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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 166 out of 3,524

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VAERS ID: 1337924 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-18
Onset:2021-05-14
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Deep vein thrombosis, Echocardiogram abnormal, Ejection fraction normal, Pain in extremity, Peripheral swelling, Pulmonary embolism, Right ventricular dysfunction, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Pulmonary hypertension (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: anxiety, depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient transferred from outlying hospital for higher level of care. Patient had previously presented to ED with complaint of localized pain in the right calf for 4-5 days. Patient also noticed swelling in R calf. CT chest showed acute pulmonary embolism within distal right pulmonary artery extending into the segmental arteries to both right upper and right lower lobes. Patient was treated with heparin drip. Echo showed EF 68% and hypokinetic free right ventricular wall and apex. Echo also showed reduced right ventricular function. Patient underwent bilateral lower extremity duplex ultrasound which showed acute right femoral, popliteal, posterior tibial and peroneal vein thrombosis. Patient was transitioned and discharged to home. Patient received J&J COVID-19 vaccine in March 2021. Patient denies cigarette smoking/vaping, illicit drug use, ETOH use. Denies recent travels or long distance travels. Denies use of oral contraceptives.


VAERS ID: 1337926 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Massachusetts  
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 EW0182 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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

Write-up: pts neck started swelling after taking the vax. she was having a hard time breathing due to the swelling. she went to Hospital ER. pt was triaged and then left due to the situation at the hospital. Pts mother gave her Advil and was monitored all night. The swelling seemed to be better the next day. She had fatigue that lasted about 3 days. Parents called the Pediatrician. They were advised to call her Endocrinologist. They recommended her back to Pediatrician due it being a immune reaction. They called an infectious disease specialist which recommended her to an allergist. Pt has follow up appts next week for thyroid.


VAERS ID: 1338137 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nevada  
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 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Cardiac flutter, Cardiac monitoring abnormal, Chest X-ray, Chest pain, Computerised tomogram thorax, Condition aggravated, Decreased appetite, Diarrhoea, Disturbance in attention, Ear pain, Echocardiogram, Electrocardiogram abnormal, Extrasystoles, Fatigue, Headache, Hypertension, Injection site pain, Injection site swelling, Mental impairment, Nausea, Pain, Pulse abnormal, Sleep disorder, Ventricular extrasystoles
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Hypokalaemia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Torsemide Potassium Vitamin C Zinc Calcium Vitamin D
Current Illness: Became sick 2 weeks before vaccine with headache, then 7 days before vaccine I had a headache, nausea, diarrhea, and fatigue ( I slept for 4 days with only a few hours awake. I had a covid test 6 days before my vaccine at pharmacy and it was negative.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: May 18, 2021 - ER visit, EKG, Blood work, CT scan, Chest x-rays, Echo cardiogram, hospital admission. May 19, 2021 - In Hospital May 20, 2021 - In Hospital - discharged later in the day
CDC Split Type:

Write-up: Day of Vaccine Friday May 14 Almost immediately following the vaccine I had a severe headache and nausea. I was unable to eat anything the entire rest of the day. A few hours later I experienced severe diarrhea. Saturday May 15th Moderate pain at injection site Severe headache Moderate body aches Mild fatigue Moderate diarrhea Sunday May 16th During the day Mild pain and mild swelling at the injection site Moderate headache Moderate fatigue Sharp intermittent pain in both ears that lasted a few hours After bed I had a severe headache and moderate nausea that woke me in the middle of the night. I took tylenol and drank some gingerale. Monday May 17th Mild headache Mild fatigue Mild nausea Tuesday May 18th I was feeling ok with only mlid fatigue then later in the afternoon my heart started fluttering. My pulse kept dropping into the 40''s then going high into the 120''s. I was having chest pain''s and my blood pressure was higher than normal. My oxygen level was good. Around 10pm my husband brought me to the emergency room. My BP was 181/98 when I arrived. They did an EKG immediately and said I had multiple PVC''s. Then they did chest x-rays, a CT scan, blood work and an echo cardiogram. The heart monitor over the next few hours showed frequent PVC''s and Bigeminy. They started me on heparin and admitted me. May 19th I was in the hospital and experienced a moderate headache and nausea. They continued the heparin and IV fluids and also gave me potassium. The PVC''s continued but were less frequent. May 20th I was discharged from the hospital later in the day. I had a moderate headache and moderate nausea. The PVC''s continued but less frequent. May 21st Moderate headache Moderate fatigue Moderate nausea I''m not thinking clearly and I''m having troubles concentrating. My headache woke me up at 2am and I could not get back to sleep until almost 3am when the tylenol finally took the edge off.


VAERS ID: 1338330 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: superficial thrombophlebitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ECG 5/18/21 and 5/20/2021
CDC Split Type:

Write-up: possible pericarditis


VAERS ID: 1338398 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-01
Onset:2021-05-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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 vitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had bloody noses for 3 days after my vaccine of J and J.


VAERS ID: 1338600 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
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 (JANSSEN)) / JANSSEN ZOLAZIA / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Back pain, Decreased appetite, Dizziness, Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, severe fatigue, arm pain, loss of appetite, GI upset, low grade fever, light headacheness, back pain,


VAERS ID: 1338627 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Unknown  
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 EW0193 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, Blood creatinine increased, Blood test, C-reactive protein increased, COVID-19, Chest pain, Computerised tomogram, Costochondritis, Dyspnoea, Echocardiogram abnormal, Myocarditis, Pain, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Troponin increased, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), 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 (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Enbrel injection(didnt take 2 weeks prior to vaccination); Leflunomide, omeprazole, marvelon birth control. Fluoxetine(never took for a month prior to vaccine.
Current Illness: Juvenille Arthritis
Preexisting Conditions: None Diagnosed with JA approx 2 years ago.
Allergies: None
Diagnostic Lab Data: May 17- Blood test - Tropolin numbers high and Cr, high Crp levels, cat-scan, ultrasound. May 18, May 19- blood tests, heart ultrasound. 2 positive tests with low numbers for covid Continual blood tests checking Troponin level, crp. Did antibody serum testing to check for pre covid- test positive.
CDC Split Type:

Write-up: Chest pains, difficulty breathing, outcome: diagnosed with myopericarditis and costochondritis as well as inflammation in joints. Was in the hospital for 7 days and was on IV, morphine and then switched to hydro-morph for severe pain. Was given ketorlax via Iv for inflammation as well and steroids. Has been put on steroids for 1 month, Colchicine for 3 months, naproxen for inflammation.


VAERS ID: 1338628 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-02
Onset:2021-05-14
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure fluctuation, Blood pressure increased, Blood test abnormal, Catheterisation cardiac abnormal, Condition aggravated, Electrocardiogram abnormal, Hypertension, Myocardial infarction, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Hypertension (narrow), Cardiomyopathy (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: Aspirin 81mg, daily Atorvastatin 40mg, daily Fenofibrate 145mg, daily
Current Illness: None
Preexisting Conditions: Heart disease
Allergies: None
Diagnostic Lab Data: May 14th, 2021. Blood test and EKG determined I had a heart attack. Heart cath-lab determined it was due to a clot.
CDC Split Type:

Write-up: Although I have heart disease, and had triple bypass surgery three years ago, I consistently take my blood pressure. My blood pressure has been in a normal range since the operation, and following receiving the first dose of the vaccine it became elevated and I needed to go back on an old medication. Even then, my blood pressure was erratic. Two weeks after my 2nd COVID shot I had a heart attack due to a blood clot. This clot was able to be removed by a heart cath-lab. This could be a coincidental flare up due to an old issue, but the timing aligns with both doses of the vaccine.


VAERS ID: 1339087 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-06
Onset:2021-05-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 018B21A / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiovascular evaluation, Pulmonary embolism, Respiratory failure, Ultrasound Doppler, Ventilation/perfusion scan
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), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Citalopram 20mg daily fluticasone-vilanterol inhaler 1 puff daily lisinopril 5 mg daly
Current Illness: none
Preexisting Conditions: Hypertension COPD
Allergies: contrast?
Diagnostic Lab Data: venous doppler, VQ scan, cardiac evaluations.
CDC Split Type:

Write-up: onset of respiratory failure on 05/14/2021 to be eventually diagnosed with pulmonary embolism. hospitalized at facility .


VAERS ID: 1340210 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Facial paralysis, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Abstains from alcohol; Asthma; Cigarette smoker
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210532244

Write-up: FEVER; ANAPHYLACTIC REACTION (PASSING OUT/ COULD NOT BREATH/ SWOLLEN LIPS AND FACE); LIPS WERE DROOPING TO THE RIGHT SIDE OF FACE; This spontaneous report received from a parent concerned a 22 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included asthma (as a child), non-alcoholic, and cigarettes smoker. The patient experienced drug allergy when treated with Tamiflu (oseltamivir phosphate). The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown, expiry: unknown, NDC number: 59676-0580-15) dose was not reported, 1 total administered on 14-MAY-2021 at 10:00 for prophylactic vaccination on left arm. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-MAY-2021, as soon as the patient got the shot (within the 15 minutes of wait at the pharmacy), he had an anaphylactic reaction. It was further reported that he could not breath, his lips and face started to swell and then he passed out. The patient was taken to ER (emergency room) and his doctor gave him EpiPen (epinephrine) shot, Medrol (methylprednisolone), Benadryl (diphenhydramine hydrochloride) and IV (intravenous) fluids. The patient''s lips were drooping to the right side of his face even after taking the medications. The patient stayed at the ER for 6 or 7 hours then was sent back to home on the same day. On 15-APR-2021 (reported as Saturday), the patient had fever. On 16-MAY-2021 (reported as yesterday from the date of reporting), the patient was much better, and his drooping lips was there a little bit but not as bad. The reporter did not have patient''s vaccination card (for lot number or expiration date). The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from anaphylactic reaction (passing out/ could not breath/ swollen lips and face) on MAY-2021, and was recovering from fever, and lips were drooping to the right side of face. This report was serious (Other Medically Important Condition, and Life Threatening).; Sender''s Comments: V0: 20210532244-COVID-19 VACCINE AD26.COV2.S-ANAPHYLACTIC REACTION. This event(s) is considered related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and is scientifically plausible. There is no information on any other factors potentially associated with the event(s). 20210532244-COVID-19 VACCINE AD26.COV2.S-LIPS WERE DROOPING TO THE RIGHT SIDE OF FACE. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1340496 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Appendicitis, Computerised tomogram, SARS-CoV-1 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: CT scan; Result Unstructured Data: Test Result:Acute Appendicitis; Test Date: 20210514; Test Name: Nasal swab; Test Result: Negative ; Comments: Nasal Swab,
CDC Split Type: USPFIZER INC2021549686

Write-up: appendicitis/diagnosis was acute appendicitis with prerenal azotemia; appendicitis/diagnosis was acute appendicitis with prerenal azotemia; This is a spontaneous report from a contactable consumer. A 22-years-old male patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in Arm Left on 11May2021 12:45 (Batch/Lot Number: EW0176) as SINGLE DOSE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient previously received the first dose of BNT162B2 on 20Apr2021 for covid-19 immunization (lot_number=ER8735,lot_unknown=False, administration_date=20Apr2021,administration_time=12:30 PM, dose_number=1,vaccine_location=Left arm]. He did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced appendicitis/diagnosis was acute appendicitis with prerenal azotemia on 14May2021 10:00 with outcome of recovering, lower abdominal pain on 14May2021 10:00 with outcome of recovering. The patient was hospitalized for appendicitis/diagnosis was acute appendicitis with prerenal azotemia for 2 days.The patient was hospitalized for lower abdominal pain for 2 days. The patient underwent lab tests and procedures which included computerised tomogram: acute appendicitis on 14May2021, sars-cov-1 test negative: negative on 14May2021 Nasal Swab. Three days after receiving his second dose, he noticed lower abdominal pain, which resulted in visit to his primary care physician, who suspected appendicitis. He was immediately sent to the hospital for a CT scan that Friday night, and had surgery to remove my appendix Saturday morning. Official diagnosis was acute appendicitis with prerenal azotemia. He was discharged Sunday afternoon. Therapeutic measures were taken as a result of all events. The all events were reported as seriousness criteria of life-threatening. Information on lot/batch number was available. Additional information has been requested.


VAERS ID: 1340665 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: maybe a cold, I have kids so its hard to remember if I got the sniffles from one of them
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: my arm got hard at the injection site almost immediately and sore, the feeling and hardness has persisted for more than 7 days.


VAERS ID: 1340716 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-22
Onset:2021-05-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall, asa, atorvastatin, remeron, nicotine patch, oxycodone
Current Illness: None
Preexisting Conditions:
Allergies: PCN, nickel
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented in the ED on 5/14/20 at Hospital with a left sided stroke. Was treated with alteplase. Pt was then transferred to another Hospital


VAERS ID: 1340825 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-30
Onset:2021-05-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Abnormal uterine bleeding, Asthenia, Back pain, Biopsy endometrium, Blood test, Chest pain, Dizziness, Dyspnoea, Endocrine test, Fatigue, Full blood count, Glucose urine present, Haematuria, Menstrual disorder, Muscle spasms, Pain in extremity, Palpitations, Pelvic pain, Thirst, Ultrasound scan, Urinary tract infection, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Fertility disorders (broad), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? Yes
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: PRESCRIPTION: ATENOLOL 50MG 1X DAILY SUPPLEMENTS: MULTI VITAMIN D-3 GLUCOSAMINE/CHONDROITIN PRO/PRE BIOTICS BIOTIN VITAMIN C L LYSINE RED YEAST RICE CO Q10
Current Illness: NO KNOWN ILLNESSES ONE MONTH PRIOR OR AT TIME OF VACCINE SUDDEN UTI- POST VACCINE- BEGIN 5-7-21 SUGAR IN URINE UNSPECIFIED HEMATURIA
Preexisting Conditions: UTERINE FIBROIDS- BULK SYMPTOMS ONLY- NO HISTORY OF BLEEDING SYMPTOMS IBS- BARRETT''S ESOPHAGUS HYPERTENSION- CONTROLLED
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: BLOOD TESTS- HORMONE LEVELS/CBC ENDOMETRIAL BIOPSY ULTRA SOUND
CDC Split Type:

Write-up: PFIZER VACCINE- DOSE 1 -4/30/2021 5/7/2021- SUDDEN ONSET UTI- UNSPECIFIED HEMATURIA- SUGAR IN URINE LEG CRAMPING/PAIN FATIGUE SEVERE PELVIC PAIN SEVERE BACK PAIN SHORTNESS OF BREATH HEART PALPITATIONS DURATION- STARTING 5/1/2021- CURRENTLY 5/14/2021 SUDDEN ONSET- UTERINE/VAGINAL BLEEDING -PROFUSE!!! DURATION- 5/14/2021- 5/17/2021- PROFUSE/HEAVY 5/18/2021- 5/22/2021 (AS OF THIS SUBMISSON)- LIGHT SPOTTING (NOTE- LAST MENTRUAL CYCLE- 2/2021- DID NOT MENSTRUATE 3/2021 OR 4/2021) DIZZINESS/RACING HEART/LEG PAIN/CHEST PAIN/SHORTNESS OF BREATH/THIRST/EXTREME WEAKNESS AND FATIGUE


VAERS ID: 1341019 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-26
Onset:2021-05-14
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Anticoagulant therapy, Blood test, Computerised tomogram abdomen, Computerised tomogram abnormal, Echocardiogram, Electrocardiogram, Exposure during pregnancy, Induced labour, Inflammation, Pre-eclampsia, Pulmonary embolism, Ultrasound Doppler normal
SMQs:, Embolic and thrombotic events, venous (narrow), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, b6, unisom, lexapro
Current Illness: None
Preexisting Conditions: None
Allergies: N/a
Diagnostic Lab Data: CTA, CT abdomen/pelvis, ultrasound abdomen, ultrasound bilateral lower extremities, EKG, cardiac echo, and blood work which occurred multiple times. This was all from 5/14-5/16/2021
CDC Split Type:

Write-up: I gave birth to a healthy baby boy who was 4 weeks early on 5/10/21. I had developed severe preeclampsia the week prior and had to be induced. The baby weight 6lbs 140z. I developed a pulmonary embolism on 5/14, just four days after delivering. I do not take birth control pills nor have I ever smoked. I do not have a personal or family history of blood clots. I was in the hospital from 5/14-5/16 for management of the PE. I am now on blood thinners for at least 3 months. The doctors are not positive as to where the clot came from, but think possibly the ovarian vein which is very rare. CT scan did not show any active thrombus, just signs of inflammation to that are. Bilateral lower extremity Doppler ultrasounds were negative. I will be worked up by hematology to make sure I do not have a clotting disorder as a clot from the ovarian vein is so rare.


VAERS ID: 1341255 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood culture, Blood thyroid stimulating hormone, Brain natriuretic peptide, Chest X-ray, Electrocardiogram, Full blood count, Heart rate increased, Metabolic function test, Pyrexia, Tachycardia, Thyroxine free, Toxicologic test, Troponin, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buproprion SR 150 mg tablet - 1 tablet two times per day
Current Illness: Anxiety- buproprion started 2 weeks prior with dose increase a few days prior to admission
Preexisting Conditions: ADHD, anxiety
Allergies: None
Diagnostic Lab Data: EKG, chest x-ray, free T4 and TSH, troponin, creatine kinase, comprehensive metabolic panel, pro-BNP, blood culture, urinalysis, urine toxicology screen, complete blood count all were done on 5/14/21
CDC Split Type:

Write-up: Tachycardia began at 27 hours after vaccine with hear rate up to the 160s . Fever developed after the tachycardia 31 hours after vaccine. Patient was monitored in the hospital on propranolol and was sent home on propranolol.


VAERS ID: 1341309 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: PATIENT RECEIVED SINGLE DOSE JOHNSON AND JOHNSON COVID 19 VACCINE ON 5/14/2021 AFTER HAVING RECEIVED FIRST DOSE MODERNA COVID 19 VACCINE ON 4/22/2021.


VAERS ID: 1341677 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177.CCC-MN / 1 LA / UN

Administered by: School       Purchased by: ?
Symptoms: Dysarthria, Mental impairment
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Nonw
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: slurred speech, difficulty putting thoughts into words, difficulty completing a whole sentence when talking occurred almost immediately after receiving the vaccine (within 15 minutes or so) lasted for about 8 hours


VAERS ID: 1341869 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin c medications for heart failure & hypertension
Current Illness: none
Preexisting Conditions: heart failure
Allergies: none
Diagnostic Lab Data: did not go to the doctor or hospital
CDC Split Type:

Write-up: fever, chills, chest pain/dizziness for 4 days starting 48 hours after vaccine - dizziness - SOB since


VAERS ID: 1342073 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-04
Onset:2021-05-14
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Echocardiogram, Electrocardiogram, Fibrin D dimer, Myocardial infarction, Troponin
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft 50mg Drospirenone and ethynyl estradiol 3mg Cefuroxime 500mg
Current Illness: Ear infection
Preexisting Conditions: CSF leak through ear
Allergies: Sulfa, morphine, paraphenylenediamine
Diagnostic Lab Data: Troponin, d-dimer, ekg, angiogram, echocardiogram
CDC Split Type:

Write-up: Myocardial infarction (NSTEMI)


VAERS ID: 1342077 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

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

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

Write-up: OUTSIDE OF FDA APPROVED AGE RANGE


VAERS ID: 1342408 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypomenorrhoea, Menstruation irregular
SMQs:, Fertility 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: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Early period lasting for 9 days. Normal period is 5 days. Started after 21st day if previous cycle. Average cycle length is 30 day. Very light flow with dark brown color for first few days. Started 5/14, ended 5/22


VAERS ID: 1342420 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Headache, Impaired work ability, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Very ill feeling started on the following morning from the vaccination. Joint and muscle ache, chills, headache, stomach ache and fever. The symptoms were severe on the first day, and they were gradually fainting during the next two days. Was unable to work on the next day following the vaccination.


VAERS ID: 1342438 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: ?Moderna COVID-19 Vaccine EUA?


VAERS ID: 1342969 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Injection site erythema, Injection site inflammation, Injection site swelling, Injection site warmth, Malaise, Pain, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Body aches, chills, swollen throat, severe head ache, dizzy. Got sick around 10 pm on Friday 5/14/2021. Felt better Sunday morning 5/16/2021. The injection sick had a large red circle, swollen inflamed and hot to touch. That went away on Tuesday 5/18/2021.


VAERS ID: 1343019 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Injection site discolouration, Injection site papule, Injection site pruritus, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 76 year old female received the 2nd dose of the Moderna COVID-19 vaccine at Church on 05/14/2021 @ 09:15. Same day 05/14/2021 pt started experiencing errythema and site of injection was warm to touch. On 05/20/2021 pt started experiencing pruritus at the site of injection. On 05/21/2021 pt noticed a pimple at the site of injection and discoloration of the injection site from red into a more blue color. Pt placed peroxide and neosporin on injection site on 05/22/2021. Pt denies any allergies. Pt takes Levothyroxine and multivitamins. Pt is diagnosed with hypothyroidism. Pt was advised to make an appointment with doctor to have the injection site physically examined.


VAERS ID: 1343108 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: is a 14 y.o. female who has a history of Hashimoto''s followed by Endo. also has no known allergies. She received the COVID vaccine on 5/14/2021 at 10AM. Per notes, 10- 12 hours later, she developed throat swelling and trouble swallowing. She went to ED, but left without being seen. There is no description of skin, mucous membranes or gastro-intestinal involvement. There is no description of respiratory distress following the events. There are no vital signs listed following the event (BPs, oxygen saturation, etc). She was given advil. The neck swelling "got better" the following day. will be getting an USS of the thyroid to assess.


VAERS ID: 1343136 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-05-14
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (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: I am taking a prescription for my blood clot.
Current Illness: No other illnesses.
Preexisting Conditions: I have a health condition essential thrombocythemia.
Allergies: No allergies to meds, foods, or products.
Diagnostic Lab Data: No medical test or lab test.
CDC Split Type: vsafe

Write-up: After vaccination my arm became swollen and the doctor told me it was a symptom from the vaccine.


VAERS ID: 1343147 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-08
Onset:2021-05-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Heart rate irregular
SMQs:, Cardiac arrhythmia terms, nonspecific (narrow)

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

Write-up: Irregular heartbeat lasting at least one week following my second dose of Pfizer. Began around May 14 & is beginning to settle as of May 23. Frequency has decreased immensely over the last few days. Was having irregular heartbeat consistently throughout the day for nearly five days straight & am now only experiencing 0-1 times per day. I am currently living out of the country & had returned to my home to receive my first dose of Pfizer in April. I had been home for one month before departing back on May 10th & began experiencing side effects four days after my return (roughly one week after my second dose). I currently do not have a doctor to report to back home, & had not yet seen my doctor here to report the irregularity. Note: I did not experience symptoms with my first shot.


VAERS ID: 1343151 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (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: Thought it was heart burn and did not go to doctors.
CDC Split Type:

Write-up: She complained of her heart hurting about two hours after vaccine was administered


VAERS ID: 1343169 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ELL0167 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angina pectoris, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, Losartan, hydrochlorthiazide, rosuvastatin, Vit D3, aspirin (81 mg)
Current Illness: Apparent, unconfirmed COVID infection. 2 week quarantine from onset of symptoms passed 1 week prior to getting vaccination. Sore throat, cough, fatigue, stomach pain, pain in lower thorax/lungs/ribs, irregular bowel movements, slight fever) I had been isolating most of last year, only necessary grocery and supplies shopping.
Preexisting Conditions: benign hypertension, supraventricular tachycardia, BPPV/vertigo, reactive airway disease without complication, overweight, osteoarthritis, hyperlipidemia, GERD
Allergies: Cumin, most antibiotics (penicillin, tetracyclines, erythromycin, sulfa/dimethoprim, cephalosporins)
Diagnostic Lab Data: I was in a remote area unable to get to care. (I''m staying in right now; could not find staff who knew my language at hospital an hour away.) I reported to my primary care physician at via their online communication system.
CDC Split Type:

Write-up: 2 days after vaccination I was awakened by acute, sharp pains in my left thorax in the region of my heart. They steadily got worse over the next half hour. I did not experience shortness of breath, swelling of extremities, or discoloration. The pains continued intermittently over the next several days with any exertion, lifting, etc. I started bed rest and limited activity and continued my hypertension and arrhythmia medication. Note: * I have not had any similar pains before this incident * I am due for vaccination #2 on June 2 * The Lot number above may be EUU0167. The handwriting on the card is difficult to determine L or U


VAERS ID: 1343186 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-04
Onset:2021-05-14
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Cough
SMQs:, Anaphylactic reaction (broad)

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

Write-up: Pt. states she developed an ongoing cough after the 1st vaccine.


VAERS ID: 1343204 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Feeding disorder, Myalgia, Nausea, Pain in extremity, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dulaglutide metformin cetirizine nph/regular insulin aspirin paroxetine atorvastatin lisinopril ferrous sulfate vitamin D3
Current Illness:
Preexisting Conditions: diabetes mellitus on insulin depression hyperlipidemia
Allergies: cat hair
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1-2 days after vaccination developed myalgias, arm soreness, and n/v/d. unable to tolerate solids. myalgias and soreness improved in 3-4 days, persistent n/v for a week now milder for the past 3 days.


VAERS ID: 1343271 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-05-14
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Gingival erythema
SMQs:, Gingival 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is not adverse, but noteworthy. I?ve had a bad tooth for roughly six months - pain with biting and I did not chew on that side. No visible signs on gum. I finally booked my root canal with a dentist. ONLY after the vaccine, I noticed exterior gum redness coincidentally around the same sore tooth. A few weeks go by after being vaccinated, and I notice my tooth doesn?t hurt anymore. I kept the dental appointment anyway, but no treatment required. The timing can only point to the vaccine probably ramping up my immune system and fighting whatever infection I was harboring in that tooth. While this may not be related to covid, the immune response factor was interesting to me - and hopefully you. There is no other explanation in my mind; and given the length of time it was sore, it doesn?t seem to be a coincidence.


VAERS ID: 1343391 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chest discomfort, Chills, Fatigue, Headache, Heart rate irregular, Musculoskeletal chest pain, Musculoskeletal discomfort, Nightmare, Oesophageal pain, Pain, Pain in jaw, Paraesthesia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Osteonecrosis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: seasonal allergies
Preexisting Conditions: Supra ventricular tachycardia, migraines, anxiety
Allergies: pollen - spring
Diagnostic Lab Data:
CDC Split Type:

Write-up: May 14 Low fever (100.4 at highest measure), chills, headache - lasted about 8 hours, treated with Tylenol and sleep Joint aches - in random places on body, but worst in left knee (moderate - severe pain when standing with weight on left leg) Fatigue May 15 High temp but not fever (99.8 or so) - slight feverish feeling Fatigue Pain on sides of ribcage about midway down, accompanied by tightness in chest and upper back, pain between left shoulder blade and spine, pain on right side of esophagus (?), pain in right jaw, heart rhythm felt normal speed but very hard - this all went away on its own after 1 - 1.5 hours Sharp pains in random places on body Tingling in feet and hands that came and went (mainly left hand, right foot) Nightmares


VAERS ID: 1343392 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Contusion, Fatigue, Headache, Injection site bruising, Insomnia, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc, b12, iron, multivitamin
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, fatigue, chills, fever, bruised arm at injection site, headache, insomnia. Used Tylenol at night to help with aches. Felt better the next night and normal 48 hours later.


VAERS ID: 1343396 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I''ve taken ibuprofen a couple of times.
Current Illness: Dealing with tendonitis in my knee that''s the reason for the ibuprofen.
Preexisting Conditions: No e
Allergies: Nope
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started to have blood coming out of my butt in the morning a week after the shot. The blood was enough to fill up my toilet but it only happens in the morning when I first wake up.


VAERS ID: 1343420 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-28
Onset:2021-05-14
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (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: Diovan 160/12 mg, levothyroxine 75mcg,
Current Illness:
Preexisting Conditions: Hypothyroidism HBP
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt says she has episodes of her heart was beating very fast and she gets very dizzy so she has to sit down. Pt went to pharmacy where she got the vaccine to get the literature about the side effects since she was not given at time of injection. She found out this could be a symptom from taking the vax. Pt says this symptom comes and goes and she is scared because she has never had this happen before. pt will contact her PCP.


VAERS ID: 1343429 (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: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Parent provided the incorrect date of birth in order to make child eligible to receive vaccine. After contacting insurance, father again gave me the incorrect date of birth, 5/1/2009. I asked him to contact insurance to clear up the matter. He later called back and told me he had provided the wrong birthday and would not be returning for the second dose. I am not aware of any actual adverse events suffered by the child.


VAERS ID: 1343438 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-10
Onset:2021-05-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Ear discomfort, Malaise, Oropharyngeal pain, Pain, Streptococcus test negative, Tinnitus, Vertigo
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hearing impairment (narrow), Vestibular disorders (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: N/a
Current Illness: None
Preexisting Conditions: Meniere''s Disease (in remission for 14 years).
Allergies: Sulfa, cats, juglans.
Diagnostic Lab Data: Strep test - negative.
CDC Split Type:

Write-up: 4 days afterwards, I developed intense tinnitus in my right ear (the one affected by Meniere''s) and fullness. The ringing, deafness & fullness continues until today. I have lost a lot of hearing acuity in both ears. I felt really ill (flu like) on 5/20/21. I had full body aches and severely sore throat. The PA prescribed Methylprednisolone 4 mg dosepak. I have been taking according to instructions. Today, I developed vertigo for the first time in 14 years.


VAERS ID: 1343457 (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: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Headache, Pain in extremity, Rash, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Heart Pain, Pain in left arm (shot in right), fatigue, lightheartedness, severe diarrhea, headache, sharp vision, rash, shortness of breath


VAERS ID: 1343644 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

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

Write-up: tinnitus for 10 days non stop


VAERS ID: 1343663 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Dyspnoea, Pharyngeal swelling, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pneumonia vaccine
Other Medications: advair levothyroxine vit D topiramate sertraline Montelukast tumeric
Current Illness: was not sick at the time
Preexisting Conditions: MS Emphysema hypothyroidism
Allergies: BENADRYL: Bradycardia - asthma BUSPAR: Dizziness (Moderate to severe) - vertigo PERTUSSIS VACCINES: Other (Severe) - hx of grand mall seizures PNEUMOCOCCAL VACCINE: Other - arm swelling, redness, pain TRAMADOL: Hives (Moderate) TYLENOL: Other (Moderate to severe) - hx of non alcoholic fatty liver disease
Diagnostic Lab Data: none
CDC Split Type:

Write-up: about 1 hour after receiving vaccine had swelling in throat resolved on own in 15 minutes. then 7 hours later returned with difficulty swallowing and breathing. started wheezing, felt light headed and dizzy, took epi injection.


VAERS ID: 1343760 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 UN / IM

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

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

Write-up: Patient fainted in the observation area after receiving vaccine. Patient was assessed by RN and refused EMS. Patient appeared flushed and diaphoretic. Patient was unaccompanied but waited for her mother to pick her up. Patient left in stable condition.


VAERS ID: 1343790 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Dysphagia, Pharyngeal swelling, Throat irritation, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol atorvaSTATin diclofenac gel Epi-Pen FLUoxetine hydrOXYzine ibuprofen loratadine metFORMIN nedocromiL ophthalmic
Current Illness: itching after first dose of vaccine, resolved with diphenhydramine
Preexisting Conditions: asthma, arthritis, COPD< emphysema, migraines, type 2 diabetes mellitus
Allergies: coconut, morphine, opioids, wasp, betadine, cephalosporins, iodine, kiwi, lidocaine, raspberry, strawberry, penicillin
Diagnostic Lab Data: Chest x-ray: no acute cardiopulmonary disease
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: fifteen minutes after immunization patient reported scratchy throat. Diphenhydramine administered immediately and patient noted to have patient oral airway with small amount of swelling noted at left side of back of throat but no tongue or lip swelling. Eight minutes later patient reported difficulty swallowing, vital signs within normal ranges, patient placed on oxygen. Three minutes later wheezing noted and increased difficulty swallowing reported: epinephrine administered and patient transported to emergency department (ED). Patient arrived to ED hoarse with scratchy throat; vital signs within normal ranges. Patient monitored for several hours, symptoms improved, and patient discharged to home stable with prescription for prednisone and follow-up in place.


VAERS ID: 1343817 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 - / IM

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

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

Write-up: received 2nd dose too early; 1st dose 4/23/2021, 2nd dose 5/14/2021


VAERS ID: 1343845 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Electrocardiogram abnormal, Enzyme level increased, Enzyme level test, Hyperhidrosis, Myocarditis, Palpitations, Pericarditis, Pyrexia, Respiration abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 200mg Lamotrigine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Unsure exact procedures and numbers. Multiple EKGs and blood enzyme laboratory tests throughout 5/15 and 5/16 indicating pericarditis and mild myocarditis throughout stay. Enzymes spiked at around 3AM 5/16.
CDC Split Type:

Write-up: Typical side effect symptoms experienced and cleared within 24 hours. Same symptoms returned (chills, low fever, heavy sweating, tense breathing) approx. 60 hours later along with severe aching chest pain. All symptoms resolved by next morning besides chest pain, which was severe enough to warrant emergency room admission about 72 hours after vaccination. Admitted to hospital overnight with an episode of palpitations around 6pm on the first night, being given motrin and colchicine throughout stay. Pain somewhat resolved and was discharged aprox. 100 hours after vaccination. Continued use of ibuprofen and colchicine in weeks following as pain slowly resolves.


VAERS ID: 1344008 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-08
Onset:2021-05-14
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline, Spironolactone, multi-vitamin, vitamin C, calcium plusD supplement, SAM-E, B12
Current Illness: Sinus Infection 4/6/2021 Upper Respiratory Infection 5/14/2021
Preexisting Conditions: Migraines
Allergies: Codine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Antibiotics, steroids, rest


VAERS ID: 1344134 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-30
Onset:2021-05-14
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Burning sensation, Feeling cold, Injection site pain, Injection site rash, Lymphadenopathy, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen 20mg
Current Illness: None
Preexisting Conditions: Breast cancer (remission)
Allergies: Allergy to diclofenac
Diagnostic Lab Data: No tests yet. Medical appointments forthcoming.
CDC Split Type:

Write-up: Soreness at injection site after first and second doses for a few days. Soreness in left armpit (swollen lymph nodes) after first dose for a few days. Tingling/burning/chilling sensation in feet (almost constant from onset till time of reporting - 10 days), sometimes also in legs and arms, and once in scalp. Rash at injection site two days after second dose (05/21/2021), still present at time of reporting. Swollen lymph node near left clavicle two days after second dose, still present at time of reporting. Swollen


VAERS ID: 1345266 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

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

Write-up: I have been experiencing heart palpitations ever since my second Modera shot. On the day of the vaccine, it happened roughly 10 times, the second and third days were similar. Slowly the palpitations became fewer and fewer, but now, 10 days after my shot, they seem to be increasing again. I am currently 20 weeks pregnant, due October 12.


VAERS ID: 1345394 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-05
Onset:2021-05-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor 75mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives all over body.


VAERS ID: 1345416 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Computerised tomogram, Headache, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D; magnesium;
Current Illness: none
Preexisting Conditions: none
Allergies: no
Diagnostic Lab Data: i went to Hospital, MD on May 20 for the tightness in my chest but they found nothing wrong after a chest x-ray and cat scan.
CDC Split Type:

Write-up: within 5 hours of receiving vaccine - i started itching all over my body - under my arms, stomach, chest and back of neck were the most inflamed area. this has now lasted for 10 days. I''m also experiencing tightness in my chest. I feel like someone is choking/pressing on my chest from the inside. I also had a fever, massive headache and muscle pains


VAERS ID: 1345422 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pneumonia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night 1 fever. Day 2,3,4,5 pneumonia.


VAERS ID: 1345435 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Fatigue, Feeling of body temperature change, Flatulence, Headache, Injection site erythema, Injection site pain, Injection site rash, Injection site swelling, Injection site warmth, Lethargy, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 34 years old: Moderna Covid initial dose 4/14/21, sore throat with swollen lymph nodes 4/17-5/1/21 and arm rash 4/22-4/28/21 1-2
Other Medications: Latanoprost eye drops, Iron, D3, Multivitamin
Current Illness: Swollen and sore lymph nodes neck and jaw 4/17/21-5/1/21 following initial Moderna Covid Vaccine dose. Arm rash 4/22/21-4/28/21 1-2 inches distal to injection site of initial Moderna Covid Vaccine dose.
Preexisting Conditions: Hashimoto''s autoimmune hypothyroid, Iron deficient, Increased eye pressure
Allergies: Sulfa drugs, seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 5/14/21 Sore and tender arm, overnight fever and chills, nauseous, body aches and pain especially neck, back, and hips. 5/15/21 Continued fever symptoms, throbbing headache, nearly passed out, light headed upon transitions from supine to sit or sit to stand. Fatigue and lethargy. Excedrine after nausea resolved decreased other symptoms somewhat. 5/16/21 Poor temperature regulation i.e. hot then cold all day, continued light headedness upon standing, less body aches, no longer nauseous but gassy with loose stools. 5/16-5/18/21 Warmth and swelling, mild redness and skin texture change right arm 1-2 inches distal to injection site, intermittent itching. Gradually decreased until resolved. 5/19/21 Mildly sore throat right side. All symptoms seem resolved by reporting date of 5/24/21.


VAERS ID: 1345438 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dysgeusia, Hypoaesthesia oral, Lip swelling, Oral discomfort
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lidocaine prior to injection site (numbing cream for shots) Advair inhaler 2 puff in early am daily claritin
Current Illness: None
Preexisting Conditions: Asthma, Allergies, infection and exercise induced Venous Reflux Hypermobile joints Hyperhidrosis hands/feet
Allergies: no known, has diagnosis of non-allergic rhinitis
Diagnostic Lab Data: None yet, we have an appointment with her allergy and asthma specialist Friday, May 28 at 3:45 pm.
CDC Split Type:

Write-up: Approximately 50 minutes after getting patient her first shot of Pfizer, she quickly complained of the following symptoms in this order: metal taste in mouth, lips burning and going numb, I can''t feel my lips and then my lower lip is swelling and then less swelling in the upper lip. No additional symptoms were experienced other then surprise and worry.


VAERS ID: 1345755 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-05-14
Submitted: 0000-00-00
Entered: 2021-05-25
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Shoulder fracture; Comments: Patient did not have any known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210540702

Write-up: SORE LEFT ARM; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s past medical history included broken shoulder, and other pre-existing medical conditions included patient did not have any known drug allergies. 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. No concomitant medications were reported. The batch number was not reported and has been requested. On 14-MAY-2021, the subject experienced sore left arm. The action taken with covid-19 vaccine was not applicable. The patient recovered from sore left arm on 17-MAY-2021. This report was non-serious.


VAERS ID: 1346361 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zolpidem, alprazolam, morphine, hydrocodone/acetaminophen, metoprolol tartrate, estradiol
Current Illness: no known
Preexisting Conditions: Degenerative disc disease of spine, hypertension,
Allergies: no known
Diagnostic Lab Data: Referred patient to physician
CDC Split Type:

Write-up: On 5/24/21 patient stated at injection site, arm feels raised, warm and sore


VAERS ID: 1346529 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: None. Called Dr for hemorroids referral and she told me to go to the emergency room and wrote a prescription. They told me they couldn''t do anything and wrote the same prescription plus one more.
CDC Split Type:

Write-up: Fatigue, Violent Diarrhea and Vomiting that lasted 2 1/2 days for the diarrhea and overnight for the vomiting. Caused hemorroids.


VAERS ID: 1346663 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron, Vit C, Calcium,Saw Palmetto, Vitamins etc that never messed with me and actually made me feel better... This vaccine is screwing me up
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: none... just reporting symptoms as i don''t know what to think at this point
CDC Split Type:

Write-up: chest pains during breathing (harshness of this has subsided), severe joint pain, chest pains what feels like behind my heart, and it comes and goes


VAERS ID: 1346740 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

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

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

Write-up: Pt had syncopal episode after vaccination (BP 86/60, HR 74). Pt stable VS improved (BP 101/77, HR 79, RR 20). Pt stable & released from vaccination site. Pt has hx of eczema


VAERS ID: 1346814 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Condition aggravated, Full blood count, Pain in extremity, Peripheral artery thrombosis, Peripheral swelling, Skin warm, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
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: Aspirin 81mg daily, Atorvastatin 10mg daily, Multivitamin
Current Illness: Hyperlipidemia, Vitamin D deficiency
Preexisting Conditions: History of B-Cell lymphoma, in remission for 2+ years History of left subclavian and left internal jugular DVT, full resolved after year of Lovenox/Xarelto in 2017-2018
Allergies: Shrimp, Keflex
Diagnostic Lab Data: CBC done on 5/20/21, normal Left arm venous doppler done on 5/18/21
CDC Split Type:

Write-up: Patient received vaccine in left deltoid on 5/12/21. On 5/14/21 started to have left upper arm swelling, pain, warmth. Had doppler done on 5/18/21that showed left brachial vein DVT. Started on Eliquis immediately At followup on 5/25/21, swelling reduced, pain and warmth resolved.


VAERS ID: 1346894 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / IM

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

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

Write-up: Covid arm, entire arm red and inflamed, swollen lymphomas, neck glands hurt, severe headache, upset stomach


VAERS ID: 1347202 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-22
Onset:2021-05-14
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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: None
Allergies: No
Diagnostic Lab Data: None,
CDC Split Type:

Write-up: I believe it''s shingles. I believe it started between the second and first dose.


VAERS ID: 1347215 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-09
Onset:2021-05-14
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Nasal swab PCR + done on 5/19/2021 cycle threshold: ORF1 ab: 19.18; N:33.97
CDC Split Type:

Write-up: Developed COVID-19 symptoms on 5/14/2021 confirmed by PCR on 5/19/2021


VAERS ID: 1347250 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ophthalmic herpes zoster
SMQs:, Ocular infections (narrow), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Onset of herpes zoster ophthalamicus approximately 24 hours following vaccination Patient is fully vaccinated against varicella with no clinical history of wild-type varicella infection


VAERS ID: 1347259 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-14
Onset:2021-05-14
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 2 UN / UN

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

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

Write-up: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.


VAERS ID: 1347664 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (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: Blood Pressure meds
Current Illness: none
Preexisting Conditions: High Blood Pressure
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt experienced right upper chest "muscle twitch". Vitals 188/92, HR 92, OxSat 91. Pt stated that it lasted about three minutes no longer can feel it. No other complaints at this time. Oriented x 4. No distress noted.


VAERS ID: 1347681 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hot flush, Muscle spasms, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Vertigo, sore muscles, cramps, hot flashes


VAERS ID: 1347697 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-17
Onset:2021-05-14
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Chills, Computerised tomogram abnormal, Heart rate increased, Hypoaesthesia, Muscular weakness, Paraesthesia, Pulmonary embolism, Pulmonary thrombosis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin Claritin D
Diagnostic Lab Data: Hospitalized 5/15/21 for PE CT Scan 5/15/21
CDC Split Type:

Write-up: Blood Clots (2 PE in right lung) Chills Memory Loss Numbness in limbs Tingling in limbs Muscle weakness Rapid Heart Beat


VAERS ID: 1347888 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-07
Onset:2021-05-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Full blood count, Mineral supplementation, Platelet count decreased, Platelet count normal, Rash, Rash papular, Rash pruritic, Vasculitic rash
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: None
Current Illness: Iron deficiency anemia
Preexisting Conditions: Chronic constipation
Allergies: None
Diagnostic Lab Data: I went to an urgent care and tested my CBC. Platelet count is normal although dropped from ~400 (lasted tested, around 2 weeks ago) to ~310.
CDC Split Type:

Write-up: Roughly one week before the vaccine, I received an iron infusion without experiencing any adverse event. One week after I was vaccinated, I received my 2nd infusion. After the infusion, I developed itchy and raised rash on torso and leg. One day after, I developed vasculitic rash (red, patchy, not itchy) on both legs. The rash slowly went away. In communication with my hematologist, given my experience with the first infusion, the probability is very low for me to experience what I had had it not been for the vaccine, which potentially altered my immune response.


VAERS ID: 1348843 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-08
Onset:2021-05-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 06339 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood iron decreased, Blood magnesium decreased, Dyskinesia, Dyspnoea, Laboratory test, Seizure like phenomena, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Dyskinesia (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: Escitalopram, Enpress, Lisinopril, Levothyroxine
Current Illness: Fatty liver, hypothyroidism, hypertension
Preexisting Conditions: Chronic pancreatitis
Allergies:
Diagnostic Lab Data: Lab work, date: 5/19/2021, results: low iron and magnesium
CDC Split Type:

Write-up: Seizure like shaking and jerking in my sleep since week after COVID vaccine, symptoms: shaking and jerking and difficulty breathing and can?t wake up


VAERS ID: 1348872 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-08
Onset:2021-05-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

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

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

Write-up: Minor chest pain left side. Never had this feeling before. Read few reports online, feels like heart inflammation?


VAERS ID: 1349125 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Pyrexia, Seizure, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Previous Vaccinations:
Other Medications: PHENOBARBITONE COX; LEVETIRACETAM; ZONISAMIDE; TYLENOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Epilepsy
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Test Result: 100 {DF}; Result Unstructured Data: 100 ?F
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: one episode of seizure attack while sleeping; low grade fever of 100F; injection arm soreness; tiredness; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (one episode of seizure attack while sleeping) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 027C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Epilepsy. Concomitant products included PHENOBARBITAL (PHENOBARBITONE COX) and LEVETIRACETAM for Seizure, ZONISAMIDE and PARACETAMOL (TYLENOL) for an unknown indication. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced VACCINATION SITE PAIN (injection arm soreness) and FATIGUE (tiredness). On 15-May-2021, the patient experienced PYREXIA (low grade fever of 100F). On 17-May-2021, the patient experienced SEIZURE (one episode of seizure attack while sleeping) (seriousness criterion medically significant). At the time of the report, SEIZURE (one episode of seizure attack while sleeping), VACCINATION SITE PAIN (injection arm soreness), FATIGUE (tiredness) and PYREXIA (low grade fever of 100F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 100 ?F (High) 100 ?F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The treatment information included Tylenol. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1349666 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Shellfish allergy (allergies:shellfish); Sulfonamide allergy (allergies: Sulfa)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021548104

Write-up: Hives all over the body; This is a spontaneous report from a contactable consumer (patient). A 43-year-old female patient received the second dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: unknown), in left arm on 13May2021 10:00 at single dose for covid-19 immunisation. Medical history included known sulfa and shellfish allergies. The patient was not pregnant at time of vaccination. The patient was not diagnosed with covid-19 prior to vaccination. The patient didn''t receive any other vaccines within 4 weeks prior to vaccination. The patient previously received the first dose of BNT162B2 (lot number: unknown), on an unspecified date at single dose for covid-19 immunisation. The patient experienced hives all over the body on 14May2021 16:00. The patient had not been tested for covid-19 since the vaccination. Therapeutic measures were taken as a result of hives all over the body and included treatment with oral steroids. The outcome of the event hives all over the body was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1349668 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Body temperature, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), 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:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: body temperature; Result Unstructured Data: Test Result:102.8; Comments: degrees
CDC Split Type: USPFIZER INC2021548228

Write-up: Heavy fever - 102.8 degrees; Body aches; loss of taste; This is a spontaneous report from a contactable consumer (patient). A 34-year-old male patient received the second dose of BNT162B2 via an unspecified route of administration on left arm on 13May2021 at 13:30 as single dose for COVID-19 immunization. Medical history was none. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, unknown whether the patient had been tested for COVID-19. No known allergies. Concomitant medication were not reported. The patient previously took the first dose of BNT162B2 as single dose for covid-19 immunization. The patient experienced heavy fever-102.8 degrees, body aches and loss of taste on 14May2021 at 12:00. The treatment was not taken. The outcome of events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1349669 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Headache, Off label use
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021548303

Write-up: current_age: 15; Headache; chest pain; fatigue; This is a spontaneous report received from a non-contactable consumer. A 15-year-old male patient reported for himself that he received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection), via an unspecified route of administration, administered in Left Arm on 13May2021 16:00 (at the age of 15-year-old) as single dose for COVID-19 immunization. The patient medical history was not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not have any known allergies. The patient did not receive any other medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 14May2021 at 16:30 the patient experienced Headache, chest pain, and fatigue. The patient received Tylenol as treatment for the events. The reporter stated that events as non-serious. The outcome of the events was reported as recovered on an unspecified date. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1349670 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Paraesthesia, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Medical History/Concurrent Conditions: Allergy (known_allergies:Yes); Asthma; Hypertension; Medullary sponge kidney (medullary sponge kidneys); Rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021549799

Write-up: This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EW0183), via an unspecified route of administration in right arm, on 14May2021 at 10:00 (at the age of 55-years-old) as first dose, single for COVID-19 immunization in a hospital. Medical history included rheumatoid arthritis, asthma, hypertension and medullary sponge kidneys. The patient had known allergies. The patient had concomitant medications but not reported. The patient was not pregnant and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was never tested for COVID-19. The patient''s both feet feel like having pins and needles and feel asleep on 14May2021 at 10:45. No treatment was received by the patient for these events. The outcome of these events was not recovered at the time of report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1349683 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021562811

Write-up: low grade fever; headache; fatigue; malaise; This is a spontaneous report from a contactable consumer or other non hcp. A 15-years-old female patient received first dose of bnt162b2 (BNT162B2, Solution for injection, Batch/lot number and expiry date: not reported) via an unspecified route of administration on 13May2021 (at the age of 15-years-old) as SINGLE DOSE for covid-19 immunisation. Patient medical history and concomitant medication were not reported. Mother stated that the side effects started the next day on 14May2021. She was experiencing low grade fever, headache, fatigue, and malaise (on 14May2021). The had talked to her Doctor and they did not seem to know much since the vaccine was so new for this age group. There were adults in their house hold who had gotten the vaccine and had not has side effects like this. It been Friday, Saturday, Sunday, Monday, and now Tuesday. It was enquired about how long were these side effects going to last. The outcome of the events was unknown E-transmitting for possible duplicate information. 15 year old female consumer. No follow up attempts possible. Information on lot/batch number cannot be obtained


VAERS ID: 1349690 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-06
Onset:2021-05-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Feeling abnormal, Headache, Limb discomfort
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021568134

Write-up: Headache; dizziness; foggy; heavy feeling in chest; heavy feeling in shoulders, and arm; This is a spontaneous report from a contactable consumer (patient). A 54-year-old male patient received the first dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: unknown), at the age of 54 years old, in left arm on 06May2021 15:30 at single dose for covid-19 immunisation. The patient medical history was reported as none. The patient had no known allergies. The patient was not diagnosed with covid-19 prior to vaccination. The patient didn''t receive any other vaccines within 4 weeks and any other medications within 2 weeks prior to vaccination. The patient experienced headache, dizziness, foggy, heavy feeling in chest, shoulders, and arm on 14May2021 05:00. The patient had not been tested for covid-19 since the vaccination. No treatment was received. The outcome of events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1350527 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: first COVID vaccine (chills, aches, bleeding at injection site)
Other Medications: vitamin C
Current Illness: possible allergies a few days before vaccine
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: went to the doctor on 5/25 to get antibiotics just in case it is an infection.
CDC Split Type:

Write-up: Achiness (especially in legs), headache the first two days, low grade fever (between 99-100) for 12 days


VAERS ID: 1350532 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Productive cough, Pulmonary embolism, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (broad)

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

Write-up: Per medical record, the patient complained of a productive coughing, difficult breathing, wheezing an chest pain. His discharge diagnosis was noted to be Saddle embolus of pulmonary artery.


VAERS ID: 1350542 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: Arm pain, headache and fatigue lasting less than 24 hours


VAERS ID: 1350617 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Injection site pain, Mobility decreased
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Extremely painful injection followed by shoulder pain, weakness, lack of mobility. Been taking Advil or Tylenol everyday. Have tried ice and heat. Still in a lot of pain. I?m so frustrated I don?t know what kind of doc to go to. Please get back to me


VAERS ID: 1350660 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-05-14
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 1 UN / UN

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

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

Write-up: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.


VAERS ID: 1350735 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient Presented with body aches and fever, which persisted for 24 hours. Patient presented with left arm redness at injection site, two days post injection, and showing improvement. The doctor prescribed conservative therapy, hydration, and over the counter Tylenol as needed. The doctor will continue to follow up daily with the patient for two weeks post injection.


VAERS ID: 1350811 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: I had facial numbness (upper lip , nose and che) that started ~2 hrs after the injection and continued for several hours.


VAERS ID: 1350933 (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: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Chills, Dizziness, Facial pain, Headache, Lymphadenopathy, Malaise, Neck pain, Night sweats, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I developed a headache, dizziness, chills, and general unwell feeling a few hours after the shot. The headaches continue to occur everyday since the shot (5/14-5/26). Two days after the vaccine, I developed night sweats, which have occurred every night since then. Approximately a week after the vaccine, I woke up with swelling and pain in my shoulder and armpit area on the left side where I received the vaccine. The swelling and pain in the area has improved, but is not yet better as of today (5/26/2021). The swelling and pain moved into my neck area and is now in my face causing tightness and pain. I believe my lymph nodes are swollen due to the vaccine.


VAERS ID: 1350974 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Chills, Inappropriate schedule of product administration, Pain, Rash, Rash pruritic
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: None
CDC Split Type:

Write-up: Patient received 1st Covid vaccine on 4/12/21 without incident. He received 2nd dose on 5/12/21. Patient states he had chills and felt achy about 12-24 hours after vaccination, but was fine after that. Approximately 2 days after 2nd vaccine, he developed a rash on his chest. The rash was contained to the chest area. It started as a rash, then patient states it blistered and was itching. Patient saw his PCP on 5/25/21 about the rash and that was the first notification from the patient regarding the reaction. No medication was prescribed, patient instructed to monitor and call if not improving.


VAERS ID: 1351046 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Candida infection
SMQs:, Opportunistic infections (broad)

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

Write-up: Client reported having white patches to back of throat beginning 2 days following COVID-19 vaccination. Client seen by PA, ND on 5/26/21. PA contacted this nurse to add information to VAERS - stated diagnosed as thrush and prescribed Nystatin gargle.


VAERS ID: 1351112 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: None
Current Illness: None
Preexisting Conditions: Asthma and Migraines
Allergies: Allegergic to apples a d receives allergy shots for seasonal allergies and allergy to dogs.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Both arms began to shake about 45 minutes after receiving the shot and continued for approximately 30 minutes. The shaking was mild-moderate , she could continue her activities, but the right arm shook more than the left arm.


VAERS ID: 1351142 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Vitamin D2 (50,00 cap), Sertraline (100 mg), Atorvastatin (20 mg), Pantaprazole Sodium (40 mg), Super Omega-3 (1200 mg), Women''s Daily Multi-Vitamin,
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Soreness, fever, pain in right arm started about three days after vaccination. Applied cold compress and took Ibuprofen or Aleve as recommended . Nagging pain still persists with great intensity at times, especially when I try to lift my arm. Disrupts my sleep at night. The arm muscle where injection was made is still sore two weeks after the second injection.


VAERS ID: 1351186 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Arthralgia, Axillary pain, Breast pain, Disturbance in attention, Dizziness, Fatigue, Feeling abnormal, Headache, Neck pain, Staring
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Lipodystrophy (broad), Arthritis (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: Advil as needed
Current Illness: Rheumatoid Arthritis/Sjogren''s
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: 15 minutes after getting my 1st dose, I got immediate pain in my armpit (left side) and it spreaded into left breast area. The pain continued up into the left shoulder, left side of neck and head. Experience weird feeling too in head, was very dizzy and felt like I had dementia. I stared into space, could not focus. Worst brain fog ever. Could not communicate well and had extreme fatigue. These symptoms lasted 2 days and then it finally went away except for the fatigue. Still have fatigue week and a half later.


VAERS ID: 1351578 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Decreased appetite, Feeling cold, Headache, Hyperhidrosis, Paraesthesia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: mulitvitamin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EMT confirmed vital signs were normal and suggested the symptoms may have caused him to have a panic attack
CDC Split Type:

Write-up: high fever- 102, tightness in chest, headache, cold & sweaty, tingling feeling, loss of appetite. He took 2 ibuprofen, was able to sleep through the night and felt much better the next day. 2 days later he felt like himself again.


VAERS ID: 1351606 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Flushing, Full blood count normal, Metabolic function test normal, Palpitations, Throat irritation, Tryptase
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin B, MVI, Turmeric, apap, fish oil
Current Illness: none
Preexisting Conditions: none
Allergies: ibuprofen
Diagnostic Lab Data: EKG, CBC, BMP, tryptase nl
CDC Split Type:

Write-up: Per patient. This is a 48 year old female with no relevant PMH who presents to the ED for evaluation of chest pain and palpitations after COVID 19 vaccination. The patient reports that approximately at 8:45 AM she received the first shot of the Pfizer coronavirus vaccine. Within 15 minutes she began to develop palpitations a flushed feeling, tickling in the back of her throat. There is no itching or rash. There is no difficulty handling secretions. The patient has never had an adverse reaction to vaccine in the past. Her only allergy is of ibuprofen, which causes hives. Patient reports ongoing palpitations since this started. No difficulty handling secretions. No leg swelling. No hx of cardiac disease.


VAERS ID: 1351959 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Fatigue, Headache, Laboratory test, Pain, Sensation of foreign body, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Spironolactone, Acyclovir, Probiotic,
Current Illness: None
Preexisting Conditions: Auto-immune disease -- Graves Disease. In remission since 2016.
Allergies: Sulfa
Diagnostic Lab Data: 5/15/21: Blood draw/labs in ER 5/24/21: Blood draw/labs at Dr office
CDC Split Type:

Write-up: 5/14/21: Approx. 4-5 hours after 2nd dose, developed full body hives, headache, fatigue, body aches, lump in throat. Treated with Tylenol and Benadryl. On 5/15/21, at 6pm called Pharmacy and instructed to go to ER. ER administered epi-pen, prednisone, Benadryl, Pepcid and Tylenol. 5/17/21: Appointment w/ Allergist and advised to take Zyrtec, Allegra, Singular, and Pepcid, until symptoms resolve. If still symptomatic after 6-weeks, call Allergist back and re-evaluate.


VAERS ID: 1352153 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram, Full blood count, Metabolic function test, Troponin
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MVI
Current Illness: No recent fevers, chills, cough, leg swelling, rash
Preexisting Conditions: none
Allergies: PCN
Diagnostic Lab Data: EKG, BMP, CBC, troponin
CDC Split Type:

Write-up: evaluation of chest tightness. She reports chest pain?described as tightness in her left chest. Pain does not radiate. She states she experienced symptoms about 10 minutes after taking her first Pfizer Covid?19 vaccine at 14:10 today. She also reports mild shortness of breath and lightheadedness. She states symptoms feel like anxiety. No rash, throat discomfort, leg swelling. Patient states she is starting to feel better at this time. Presentation likely consistent with anxiety. Vaccine adverse/allergic reaction was also considered but less consistent at this time. Patient states feels like anxiety reaction. Discussed consideration for as needed medication for intermittent anxiety attacks?safety precautions were discussed.


VAERS ID: 1353104 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Spasms-had 28 episodes until 4:12 pm today; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of MUSCLE SPASMS (Spasms-had 28 episodes until 4:12 pm today) in a 73-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 14-May-2021, the patient experienced MUSCLE SPASMS (Spasms-had 28 episodes until 4:12 pm today) (seriousness criterion hospitalization). The patient was hospitalized from 14-May-2021 to 15-May-2021 due to MUSCLE SPASMS. At the time of the report, MUSCLE SPASMS (Spasms-had 28 episodes until 4:12 pm today) outcome was unknown. No concomitant medication information was provided. Additional information received included that the patient had 28 episodes till now from the first dose vaccination. Treatment information was not provided. Action taken with mRNA-1273 in response to the drug was not applicable. This case was linked to MOD-2021-076263 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.


VAERS ID: 1353107 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-26
Onset:2021-05-14
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Crying, Feeding disorder, Pain in extremity, Social avoidant behaviour, Vaccination site erythema, Vaccination site swelling
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210514; Test Name: CT scan; Result Unstructured Data: Diagnosed with Bell''s palsy
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Bell''s Palsy; Soreness in arm; Cries all the time; Can''t eat or drink right; Doesn''t want to go out in public; Swelling; Redness; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of BELL''S PALSY (Bell''s Palsy) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 016C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 26-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced BELL''S PALSY (Bell''s Palsy) (seriousness criteria hospitalization and medically significant). On an unknown date, the patient experienced PAIN IN EXTREMITY (Soreness in arm), CRYING (Cries all the time), FEEDING DISORDER (Can''t eat or drink right), SOCIAL AVOIDANT BEHAVIOUR (Doesn''t want to go out in public), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE ERYTHEMA (Redness). The patient was hospitalized on 14-May-2021 due to BELL''S PALSY. At the time of the report, BELL''S PALSY (Bell''s Palsy), PAIN IN EXTREMITY (Soreness in arm), CRYING (Cries all the time), FEEDING DISORDER (Can''t eat or drink right), SOCIAL AVOIDANT BEHAVIOUR (Doesn''t want to go out in public), VACCINATION SITE SWELLING (Swelling) and VACCINATION SITE ERYTHEMA (Redness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-May-2021, Computerised tomogram: Diagnosed with Bell''s palsy. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included steroids, eye drops, and eye ointment which was given at the emergency room It was reported that the patient was not taking any prior concomitant medications. The pharmacy where she received her first dose told her she should not get the second dose. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1353117 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Discomfort, Dysphagia, Facial pain, Heart rate, Hemiplegia, Hypoaesthesia, Neck pain, Palpitations
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Arthritis (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: Test Date: 20210518; Test Name: Heart rate; Result Unstructured Data: 140
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: pressure on right side; paralysis on right side of body; numbness; sharp pain from neck up to face; sharp pain from neck up to face; racing of the heart with heart rate of 140; unable to swallow; This spontaneous case was reported by a consumer and describes the occurrence of HEMIPLEGIA (paralysis on right side of body) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 041C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-May-2021, the patient experienced DYSPHAGIA (unable to swallow). On 18-May-2021, the patient experienced HEMIPLEGIA (paralysis on right side of body) (seriousness criterion medically significant), HYPOAESTHESIA (numbness), NECK PAIN (sharp pain from neck up to face), FACIAL PAIN (sharp pain from neck up to face) and PALPITATIONS (racing of the heart with heart rate of 140). On an unknown date, the patient experienced DISCOMFORT (pressure on right side). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 14-May-2021, DYSPHAGIA (unable to swallow) had resolved. At the time of the report, HEMIPLEGIA (paralysis on right side of body), HYPOAESTHESIA (numbness), NECK PAIN (sharp pain from neck up to face), FACIAL PAIN (sharp pain from neck up to face), PALPITATIONS (racing of the heart with heart rate of 140) and DISCOMFORT (pressure on right side) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-May-2021, Heart rate: 140 (High) 140. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product use was not provided by the reporter. Treatment medications included Tylenol Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1353581 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-05-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Feeling abnormal, Feeling cold, Headache, Neck pain, Pain
SMQs:, Dementia (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021555621

Write-up: Feeling terrible; Chills; Achiness; headache; Neck pain; Hip Hurts; freezing; This is a spontaneous report from a contactable consumer (patient). A 51-year-old female patient received second dose of bnt162b2 (PFIZER-Biontech Covid-19 Vaccine, Solution for injection, Lot Number: EW0182, Expiration date: 31Aug2021), dose 2 via an unspecified route of administration, administered in Arm Left on 13May2021 18:30 (Batch/Lot Number: EW0182; Expiration Date: 31Aug2021) as 2nd dose, single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 14May2021, the patient experienced feeling terrible, chills, achiness, headache, neck pain, hip hurt, freezing. Caller reported dry skin and scaling inside to the outside of the ear after receiving the first dose of the Pfizer COVID-19 vaccine. She mentioned it''s getting worst since the second dose. Caller is calling about the vaccination. She clarified it as the Covid vaccine. She is curious about the side effects. She got this on Thursday and still feels terrible. She still feel chills and achiness and freezing. She feels terrible from Thursday and everything is hurting her. The other thing, its a weird thing did anyone report dry and scaly-ness on the ear. She mentioned it to her cousin and her cousin mentioned she felt terrible as well and has Hives on her ears. They both had the same thing- dry skin and scaly-ness from the inside of the canal to the outside. She would like to know how to treat it. She has been putting things on it and its not going away and she wanted to know if someone else had the same thing. The other thing, its a weird thing did anyone report dry and scaly-ness on the ear. She has been putting things on it and its not going away and she wanted to know if someone else had the same thing. Feeling terrible treatment: no she thought it would wear off, it has been going on since thursday and now its monday, time: 1pm on Friday. For the chills treatment: she has been putting on extra cloths, time: she does not know exact time on Friday. Achiness treatment: none, time: friday in the afternoon. Headache, treatment: none, time: Friday in the afternoon. Neck pain caller stated its ongoing, outcome of event: Attempted to clarify with caller she stated she she still has it. It''s not as bad as it was, treatment: none, time: Friday in the afternoon. Hip hurt caller stated it went away, outcome: caller stated unknown, treatment: none, time: afternoon. Dry and Scaly-ness of the Ear: Start - caller stated this is the second dose that started. The first dose she had 3 weeks ago. Stop - Its ongoing. Its gotten worse she is wondering if its related to the second dose of the vaccine. Treatment: steroid cream. She had it prescribed for something else. It didn''t go away. She though it may heal this sore too. serial by the barcode - 51672404819. NDC: Prescription label on product. Caller unable to find NDC at this time. lot: 342227, exp: 09/2022, time: from the first one not the last one her ears are itching more since the second one. The clinical outcome of feeling terrible, chills, headache, freezing were not recovered, of the achiness, neck pain were recovering and of the hip hurts was unknown. Follow up attempts are needed. Further information has been requested.


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