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From the 6/4/2021 release of VAERS data:

Found 323,133 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 178 out of 3,232

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VAERS ID: 1343674 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood glucose increased, Blood pressure increased, Blood test, Chills, Cold sweat, Decreased appetite, Disturbance in attention, Fatigue, Feeling abnormal, Headache, Insomnia, Mobility decreased, Muscle disorder, Panic attack, Pollakiuria, Tachyphrenia
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50mg desvenlafaxine; Zyrtec, 5-10 mg melatonin.
Current Illness: None
Preexisting Conditions: Fructose malabsorption
Allergies: None
Diagnostic Lab Data: 5/14/21, GP ran blood panel, blood sugar was high after night of fasting, negative for diabetes. All other blood work within range.
CDC Split Type:

Write-up: On 4/13/2021, strong chills and mind racing followed by fatigue. Then on or about 5/3/21, onset of severe anxiety, panic attacks, raised blood pressure, buzzing in left thigh muscle, loss of appetite, frequent urination, strong urge to urinate, not able to sleep, feel on edge at all times, cannot focus, brain fog, fatigue. On 5/7 GP increased desvenlafaxine to 100 mg and prescribed lorazepam .5 to 1 mg to sleep. On 5/14, no improvement of symptoms, added buspirone 3 times a day. As of 5/24, no improvement in symptoms, muscle buzzing is worse, and hands are unsteady. Still no real appetite, constant cold sweats and headache.


VAERS ID: 1343812 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

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

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

Write-up: Patient experienced generalized rash to trunk, arms, and legs after receiving the vaccine on 03May2021. Patient still has rash three weeks later.


VAERS ID: 1343992 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-30
Onset:2021-05-03
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Confusional state, Diabetic ketoacidosis, Lung opacity, Procalcitonin increased, SARS-CoV-2 test positive, White blood cell count increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine 3/9, 3/30. Admit 5/3. Admit for COVID PNA, DKA. Treated w/ abx, steroids, remdesivir, zinc. CXR shows bilat opacities. Elevated WBC and procalcitonin. He was found to be COVID-19 positive and pulmonology was consulted. Required increasing amounts O2, tfer to PCU. Some clinical improvement but none for worsening confusion. Family opted for DNR and hospice. DC to IP hospice.


VAERS ID: 1344208 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-23
Onset:2021-05-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mirena birth control insert
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue ,dizziness on 05/03/21. vomiting, lost consciousness on 05/04/21. was taken to MC and hospitalized 2 days .


VAERS ID: 1344314 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Inflammation, Rash, Rash pruritic, Skin weeping
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: I believe I had a reaction to a malaria vaccine age 8
Other Medications: Vitamin C 1,000 mg/day Vitamin D3 5,000 IU/day Digestive Enzymes
Current Illness: None
Preexisting Conditions: back pain due to a short leg
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I received the vaccine in my right arm and sometime in the week following a small rash developed on that arm on the radial side of the elbow crease. The rash has grown to be about the size of a quarter, itches and oozes after itching. Ha persisted to present which is more than 3 weeks post vaccine. I believe the reaction was a re-activation of prior inflammatory reactions.


VAERS ID: 1344639 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-11
Onset:2021-05-03
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Angiogram cerebral, Antineutrophil cytoplasmic antibody increased, Biopsy artery normal, Blister, Blood magnesium, Body temperature increased, C-reactive protein increased, Cerebral infarction, Computerised tomogram abnormal, Computerised tomogram head, Cough, Decreased appetite, Dysarthria, Dyspnoea exertional, Facial paralysis, Flank pain, Full blood count, Glycosylated haemoglobin, Herpes zoster, Hypoaesthesia, Incomplete course of vaccination, Inflammatory marker increased, Lipids, Low density lipoprotein increased, Magnetic resonance imaging head abnormal, Metabolic function test, Muscular weakness, Neurological symptom, Night sweats, Rash, Red blood cell sedimentation rate increased, Rheumatoid factor increased, SARS-CoV-2 test negative, Skin discolouration, Troponin, Ultrasound Doppler, Vasculitis
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: From 05/03/2021-05/15/2021 during hospitalization: CT HEAD WO CONTRAST, CTA HEAD NECK, Venous duplex LE left , MR HEAD WO CONTRAST, Venous Duplex Lower Extremity - Bilateral . CBC, CMP, troponin, C-reactive protein, Magnesium, Rapid Covid-19, Lipid panel, hemoglobin A1C, BMP,
CDC Split Type:

Write-up: Patient arrived at ED 05/03/2021 with slurred speech, left-sided facial droop, left leg weakness. Per discharge summary by MD : Before January 2021 pt was quite healthy and working in a casino. On January 15, she fell in the parking lot and was started on Ibuprofen (800 mg) and flexeril for pain control. On mid-February pt received COVID vaccine and about 1 week afterwards she developed dyspnea on exertion associated with night sweats, poor appetite, dry cough. She had multiple workup done in the clinic including PCR-SARS-COVID x 2, which on both occasions were negative. She was found to have elevated inflammatory markers including ESR and C-reactive protein. She subsequently presented to ER the first time on 3/23 and found to be febrile with temperature of 39.3, saturation of oxygen was 100% on room air. She had a repeat PCR-SARS-COVID. This is her third one, which was negative. She was found to have elevated levels of RF, ANCA, markedly elevated CRP ($g150). She had (B) temporal artery biopsy that was negative. She was discharged with oral prednisone 20 mg a day. When she seen by Dr of rheumatology in clinic a few weeks later, her prednisone was increased to 60 mg a day for 2 weeks, then reduced to 50 mg a day. She presented back to the hospital (this admission) on 5/3/21 with slurred speech, left facial droop, and LLE weakness and left foot numbness. MRI brain showed acute infarct of left corona radiata though Dr of neurology reviewed the MRI and felt that there is some abnormality in the right temporal region as well, which would explain pt''s neurologic symptoms. She was placed on aspirin and high-dose statin (LDL was 132). Usual stroke workup was negative. She was maintained on prednisone for her recent dx of vasculitis. She subsequently developed severe pain of her left flank and subsequent eruption of a dermatomal rash, consistent with shingles. She was started on Valtrex 1 g three times daily. She was also started on neurontin with uptitrating doses. She had persistent pain so Lidoderm patches were tried which improved her pain significantly. Initially there was consideration of rehab placement though pt improved to a point that she was felt appropriate to discharge home. However, pt''s daughter, who would be caring for patient at home, is 6-month pregnant, and worried about pt''s shingles and the risk of transmission. Therefore pt was not discharged home but rather kept in the hospital on Valtrex with ongoing attempts at placement. Pt ultimately finished 7-day of Valtrex. The vesicles on her left back have all flattened and the area now is mostly a nearly confluent region of dark discoloration. At this point we re-discussed with pt''s daughter that since pt has finished a 7-day course of Valtrex and that her vesicles have resolved, there is extremely low risk of transmission, especially with standard hand-washing hygiene at home. Pt is also quite independent at this time and would not need assistance from her daughter for ambulation/ADL. Pt will also have her own room at home. At this time, pt''s daughter and family were agreeable to take patient home. In retrospect, pt''s "vasculitis" symptoms appear to have started in earnest about 1 week after she received her COVID shot (1st shot, she never received a 2nd shot due to severe symptoms) so it is possible that her vasculitis may have been caused/triggered by COVID vaccine. Other possibilities (less likely) include high-dose Ibuprofen (though she took lots of this in 2010 after another fall) or flexeril, though the timeframe is a bit longer. In any event, she was advised to avoid unnecessary medications, particularly NSAIDs and flexeril at this time until her clinical picture becomes clearer. She should also never receive COVID vaccine again.


VAERS ID: 1344670 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-15
Onset:2021-05-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Buttock injury, Contusion, Fibrin D dimer, Full blood count, Haematocrit normal, Haemoglobin normal, International normalised ratio normal, Pain in extremity, Platelet count normal, Prothrombin time prolonged, White blood cell count normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oral contraceptives- for treatment of endometriosis
Current Illness: none
Preexisting Conditions: endometriosis
Allergies: none
Diagnostic Lab Data: CBC WBC 7.6, Hgb 13.4, Hct 39.7, Plts 285 D-Dimer 0.57 , INR 1.1, PT 25
CDC Split Type:

Write-up: Bruises to bilateral thighs and buttocks with no history of trauma. Ongoing leg pain although bruising is resolving


VAERS ID: 1345283 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Metabolic function test, Pericarditis, Troponin normal
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: YAZ, Synthroid
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG - Normal with right axis deviation CXR - Normal D-Dimers Normal Troponin Normal CBC and CMP Normal
CDC Split Type:

Write-up: Patient developed substernal chest pain that began about 3 days after her first Pfizer Covid shot. It was worsened by laying flat and relieved somewhat by sitting upright or forward. NSAIDS were slightly effective at improving the pain. It took about a week to totally resolve. The patient went to a walk-in clinic initially and they noticed right-axis deviation on an EKG and sent her to the Hospital for further workup. She was discharged from the ER several hours later with no clear diagnosis but a suggestion that it sounded clinically like a viral pericarditis.


VAERS ID: 1345814 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-31
Onset:2021-05-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Haemoptysis, Headache, Night sweats, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VITAMIN D [COLECALCIFEROL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bronchoscopy (left lung filled with blood)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: blood clot in left lung, left lung filled with blood; coughing blood; slight headache for 2 days; tightness of chest; night sweats; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HAEMOPTYSIS (coughing blood) and PULMONARY THROMBOSIS (blood clot in left lung, left lung filled with blood) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 039B21A and 019B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Bronchoscopy (left lung filled with blood). Concomitant products included COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for an unknown indication. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 28-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 03-May-2021, the patient experienced HAEMOPTYSIS (coughing blood) (seriousness criterion hospitalization), CHEST DISCOMFORT (tightness of chest) and NIGHT SWEATS (night sweats). On an unknown date, the patient experienced PULMONARY THROMBOSIS (blood clot in left lung, left lung filled with blood) (seriousness criteria hospitalization and medically significant). an unknown date, the patient experienced HEADACHE (slight headache for 2 days). The patient was hospitalized on 03-May-2021 due to PULMONARY THROMBOSIS. The patient was treated with HEPARIN (intravenous) on 04-May-2021 for Clot blood, at an unspecified dose and frequency. At the time of the report, HAEMOPTYSIS (coughing blood) and PULMONARY THROMBOSIS (blood clot in left lung, left lung filled with blood) had not resolved, CHEST DISCOMFORT (tightness of chest) and NIGHT SWEATS (night sweats) outcome was unknown and HEADACHE (slight headache for 2 days) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. They did some tests and found there was blood clot in his left lung and put him on blood thinner but he reported that the blood thinner made his bleeding more worse. The patient still in hospital and currently in ICU and the Doctors are unable to determine where the blood is coming from and unable to remove the clot. And he is still suffering with blood cough. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested. This case was linked to MOD-2021-116374 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.


VAERS ID: 1345851 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan Amino acids Fish oil Allergy medicine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Office visit 5/14
CDC Split Type:

Write-up: New and worsened muscle and joint pain. Treatment with Naprosyn sodium. It is not improving


VAERS ID: 1345948 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary mass, Feeling abnormal, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Gout
Preexisting Conditions: Comments: The patient had No known drug allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210545103

Write-up: FEELING SPACEY; PEA-SIZE LUMP UNDER LEFT ARM; ITCHY UNDER LEFT ARM; INJECTION SITE PAIN LEFT ARM; This spontaneous report received from a patient concerned a 62 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included gout, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-MAY-2021, the subject experienced injection site pain left arm. On 07-MAY-2021, the subject experienced pea-size lump under left arm. On 07-MAY-2021, the subject experienced itchy under left arm. On 16-MAY-2021, the subject experienced feeling spacey. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from injection site pain left arm on 07-MAY-2021, and had not recovered from pea-size lump under left arm, itchy under left arm, and feeling spacey. This report was non-serious.


VAERS ID: 1347142 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Palpitations, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot
Other Medications: suboxone, benadryl, aspirin, and atorvastatin
Current Illness: Had a mini stroke 2 months before cause of cholesterol way hi!
Preexisting Conditions: headaches, high cholesterol
Allergies: ct dye, morphine, Zofran , Robaxin
Diagnostic Lab Data: I just asked a clinic dr. and they suggested I don''t get the second shot, it was very scary!
CDC Split Type: 05/03/2021

Write-up: I had heart papatations, feeling really flused, shaking, and dizzyness


VAERS ID: 1347191 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-24
Onset:2021-05-03
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023M20A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus
SMQs:

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

Write-up: Itchiness at injection site,


VAERS ID: 1347339 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, C-reactive protein increased, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Had a CRP test done on May 4th and it came back elevated at a 2.0 instead of under .8
CDC Split Type:

Write-up: Chest pain in the heart. Had a CRP test done on May 4th and it came back elevated at a 2.0 instead of under .8 Chest pain came with laying down, heavy breathing and getting going the first few hours of the day. Last for about 2 weeks.


VAERS ID: 1347589 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Coagulopathy, Headache, Heavy menstrual bleeding, Mood swings
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Dementia (broad), Depression (excl suicide and self injury) (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: Fluoxetine 40mg daily, Valtrex 1gm daily. Also have had IUD (Mirena) since 2016
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I?ve had a heavy period with clotting for a month now. I usually don?t have one at all because I have an IUD, but it started on May 3rd, and has lasted throughout the whole month. Also have had mood swings and headaches that are unusual to me.


VAERS ID: 1347628 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / IM

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

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

Write-up: Vaccine given to patient under the age of 18


VAERS ID: 1348332 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Ear pain, Gait disturbance, Headache, Hypoaesthesia, Hypoaesthesia oral, Magnetic resonance imaging head, Pain of skin
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 175 mcg 1xdaily 4 days a week. Levothyroxine 150 mcg 1 time daily 3 days a week (alternate 175/150 mcg) D3 sublingual 5000 international units (IU) 125 mcg equivalency as cholecalciferol
Current Illness:
Preexisting Conditions: Ehlers Danlos Hashimotos Fibormyalgia I stated I did not want this. This vaccine was forced upon me. I was fear mongered and told by a nurse I was literally die if I did not get it.
Allergies: basil bees regland doxycline methergine, fentanyl, versed. (an allergy consult was performed prior, a neurology consult and a dept chief of internal med
Diagnostic Lab Data: MRI of brain 5/04 Lab work Startnig medication which will impact TSH and make me susceptible to not be able to fight off covid if I were to contract it So angry 2 hours of MRIS have to be done now and other imaging, and they are demanding I am give gadalinium. I cannot have that I am allergic, so we cannot even do proper scans. Infuriated FOUR more MRIS scheduled in three weeks Also have to take ativan for that no driver have to pay for medical transport Beyond livid
CDC Split Type:

Write-up: Within an hour, extreme headache, left side of entire body ;limp/numb, tongue and face numb-- nexty day, entire body numb, except extreme pain and stinging wrists, hands, feet, mouth, ear to ear (trigeminal) extreme pain, difficulty wakling cannot use body strength came back and left again today 5/25 started course of methlyprednisone which will make me have weakened immune system fear getting covid now as I have to be around people I have not contracted covid. Docs at a aloss. said I was having signs of MS I do not have MS MS medically, and legally requires LP MRI is no longer gold standard for MS I went to school for things A transfection and expression event took place in my arm without my permssion after I was fear mongered to get this being told I would die if I did not I fear death now I have loss of function in arms and hands, I cannot do homework, it is difficult to ype, my hands feel like I am being stung by bees I just moved here because I was the main witness in a jury trial Upset is not the word I would use to describe


VAERS ID: 1348336 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-23
Onset:2021-05-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cardioversion, Electrocardiogram, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG on 5/3/2021
CDC Split Type:

Write-up: Heart palpitations and atrial fibrillation, starting 5/3/2021 6:45 AM. Resolved by electric cardioversion on 5/3/2021 5:00 PM.


VAERS ID: 1349099 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cerebrovascular accident, Functional gastrointestinal disorder, Illness, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific inflammation (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVEMIR; INSULIN
Current Illness: Type 2 diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 test; Test Result: Negative ; Result Unstructured Data: Negative; Test Name: COVID-19 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: stroke; tested positive for Covid; Covid-19; lost bowel function; got sick 4 hours later; This spontaneous case was reported by a consumer and describes the occurrence of CEREBROVASCULAR ACCIDENT (stroke) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in December 2020. Concurrent medical conditions included Type 2 diabetes mellitus. Concomitant products included INSULIN DETEMIR (LEVEMIR) and INSULIN for Type 2 diabetes mellitus. On 03-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-May-2021, the patient experienced FUNCTIONAL GASTROINTESTINAL DISORDER (lost bowel function) and ILLNESS (got sick 4 hours later). On an unknown date, the patient experienced CEREBROVASCULAR ACCIDENT (stroke) (seriousness criterion medically significant), SARS-COV-2 TEST POSITIVE (tested positive for Covid) and COVID-19 (Covid-19). At the time of the report, CEREBROVASCULAR ACCIDENT (stroke), FUNCTIONAL GASTROINTESTINAL DISORDER (lost bowel function), ILLNESS (got sick 4 hours later), SARS-COV-2 TEST POSITIVE (tested positive for Covid) and COVID-19 (Covid-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative and positive (Positive) Positive. The patient had stroke 2 days later to the second dose vaccination and was rushed/admitted to the ER for a while. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Based on the mechanism of action of mRNA-1273, the event (Covid-19) is assessed as unlikely related to mRNA-1273. This case was linked to MOD-2021-117175 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Based on the mechanism of action of mRNA-1273, the event (Covid-19) is assessed as unlikely related to mRNA-1273.


VAERS ID: 1349115 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-14
Onset:2021-05-03
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fall
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high; Borderline diabetes; Cholesterol high
Preexisting Conditions: Medical History/Concurrent Conditions: Arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Fell on left shoulder; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of FALL (Fell on left shoulder) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020B21A) for COVID-19 vaccination. The patient''s past medical history included Arthritis. Concurrent medical conditions included Borderline diabetes, Cholesterol high and Blood pressure high. On 14-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-May-2021, the patient experienced FALL (Fell on left shoulder) (seriousness criterion medically significant). At the time of the report, FALL (Fell on left shoulder) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication includes medication for diabetes, cholesterol and blood pressure. Treatment medication includes ice packs, took Tylenol and put her left arm in a sling. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1349493 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Dyspepsia, Malaise, Nausea, Oesophageal pain, Pain in extremity, Presyncope, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug hypersensitivity; Heartburn (before)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021506982

Write-up: nausea; vomiting/almost threw up with severe; almost threw up with severe,frightening, severe, heartburn, felt like esophagus was going to burst it hurt so bad; almost threw up with severe,frightening, severe, heartburn, felt like esophagus was going to burst it hurt so bad; fever of 101 all day; Caller almost passed out at one point; feeling terrible; dizzy; weak after second dose; chills/got really bad chills; arm started hurting all at once; This is a spontaneous report from a contactable consumer (patient). A 45-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in left arm on 03May2021 10:00 (Batch/Lot Number: ER8731) as 2nd dose, single for covid-19 immunisation. Medical history included she was very sensitive to medications and had a heart burn before. The patient''s concomitant medications were not reported. The patient previously had a flu shot more than a month ago and experienced pain in joints for like a couple of weeks. The patient received first dose of bnt162b2 on 12Apr2021 (Lot: ER8734; left shoulder at 10:00) for COVID-19 immunization and experienced chills for like a week after the first dose, arm was sore and numbness inside mouth and face. Patient reported that she had no side effects occurred after second dose of the vaccine until about 2300, 12 hours after caller received the second dose. On 03May2021, 23:30, she was dizzy, and was weak after second dose. What started it was she got really bad chills, she tried to get up and was dizzy, felt like she couldn''t stand up without holding onto something. The dizziness was ongoing maybe a little bit, probably related to the fact she can''t eat more than the vaccination itself. She stated the dizziness was probably a lot less, and she was able to walk around now. Her bad chills were not ongoing and didn''t last all that long. It lasted an hour that night of 03May2021 and she had chills again yesterday, 04May2021, when fever was going back up. They were really not that bad and stated that chills were gone now and recovered completely. On 03May2021, 23:30, her arm was sore; she reported that it started hurting all at once 23:30 on 03May2021. It was pretty severe, felt like entire arm it went through, it wasn''t just like it went through to inside of her arm. It was where lymph nodes were and partially across chest. It was still sore but definitely not anywhere near the degree it was Monday night, 03May2021. She stated that it has improved. On 04May2021, around 18:00, the patient experienced nausea and vomiting but this was different, hasn''t thrown up, almost threw up with severe, frightening, severe, heartburn, felt like esophagus was going to burst it hurt so bad. Patient reported that she has had heart burn before but she doesn''t typically suffer from it and this was beyond, extremely painful. The events lasted about an hour. She immediately took some antacid tablets, but they did not work. Her husband got her Tagamet, by the time the she took it she felt a lot better. The patient guessed that she recovered with lasting effects. She tried to drink plain broth with nothing, no noodles. This was why she called because acid started jumping up into her throat from drinking that. She was afraid to eat, and she was going to have to eat at some point. On 04May2021, the patient almost passed out at one point, felt like she was going to pee her pants because of the pain, and it hurts so bad. She was close to calling 911 it was scaring her that much. This occurred after she had just eaten a small roll with butter on it. She also had fever of 101 all day, Tuesday (04May2021). She doesn''t know when this began, and she finally took temperature mid-day, husband bought a new thermometer and she didn''t realize she had a fever. She was taking Tylenol every 8 hours. She wondered if the Tylenol bothered her, she doesn''t usually take Tylenol and she was told not to take Ibuprofen by the lady who gave her the second dose vaccination. She did take one Ibuprofen last night because she was feeling terrible and she felt a lot better. The events did not required a visit to the emergency room or physician office. Outcome of event almost passed out at one point, fever of 101 all day, weak after second dose was unknown; nausea, vomiting/almost threw up with severe, almost threw up with severe, frightening, severe, heartburn, felt like esophagus was going to burst it hurt so bad was recovered with sequel; dizzy, arm started hurting all at once and feeling terrible was recovering; and chills/got really bad chills was recovered on an unspecified date.


VAERS ID: 1349502 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Feeding disorder, Haemorrhoids, Hyperhidrosis, Inflammation, Musculoskeletal disorder, Musculoskeletal stiffness, Poor quality sleep, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; Diabetes; Heart disorder; High cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021508941

Write-up: Inflammation; Chills; Sweats; Fever; Shaking; could not sleep very well and was going in and out of sleep; Dizziness; Unable to eat; Weakness; Shortness of breath; Excruciating hemorrhoid pain; Left arm was really stiff; Left arm gets locked up; This is spontaneous report received from a contactable consumer (patient). A 31-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 intramuscular, administered in arm left on 03May2021 (Lot Number: EW0179) as 2nd dose, single at the age of 31-years-old for covid-19 immunization. Medical history was none. Family medical history included: High blood pressure, diabetes, high cholesterol and heart problems. The patient''s concomitant medications were not reported. The patient received 1st dose of bnt162b2 on 12Apr2021 with Lot ER8729, expiration is unknown, injected intramuscularly in left arm. No additional vaccines administered on same date of the pfizer suspect. No AE following prior vaccinations. No other prior vaccinations (within 4 weeks). The patient received the 2nd dose of the bnt162b2, and the next day (04May2021 12:00) the patient had excruciating slowly pain like a hemorrhoid pain. The patient bought hemorrhoid cream. The patient experienced shortness of breath on 05May2021, when he woke up yesterday he had it as well. He could not sleep very well and was going in and out of sleep. He could not sleep because of discomfort for hemorrhoid pain. The patient also had dizziness on 06May2021 12:00, inflammation, chills, sweats, and fever. He said that his left arm (injection site) gets locked up on 03May2021 23:00. He also said that he experienced shaking, weakness and was unable to eat on 05May2021 11:00. When he woke up on 04May2021, his left arm was really stiff. Yesterday, he was not able to eat (worsened). His weight was provided as being between 180-190 lbs. There was no prescriber. NO ER or physician''s office required. Outcome for hemorrhoids was provided as both persistent and worsened, of the events shortness of breath, dizziness, weakness, left arm gets locked up was not recovered, of other events was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1349540 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Fatigue, Flushing, Hyperhidrosis, Hypoaesthesia, Hypoaesthesia oral, Pain, Pain in extremity, Paraesthesia, Paraesthesia oral, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: body temp; Result Unstructured Data: Test Result:fever; Test Date: 20210507; Test Name: body temp; Result Unstructured Data: Test Result:100
CDC Split Type: USPFIZER INC2021520369

Write-up: Sweating profusely; could not even move her body it was so sore; flushed/this is like a hot feeling in her face; tingling feeling on the side of her face, above the eye; tingling feeling on her lip; numb feeling on the side of her face, above the eye and on her lip; numb feeling on her lip; fever of 100; arm started hurting really bad; felt really tired/exhausted; This is a spontaneous report from a contactable consumer (patient). A 60-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 03May2021 (Lot Number: EW0171; Expiration Date: Aug2021) as 2nd dose, single for covid-19 immunisation. Medical history and concomitant drugs were reported as no. The patient previously received 1st dose, single of bnt162b2 on 12Apr2021 (Batch/lot number - ER8729, Expiry Date: Jul2021) for covid-19 immunisation, and she was fine but then the next day her arm was a little sore if she touched it. Caller stated she just needs to ask a question because she is getting concerned. Caller stated then she went Monday to get the second dose and right after the shot her arm started hurting really bad which is a common side effect and she felt really tired so when she got home she went to bed. Caller stated then she noticed on the side of her face felt like she had Novocaine where she had this tingling and numb feeling on the side of her face, above the eye and on her lip and she was also still sore on her arm on Tuesday. Caller stated then Wednesday she was still experiencing a little bit of this tingling and numb feeling, was exhausted, and her arm was killing her. Caller stated on Thursday she was like ok she is feeling really good and starting to get back to normal. Caller stated and she just wanted to let this DSU agent know she has not been sick with anything not even a cold for over three years so this is not common. Caller stated then last night (was early this morning on 07May2021) she woke up sweating profusely and she could not even move her body it was so sore like she got beat up as it was just like an ache from her head to toes (this was like she had exercised and was really sore like that type of soreness) and also her arm was killing her still and she had a fever of 100. Caller stated she was calling because she is not sure if this is common? By Thursday she started feeling better from tired and made it through the whole day until last night she got really tired again and is still tired now. Caller stated she is just flushed (like a hot feeling in her face) now since the sweating had stopped. Caller stated she had a fever the first day on 03May2021 and then went away on Tuesday and she had recovered completely. But then she and woke up early this morning in the middle of the night on 07May2021 and the fever had started back. Caller stated she still has a fever as of now and it has stayed the same since she first noticed it early this morning. Treatment included: Tylenol and Ibuprofen. The outcome of sweating was recovered. The outcome of arm started hurting really bad, could not even move her body it was so sore and flushed was not recovered. The outcome of fever was unknown. The outcome of others was recovering. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1349543 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: ADVIL 12 HOUR
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021522777

Write-up: acute DVT of left peroneal vein (in the left calf); This is a spontaneous report from a non-contactable consumer (patient). This 49-year-old female patient (not pregnant) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number not provided), via an unknown route, on 29Apr2021 11:30 (at the age of 49-year-old) at single dose in the left arm for COVID-19 immunisation. No relevant medical history was provided. No other vaccine was received in four weeks. Relevant concomitant medications included ibuprofen (ADVIL 12 HOUR). From 03May2021, the patient developed sharp, piercing pain in my left calf over several days. The frequency increased the early morning (06:00-09:00) of 09May2021 so she contacted her primary care physician to discuss what she thought might be an indicator of deep vein thrombosis (DVT). She presented to the Emergency Room the morning of 09May2021 and was diagnosed with acute DVT of left peroneal vein (in the left calf). She was given blood thinner. Pre-vaccination and post-vaccination COVID tests were not performed. The patient was recovering from the events. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1349562 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-05-03
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0161 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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? 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: USPFIZER INC2021523847

Write-up: SOB; hives; axilla swelling; This is a spontaneous report from a non-contactable other health professional. This other HCP reported for specific patient that a 43-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EN0161) at the age of 43-years, via an unspecified route of administration on 17Apr2021 at single dose for COVID-19 immunization. Medical history was not reported. The patient was not pregnant at time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medications were not reported. On 03May2021, the patient experienced hives, axilla swelling and SOB. The events result in emergency room/department or urgent care. The patient received steroids as treatment to the events. Outcome of the events was recovering/resolving. No follow-up attempts are possible. No further information expected.


VAERS ID: 1350335 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Patient reported having swelling in his left side chest that went up to his jaw for several days


VAERS ID: 1350338 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Myocarditis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Banzel, Depakote, and Vimpat
Current Illness: Epilepsy-was diagnosed at age 8, has taken anti-seizure medication since
Preexisting Conditions: Epilepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, myocarditis, fatigue


VAERS ID: 1350360 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-05-03
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (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: rosuvastatin 10mg/daily enalapril 20mg/daily metoprolol succinate ER 50mg/daily Omeprazole Magnesium 20mg/daily Vitamin D3 400unit 1tab/daily
Current Illness: N/A
Preexisting Conditions: Hypertension
Allergies: N/A
Diagnostic Lab Data: Had a hearing test at ENT - showed WNL for age.
CDC Split Type:

Write-up: Bilateral Tinnitus approximately 2 weeks after injection.


VAERS ID: 1350569 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Cellulitis, Chills, Fatigue, Full blood count normal, Headache, Metabolic function test normal, Night sweats, Pollakiuria, Rash macular, Red blood cell sedimentation rate increased, Scar pain, Urine analysis normal
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Oxycotin and red delicious apples
Diagnostic Lab Data: May 5, 2021 Dr at Emergency room, CRP was 13.8 mg/dl, ESR was 32 mm/hr, CBC with differential were all in normal ranges. May 10, 2021, Dr at Clinic, ESR was 25 mm/hr, CRP was 1.4 mg/dl, and basic metabolic panel results were in the normal range. Urinalysis showed no evidence of inflammation in the kidneys causing the higher creatinine and or the possibility of vasculitis as a cause for the rash.
CDC Split Type:

Write-up: No initial reactions or side effects from the first dose on April 12, 2021. Three weeks later on May 3, 2021 if felt fatigued by evening time and had chills and sweats all night. No energy on May 4, 2021 and slept all day with bouts of chills and sweats but never had a temperature over 98F. Woke up the morning of May 5, 2021 and discovered a large red patch centered over my left hip THR incision scar. The incision scar was very sore and a dark purple. I had a dull dehydration type of headache and had to urinate about every 20 minutes on May 4th. Went to the emergency room and was diagnosed to have cellulitis and given a 7 day dose of antibiotics and 10 day dose of antiviral medication. The rash never was very itch and started to subside immediately after taking the first dosage of these two medications. Went to see my primary physician on May 10, 2021 and he believes I had vasculitis and not cellulitis. No signs of any insect bites or cuts to have started the infection/inflammation. He noticed that blood vessels in and around the red patch which was about the size of a dinner plate were elevated to the surface. Followed up with Dr on May 25th via telemedicine visit and he ordered another series of blood lab and urine tests on June 10, 2021, to make sure my ESR, CRP, and urinalysis results were continuing to decline.


VAERS ID: 1350650 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: patient had knowingly gotten the janssen(j&j) vaccine a few weeks back but decided to get the 2 series moderna vaccine in addition to the j&j and failed to disclose that he had already been fully vaccinated and stc couldn;t be accessed since it was an offsite event, information on his prior covid immunization was not accertained. as a result he had an additional dose of 1 moderna vaccine plus his previous j& j vaccine he had gotten from a different facility. patient described not having any adverse events from the 2 vaccines given. he had no symptoms to the additional moderna dose gotten. since pt had gotten 2 different doses of covid 19 from 2 different manufactures, its incumbent upon us to report the incident although patient did not have any adverse events


VAERS ID: 1350715 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Facial discomfort, Feeding disorder, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 1st Shot: The right side of my face felt like someone punched me and knocked my teeth out. Every joint in my body hurt terribly (ie: neck, fingers, wrists, shoulders, elbows, hips knees, ankles toes). I had an excruciating pain that started from the top of the right side of my head continued on down my jaw thru my neck down to my chest just below my right breast. This pain was intense and would follow thru to my back. It literally put me on the floor when it hit. I had a fever of 99.7 despite talking Tylenol. I was is bed for 34 hour starting about 10 hrs after injection, lights out, no phone, no TV. I was unable to eat, all the water I was able to drink I threw up immediately. 72 hrs after injection I returned to work still achy and nauseous. 2nd Shot: Almost identical results.


VAERS ID: 1350890 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Chills, Erythema, Induration, Pain, Peripheral swelling, Pyrexia, Skin warm, Viral titre
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: On 5/11/21, patient went to doctor and her bloodwork revealed a 2.7 titer of her antibodies against the virus.
CDC Split Type:

Write-up: Patient went to the doctor on 5/11/21 due to adverse reaction to vaccine .The patient had a swollen arm (lump) for two weeks after vaccine. The area was hot, hard, and red. She experienced a fever, chills, and body ache for three days. Her bloodwork showed a 2.7 titer of antibodies therefore Doctor is suggesting not to take second dose of vaccine.


VAERS ID: 1350970 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-02
Onset:2021-05-03
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3906 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3906 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Disorientation, Fatigue, Hypertension, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen 500mg, Alendronate FOSAMX 70mg, Lisinopril 20mg, Omeprazole 20mg, RisperiDONE 1mg
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Son reports that the case was not reacting the same after taking his usual blood pressure medications-disoriented, fatigue, complaints of not feeling well and blood pressure was not responding as normal to the medications. THus son took this case to the hospital for his hypertension around 700pm on 05/21/21. He was never in the mechanically ventilated nor in the intensive care unit.


VAERS ID: 1350980 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-05-03
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ataxia, Dyspnoea, Electromyogram, Heart rate increased, Muscle contractions involuntary, Muscular weakness, Nerve conduction studies, Paraesthesia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic, Aspirin, Allopurinol, Crestor, Vitamin D
Current Illness: None
Preexisting Conditions: Hypertension, gout, hypercholesterolemia
Allergies: None
Diagnostic Lab Data: EMG/NCV upper and lower extremities and lumbar region.
CDC Split Type:

Write-up: 05/03/2021 Paresthesias both feet, weakness lower extremities. Increased heart rate. Shortness of breath when recumbent. Ataxia. 05/07/2021 Paresthesias both hand, fasciulations, tremors 05/21/2021 Evaluation by neurologist, Dr. Diagnosis


VAERS ID: 1351040 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA / 2 RA / SYR

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

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

Write-up: I broke out in hives head to toe. This went away with Benadryl. However I have been having a red itchy hand for weeks now that will not subside with antihistamine.


VAERS ID: 1351087 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-05-03
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Coronary angioplasty, Fatigue
SMQs:, Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

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

Write-up: Patient presented to the ED on 3/25/21 for fatigue. Patient presented to the ED and was subsequently hospitalized on 5/3/21 for chest pain. Patient was hospitalized on 5/11/21 for percutaneous transluminal coronary angioplasty. These visits are within 6 weeks of receiving COVID vaccination.


VAERS ID: 1351286 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Tinnitus both ears


VAERS ID: 1351339 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-03
Onset:2021-05-03
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Platelet count decreased, Platelet disorder
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvistatin, omega 3, probiotic.
Current Illness: None
Preexisting Conditions: Light asthma. Had pneumonia 3 times within 18 months but a few years back. Did not get pneumonia this time.
Allergies: None
Diagnostic Lab Data: Blood panel on May 3, platelets 17,000. Blood panel on May 6, platelets 72,000. Blood panel on May 10 platelets 156,000
CDC Split Type:

Write-up: Had COVID the month of December- no hospitalization. Had first moderna April 3, 2021. Second moderna shot May 4. I have had low platelets for a few years but not any lower than 43,000. Went for blood work on May 3 2021 for Dr. for check up and my platelets were 17,000. She prescribed me a steroid and brought them back up to 156,000 by May 10. She told me it was from COVID . My vaccine was very close to my appointment.


VAERS ID: 1351392 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-26
Onset:2021-05-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Injection site rash, Skin mass, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blisovi 24 Fe tablet
Current Illness: None
Preexisting Conditions: None
Allergies: Skin allergic reactions to creams with retinol or bb creams
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 week after the first dose I developed a rash on the injection site(left arm) and had soarness in my left armpit and a tightness bulge that moved over my left collarbone. After the second covid shot the bulge feels like there are now two of them and they are more tender and moves around my collarbone. They are about the size of the tip of my pinky finger. I have body aches and diarrhea.


VAERS ID: 1351398 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-24
Onset:2021-05-03
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the ED and was subsequently hospitalized for pulmonary embolism within 6 weeks of receiving COVID vaccination.


VAERS ID: 1351607 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-29
Onset:2021-05-03
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bilevel positive airway pressure, COVID-19, Chest X-ray abnormal, Chills, Dyspnoea, Exposure to SARS-CoV-2, Lung infiltration, Pulmonary congestion, SARS-CoV-2 test positive, Tachycardia, Tachypnoea
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, aspirin, Lipitor, Combivent Respimat inhaler, Cardizem CD, Aricept, ferrous sulfate, Lasix, Imdur, levothyroxine, Lopressor, multivitamin, Nitrostat, Protonix, Paxil, Compazine, Ranexa, Desyrel
Current Illness: Diarrhea
Preexisting Conditions: A-fib, anxiety, aortic regurgitation, arthritis, asthma, chronic constipation, COPD, DVT, dementia, depression, diverticulosis, DJD, essential hypertension, GERD, Grave''s disease, hypothyroidism, insomnia, lung cyst, OSA, osteopenia, TIA, venous insufficiency
Allergies: Beta adrenergic blockers, clarithromycin, erythromycin, levofloxacin, losartan, propranolol
Diagnostic Lab Data: Outpatient COVID test
CDC Split Type:

Write-up: 81-year-old female with past medical history of hypertension, chronic respiratory failure on 2 L oxygen at night, asthma, depression, anxiety, atrial fibrillation, coronary artery disease, who presented to the hospital complaining of a shortness of breath. The patient reported that she was vaccinated for a COVID-19 couple months ago 2nd shot, again presented to the hospital for a shortness of breath getting worse for the last 2 days. The patient has been in contact with and exposed to a positive COVID person, her husband, and he is in the ICU. Vitals were T-max 98.6, heart rate tachycardic, tachypneic, and blood pressure 150/100. The patient had a chest x-ray, which showed a congestion as well as right perihilar infiltrate. Patient was in the ER on BiPAP. She denied any headache. No dizziness. No blurry vision. No difficulty swallowing or difficulty hearing. No chest pain. Reported shortness of breath with some chills. No fever. She denied abdominal pain. No nausea or vomiting. No change in bowel habits or urination habits. Diagnosed with COVID on 5/3/2021 prior to admission.


VAERS ID: 1351953 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-26
Onset:2021-05-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWU177 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Hypoaesthesia, Muscle spasms, Muscle tightness, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (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: Ketoconazole cream
Current Illness: None
Preexisting Conditions: Acid reflux every once in a while
Allergies: Minocycline
Diagnostic Lab Data: Ultrasound on legs Bloodwork EMG MRI (to be done this week)
CDC Split Type:

Write-up: About a week or so after my first dose I started having muscle tightness and cramping in my legs and some ?electric? type radiating shots down my left leg starting up in my thigh down to my ankle. I thought it was getting better but then a week or so after my second shot I began having worse leg problems (weakness, pains, pulsing, numbness, tingling). It?s just gotten worse and I?m having tests done and seeing a neurologist.


VAERS ID: 1352347 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram neck, Computerised tomogram normal, Dizziness, Head discomfort, Musculoskeletal discomfort, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D - daily dose, vitamin C daily dose
Current Illness: slight fever 99 deg due to first vaccine , and slight fever a week before second
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: CT of head and neck., chest Xray - normal
CDC Split Type:

Write-up: 3 weeks after second dose of Pfizer, woke up with vertigo/dizziness. Almost fell as I left the bed. Felt ok on and off - but in the evening felt moderate vertigo multiple times. Went to ER and physician judged either BPPV or vestibular neuritis or something similar. No prior vestibular history or tinnitus experience. It seemed to resolve after 2-3 days of meclizine. Then again on May 22, it started and continues where on adn off vertigo and dizziness persists. Meclizine is not very effective. Hoping I feel better soon. Have an appt with PCP on Friday. Feel some neck ache occasionally. and a bit of full ear


VAERS ID: 1352391 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Headache
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: flonase, vitamin D, multivitamin
Current Illness: none
Preexisting Conditions: headache
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sharp, stabbing unilateral headaches lasting 1-3 seconds, initially 2/day, now 15/day. Different from baseline headache type. Started day after second dose.


VAERS ID: 1352771 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Contrave
Current Illness: No
Preexisting Conditions: None
Allergies: Never
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Breaking out in hives a little Every evening since getting the 2nd shot


VAERS ID: 1352780 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-05-03
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 45A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Stillbirth
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Nond
Preexisting Conditions: Nond
Allergies: Sulfas
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stillbirth at 39 weeks and 3 days


VAERS ID: 1353501 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-21
Onset:2021-05-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Colonoscopy, Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Colon cancer (Patient had history of colon cancer 2 years removed)
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Colonoscopy; Result Unstructured Data: Test Result:Clear; Test Date: 20210503; Test Name: Ultrasound; Result Unstructured Data: Test Result:Diagnosed with blood clots confirmed by ultrasound
CDC Split Type: USPFIZER INC2021530763

Write-up: Patient was diagnosed with blood clots confirmed by Ultrasound; This is a spontaneous report received from a contactable physician. A 48-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EW0164), on 21Apr2021 as 2nd dose, single for COVID-19 immunization. The patient''s medical history included colon cancer (patient had a history of colon cancer 2 years removed) from unspecified date. The patient''s concomitant medications were not reported. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number not reported), on 30Mar2021 as 1st dose, single for COVID-19 immunization. It was reported that patient was diagnosed with blood clots confirmed by ultrasound during the emergency room visit on 03May2021. Patient was placed on apixaban (ELIQUIS) 5 mg, twice a day. Patient had history of colon cancer 2 years removed, and recent colonoscopy on 13Apr2021 was clear. The event was reported as non-serious. The outcome of the event was unknown.; Sender''s Comments: The event of blood clot is assessed as possibly related to the suspect BNT162B2 based on temporal association, but medical history of colon cancer was confounder. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Committees, and Investigators, as appropriate.


VAERS ID: 1353540 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Unknown  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Dermatitis, Herpes zoster, Insomnia, Magnetic resonance imaging
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CYTOMEL; SYNTHROID; EFFEXOR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Test Result: Negative ; Test Name: MRI; Test Result: Negative
CDC Split Type: USPFIZER INC2021534985

Write-up: can''t even sleep at night.; couldn''t diagnose that the part was either dermatitis or shingles; couldn''t diagnose that the part was either dermatitis or shingles; This is a spontaneous report from a contactable consumer (patient). A 48-years-old patient of an unspecified gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2, via an unspecified route of administration, administrated in arm right on 12Apr2021 (Batch/Lot Number: EW0150) at the age of 48-years-old as single dose for covid-19 immunisation. Medical history included Hypothyroid. Concomitant medications included liothyronine sodium (CYTOMEL) taken for Hypothyroid from 2017 to an unspecified stop date; levothyroxine sodium (SYNTHROID) taken for Hypothyroid from 2017 to an unspecified stop date; venlafaxine hydrochloride (EFFEXOR) taken for Hypothyroid from 2017 to an unspecified stop date. The patient previously received the first dose of BNT162B2 (''EW/N 6207'', is it E, don''t know is it EN or EW) on 20Mar2021 at the age of 48-years-old for covid-19 immunization. Patient had the Covid vaccine on an April 12 and it went three week now and patient just recently started having a reaction and patient went to see my doctor yesterday and they couldn''t diagnose that the part was either dermatitis or shingles. The patient had second dose of vaccine on April 12. Last Monday (03May2021), patient started having itchiness on only the right side of upper portion of face. Patient had shot in right arm, patient lymph nodes were enlarged. That''s the one thing then second thing was last Monday, patient started this, this itchiness started and right side of nose and over to cheek up to a kind of outside corner of eye and next the itchiness was gone away for that well patient guess eye was still there for cheek portion is done. Now it''s from that outside corner of forehead and on scalp and it was so itchy, it''s like chickenpox patient mean like patient had to take two Benadryl every four hours to keep itching it''s kind of that pain but patient do have some red spots on head but again they couldn''t diagnose as shingles, they couldn''t diagnose it really yesterday. The only thing patient had done making patient aware, patient could potentially have recurrence of shingles and patient did have that two years ago. Patient was loosing mind, it''s so itchy. patient mean patient could even sleep at night. Patient had to put cold tampons on head and it just on right side, it is never move to left side only to right side which was so weird. The patient was just having a really bad reaction, first it was itchiness was on, it went from like the center of patient''s forehead nose all the way over to right side. Patient had shot on the right side and it was on nose and cheeks to begin with, just itchy not a rash and now it''s moved to forehead and in to patient''s scalp and on patient scalp there are little red dots. Patient went on to primary doctor and they can''t diagnose it because it didn''t look like shingles, the patient was about out of my mind itchy, so bad. The patient was having to take 2 Benadryl''s every 4 hours to kind of keep it at bay or a cold compress. Other treatment for the events included Valacyclovir and prednisolone. Valacyclovir 1mg, three times a day for 7 days. Prednisolone 20mg, 3 tablets for first 3 days then 2 tablets for three days, one tablet for three days, half tablet for three days and I am on my second day of that. Tablet, orally. The patient underwent lab tests and procedures which included computerised tomogram (CT) scan: negative on an unknown date, magnetic resonance imaging (MRI): negative on an unknown date. The outcome of the events was unknown.


VAERS ID: 1354476 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-23
Onset:2021-05-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram normal, Aortic dilatation, Aortic stenosis, Aortic valve incompetence, Arthralgia, Cardiac monitoring, Cardiac septal hypertrophy, Chest X-ray normal, Chest discomfort, Chest pain, Echocardiogram, Electrocardiogram normal, Left ventricular dilatation, Magnetic resonance imaging abnormal, Myocarditis, Neck pain, Pain, Troponin increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 mg tablet Take 5 mg by mouth Daily . aspirin 81 mg chewable tablet Chew and swallow 81 mg Daily. atorvaSTATin (LIPITOR) 20 mg tablet Take 20 mg by mouth nightly. escitalopram (LEXAPRO) 10 mg tablet Take by mouth Daily
Current Illness: none reported
Preexisting Conditions: Past Medical History: Diagnosis Date ? Hypertension ? Tremor
Allergies: NKDA
Diagnostic Lab Data: On admission HS-Tn elevated at 230 and EKG shows NSR, no ST/Twave changes. ECHO shows EF 60%. Received ASA and nitro in the ED. -monitor on telemetry -cardiology consulted, angio on 5/14 showed normal coronaries, cardiac MRI with evidence for myocarditis per discussion with cardiology - final read is pending at dc: LEFT VENTRICLE: The left ventricle is dilated. There is asymmetric septal hypertrophy measuring up to 16 mm at the basal anteroseptal segment. Regional edema or iterative T1 signal elevation is seen. LV myocardial nulling sequence is normal. EDV:258.94 ml ESV:109.93 ml SV:149.01 ml EF:57.55 % CO:8.48 l/min CI:3.62 l/min/m2 HR:56.9/min Myo Mass (Diast):274.03 g EDV/BSA:110.52 ml/m2 RIGHT VENTRICLE: Right ventricular size is normal. There are no wall motion abnormalities. Wall thickness is normal. RVEDV:197.14 ml RVESV:67.46 ml RVSV:129.68 ml RVEF:65.78 % RVCO:7.38 l/min RVCI:3.15 l/min/m2 RVEDV/BSA:84.14 ml/m2 ATRIA: Normal in size and appearance. VALVES: The aortic valve leaflets are thickened and there is decreased systolic excursion. There is turbulent flow across the aortic valve. Moderate aortic regurgitation is present. AORTA: The aortic root measures approximately 40 mm at the sinuses of Valsalva. PULMONARY VASCULATURE: Grossly normal PERICARDIUM AND PLEURA: Unremarkable DELAYED MYOCARDIAL ENHANCEMENT: There is a small area of late enhancement involving the subendocardium of the basal inferolateral segment. No subepicardial enhancement is seen. NON-CARDIAC FINDINGS: Grossly normal
CDC Split Type:

Write-up: Please refer to the H&P for full details. This is a 63 y.o. male with PMHx of HTN and HLD who presented to the ED with chest pain NSTEMI Type 2 Myocarditis Patient was seen by her PCP on 5/12 with c/o chest pain found to have elevated troponin 0.06 (0.03 upper limits of normal) otherwise EXG and CXR nl and was recommended to come to the ED. Patient reports the chest pain started ~1.5 weeks ago, initially resolved, however began to have discomfort again 4d PTA. She describes the sensation as a dull ache with radiation to the neck and her right shoulder. No history of heart disease. Risk factors for this pt include HTN, HLD and tobacco use. On admission HS-Tn elevated at 230 and EKG shows NSR, no ST/Twave changes. ECHO shows EF 60%. Received ASA and nitro in the ED. -monitor on telemetry -cardiology consulted, angio on 5/14 showed normal coronaries, cardiac MRI with evidence for myocarditis per discussion with cardiology - final read is pending at dc - colchicine started Moderate aortic stenosis Noted on ECHO, no significant change in the aortic valve pathology or aortic root dimension compared to prior in 2017 HTN Normotensive in the ED -continue amlodipine and lisinopril HLD Last lipid panel on 12/1/2020 with LDL 109 -continue statin - increased to high dose 80 mg Tobacco abuse Current everyday smoker of at least 1 ppd -cessation discussed Tremor: Continue home med Aortic root dilation - 4.0 cm. Monitor.


VAERS ID: 1354749 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports pain during injection. Pain intensified the following Monday. The pain felt like "being hit by a mac-truck". Patient reports pain was in left arm, then spread to left trap and then to the right shoulder/arm area. It stayed with severe intensity for 3 weeks, finally subsiding at 3.5 weeks after injection.


VAERS ID: 1354821 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-05
Onset:2021-05-03
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Bacterial infection, Campylobacter infection, Chills, Pyrexia, Stool analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: When I had the Covid vaccine I had chills, fever, and joint pain
Other Medications: None
Current Illness: None
Preexisting Conditions: Gallbladder disease
Allergies: Penicillin
Diagnostic Lab Data: Stool tests Carry sites bacterial infections
CDC Split Type: vsafe

Write-up: I had the vaccine and about a month later I was diagnosed with Campylobacter which is a bacterial infection and they told me it was definitely not related to the vaccine. I took Azithromycin.


VAERS ID: 1355078 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 AR / IM

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

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

Write-up: Patient under age 18 was vaccinated with Moderna, which is a vaccine error, on 4/02/2021. Second vaccine provided 5/03/2021 - Moderna 017C21A. Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn away on a Moderna-only day. For the second error (Pfizer #2) scribe, screener, and vaccinator did not look at the record, but second vaccine could have been given per standing orders. Unreported as error, found in data mining. Age restriction/confirmation rules were put into effect after the date of the first vaccine to prevent underage vaccines.


VAERS ID: 1355223 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, X-ray
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium- (300mgx2daily Fluticasone propionate 50mcgx4daily Loratidine 10mg Esomeprazole (generic nexium)20mg Vit D3, 5000iu Ginkgo 120mcg Super B complex
Current Illness: None
Preexisting Conditions: Had shingles several years back (about age 47), had shingles vaccine (1st dose) February 18, 2021, waited after that until April first for 1st Covid vaccine.
Allergies: Erithromiacin, citrus pith, duck feathers, bluegrass, mild/mildew
Diagnostic Lab Data: X-rays, lab tests run on May 25, 2021
CDC Split Type:

Write-up: 4 days after 2nd injection I experienced sudden sharp pain in left heel when knee is straight and toes flex up. I experience this pain each time I make this motion. About a week later I noticed persistent numbness in the same area, left heel around outside and back of heel. After a week I called my PA for appointment and on May 25 I saw her and got a full blood panel and an xray. She referred me to a podiatrist but also mentioned it might be connected to the vaccine, as other cases of neuralgia have been noted.


VAERS ID: 1355290 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-28
Onset:2021-05-03
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Pyrexia, Rash, Sleep disorder, Urticaria, Vaccination complication, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Birth control- brand name: Alyacen 1/35
Current Illness: None known
Preexisting Conditions: None known
Allergies: Penicillin
Diagnostic Lab Data: Doctor decided tests were unnecessary
CDC Split Type:

Write-up: Date of vaccination (4/28), fever of 102 F, resulting in loss of sleep. A week later (5/03), singular hives began to appear on arms and legs, resulting in loss of sleep. Much worse the next day (5/04)- clustered hives accompanied with burning rash all over arms and legs. Benadryl anti-itch cream only enflamed them more. Vomited the next morning (5/05) and made an appointment with healthcare clinic, despite hives and rash subsiding overnight. Doctor ruled vomiting as an effect of prescription medication, but rash and hives as a result of a reaction to the vaccine. Next day and the day after,(5/06-5/07), had a few single hives appear on body. Haven''t had any more appear since then, and I''ve felt fine.


VAERS ID: 1355297 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Gait disturbance, Pain in extremity, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I went to general doctor on 05/07/21 and I am scheduling a visit with cardiologist today.
CDC Split Type:

Write-up: Three days after my second shot (on 05/03/2021) I started to feel pain in my left arm, tightness in chest, and I became very light headed. I tried to go to shower but I could not walk and laid down. My ears felt very tingly and I thought I was going to pass out but as far as I know, I did not. I went to my primary care doctor and he has me taking baby aspirin daily (in case blood clot) and wanted to see if it got better I am going to follow up with a cardiologist. I''ve never had a problem with heart before and get an annual physical at work.


VAERS ID: 1356500 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-01
Onset:2021-05-03
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chronic fatigue syndrome, Condition aggravated, Epstein-Barr virus test positive, Fatigue, Human herpes virus 6 serology positive, Human herpesvirus 6 infection, Human herpesvirus 6 infection reactivation, Inappropriate schedule of product administration, Post viral fatigue syndrome
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Several
Current Illness: Common variable Immunodeficiency Autoimmune POTS Autoimmune MCAS Hemochromatosis Hashimotos Adrenal insufficiency ME/CFS
Preexisting Conditions: Common variable Immunodeficiency Autoimmune POTS Autoimmune MCAS Hemochromatosis Hashimotos Adrenal insufficiency ME/CFS
Allergies: Corn, milk, eggs, bactrim, Biaxin, sulfa, ampicillin, amlodipine
Diagnostic Lab Data: March ? 2021 HHV6 PCR May 3, 2021 HHV6 PCR May 20? 2021 HHV6 quantitative PCR March 2021 Lymphocyte Subset Panel
CDC Split Type:

Write-up: I had a negative HHV6 PCR in late March. I had Moderna vaccine on March 24 and April 17. On May 3, I had a positive HHV6 PCR test and last week ~May 20, I had a HHV-6 quantitative PCR positive and above range. I have a history of reactivated HHV6 after my 2014 stage 3 cancer treatment, which triggered my ME/CFS. I subsequently went on IVIG every three weeks which I continue to this day, and I was on 20 months of Valcyte, as I had PCR positive Epstein-Barr as well as HSV-2 outbreaks. I was on Rituximab from May 2019 to February 2020 for my autoimmune conditions, and have 5% of normal B cells. I have been noticing increased fatigue, and I suspect that this HHV-6 reactivation might be a reason. This is a serious event and puts all the substantial gains in my ME/CFS at risk. I am now back on Valcyte, but one of the treatments I was using to help me, as I have a history of low NK cell function, was thymosin alpha 1, which has been shown to be effective in stimulating T cell and NK cell function, the FDA helpfully banned in February of this year and now I cannot access it. I have an incompetent immune system and this vaccine has created harm that I don''t know how to undo. What do I do now?


VAERS ID: 1356569 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Back pain, Headache, Insomnia, Nausea, Neck pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Men''s Multivitamin and Fish Oil taken daily
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I almost immediately started getting soar in my arm. After a few hours my arm down to my elbow was VERY soar, my back around my shoulder blade became soar, and over my shoulder up to my neck into the left side of my head was very soar and achy. Headaches were present most of the first day. That night, around supper time I felt nauseous and then had some severe stomach cramps. I didn?t sleep well and woke up with the same bad pain from my elbow to my shoulder and also my shoulder blade to my neck and head. Most of the symptoms were gone after 48 hrs.


VAERS ID: 1357052 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Myalgia, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZINC; MULTIVITAMINS [VITAMINS NOS]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210549072

Write-up: MAGNETS ARE STICKING TO HIS LEFT SHOULDER; CHILLS; HEADACHE; MUSCLE ACHES; VERY TIRED; This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. Concomitant medications included vitamins nos, and zinc. On 03-MAY-2021, the subject experienced chills. On 03-MAY-2021, the subject experienced headache. On 03-MAY-2021, the subject experienced muscle aches. On 03-MAY-2021, the subject experienced very tired. On 25-MAY-2021, the subject experienced magnets are sticking to his left shoulder. The action taken with covid-19 vaccine was not applicable. The patient recovered from chills, headache, muscle aches, and very tired on 04-MAY-2021, and had not recovered from magnets are sticking to his left shoulder. This report was non-serious.


VAERS ID: 1357108 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-24
Onset:2021-05-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Cerebrovascular accident, Chills, Decreased appetite, Fatigue, Gait inability, Headache, Hospitalisation, Joint lock, Limb discomfort, Migraine, Muscle spasms, Nausea, Paraesthesia, Pruritus, Pyrexia, Vaccination site erythema, Vaccination site induration, Vaccination site pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VITAMIN D NOS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210506; Test Name: fever with temperature of 97.4F; Result Unstructured Data: 97.4F
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: hospitalization; neurologist noted it might be complex migraine; tired; nauseated; chills; very tired just like not wanting to move; headache; threw up; no appetite; tingling in both hands; forearms with tightness; feet tingling; knees were locked; hands were cramped up; tingles came up to the stomach area; not strong enough to be full spasm; could not move the body; migraine headache; had feelings in arms and legs after 2 hours; Call 911, could be a stroke; had the headache; itchiness was noticeable; itchy, red, hot to the touch, hard at the injectiion site; itchy, red, hot to the touch, hard at the injectiion site; itchy, red, hot to the touch, hard at the injectiion site; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HOSPITALISATION (hospitalization) and CEREBROVASCULAR ACCIDENT (Call 911, could be a stroke) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included VITAMIN D NOS for an unknown indication. On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-May-2021, the patient experienced PRURITUS (itchiness was noticeable), VACCINATION SITE INDURATION (itchy, red, hot to the touch, hard at the injectiion site), VACCINATION SITE ERYTHEMA (itchy, red, hot to the touch, hard at the injectiion site) and VACCINATION SITE PRURITUS (itchy, red, hot to the touch, hard at the injectiion site). On 06-May-2021, the patient experienced HOSPITALISATION (hospitalization) (seriousness criterion hospitalization), CEREBROVASCULAR ACCIDENT (Call 911, could be a stroke) (seriousness criterion medically significant), DECREASED APPETITE (no appetite), PARAESTHESIA (tingling in both hands), LIMB DISCOMFORT (forearms with tightness), PARAESTHESIA (feet tingling), JOINT LOCK (knees were locked), MUSCLE SPASMS (hands were cramped up), ABDOMINAL DISCOMFORT (tingles came up to the stomach area), MUSCLE SPASMS (not strong enough to be full spasm), GAIT INABILITY (could not move the body), MIGRAINE (migraine headache), LIMB DISCOMFORT (had feelings in arms and legs after 2 hours), FATIGUE (tired), NAUSEA (nauseated), CHILLS (chills), FATIGUE (very tired just like not wanting to move), HEADACHE (headache), VOMITING (threw up) and HEADACHE (had the headache). On 07-May-2021, the patient experienced MIGRAINE (neurologist noted it might be complex migraine). The patient was hospitalized from 06-May-2021 to 08-May-2021 due to HOSPITALISATION. On 08-May-2021, HOSPITALISATION (hospitalization) had resolved. On 10-May-2021, HEADACHE (had the headache) outcome was unknown. At the time of the report, CEREBROVASCULAR ACCIDENT (Call 911, could be a stroke), PRURITUS (itchiness was noticeable), DECREASED APPETITE (no appetite), PARAESTHESIA (tingling in both hands), LIMB DISCOMFORT (forearms with tightness), PARAESTHESIA (feet tingling), JOINT LOCK (knees were locked), MUSCLE SPASMS (hands were cramped up), ABDOMINAL DISCOMFORT (tingles came up to the stomach area), MUSCLE SPASMS (not strong enough to be full spasm), GAIT INABILITY (could not move the body), MIGRAINE (migraine headache), LIMB DISCOMFORT (had feelings in arms and legs after 2 hours), MIGRAINE (neurologist noted it might be complex migraine), FATIGUE (tired), VACCINATION SITE INDURATION (itchy, red, hot to the touch, hard at the injectiion site), VACCINATION SITE ERYTHEMA (itchy, red, hot to the touch, hard at the injectiion site), NAUSEA (nauseated), CHILLS (chills), FATIGUE (very tired just like not wanting to move), HEADACHE (headache), VOMITING (threw up) and VACCINATION SITE PRURITUS (itchy, red, hot to the touch, hard at the injectiion site) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 06-May-2021, Pyrexia: 97.4f ?F (High) 97.4F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment: Zyrtec, B-12 tablets. Patient was informed about low vitamin D level. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Reporter did not allow further contact; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1357174 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Areflexia, Campylobacter infection, Guillain-Barre syndrome, Polymerase chain reaction, Somnolence
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VYVANSE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Campylobacter infection
Allergies:
Diagnostic Lab Data: Test Date: 20210509; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC2021535552

Write-up: Acute somnolence; Flaccid Areflexia in legs; Suspected Guillain-Barre Syndrome; Possible linkage to simultaneous campylobacter infection; This is a spontaneous report from a contactable consumer (patent). A 16-years-old male patient received bnt162b2 (FIZER-BIONTECH COVID-19 MRNA VACCINE), dose 1 via an unspecified route of administration, in Arm Left (at the age of 16 years old) on 01May2021 at 10:00 (Batch/Lot Number: ER8736) as 1ST DOSE, SINGLE for covid-19 immunization. Medical history included campylobacter infection from an unknown date and unknown if ongoing. The patient had no known allergies. Concomitant medication included lisdexamfetamine mesilate (VYVANSE) taken for an unspecified indication, start and stop date were not reported. The facility in which the most recent COVID-19 vaccine was administered was a Public Health Clinic/Administration facility. No other vaccines were given within 4 weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced Acute somnolence, Flaccid areflexia in legs, Suspected Guillain-Barre Syndrome, Possible linkage to simultaneous campylobacter infection on 03May2021 at 0000. The events required an emergency room visit. The patient was hospitalized for acute somnolence, flaccid areflexia in legs, suspected guillain-barre syndrome, possible linkage to simultaneous campylobacter infection from 2021 to an unknown date for 5 days. The patient underwent lab tests and procedures which included polymerase chain reaction (post vaccination) results: negative on 09May2021 (Nasal Swab). Therapeutic measures were taken as a result of acute somnolence, flaccid areflexia in legs, suspected guillain-barre syndrome, possible linkage to simultaneous campylobacter infection. Treatment included IV immunoglobulin. The clinical outcome of the events was not recovered. Additional information was requested.


VAERS ID: 1357822 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood pressure abnormal, Chills, Dehydration, Electrocardiogram abnormal, Fatigue, Hypotension, Migraine, Nausea, Pyrexia, Sleep disorder, Tremor, Ventricular extrasystoles
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Hydrocortisone Estrogen Progesterone Vit C Multiple Vitamin
Current Illness: None
Preexisting Conditions: Slight Hypothyroidism Mild Adrenal Insufficiency
Allergies: No
Diagnostic Lab Data: EKG abnormal Dehydration Low blood pressure Variable blood pressure
CDC Split Type:

Write-up: Uncontrollable Shaking, PVC?s, fever, nauseous, migraine, chills, extreme, fatigue, unable to sleep


VAERS ID: 1357998 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

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

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

Write-up: Difficulty breathing; Nausea; Vomiting; Lightheadedness; Patient feel nausea, lightheadneness. EMS was at patient side for 10 min .Water given. After the 30 minute patient stated " I feel ok now". Patient left to go home.


VAERS ID: 1358219 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone normal, Chills, Condition aggravated, Differential white blood cell count normal, Drooling, Facial spasm, Fatigue, Flatulence, Frequent bowel movements, Full blood count normal, Headache, Injection site erythema, Injection site pain, Laboratory test normal, Liver function test normal, Metabolic function test, Migraine, Muscle spasms, Myalgia, Nausea, Night sweats, Pyrexia, Rash erythematous, SARS-CoV-2 test negative, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC daily multivitamin
Current Illness: None
Preexisting Conditions: vocal cord dysfunction, chronic facial spasms
Allergies: amoxicillin (hives) PCN (unknown) albuterol (GI intolerance, headache)
Diagnostic Lab Data: CBC with differential, BMP, LFTs, TSH, Lyme Ab, and COVID-19 PCR swab in nares all WNL/negative
CDC Split Type:

Write-up: As of Day 25 post-vaccination, patient has experienced the following: - HA (slightly improved, no longer occurring daily) - facial spasms (worsening of chronic condition, now more frequent and lasting longer when they occur) with associated drooling - migraines (hasn''t had in $g10 years prior to vaccine) - fatigue, feeling just wiped out (before able to 1 hour w/o fatigue, now 10 min lucky) - myalgias - subjective fever/chills (that measures as low as 96.1 ?F) - rash (intermittent, transient, palm-sized patches of erythema/pinkness located primarily on extremities, none currently) - left deltoid redness x5 days -- $g persistent soreness with palpation - tinnitus (daily) - pelvic cramps that remind her of period pain, but LMP 13 months ago - more frequent BMs (7x/day max) - more gassy after meals - previously had nausea and night sweats, but these improved over the course of the past week


VAERS ID: 1358281 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Groin pain, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Osteonecrosis (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: magnesium glycinate ? 400mg daily vitamin D3 ? 5000 IU vitamin K2 ? not sure of dosage nicatinomide mononucleotide ? .5g daily
Current Illness: None.
Preexisting Conditions: Viral-induced asthma
Allergies: I don''t think I''m allergic to anything. Except cats, kind of.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever 15 through 28 hours after second dose of vaccine. Fatigue 0-4 days after second dose of vaccine. Achey body (everywhere) 0-4 days after second dose of vaccine. Dull aches and soreness in my groin area, and also in my knee joints and feet, 0 days to 26 days (present day, i.e. I''m still experiencing these issues) after second dose of vaccine.


VAERS ID: 1358327 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Injection site erythema, Peripheral swelling, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion XL 150mg Buspirone 10mg BID
Current Illness:
Preexisting Conditions: Anxiety Autism Depression Erosive Gastritis Right Bundle Branch Block
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The night of the vaccination, experienced fatigue, headache, and dizziness. The next day, these symptoms continued, but were accompanied by left arm swelling, pain, heat, itching, and redness below injection site but above the elbow. Meclizine 25mg and acetaminophen 500mg helped negate the symptoms.


VAERS ID: 1358468 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-05-03
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid Test which was positive.
CDC Split Type: vsafe

Write-up: I test positive for Codvid- 19. I had fever, chills, and a temp of 104*.


VAERS ID: 1358731 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-05-03
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Inflammatory marker increased, Pericardial effusion, Pericarditis, Pleural effusion, Pyrexia, Rash, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Pericarditis and pericardial effusion with pulmonary effusion, fever, tachycardia and elevated inflammatory markers, knee pain, rash


VAERS ID: 1358735 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-05-03
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20 2A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal X-ray, Bladder catheterisation, Blood thyroid stimulating hormone, Chest X-ray, Cough, Dyspnoea, Dysuria, Fatigue, Fibrin D dimer, Full blood count, Metabolic function test, Pregnancy test urine, Respiratory tract congestion, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Flovent
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Rapid test, 5/5/2021, SARS-COV2 TMA 5/7/21, POC SARS-COV-2 BY PCR 5/8/21, all negative, Chest Xray PA and Lateral 5/8/21, Complete blood count 5/10/21, D-Dimer 5/10/21, TSH Reflex 5/11/21, XR Abdomen flat 5/11/21, Basic Metabolic Panel 5/11/21, Urinalysis 5/11/21, POC Urine Pregnancy 5/11/21
CDC Split Type:

Write-up: I had a severe cold, with a harsh cough for over a week, extreme shortness of breath, and exhaustion. Slight fevers. I tried mucinex, but had to go to the hospital for an inability to void, with resulted in a catheter. We couldn''t figure out what was wrong, so I stopped the mucinex. Then, I took doxycycline, and that seemed to help significantly. After four or five days on the doxycycline, the symptoms were almost gone.


VAERS ID: 1359714 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

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

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

Write-up: Shortness of breath.


VAERS ID: 1360575 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-24
Onset:2021-05-03
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, 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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Food allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021568101

Write-up: Swollen gland in armpit; flu like symptoms; This is a spontaneous report from a contactable consumer (patient). A 34-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on 24Apr2021, (at age of 34-year-old) in left arm as single dose for COVID-19 immunisation. Medical history included asthma and turmeric allergy. Patient did not receive concomitant medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. On 03May2021, at 08:00PM, patient experienced swollen gland in arm pit, flu like symptoms. Events were considered non-serious by the reporter. Patient received second dose of vaccine on 15May2021 at 10:30AM in left arm. It was unknown if the patient received treatment for the events. Outcome of the events were unknown. Information on the lot/batch number has been requested


VAERS ID: 1360597 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Palpitations, Paraesthesia, SARS-CoV-2 test, Syncope, Tinnitus, Tremor, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Latex allergy; Migraine headache
Allergies:
Diagnostic Lab Data: Test Date: 20210507; Test Name: Saliva pool test; Test Result: Negative ; Test Date: 20210514; Test Name: Saliva pool test; Test Result: Negative
CDC Split Type: USPFIZER INC2021571273

Write-up: Feeling faint; dizzy; shaky; racing heart began 10 minutes after 1st shot.; Sense of dizziness and vertigo has persisted now; ringing in ears; tingling sensation in back of neck, legs and feet; This is a spontaneous report from a contactable consumer (reported for herself). This 49-year-old not pregnant female received first dose of BNT162B2 (Solution for injection, Lot number was not reported) via an unspecified route of administration in left arm on 03May2021 08:00 AM, as first dose, single for COVID-19 immunization. Medical history included migraine headaches. The patient had known allergies: Doxycycline, latex, sensitivity to Relpax, Minocyclin, aspartame and stevia. Did not receive any concomitant medications within two weeks of suspect. On 03May2021 08:15 AM, the patient experienced feeling faint, dizzy, shaky, racing heart began 10 minutes after first shot, sense of dizziness and vertigo had persisted for 2 1/2 weeks later episodes of racing heart and feeling faint, ringing in ears, tingling sensation in back of neck, legs and feet. She did not receive any treatment for events. She did not receive other vaccine in four weeks. The patient did not have covid prior vaccination. She was tested post vaccination: Saliva pool test on 07May2021 and on 14May2021 was Negative. The outcome of the events of Feeling faint, dizzy, shaky, racing heart began 10 minutes after 1st shot, Sense of dizziness and vertigo has persisted now, ringing in ears, and tingling sensation in back of neck, legs and feet was not recovered. Information about lot/batch number had been requested.


VAERS ID: 1360752 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1800609 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer COVID vaccine, March 13, 2021, 61 years old, asthma flare one hour after shot that resolved in two hours
Other Medications: Diltiazem 180 mg, Losartan 25 mg, Levothyroxine 100 mcg, Vitamin D 2000 IU
Current Illness: None
Preexisting Conditions: Hypertension, afib
Allergies: Penicillin, Keflex, Erythromycin, cephlasporins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Small number of hives two hours after shot that faded within an hour; small number of hives 24 hours after shot that faded within an hour.


VAERS ID: 1361115 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait disturbance, Headache, Myalgia, Nasopharyngitis, Nausea, Oropharyngeal pain, Pain, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix Klonopin Fluoxetine Reglan Zyrtec Metoprolol Albuterol Inhaler Multivitamin Elderberry Probiotics Vitamin D Calcium Magnesium
Current Illness: None
Preexisting Conditions: Immune disorder Gastro issues
Allergies: Penicillin Latex Th shell of a shellfish
Diagnostic Lab Data: No tests, did not see Dr. When it began. I did have a covid test at Same day testing on 5/29/2021 awaiting results.
CDC Split Type: vsafe

Write-up: On day of vaccine, I was nauseous, body aches all except arm until few days later, muscle pain, hard time walking, headache. As of today 05/24/2021, I declined, I have had a multitude of symptoms, sore throat, cold symptoms, covid like symptoms


VAERS ID: 1361117 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Furuncle, Lymph node pain, Lymphadenopathy, Migraine, Pain in extremity, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm felt sore and started a migraine like headache withing 30 mins Took a painkiller at the start of the next day....on the 3rd day, lymph nodes at the armpits were swollen and painful and got numerous boils on the trunk of my body and back, that were very red, sore, sensitive to touch, and very painful(looked up the net and it resembled shingles). This was the case for about 2 weeks, and then the pain started easing and scabs started forming on the boils, still have the scars


VAERS ID: 1361148 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal
SMQs:, Dementia (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: Patient gets monthly allergy shots.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she started to get severe brain fog about 72 hours after receiving her first dose of Moderna. She was unsure if it was due to her allergy shots or due to the vaccine. Patient stated her brain fog got worse after a week and only happens when she is trying to focus on song lyrics or people''s names. Brain fog has stayed the same way for about a month. Patient did talk to her physician and other MDs and no one could think of a cause of sudden brain fog. She states she has no problems with memory if she isn''t trying to focus on something.


VAERS ID: 1361296 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (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: Unknown
Current Illness: unknown
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Tests ordered, yet to be completed
CDC Split Type:

Write-up: Pt reports severe muscle aches, nausea and vomiting, dizziness, and weakness which persisted until today. Pt has given symptom management medications such as antivert, zofran and Acetaminophen.


VAERS ID: 1361485 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-30
Onset:2021-05-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Fall, Fatigue, Impaired healing, Psoriasis, Rash, Skin laceration, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: Slept over 10 hours next day. A few days after 2nd shot developed rash on both arms (maybe hives) that is still showing on May 30th. Rash is still noticeable on both arms but less irritating. I had minor psoriasis on leg that seemed to get worse after 2nd shot. Also within the last 10 day I fell and got 2 minor cuts on my arms. Usually, my cuts heals very quickly, but the 2 cuts I received did not heal fast. They were slow to heal and almost leaking puss. Overall, I feel my skin is slowly healing after any issue with cuts or rashes or minor psoriasis. In addition there were times up to the last week where I would feel very tired around midnight and just had to go to sleep. I normally don''t go to sleep till after 12:30AM, but I was so I tired that I would be in bed by 12:00AM.


VAERS ID: 1361557 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-21
Onset:2021-05-03
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Parosmia, Taste disorder
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I had covid in January 2021
CDC Split Type:

Write-up: My smell and taste are completely different. Every time I eat something it tastes the same.


VAERS ID: 1361669 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdomen scan normal, Abdominal pain upper, Laboratory test normal, Nausea, Pain in extremity, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: I have issues with my stomach and the doctors cannot determined what is wrong with it.
Allergies: I am allergy to Iodine, avocados, mangos, and deer meat.
Diagnostic Lab Data: They ran tests and all of them came back negative. I still have the red spots on my stomach and upper arm along with severe nausea. The CT scan came back negative as well and I was discharged from the ER.
CDC Split Type: vsafe

Write-up: The next day/week my entire arm was in pain. Then a week later, I had to go to the hospital because my stomach was in serious pain and I noticed red dots on my skin.


VAERS ID: 1361872 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-22
Onset:2021-05-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Colitis ulcerative, Condition aggravated, Faecal calprotectin, Laboratory test
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal ulceration (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Delzicol, Stelara, Rowasa, Uceris, singulair, Allegra, Vit. D and K2, Calcium, b-12, xanax, Benadryl.
Current Illness: Chronic ulcerative colitis, but I was in remission before the vaccination.
Preexisting Conditions: Ulcerative colitis.
Allergies: IV contrast.
Diagnostic Lab Data: Calprotectin test and CRP. I will be having a colonoscopy June 8. I had to go back on prednisone to treat the flare.
CDC Split Type:

Write-up: It caused a severe flare-up of my ulcerative colitis. My GI doctor told me it seemed like it was from the vaccine and that some other patients were experiencing the same thing. He told me to "give it a few weeks" to see if it would magically go away. I waited 2 weeks and continued to get worse (bad abdominal pain, stuck in the bathroom 12-15 hours a day, passing blood and mucous).


VAERS ID: 1361972 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Herpes zoster, Pruritus, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac 40mg, 1 daily; Effexor XR 75mg, 3 QHS; XANAX 1MG, PRN, Ambien 10 mg, 0.5 tab Prn; seroquel 25mg, 1 PO QHS; Lisinopril 10mg, 1 daily; Vitamin D supplement.
Current Illness: None
Preexisting Conditions: Polycystic kidney disease, htn, panic disorder
Allergies: Compazine, Valcyclovir
Diagnostic Lab Data: 05/22/2021 obtained Acyclovir.
CDC Split Type:

Write-up: Burning sensation both arms, chest, face; itching upper torso; "moderma arm"; outbreak of shingles in week 2 after receiving first dose.


VAERS ID: 1361993 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT#021C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood calcium, Blood magnesium, Bone pain, Brain natriuretic peptide, Differential white blood cell count, Electrocardiogram, Feeling of body temperature change, Fibrin D dimer, Full blood count, Glycosylated haemoglobin, Human chorionic gonadotropin, Lipids, Metabolic function test, Myalgia, Pain, Prothrombin time, SARS-CoV-2 test, Troponin I, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin er 500 mg tablet extended release 24 hr
Current Illness: Sickness due to 1 st covid shot
Preexisting Conditions: diabetes
Allergies: codeine penicillin NASID
Diagnostic Lab Data: nm Myocardial Perfusion troponin 1 sars cov 2 colecular assay naa/pcr Chemestry Panel Magnesium Hemoglovin a1c fasting lipid panel complete blood count with differential white blood cell differential chemistry panel Xray of check d dimer Prothrombin time btype natriuretic peptide bnp calcium serum Human choronic gonadotropin hcg cbc complete blood count ekg 12 or more leads w int & rpt
CDC Split Type:

Write-up: Pain through out the body, muscles, joints, bones. cold then hot.


VAERS ID: 1362024 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Exercise tolerance decreased
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus , 20+ yrs ago, swelling, bruising at injection site for three months, flu symptoms for a year.
Other Medications: Multi Vitamin Vitamin D Vitamin B12 Airborne
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Anti Histamine ingredients
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had injection Thursday afternoon. Was home next few days, so no physical exertion. Monday 4.3.21 morning went down flight of stairs on way out, noticed heavy breathing/out of breath. Usual day out activities, Walk in Park and Zoo. Same breathing issues through out day. Repeated for next two days out. Accompanied by air-y cough. Chest ache after. Home four days, no exertion. Out again next week Monday 4.10.21-Thursday, same symptoms. Weekend same as previous, slight ache from cough, no breathing issues since no exertion. Monday 4.17.21 Breathing and ache so bad, changed routine for week and did not take any walks. Did errands with rest periods between. Thought was getting better by Thurs as went up stairs with little issue. Weekend same as prior. Monday 4.24.21-Wed - Resumed regular walking activity, breathing, coughing, chest ache presented. Weekend, consistent cough and chest ache through out. Today, Sunday 5.30.21 is day 31.


VAERS ID: 1362378 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain lower, Blood urine present, Computerised tomogram, Decreased appetite, Diarrhoea, Herpes zoster, Influenza like illness, Liver disorder, Muscle spasms, Nephrolithiasis, Rash papular, Tachycardia, Urine analysis
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: Premarin, Vitamin D
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: ER Dr. did Cat Scan on 5/9/21 and observed the developing Shingles rash. Scan showed a Kidney Stone and some Liver lesions. Primary Care Dr. did urinalysis on 5/10/21 which revealed blood in my urine. No other tests have been performed to date, but I have a Dr appt tomorrow. According to the on-call Dr for CVFP, they will probably do blood work and a get a stool sample.
CDC Split Type:

Write-up: Developed flu like symptoms about 6 hours after receiving the vaccine. About 12 hours after receiving vaccine, I developed tachycardia. Saw primary care doctor the next day. About 2 days later, I developed pain in my right side. Bedford Memorial Hospital Dr. said it was a severe case of Shingles. A raised rash developed, but due to the antiviral medication the ER Dr gave me, it seemed to slow the rash and keep it from developing the fluid filled bumps. Where the rash is subsiding (after 2 weeks), I am still dealing with unbearable pain that wraps around the right side of my torso from my spine to my stomach. I was taking Morphine (Ibuprofen and Gabapentin) to control the pain, but because of severe gut issues, I stopped the Morphine & Ibuprofen. I''m currently taking the Gabapentin and Tylenol. However, my gut issues remain. I have no appetite and cramping and diarrhea . I''m heading back to the Dr tomorrow for more testing.


VAERS ID: 1362424 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Gait disturbance, Peripheral swelling, Skin discolouration
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc Vit D3
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After normal 45 min walk sat down got up 20 minutes later and it felt like rocks were in my right foot. I couldn?t walk normally. Bottom of foot was swollen. Next day the same thing happened a few times but I was able to walk. Then bottom of right foot turned purple and white kinda like Reynard


VAERS ID: 1362617 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

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

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

Write-up: Client reported to have a reaction to 1st COVID vaccine of Moderna (Lot# 017C21A) administered on 05/03/21. Client states having intermittent "numbness and tingling" on the left calf since the first dose. Client states there is no pain, but more of a discomfort. Client states after 1st dose, Client felt "muscle tension" from the vaccination site (left arm) to left calf. Client states she has not followed up with primary care provider. RN and PHN educated Client about following up with primary care provider. Client reports a medical history of hypertension and is currently taking medication from another country to treat it. Client has no known allergies. Elevated to medical team consult and was approved to get 2nd COVID vaccine of Moderna today (05/31/21).


VAERS ID: 1364529 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 RA / IM

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

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

Write-up: developed rash on neck and then onto trunk about 4-6 days post 1st injection. Rash redeveloped on day 27. Patient contacted PCP and they advised her to get 2nd dose on 5/28/21. Rash was noted to neck at vaccine clinic 5/28/21. Patient states that it did itch but that she had no other symptoms. Vaccine administered. Patient waited 30minutes without difficulty.


VAERS ID: 1364687 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pyrexia, Vomiting
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)

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: penecillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Short term (6-10 hours) low grade fever after first dose. Vomiting, fever (100-102.5) for 2-3 days after second dose; difficulty breathing. Four weeks after second dose, chest pain, low-grade fever, and difficulty breating.


VAERS ID: 1364790 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Patient under age 18 was vaccinated with Moderna, which is a vaccine error. (If the person may receive a second dose, it will be per policy off-label use for a 17-year old). Troubleshooting: Scribe and vaccinator did not validate age; screeners at the beginning of the process did not ask or turn away. Parent validated age as 18. Unreported as error, found in data mining.


VAERS ID: 1364865 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-22
Onset:2021-05-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cheilitis, Rash, Rash pruritic, Skin exfoliation, Skin irritation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 40 mg., Hydrochlorothiazide 25 mg., Janumet
Current Illness: NONE
Preexisting Conditions: HBP, , Diabetes
Allergies: NO
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Dark rash appeared on the left side of my face near my lips. Rash spread to my upper lips, my lips and some spots on my forehead. I treated it as if it was a simple rash with vitamin E and Aleo Vera Gel. The rash was itchy, flaky and irritating. The rash is still very visible even though I have been using the above items.


VAERS ID: 1364884 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-26
Onset:2021-05-03
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 028L20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Nasal congestion, Oropharyngeal pain, Pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler cetirizine (ZyrTEC) 10 mg tablet LORazepam (ATIVAN) 0.5 mg tablet(Expired) montelukast (SINGULAIR) 10 mg tablet selenium sulfide 2.5 % lotion sertraline (ZOLOFT) 50 mg tablet
Current Illness:
Preexisting Conditions: Nervous Acute bilateral low back pain without sciatica Respiratory Allergic rhinitis Mild persistent asthma without complication Genitourinary Abnormal uterine and vaginal bleeding, unspecified (CODE) Ovarian cyst Other Pelvic floor weakness in female Anxiety disorder Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence Keratotic lesion
Allergies: PenicillinsDermatitis
Diagnostic Lab Data: 05/10/21 1945 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 05/10/21 0948 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: Cough Fatigue Sore throat Muscle or body aches Headache Congestion or running nose


VAERS ID: 1364897 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       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: Loestrin FE 1-20 Md-Mcg oral tablet
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: A vial that was previously punctured and stored at room temperature greater than the allowed 2 hours was used for this vaccination. There were no known adverse reactions experienced by the patient.


VAERS ID: 1364906 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, 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: none
CDC Split Type:

Write-up: A vial that was previously punctured and stored at room temperature greater than the allowed 2 hours was used for this vaccination. There were no known adverse reactions experienced by the patient.


VAERS ID: 1364920 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: none known


VAERS ID: 1364982 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

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

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

Write-up: Patient reported feeling itchy all over like she had hives about 30 minutes after receiving the first dose of Moderna. She reported no trouble breathing and no visible rashes/hives present. We discussed reaction with PCP and advised not to receive second dose.


VAERS ID: 1365168 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-31
Onset:2021-05-03
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood alkaline phosphatase normal, C-reactive protein decreased, Fatigue, Influenza like illness, Myalgia, Pain in extremity, Polymyalgia rheumatica
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Vasculitis (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Vitamin D, Tramadol, Benefiber, Advil, Tylenol
Current Illness: None
Preexisting Conditions: Osteoarthritis, goiter
Allergies: Penicillin, tetracycline, c-clor
Diagnostic Lab Data: Available by request but alk ptase 168 and crp 0.60
CDC Split Type:

Write-up: By May 3 onset of fatigue, generalized aching in all muscles, soreness in shoulders, wrists, fingers, back, knees. By week of May 10 felt as though I had the flu. Saw rheumatologist on May 14 who drew labs and prescribed Prednisone for diagnosis of Polymyalgia Rheumatica


VAERS ID: 1365412 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-29
Onset:2021-05-03
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram normal, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: herbal teas to help with gastritis
Current Illness: Gastritis, diagnosed in November of 2020
Preexisting Conditions: NA
Allergies: None
Diagnostic Lab Data: EKG normal 5/3/21
CDC Split Type:

Write-up: Patient with complaints of chest pain and nausea. Seen in ER. EKG normal, nausea resolved. Gastritis medication prescribed.


VAERS ID: 1365713 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Fibrin D dimer, Joint swelling, Peripheral swelling, Synovial cyst, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: minor left knee pain
Allergies: none
Diagnostic Lab Data: d-dimer blood test 0.54 on 5/19 and left leg ultrasound on 5/21 for DVT but only found a Baker''s cyst
CDC Split Type:

Write-up: Left calf and ankle swollen after 2nd dose on 5/2, d-dimer blood test 0.54, ultrasound found a Baker''s cyst. No treatment yet and left calf is still swollen after 4 weeks.


VAERS ID: 1366134 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Severe, way beyond ordinary menstruation pain and heavy menstrual bleeding


VAERS ID: 1366821 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-05-03
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic lymphocytic leukemia; Sulfonamide allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210600147

Write-up: DULL ACHE TO RIGHT ARM/ PAINFUL TO SLEEP ON THAT SIDE; INJECTION SITE PAIN- RIGHT ARM; This spontaneous report received from a consumer concerned an 81 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included chronic lymphocytic leukemia, and sulfa allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 03-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-MAY-2021, the subject experienced injection site pain- right arm. On 17-MAY-2021, the subject experienced dull ache to right arm/ painful to sleep on that side. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine was not applicable. The patient recovered from injection site pain- right arm on 04-MAY-2021, and had not recovered from dull ache to right arm/ painful to sleep on that side. This report was non-serious.


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