK HER TO A pharmacy AND LIED TO THE PHARMACIST ABOUT HER BIRTHDAY SO SHE COULD GET A COVID VACCINE SO HE COULD GO ON VACATION. PARENTS ARE DIVORCED AND MOM HAS SOLE CUSTODY AND FATHER IS NOT ALLOWED TO MAKE MEDICAL DECISIONS WITHOUT HER CONSENT. HE ALSO LIED TO THE PHARMACIST AGAIN WHEN THEY WERE CONFIRMING THE BIRTHDAY AND FALSIFIED MEDICAL DOCUMENTS TO MAKE IT APPEAR THAT the patient WAS ELIGIBLE FOR THE PFIZER COVID VACCINE.


VAERS ID: 1334090 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: A 11-year-old patient was inadvertently immunized with Pfizer-BioNTech COVID-19 vaccine which is approved for 12 years-old and older. Patient was observed for the recommended 15 minutes post-vaccination with no adverse events noted.


VAERS ID: 1334210 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site nodule, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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: Htn Thyroid
Preexisting Conditions:
Allergies: Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot at site, red, knot present, sore joints all over body, fatigue


VAERS ID: 1334331 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Chills, Computerised tomogram, Disturbance in attention, Dizziness, Feeling abnormal, Feeling drunk, Headache, Influenza like illness, Laboratory test, Lethargy, Limb discomfort, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Mobility decreased, Neurological examination abnormal, Pain in extremity, Pyrexia, Speech disorder, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: calcium carbonate/vitamin D 250-125 mg unit, collagen hydrolysate, glucosamine-chondroitin, levothyroxine 100 mcg, magnesium, multivitamin with zinc, omeprazole 40 mg, simvastatin 40 mg, vitamin D3 2000 units, vitamin E complex
Current Illness: none
Preexisting Conditions: Post Viral Vagal Neuropathy
Allergies: acetaminophen-hydrocodone, codeine, fentanyl, hydromorphone, morphine, oxycodone, tramadol
Diagnostic Lab Data: Ct scan mri of brain and spine complete lab workup
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA. Friday, Sat and Sun flu-like symptoms sore left arm pain extending into hand fever, chills, headache lethargy. Mon May 17 above symptoms with dizziness, spinning in head, hard to think and talk, affects speech everything is fuzzy, felt like I was very drunk. Both legs became heavy feeling and unable to move. Went to hospital. Transferred to hospital for neurological evaluation. Same symptoms on Tues May 18 with some resolution later in the day. Early in the day, a test where I was to follow a finger with my eyes only, and hold my head still, brought on the symptoms. Wed May 19, symptoms resolved and I was discharged. Today, Thurs, May 20, 9:00 am, I had a 20 min episode of dizziness, spinning in head, hard to think and talk, speech was affected and I felt like I was drunk, balance was affected, but no lower leg mobility issues. I had another episode at 11:00 am of longer duration (45 mins) but the same symptoms.


VAERS ID: 1334518 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Public       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: Guardian stated age is 12 (actual age under age of 12)


VAERS ID: 1334629 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute left ventricular failure, Brain natriuretic peptide increased, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram abnormal, Epstein-Barr virus antibody negative, Left ventricular dysfunction, Respiratory viral panel, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Tachycardia, Tachypnoea, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ritalin TID, melatonin nightly, benadryl prn
Current Illness: none
Preexisting Conditions: Autism with ADHD, Obesity with BMI 40, Obstructive sleep apnea
Allergies: none
Diagnostic Lab Data: Troponin 0.08 (5/18), Viral Respiratory Panel nasal swab negative (5/17), BNP 616 (5/19), EBV antibody panel negative (5/18), Covid IgG antibody negative (5/18), COVID 19 PCR neg
CDC Split Type:

Write-up: 17-year-old male with a past medical history notable for autism who presents with 3-day history of worsening tachypnea, shortness of breath tachycardia. Patient presents with elevated BNP and troponin as well as severely depressed LV function on echocardiogram with associated EKG changes. Echo on admission with EF 22% and severe acute LV systolic and diastolic heart failure. Now on milrinone 0.5 mcg/kg/min, Lasix 20 mg IV q8h. Repeat 5/18 today continues with severe dysfunction, EF 28%. Troponin 0.09, BNP 616. Started carvedilol 5/19.


VAERS ID: 1334663 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:
Current Illness:
Preexisting Conditions:
Allergies: Contrast media, formaldehyde, naproxen, flu vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has history of allergic reaction to flu vaccine that was not disclosed at the time of vaccination. patient had premedicated with pepcid and benadryl prior to vaccination. Developed an itchy throat while in the vaccine clinic after vaccination


VAERS ID: 1334753 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210529884

Write-up: COVID-19 VIRUS TEST POSITIVE.; This spontaneous report received from a physician concerned a male patient in his 40s (exact age unknown), of an other race and unknown ethnic origin. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested No concomitant medications were reported. Four days after vaccination, the patient tested positive for covid-19 (covid-19 virus test positive).The doctor wanted to know if the vaccine could cause a positive test. The action taken with covid-19 was not applicable. The outcome of covid-19 virus test positive. was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.


VAERS ID: 1334782 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: Polymerase chain reaction; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210535251

Write-up: CONFIRMED COVID-19 INFECTION; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 06-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-MAY-2021, the subject experienced confirmed covid-19 infection. Laboratory data included: Polymerase chain reaction (NR: not provided) Positive. Treatment medications included: favipiravir. The action taken with covid-19 vaccine was not applicable. The outcome of confirmed covid-19 infection was not reported. This report was non-serious.


VAERS ID: 1334784 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prostate cancer stage IV (patient is in hospice); Sulfonamide allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210535276

Write-up: VOMITING; NAUSEA; FATIGUE; SURGE OF ENERGY; This spontaneous report received from a patient concerned a 68 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included stage 4 prostate cancer, and sulfonamide allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-MAY-2021, the subject experienced surge of energy. On 16-MAY-2021, the subject experienced vomiting. On 16-MAY-2021, the subject experienced nausea. On 16-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine was not applicable. The patient recovered from surge of energy on 16-MAY-2021, and had not recovered from nausea, vomiting, and fatigue. This report was non-serious.


VAERS ID: 1334924 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Injection site pain, Mobility decreased, Pyrexia, Somnolence
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: High fever approximately 12 hours after injection of second shot and drowsiness approximately 4 hours after injection. During the fever, had significant trouble walking and moving any part of body. Significant arm soreness at site of injection. All symptoms resolved themselves within 24 hours of receiving the vaccine aside from the arm soreness which resolved itself within 72 hours.


VAERS ID: 1335992 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Pruritus, Pyrexia, Rash morbilliform, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Developed itching of scalp 2 hours post injection, spread to arms the next day. 3 days later developed hives over her wrist and knees. On day 4 hives worsened, and experienced brief (~1hr) period of chest heaviness that self resolved. Treated with Zyrtec which helped itch for a day. Benadryl not helpful. Day 5 woke with morbilliform rash over trunk and fever to 101.9, lasted a few hours, all symptoms resolved over the course of day 5.


VAERS ID: 1336040 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Echocardiogram normal, Electrocardiogram ST segment depression, Electrocardiogram ST segment elevation, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Troponin up to 15 ng/ml Initial EKG -- Mild ST segment elevation in lead I, aVL, and V3-V6, mild ST segment depression in lead III and V1 Echocardiogram essentially normal CRP 6 mg/dl
CDC Split Type:

Write-up: About 18 hours after the vaccine was given, the patient developed chest pain. The chest pain progress over about 24 hours to 9/10. He presented to the ER where he was found to have elevated troponin (up to 15) and ST changes on EKG. Echo was normal x2. He was treated for myopericarditis with NSAIDs and colchicine. He quickly improved. No clear etiology of his myopericarditis was identified, raising suspicion that it may have been an adverse reaction to the vaccine.


VAERS ID: 1336105 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0668 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cold sweat, Hallucination, Headache, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, Streptococcus test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications
Current Illness: No other illness
Preexisting Conditions: No chronic illness
Allergies: Penicillin
Diagnostic Lab Data: Covid-19 test 05/18/2021 awaiting result Streptococcus swab 05/18/2021 Negative
CDC Split Type:

Write-up: Fever, Chills, Headache, Severe Muscle Ache, Sore Throat, Cold Sweats, Hallucinations for 8 days.


VAERS ID: 1336132 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

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

Write-up: Tinnitus, ringing in my left ear and slight hearing loss


VAERS ID: 1336484 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hyperventilation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad)

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

Write-up: Patient began hyperventilating after receiving vaccine. Observed by provider on site. No intervention required. Parent stated that this has happened previously with other vaccines.


VAERS ID: 1337140 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-10
Onset:2021-05-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Haematocrit normal, Haemoglobin normal, Immune thrombocytopenia, Immunoglobulin therapy, Platelet count decreased, Thrombocytopenia, White blood cell count normal
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin PRN, triamcinolone ointment, collagen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 5/19/2021 WBC 7.1, hgb 14.0, HCT 41.4, PLT 1
CDC Split Type:

Write-up: Immune Thrombocytopenic Purpura (ITP) Admitted to Hospital 5/19 - 5/21/21 for severe thrombocytopenia with PLT down to 1. Responded to IVIG and steroids and discharged. Will have ongoing clinic follow with oncology, undetermined if will be recurrent or chronic.


VAERS ID: 1337253 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-05-14
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19 pneumonia, Computerised tomogram abnormal, Cough, Pneumomediastinum, SARS-CoV-2 test positive, Subcutaneous emphysema, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis Albuterol Cozaar Tenormin
Current Illness: None Known
Preexisting Conditions: HTN Osteopenia Diverticulitis Asthma Parkenson
Allergies: Aspirin Codiene Atenolol Lisinopril Tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted with Covid Pneumonia when fully vaccinated. PMH significant for parkinson''s, RA, HTN, Asthma, chronic hypoxia on 3L at baseline , PE/DVT who was admitted to HCF on 5/14/21 for evaluation of symptoms of right neck swelling of 2 day duration. Work up in the ED was significant for large pneumomediastinum; large subcutaneous emphysema. She was also Covid -19 positive ( was positive in January and has received both her Pfizer vaccine doses). CTS was consulted. CTS attributed the findings to Covid 19 and associated cough


VAERS ID: 1337507 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Dyschezia, Dysuria, Fatigue, Gait disturbance, Headache, Pain in extremity, Pelvic pain, Pruritus, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 3 days of severe abdominal and pelvic pain that was debilitating. Patient was hardly able to walk - she had extreme pain with urination and defecation. She also had headache, fatigue, arm pain, fever and rash - hives, with pruritus of scalp.


VAERS ID: 1337531 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Seizure, Syncope, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient had syncopal episode with seizure. Diaphoretic and hives noted after regaining consciousness.


VAERS ID: 1337570 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-08
Onset:2021-05-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Facial paresis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Augmentin, cipro, Keflex
Diagnostic Lab Data: seeing neurology - will have MRI this week
CDC Split Type:

Write-up: Bell''s palsy - left sided facial weakness also with forehead weakness on the right


VAERS ID: 1337712 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-14
Onset:2021-05-14
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: multi-vitamin; folic acid
Current Illness: no
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data: Ultrasound last Friday, 5/14/2021
CDC Split Type: vsafe

Write-up: I have miscarriage - they aren''t sure when it happened. The heart beat had stopped when they did an ultra sound last Friday. Pregnancy history - first; Estimated date of delivery - 12/31/2021


VAERS ID: 1337800 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Arteriogram coronary normal, Brain natriuretic peptide increased, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Dyspnoea, Echocardiogram abnormal, Magnetic resonance imaging head abnormal, Magnetic resonance imaging heart, Malaise, Myocarditis, Troponin increased, Ventricular hypokinesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mens Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Eggs - rash or upset stomach
Diagnostic Lab Data: High sensitivity Troponin on 5/16/21 - 1400 which increased to 6000 in the ER Mildly elevated BNP 5/16/21 CXR normal on 5/16/21 Echocardiogram - global hypokinesis on 5/16/21 Coronary Angiography with clean coronary arteries on 5/18/21 Coronary MRI wwo contrast on 5/18/21 showed 1. Areas of T2 signal abnormality and late gadolinium enhancement in a nonischemic distribution, primarily involving the lateral wall of the left ventricle, but with inferior wall and septal involvement also. These changes are compatible with acute myocarditis.
CDC Split Type:

Write-up: MYOCARDITIS: Patient developed chest pain and shortness of breath. He was seen by me in the emergency department on 5/16/21 and was found to have an elevated troponin. He was admitted to the hospital and underwent a coronary angiogram which was normal. He has evidence of some global hypokinesis on his echocardiogram and eventually had a cardiac MRI which confirmed that he has myocarditis. He became ill the day after his 2nd Moderna shot and then more ill the next few days and I saw him on Day #3 after his 2nd shot. He is otherwise healthy. He was hospitalized for two days. He was discharged on Losartan and Metoprolol and was not on any medications prior to his presentation.


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