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

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



Case Details (Reverse Sorted by Onset Date)

This is page 167 out of 6,867

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VAERS ID: 1549330 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-18
Onset:2021-08-10
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cold like symptoms on 3/7/2021 - Negative COVID
Preexisting Conditions: Hyperreactive airway disease hyperlipidemia overweight GERD Chronic low back pain
Allergies: Ventolin HFA 90mcg/inh 2 puffs q4hrs as needed for wheezing. Zyrtec 10mg Daily PRN Fenofibrate micronized 200mg daily naproxen 500mg BID omeprazole 20mg BID sucralfate 1 g QID
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 after being fully vaccinated


VAERS ID: 1549348 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-06
Onset:2021-08-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW40174 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: She has under left armpit a lump that has come up about 1 cm in size. She also started having hands and feet turning red and itching.


VAERS ID: 1549392 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-19
Onset:2021-08-10
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Asymptomatic, tested positive for Covid house hold exposer


VAERS ID: 1549399 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-30
Onset:2021-08-10
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: tested positive for covid19 and is having some symptoms but is feeling better.


VAERS ID: 1549404 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-08-10
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / UNK - / -

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

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

Write-up: dx with CoVid 8/10/2021


VAERS ID: 1549410 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No Prescriptions
Current Illness: None
Preexisting Conditions: Weber Rendu Syndrome
Allergies: Salt, aspirin, ibuprofen, suddafed, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore swollen lymphnodes in arm pit


VAERS ID: 1549449 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Hyperhidrosis, Injection site reaction, Pain in extremity, Peripheral swelling, Skin reaction
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor XR, Chantix, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: penicillin or Codeine. Received hives while taking both.
Diagnostic Lab Data: I went back to the pharmacy when I developed covid arm the first time and they said take Benadryl.
CDC Split Type:

Write-up: This is my second shot. I had covid arm with the first one. I have it again this time. I had severe chills so bad that my teeth were chattering while I had blankets on. Severe sweating, Diarrhea, and the worst headache I''ve ever had. My symptoms started three hours after injection. My arm was so swollen and in pain last night I has to get up in the middle of the night and take Tylenol and put ice packs on my arm, It hurt from my shoulder to my wrist. I will definitely not take a booster shot because I cant imagine making myself feel like this again. I have given birth and had kidney stones and I would rather had one of those than this shot again.


VAERS ID: 1549455 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling hot, Pain in extremity, Pyrexia, Rash, Rash erythematous, Vulvovaginal rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Phenpermine Calcium Multi Vitamin Omega 3 Fiber
Current Illness: no
Preexisting Conditions: no
Allergies: Cinnamon
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reported that she started with fever and soreness to the arm, she as felt very tied... as going to the next day her fever become very high and she has rash on breast thighs and virginial area... she stated that the rash is red and hot to the touch


VAERS ID: 1549466 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Feeling hot, Nervousness
SMQs:, Hypoglycaemia (broad)

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

Write-up: Patient received dose 1 of the Pfizer COVID vaccine (lot EW0175, exp 8/2021) at approximately 1710. At 1717, patient requested that Paramedic take her blood pressure because she felt anxious. Vital signs: blood pressure 152/88, O2 99%, pulse 104, respirations 16. PHN approached to assess the patient who reported feeling hot and nervous. Patient reported experiencing similar symptoms when she felt anxious. Patient denied allergies, reported medical condition to include anxiety, and takes anxiety medication not specifying what medication. PHN gave patient water to drink and encouraged patient to remain for 30min monitoring, to follow up with provider, and when to call 911. PHN offered patient Benadryl but patient declined. Patient drank water and reported "I want to leave," stood up, and paced back and forth in the observation area. At 1725, patient requested her vitals be taken again and sat down. Vital signs: respirations 18, blood pressure 152/92. Patient reported "I feel fine I''m leaving." Patient left walking with steady gait at 1728.


VAERS ID: 1549474 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-27
Onset:2021-08-10
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 - / IM

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

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

Write-up: Admitted to hospital with weakness secondary to COVID-19 on 8/10/21. Discharged home on 8/11/21. Did not require oxygen during admission.


VAERS ID: 1549481 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-04
Onset:2021-08-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fatigue, Hepatic lesion, Lung infiltration, Lymphocyte percentage, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test positive, Scan with contrast abnormal, Tachycardia, Tachypnoea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Novolog, Toujeo, Lisinopril
Current Illness:
Preexisting Conditions: hypertension, diabetes
Allergies: NKA
Diagnostic Lab Data: 8/12/21 Chest X-ray: moderate perihilar infiltrates Lymphocytes: 20 Rapid COVID-19 swab: positive AST: 56; ALT: 68 CRP: 57.7 CT Chest with contrast: No evidence of PE, Perihilar infiltrates, multiple ill-defined liver lesions
CDC Split Type:

Write-up: Patient had known exposure to COVID-19 approximately 2 weeks prior to vaccination and again within days of vaccination. Approximately 1-2 days prior to admission, patient became symptomatic with cough, shortness of breath, fatigue, myalgias, and nausea/vomiting. Patient had tachycardia and tachypnea. Patient received IV fluids during ED stay and remained tachycardia and tachypneic. Patient is febrile at 100.5 F. O2 saturation 95%, pulse 109, Resp 25, BP 119/68. Patient will be admitted for close monitoring of vitals.


VAERS ID: 1549487 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-06
Onset:2021-08-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKONWN / 1 LA / IM

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

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

Write-up: patient developed rash several days after vaccination, came to Clinic location and was diagnosed with shingles


VAERS ID: 1549516 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-08-10
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: Ant bite looking rash. In clusters on my forearm, hips, butt and a few on hands. Doesn?t itch but it is tender. It is not shingles.


VAERS ID: 1549527 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: J&J given at 17 years of age. No adverse reactions noted at time of reporting.


VAERS ID: 1549601 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gastrointestinal disorder, Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (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: Zoloft 150mg. Trazadone 50mg. Estradiol 4mg. Spironolactone 25mg.
Current Illness: Possible flu/cold week before vaccination. Covid test was negative as of 8/7/2021
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had the first shot of the Moderna vaccine in the late morning (~10am). Around early afternoon, perhaps 3-4 hours after getting the shot, I began experiencing stomach issues. After defecating, I noticed there was blood on the toilet paper after wiping, and there was blood in the toilet bowl. There was not a lot, and it looked as though the blood was just on the outside of the stool. This happened at least 1 other time with the same result. This would have been toward the late afternoon, perhaps around 5. By the end of the day, around 10pm or so, there was no longer any blood. My stomach was still upset the following day, but it has abated mostly.


VAERS ID: 1549616 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Work       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Vac
Other Medications: Hydroxyzine, Zyrtec, Spironlactone
Current Illness:
Preexisting Conditions:
Allergies: Latex, Codeine, Tamiflu, Tylenol,
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Scattered hives to forearm, knee, & calf. She took 50 mg of Benadryl prior to vaccine, & another 100 mg post vaccine.


VAERS ID: 1549640 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-01-03
Onset:2021-08-10
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CORONAVIRUS TEST 8/10/2021 - POSTIVE.
CDC Split Type:

Write-up: Pt was admitted on 8/10/2021 with c/o sob, cough and body aches, fever. Pt wears 6L NC at home. Pt was discharged 8/11/2021.


VAERS ID: 1549663 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-08
Onset:2021-08-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER 0177 / 1 LA / IM

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

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

Write-up: Chest tightness, shortness of breath


VAERS ID: 1549664 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175-MERCY / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Injection site pain, Musculoskeletal stiffness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: Left upper arm pain, left neck stiffness. Diarrhea. Blurred vision,


VAERS ID: 1549682 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Hyperhidrosis, Pallor, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: IV contrast, and medication but did not give specific names of medications.
Diagnostic Lab Data: Employee was transported to ED within the hospital
CDC Split Type:

Write-up: Within 5 mins of getting vaccination employee began coughing and complaining of itchy throat. She then got very sweaty, pale and she felt throat closing up.


VAERS ID: 1549689 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-11
Onset:2021-08-10
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Exposure to SARS-CoV-2
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt admitted on 8/10/2021 for shortness of breath. Hx of diabetes, hypertension, morbid obesity and psoriasis. Dx with COVID-19 on August 5, 2021. Exposed from her grandson. The patient continues to be inpatient at this time.


VAERS ID: 1549746 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Insomnia, Pain in extremity, Peripheral swelling, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: adderall and vivansse
Current Illness: upper respiratory infection July 24-27
Preexisting Conditions: circadian sleep disorder
Allergies: none
Diagnostic Lab Data: I did not go to a doctor.
CDC Split Type:

Write-up: Itching that originally started on arms and chest but moved to legs. It began as mild but became more severe at times. 30 hours after the shot was given was the most severe with swelling of lower legs and a rash. Both arms also ached, especially in the forearm area and wrists. The left arm (where the shot was administered) was more painful than the right arm. Discomfort on the 2nd night after receiving the vaccine made sleep impossible.


VAERS ID: 1549748 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-03
Onset:2021-08-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Headache, Hypersensitivity, Injection site erythema, Injection site pruritus, Injection site swelling, Paraesthesia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Client called to report an adverse event post-COVID vaccination. RN spoke to the client on 8/12/21. Client reported that she received a COVID Moderna vaccine on 8/3/21 at a TCHD mobile event (confirmed). In the several days following vaccination, client stated that she had a fever, headache, mild swelling at the injection site, and itching at the injection site. Due to the itching, client began taking Benadryl daily. On 8/10/21, client reported a drastic increase in swelling and redness at the injection site that extended through her shoulder. The client reported that the redness looked like ?paint dripping?. The client began to feel ''tingling'' in her hand due to the large amount of swelling. On 8/11/21, client reportedly began to have trouble breathing and called her primary care physician (PCP). She was seen by her PCP on 8/11/21 and received steroid medication and an Epi Pen to carry in case of future anaphylaxis. Per the client, her PCP told her this was an allergic reaction and recommended that she not receive the second dose of COVID Moderna. Client reports that she has no chronic illnesses, but does have an anaphylactic allergy to PCN and a mild allergy to codeine.


VAERS ID: 1549783 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: She had a whelp on her arm about 2 inches in diameter. she said she had been throwing up since she got the shot. She stated her arm hurt very much.


VAERS ID: 1549785 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol, Pramipexole, Progesterone.
Current Illness:
Preexisting Conditions:
Allergies: Allergic to NSAIDS.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling, Redness, Hot to the touch, with soreness in a circular pattern on upper left arm just below the injection site.


VAERS ID: 1549802 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-28
Onset:2021-08-10
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Laboratory test abnormal, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: tested positive , with symptoms of head ache , sore throat and congestion


VAERS ID: 1549807 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-01-01
Onset:2021-08-10
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chronic obstructive pulmonary disease, Leukopenia, Pneumonia, SARS-CoV-2 test positive, Thrombocytopenia
SMQs:, Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medication Instructions Recorded Confirmed Type Atorvastatin Calcium [Lipitor] 20 mg PO DAILY 08/10/21 08/10/21 History C/Sourcherry/Celery/Grape Seed 850 mg PO DAILY 08/10/21 08/10/21 History [Tart Cherry Capsule] Cholecalciferol [
Current Illness:
Preexisting Conditions: 1. Some sort of chronic lung disease with 3 L oxygen requirement. 2. Diabetes mellitus type 2. 3. Erbs palsy. 4. Hypercholesterolemia. 5. gouty arthropathy. 6. depression
Allergies: none
Diagnostic Lab Data: SARS-CoV-2 positive PCR
CDC Split Type:

Write-up: This patient was admitted on 8/10/2021 with COVID-19 infection and pneumonia versus COPD exacerbation. Patient was treated with oxygen, Actemra, ivermectin, dexamethasone, vitamin C, vitamin D, and melatonin. He had thrombocytopenia and Pepcid was stopped. Developed leukopenia but this improved by date of discharge. His highest oxygen level was 7 L. Actemra seems to be the medication that helped his clinical condition improved and he was discharged on 8/12/2021.


VAERS ID: 1549982 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Erythema, Oropharyngeal pain, Pharyngeal erythema, Pharyngeal swelling, Pruritus, Swelling face, Swollen tongue, Throat irritation, Tongue erythema, Tongue pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Anaphylaxis from allergy shots on June 19, 2019. Was sleeping and went unconscious. CPR was performed for 45 min until revival.
Other Medications: Adderall 20mg, Adderall 10mg PRN, Vitamin D3 1.25mg
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: allergy shots- severe anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started to have a sore throat the night after vaccine administration (8/10/2021). Took Benadryl continuously day after (8/11/2021). Woke up next morning (8/12/2021) with severe swelling, redness, and itching of the throat, tongue, face. Could not breathe. Injected epipen. Went to doctor''s office and was sent to the ER. In the ER was given steroids, fluids, and an anti-histamine through an IV drip.


VAERS ID: 1550017 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-23
Onset:2021-08-10
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA G78C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trulicity
Current Illness: none
Preexisting Conditions: pre-diabetes
Allergies: none known
Diagnostic Lab Data: none yet - will be requesting physician oversight
CDC Split Type:

Write-up: Frequent sensation of hot water or hot air pouring down right lower leg. Not a burning or pain sensation, but "hot". Symptoms last about 30 seconds, but the frequency is increasing rather than decreasing. Current sensations are about 1-2 times per hour, intermittently


VAERS ID: 1550158 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood ketone body, Pain, Urine analysis, White blood cell count
SMQs:, Retroperitoneal fibrosis (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: Flu vaccines at one point were making my hip pain worse when I was 34/35
Other Medications: pregnancy vitamins regularly, intermittently brown rice protein, fish oil, b vitamin complex, etc.
Current Illness: no illnesses at this time.
Preexisting Conditions: decline
Allergies: nightshades
Diagnostic Lab Data: 6:48 am following morning , urinalysis test at home showed pH 5. high leukocytes, blood, proteins, and max ketones in urine. PCP called for general urinalysis unavailable until next month. Urgent care called for general urinalysis only performed urinalysis for possible uti. Rechecked at home 2:00pm, all abnormal values resolved. Urgent Care closed for following day no clinicians working, Urinalysis scheduled with minute clinic tomorrow. Pending results.
CDC Split Type:

Write-up: 9:47pm left sided pain 3/10 spread to left and right lower back then increased to 6/10 pain until 6:45 am.


VAERS ID: 1550171 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Limb mass, 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? 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: Large lump/knot on super bicep, huge swelling. Looks like another shoulder, knot is hard and mounted length wise onto bicep.


VAERS ID: 1550190 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078621A / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20 mg
Current Illness: None that is known
Preexisting Conditions: High Blood Pressure
Allergies: No known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient had already received Pfizer vaccine from another healthcare facility early in the year. She came in to pharmacy for a Covid test, but accidentally said Covid Vaccine. She filled out the screening questionnaire requesting the Moderna vaccine, which was then administered by the pharmacist on duty. Patient returned the next day and reported that she should not have been given the vaccine, rather a covid test.


VAERS ID: 1550409 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-08
Onset:2021-08-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dysarthria, Electrocardiogram, Magnetic resonance imaging, Psychomotor skills impaired, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin, Flonase, daily multivitamin, Trelegy, Singulair
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: Lactose Intolerant
Diagnostic Lab Data: CT Scan(8/10), EKG(8/10 and 8/11), blood tests(8/10 and 8/11), and MRI(8/11) all clear.
CDC Split Type:

Write-up: Speech started to slur, and then trouble speaking at all. Tremors in limbs. Motor skills severly affected.(writing as an example) Multiple episodes of this ranging over two days, in two hospitals. Longest episode was about 80 minutes. Shortest episode was 2 minutes.


VAERS ID: 1550411 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Body temperature increased, Chills, Dizziness, Eye pain, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Myalgia, Pain, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Woke up in the night with extreme chills, layered up to warm myself and fell back asleep. I then woke up soaking wet in a sweat.. the following morning I was very dizzy, stumbling around with bad balance. Throughout the day the headaches continued with blurred vision. Extreme aches and pains followed , specifically on my left side. The pain is coming in waves, It feels like it?s behind my eyes. Temperature as of today (Thursday) read 100.5. I?m very fatigued with brain fog and severe muscle aches


VAERS ID: 1550423 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Hyperhidrosis, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Guillain-Barre 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: Multivitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Terrible headache, body aches, chills, no energy, extremely tired. Going on 48+ hours with body aches and terrible headaches and sweating.


VAERS ID: 1550853 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-25
Onset:2021-08-10
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 Moderna Covid vaccine at outside facility (walmart) 4/25/2021, 5/24/2021. tested COVID positive 8/11/2021. vaccine failure.


VAERS ID: 1553448 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-08-10
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: fully vaccinated and diagnosed with Covid U07.1 - COVID-19


VAERS ID: 1553462 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-04
Onset:2021-08-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Joint Pain-Severe


VAERS ID: 1553650 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Pallor, Spinal fusion surgery, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 10 minutes after vaccination the patient and her mother came to the pharmacy window stating the patient felt flushed, her throat felt tight and she was pale. I had the patient sit down and gave her juice which she drank immediately. I stayed with her for a few minutes asking if she was feeling better and she confirmed she was. The patient (and mother) were very anxious abut the patient getting the vaccine even prior to vaccination. I observed her from my working station for about 15 more minutes. While the patient was seated the mother inquired about the patient taking a medication if she does have an allergic reaction and we advised she take diphenhydramine if needed. The patient had no history of severe allergy in her lifetime.


VAERS ID: 1553654 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Cough, Decreased appetite, Dysgeusia, Fatigue, Gait inability, Headache, Injection site swelling, Nausea, Pain, Palpitations, Pyrexia, Respiratory tract congestion, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pneumonia Vaccine: Severe pain in arm for 3 days
Other Medications: Pantoprazole 40mg (once daily)
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Trey nuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe headache that lasted two days, swelling on the right side of face, heart palpitating, couldn''t walk without assistance, nausea, metal taste in mouth, loss of appetite, arm swollen at injection sight, fever, entire body in pain, slight cough and congestion, tiredness, fluttering in chest


VAERS ID: 1553656 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-24
Onset:2021-08-10
   Days after vaccination:108
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: exposure to +covid person


VAERS ID: 1553662 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-08-10
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: exposure to covid+ person


VAERS ID: 1553668 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-14
Onset:2021-08-10
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Headache, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad)

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

Write-up: cough, headache, congestion


VAERS ID: 1553672 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-16
Onset:2021-08-10
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: unknown


VAERS ID: 1553714 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-08-10
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Chills, Cough, Dyspnoea, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cefTRIAXone
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia, chronic diastolic heart failure, COPD/emphysema, stage IV lung cancer, chronic hypoxic
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: She came to the hospital with a chief complaint of progressive worsening shortness of breath over the last 1 week. Patient reports that she was exposed to COVID-19 from son-in-law at home. She reports progressively worsening shortness of breath and some chest pain. She denies any fevers but did have some chills. Has chronic cough 8/10/2021 tested positive


VAERS ID: 1553715 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Eye swelling, Nausea
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodopine 5 mg oral Metformin 500 mg oral Lidex 0.05% ointment Lipitor 20 mg oral Singulair 10mg oral
Current Illness: none
Preexisting Conditions: Diabetes, asthma, hypertension, high cholesterol
Allergies: Penicillin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: At approx 0928, patient started feeling dizziness, nausea and eye swelling. Epi pen administered along with Solumedrol 125mg IV, Pepcid 20mg IV and Benadryl 25mg IV. Patient was also feeling short of breath and 100% NRM mask placed. Emergency called and patient transported to nearest ER at 10:12am.


VAERS ID: 1553745 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-19
Onset:2021-08-10
   Days after vaccination:113
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Had PCR test on 08/10/21
CDC Split Type:

Write-up: Tested positive for Covid 19 on 8/10/21


VAERS ID: 1553753 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia eye
SMQs:, Guillain-Barre syndrome (broad), Corneal 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: Zoloft
Current Illness: No
Preexisting Conditions: No
Allergies: Reglan
Diagnostic Lab Data: No
CDC Split Type:

Write-up: My left eye became numb for two days


VAERS ID: 1553759 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-03
Onset:2021-08-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 1 LA / IM

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

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

Write-up: 8 days after injection, arm was hard and red and inflammed. On day 10, arm is inflammed to near elbow


VAERS ID: 1553790 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-08-10
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Dyspnoea, Lung infiltration, Mobility decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 84 Y/O male fully vaccinated with moderna vaccine in april, states felt very weak and could not move also SOB. seen in PCP office and Dx with COVID 19. CXR showed mild infiltrates . Now on 2 lit nasal oxygen and maintaining SAT$g 90 %. PMHX HTN 8/10/2021 tested positive


VAERS ID: 1553808 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-19
Onset:2021-08-10
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nausea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: This is a 65-year-old male with past medical history of hyperlipidemia, morbid obesity, CLL on immunotherapy as a part of clinical trial, on chronic antiviral acyclovir and antibiotic Bactrim as a part of the clinical trial, immunocompromised status. He came to the hospital with a chief complaint of cough and shortness of breath over the last 8 days. Initially the symptoms started on Monday. He tested positive for COVID-19. He got exposure from 1 of his friends who is admitted in the hospital. The patient also had some subjective fevers and chills. He did have some nausea but denies any vomiting. Denies any abdominal pain, chest pain, burning or painful urination, diarrhea. Patient was vaccinated with 2 doses of Pfizer. Last dose was in June. Patient''s wife also had very mild symptoms but she is doing very well and has recovered.


VAERS ID: 1553813 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-04
Onset:2021-08-10
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Rapid COVID19 test - NP
CDC Split Type:

Write-up: Tested positive for COVID19 8/11/21 after being fully vaccinated


VAERS ID: 1553851 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Heart rate increased, Nausea, Pyrexia, Thirst, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: I had chills, fever 101/4, dizziness, problem focusing vision, very bad headache, rapid heartbeat, nausea, vomiting, diarrhea, and extreme thirst.


VAERS ID: 1553859 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chest pain, Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: given medication for vomiting and nausea, headache fluids
CDC Split Type:

Write-up: severe irretractable vomiting X 16 hours upper back pain radiating to chest and shoulders headache


VAERS ID: 1553861 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-08
Onset:2021-08-10
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3/8/2021 / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, CKD, Multiple myeloma not having achieved remission
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: admitted with COVID-19 on 8/10/2021


VAERS ID: 1553875 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site erythema, Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), 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: Flu vaccine years ago
Other Medications: zanax/paxil/lisinopril/crestor/co-q 10/vitamin d3/crentrum senior women/lutein/
Current Illness:
Preexisting Conditions: high cholesterol/slight high blood pressure/depression/anxiety
Allergies: codeine/naprosyn/sulfa/cipro/levequin/hydrocodone/most RX pain medications
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: low grade fever/joint pain/muscle pain lasting up to today 8/13/2021- fatigue/headache/ red-fist size swelling at injection site remain.


VAERS ID: 1553889 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-08
Onset:2021-08-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH A6780 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel Fe 1/20
Current Illness: None
Preexisting Conditions:
Allergies: NKA/NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: After 1st Dose patient had a headache for several days. After 2nd dose patient has started with a migraine that will not go away with any OTC treatment in addition to dizziness x 4 days.


VAERS ID: 1553922 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-08-10
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH GR2613 / UNK - / -

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

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

Write-up: positive covid test and symptoms


VAERS ID: 1553923 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: None
Preexisting Conditions: Hypercholesteremia, Hypertriglyceridemia, Obesity, Palpitations, Mild intermittent asthma
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine reconstituted and drawn up into syringes at 11:00am on 8/9/2021 and expired on 8/9/2021 at 5:00pm. Those syringes were not disposed of at the end of the clinic day and 1 dose was mistakenly given the following morning, after the expiration time. The patient has had no adverse reactions or symptoms and will be revaccinated in the opposite arm today per CDC guidance.


VAERS ID: 1553943 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 LA / IM

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

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

Write-up: Incorrect vaccine given


VAERS ID: 1553952 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 676270842 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nph, buspar, flonase
Current Illness: covid dx 7/27
Preexisting Conditions: diabetes
Allergies: wasp venom
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness started following morning after injection


VAERS ID: 1553956 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Patient received expired dose of Moderna. No adverse reactions reported.


VAERS ID: 1554057 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Dyspnoea, Electrocardiogram normal, Fall, Fatigue, Headache, Nausea, Paraesthesia, Pyrexia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Crab and Lobster
Diagnostic Lab Data: I went to my doctor 8/11 and got an EKG because I''m experiencing on and off chest pain . The results came back normal.
CDC Split Type:

Write-up: I woke up at 5am with a tight chest and nausea, 14 hours after receiving the first dose of the Pfizer vaccine. I decided to get up and try to puke. Within two steps to my bathroom I became dizzy and my eyesight become blurred. I fell to the ground on my hands and knees. My chest became tighter and it became harder to breath. I remember telling myself to say calm and focus on your breathing. When I began to realize my breathing was not regulating I called for my husband. We almost called 911 but after a few minutes I finally was able to breath reguraly again. I threw up after i was able to breath again and than all 10 of my fingers were tingling for a few minutes. I had all the other listed side effects later that day fever, headache, tiredness, more nausea. It''s now four days later and I''m still dealing with on and off chest pain and random nausea.


VAERS ID: 1554073 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-01
Onset:2021-08-10
   Days after vaccination:101
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site rash, Nasopharyngitis, Rash, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I started with headaches, and a small rash lower arm (I felt like I had a cold) woke up today (8/13) with a large painful rash at the injection site on my left arm. Also, today''s fingertips feel harsh (dry, peeling). Continually to have headaches.


VAERS ID: 1554085 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-12
Onset:2021-08-10
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest X-ray normal, Condition aggravated, Fatigue, Hypertension, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID: SARS-CoV-2 (COVID-19) by NAA, Micro detected; on 8/12/21. CR on 8/11 showed no acute cardiopulmonary process.
CDC Split Type:

Write-up: patient presented with generalized fatigue x 2-3 days, along with increased hypertension w BP reportedly in 200''s. Patient tested positive for COVID on 8/12. pt has hx of Alzheimer, HTN, and CKD


VAERS ID: 1554128 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-03
Onset:2021-08-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine, Dysuria, Haemorrhage urinary tract, Urinary incontinence
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol, ciprofloxacin,
Current Illness: none
Preexisting Conditions: irregular heart beat, high blood pressure,
Allergies: no known allergy
Diagnostic Lab Data: not yet, will do on 8/22/21
CDC Split Type:

Write-up: patient has blood clot while urinate, dripping urination, blood urine, pain while urine. md gave cipro to treat, urine clear a little, but still has blood, no clot, md will continue monitor


VAERS ID: 1554144 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-08
Onset:2021-08-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Troponin increased
SMQs:, Myocardial infarction (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: No Known allergies
Diagnostic Lab Data: Troponin : 8/11: 7.6-- $g11.7-- $g8.4-- $g7.48 8/12: 7.26-- $g4.92-- $g5.00 8/13: 3.06 Echo (8/12): CONCLUSIONS: 1. Normal left ventricular size and qualitatively normal systolic function. 2. Normal right ventricular size and qualitatively normal systolic function. 3. No pathologic valve stenosis or insufficiency. 4. No significant intracardiac shunt. 5. Proximal right main, left main and left anterior descending coronary arteries are of normal size and origin. 6. No pericardial effusion.
CDC Split Type:

Write-up: Developed chest pain and had elevated troponin values without any echocardiographic abnormalities.


VAERS ID: 1554176 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-31
Onset:2021-08-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: vaccinated on 7/31/21 diagnosed with Covid on 8/10/21 COVID-19


VAERS ID: 1554203 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-11
Onset:2021-08-10
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Diarrhoea, Fatigue, Headache, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT DON''T KNOW THE NAMES
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: Antigen Covid Test
CDC Split Type:

Write-up: RUNNY NOSE, FATIGUE, SORE THROAT, HEADACHE,COUGHING, DIARRHEA


VAERS ID: 1554207 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-05
Onset:2021-08-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hyperglycaemia, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: doxycycline hyclate (VIBRAMYCIN) 100 MG capsule glucagon 1 MG SOLR injection glucose blood strip (BLOOD GLUCOSE TEST STRIP) box ibuprofen (MOTRIN) 600 MG tablet Insulin Aspart (NOVOLOG FLEXPEN) 100 UNIT/ML PEN injection Insulin Glargine (LA
Current Illness: Treated in emergency department for hyperglycemia from 6/25/21 to 6/26/21.
Preexisting Conditions: Non compliance w medication regimen Insulin dependent diabetes mellitus type IA Poorly controlled type 1 diabetes mellitus Diabetic ketoacidosis without coma associated with type 1 diabetes mellitus Hyperglycemia History of self-harm UTI (urinary tract infection) Cannabis abuse Long-term insulin use Poor compliance with medication Type 1 diabetes mellitus without complication Diabetic ketoacidosis without coma associated with diabetes mellitus due to underlying condition Hyperglycemia due to diabetes mellitus Gastroenteritis DKA, type 1, not at goal
Allergies: Metronidazole (nausea, vomiting)
Diagnostic Lab Data: COVID-19 test positive on 8/10/2021
CDC Split Type:

Write-up: Patient presented to emergency department with hyperglycemia, shortness of breath, and myalgias. She was found to be COVID-19 positive and was admitted to hospital for management of hyperglycemia. Patient was asymptomatic for COVID.


VAERS ID: 1554211 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Influenza like illness, Oral discomfort, Oral pruritus, Swelling face, Throat irritation, Tongue discomfort, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD
Current Illness: none
Preexisting Conditions: endometriosis, Gestation DM, hyperlipidemia
Allergies: diflucan, miconazole, reglan
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 45 year old patient complains of covid vaccine adverse reaction. States had vaccine on 8/10/21. Waited 15 min without problems and then noticed roof of mouth started itching. Then having a numb feeling pop up with burning and itching on tongue within 1 hour of getting shot. By the time she got home it moved to lips and throat. On the 12th morning face was mildly swollen. Took a Benadryl Tuesday night after she got home. Had an immune response with flu like symptoms Tuesday after getting shot and resolved in 24 hours. States ears feel full and throat feels raw and tongue feels like it burning but it is not bad. Taking Zyrtec during day because Benadryl makes her feel too drowsy. Was able to go to karate last night. But did noticed when she was more active her throat felt inflamed.


VAERS ID: 1554237 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / IM

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

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

Write-up: Diarrhea x 3 days, fever x 12 hours, arm pit swelling, energetic.


VAERS ID: 1554242 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

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

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

Write-up: Prior to dose being given, immunizations record was blank when reviewed in the electronic health record by the vaccinator. After dose given, while attempting to make the next appointment, the electronic health record indicated that the patient had already received 2 Moderna doses previously (2/11/21, 3/11/21). Patient does not recall having received a vaccine previously.


VAERS ID: 1554268 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-07
Onset:2021-08-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Headache, chest pain, chest discomfort, fatigue


VAERS ID: 1554290 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-16
Onset:2021-08-10
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 RA / IM

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

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

Write-up: Patient tested positive for COVID-19 aafter vaccination


VAERS ID: 1554310 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Pain in extremity, Painful respiration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: unknown
Current Illness: unknown
Preexisting Conditions: Hypothyroid
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient said she developed a fever of about 100 degrees F later that evening which lasted for about 36 hours. She said her arm and shoulder started hurting a few hours after getting the vaccine. She said the next day the pain was in her shoulder and back and it hurt to take a breath. She took Advil and Tylenol which helped relieve the pain. She is still having pain 3 days after getting the vaccine.


VAERS ID: 1554323 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-08-10
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 RA / IM

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

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

Write-up: patient tested positive for COVID-19 after vaccination


VAERS ID: 1554348 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-12
Onset:2021-08-10
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Corneal reflex decreased, Ear discomfort, Facial paralysis, Hemiplegia, Mastication disorder
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (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: 08/11 - Outpatient diagnosis of Bell''s Palsy by observation of sequelae and ruling out common other causes.
CDC Split Type:

Write-up: 08/10 - Patient (me) noticed difficulty blinking, chewing, smiling. General paralysis in the left side of their face. 08/11 - Patient visits outpatient Dr. and is diagnosed with Bell''s Palsy. Dr. prescribes 6-day course of 80mg daily Prednisone. 08/11 to present - Patient is taking the medication. The severity of the sequelae ahs not noticeably changed, but Patient notes a sensitivity to sound in his left ear.


VAERS ID: 1554350 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Asthenia, Chills, Dizziness, Fatigue, Headache, Hyperhidrosis, Malaise, Myalgia, Nausea, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 100mg daily, Losartan Potassium 50mg daily, D3 2000 IU daily, Rugby Daily-Vite w/Iron and Beta-Carotene 1 daily, Docusate Sodium 100 mg - 2 daily, Nature''s Bounty Hair, Skin & Nails Gummies w/Biotin, 2 daily
Current Illness: None -- I donated at Blood Drive on the 29th of July. No adverse effects
Preexisting Conditions: High Blood Pressure when if I don''t take Metoprolol and Losartan
Allergies: Macrodantin and Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8/10/21 - 3 pm-6 hr after receiving Vaccine, Headache started and progressively worsened over next 24 hrs. Had taken1 Aleve before supper. Overall muscle and joint pain and extreme fatigue started at around 8 pm. Woke up at 1:48 am with severe abdominal cramps, nausea, Chills with Sweat running off of me, This lasted for well over an hour and half. Dizziness and weakness throughout this time and all through the following 36 hrs., as well as bouts of nausea. I felt so ill during the night that if I could have made to the phone I''d have called the ambulance.


VAERS ID: 1554423 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dizziness, Neck pain
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: She lives with her brother who had Covid infection 4 weeks ago. She had a positive covid test on 7/23/2020 AND a negative covid test on 7/17/2021.
Preexisting Conditions: Pt reports no PMH. She is still breastfeeding her 18-month old child.
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt reports no PMH. She is still breastfeeding her 18-month old child. Ten minutes post vaccination, c/o mild dizziness and ""right chest localized soreness"" for 15 min then Right neck soreness. Denies CP, SOB, HAs, palpitations, any numbness of her extremities. No problem swallowing. No angio edema. General: NAD, talkative Heart: RRR, no murmur Lungs - CTA bil Skin - intact, no rash Extremities: Full ROM, good hand grips, strength - 5/5 bil She lives with her brother who had Covid infection 4 weeks ago. She had a positive covid test on 7/23/2020 AND a negative covid test on 7/17/2021. Vitals: @14:10 BP 111/66, HR 66, RR 16, SpO2 100% -- $g @14:25 108/71, 66, 100% -- $g @14:35 110/64, 64, 100% -- $g 114/65, 64, 16, 98%. Dizziness resolved and VSS. Chest and neck soreness unchanged and not worsening. Pt given instructions to f/u w/ healthcare provider or go to ED if symptoms worsen or remain after 3 days. F/U instructions provided. Pt stable and released from the vaccination site."


VAERS ID: 1554430 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-08-10
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cough, Headache, Pain, Polymerase chain reaction positive, Respiratory tract congestion
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: RT-PCR is POSITIVE
CDC Split Type:

Write-up: Emailed / vaccinated with pfizer in Feb- March 2021. Has cough, body ache and headache and mild congestion.


VAERS ID: 1554433 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

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

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

Write-up: Patient called COVID vaccine clinic on 8/13/2021 to report that 3 1/2 hours after receiving COVID vaccine on 08/10/2021 she started to experience chest pain/pressure, fluctuating between 4/10 and 8/10 on pain scale. Also reported mild shortness of breath on exertion. Denied any other symptoms (no rash, no swelling, no GI symptoms, no light headedness). Reported she went the following day (08/11/2021) to an Urgent Care clinic and reports she had an EKG that was "not concerning." She was instructed by the provider she saw at Urgent Care to go to the ED for blood work and further work up. Reported that she did not go to the ED. When this provider spoke with patient on 8/13/2021, she reported she was still experiencing chest pain/pressure and dyspnea on exertion. Patient was again instructed to go promptly to the ED for evaluation, which she stated she would do.


VAERS ID: 1554472 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Diarrhoea, Lethargy, Menstruation delayed, Palpitations, Postmenopausal haemorrhage, Pyrexia, Vaccine positive rechallenge
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Fertility disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid Shot #1. The same exact symptoms with very similar time frames.
Other Medications: IUD
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 1.) Diarrhea starting around 5 for evening 2.) Fever began around midnight and hit 101 at 3:00. Advil reduced fever 3.) Lethargy 4.) I started by period 3 days later the exactly like I did 3 weeks prior on my shot on 7/13 which lasted for 10 days after not having it for 7 months as hitting menopause and have an IUD. 5.)Racing heart off and on similar to when I had the Covid Virus in Feb 2020


VAERS ID: 1554503 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-03
Onset:2021-08-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

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

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

Write-up: Localized swelling, erythema, tenderness at injection site


VAERS ID: 1554556 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Chest discomfort, Condition aggravated, Headache, Injection site pruritus, Nausea, Pain in extremity, Pyrexia, Sleep disorder, Tinnitus, Vertigo, Vision blurred, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine/asthma exacerbation only (and only twice of multiple times receiving vaccine (and subsequent to those events). Did n
Other Medications: Zyrtec, albuterol MDI,
Current Illness: no acute illnesses
Preexisting Conditions: Asthma, venous reflux, migraines,
Allergies: Latex. Environmental allergies (numerous).
Diagnostic Lab Data: Used oral antihistamine, rescue inhalers, etc. symptoms not so severe that it was worth waiting 3 hours in Covid overrun clinic.
CDC Split Type:

Write-up: Received vaccine at 6:30 pm. itching at site began within first 15 minutes and lasted 2 days. Improved with antihistamine. Within 4-6 hours I began having vertigo causing waking through out the night. symptoms of vertigo were intermittent, non positional, and accompanied by blurred vision and persistent nausea throughout following day.. Also, chest tightness/wheezing/asthma symptoms acutely wise for 1-2 days after vaccine. Expected reactions included Fever of 101.2 after motrin, leg pain, headache but with loud pulsatile tinnitus. As a healthcare provider I can honestly say that this was out of the expected ?normal response? and definitely the vertigo was not anxiety provoked as some articles suggest (not immediate and not syncopal).


VAERS ID: 1554798 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-08-06
Onset:2021-08-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: heart attack (stents)
Allergies:
Diagnostic Lab Data: Patient to follow up with cardiologist.
CDC Split Type:

Write-up: Patient reports tachycardia randomly occurring. This is occurring when patient is idle and not being active (ie while sleeping at night). Reports several instances of this. Patient has had this issue in the past but has been common since the vaccine. Patient is on heart medication since he has had stents/previous heart attacks.


VAERS ID: 1554971 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster, Mouth swelling, Nasal congestion, Neuralgia, Swelling face, Swelling of eyelid
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft. Finished anti-biotics for strep the Friday before.
Current Illness: Strep
Preexisting Conditions: n/a
Allergies: shrimp
Diagnostic Lab Data: not sure what you are looking for here. Sorry. All the tests they did, or just the one to verify shingles?
CDC Split Type:

Write-up: Shingles. Nerve Pain. Swelling of right side of nose, mouth, cheek and lower eyelid.


VAERS ID: 1554985 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-08-07
Onset:2021-08-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Fatigue, Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad)

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

Write-up: Extreme fatigue, dizzyness, brain fog, tingling feet, joint pain and getting worse 1 week later.


VAERS ID: 1555426 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Asthenia, Diarrhoea, Headache, Myalgia, Pyrexia, Rash vesicular
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Weakness, debilitating muscle and joint pain, headache, fever, abdominal pain, diarrhea, spreading blister rash on face, neck, chest, knees (back & front), chin, hands


VAERS ID: 1555434 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-03
Onset:2021-08-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Paraesthesia, Rash, Skin reaction, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin 300mg daily
Current Illness: None
Preexisting Conditions: Muscle aches Low ferritin
Allergies: Pcn Tetracycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm red, rash, tingles down to hand, up neck, warm to touch shoulder area. Started 1 week after injection Improving


VAERS ID: 1555593 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-30
Onset:2021-08-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Menstruation irregular, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Vagina spotting that is moderately light in color accompanied by menstrual cramps. Last cycle was 2 weeks ago


VAERS ID: 1558059 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Headache, Mobility decreased
SMQs:, Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Not at the moment
CDC Split Type:

Write-up: Headache, severe pain between the breast and the axilla, severe pain in the arm at the elbow joint, difficulty stretching the arm.


VAERS ID: 1558071 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 AR / IM

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

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

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


VAERS ID: 1558081 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 07811 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: PCN= rash
Diagnostic Lab Data: I will be calling my PCP Monday am, did not realize this was a side effect until reviewing the info about the vaccine and this is exactly what one of the side effects are. This did not happen after my first dose, but second.
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Noted fluttering feeling in my chest starting around the day after my vaccine, the feeling comes and goes, it does not matter if I am working or resting


VAERS ID: 1558082 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 AR / IM

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

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

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


VAERS ID: 1558083 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 AR / IM

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

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

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


VAERS ID: 1558110 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-06
Onset:2021-08-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
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: Primrose oil, vitamin D, biotin, albuterol inhaler, Claritin, Ubrelvy, Aspirin, and AMITRIPTYLINE HCL
Current Illness: Migraines/headaches
Preexisting Conditions:
Allergies: Penicillin, sulfa, keflex (ANYTHING in the penicillin family)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles developed 4 days after my first dose of Pfizer COVID vaccine


VAERS ID: 1558112 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-09
Onset:2021-08-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: valtrex, gabapentin, loratidine
Current Illness: Urinary tract infection 7/31/2021
Preexisting Conditions:
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reports headache for 5 days, fatigue, body aches, muscle aches.


VAERS ID: 1558135 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-06
Onset:2021-08-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling, Lymph node pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Injection sight red and swollen from 24 hours after vaccination until time of report. Lymph nodes in left arm pit sore and swollen.


VAERS ID: 1558157 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Hyperhidrosis, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Lyrica, Roboxin, Spironolactone
Current Illness:
Preexisting Conditions: Spondylolisthesis, , polycystic ovarian syndrome , asthma
Allergies: Berries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild fever, hot sweats, body ache, nausea, sore arm, headache, moderate fatigue


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