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From the 9/3/2021 release of VAERS data:

Found 661,087 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 179 out of 6,611

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VAERS ID: 1520086 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Chest pain, Cough, Diarrhoea, Electric shock sensation, Injection site bruising, Injection site warmth, Nausea, Pain in extremity, Paraesthesia, Rhinorrhoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), 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: Seasonal allergies Sinus Anemia
Preexisting Conditions: Endometriosis Asthma Anemia Osteoma of skull Conductive hearing loss in right ear Otosclerosis of right ear
Allergies: Latex Seafoods shell fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: 60-80min after the vaccine of case of throat closing, running nose and coughing due to Throat. Took Benadryl and relieve symptoms but had to take several doses Diarrhea , nausea, chest tingle / ache felt like electricity on the left side, abdominal pain, arm pain (black and blue at I heat ion site)


VAERS ID: 1520133 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-21
Onset:2021-07-29
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: THE PATIETIENT TESTED FOR COVID ON 7/29/2021 THE EESULT CAME POSITIVE COVID


VAERS ID: 1520176 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Write-up: None stated.


VAERS ID: 1520204 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (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: Lithium Carbonate 600mg
Current Illness: n/a
Preexisting Conditions: bi-polar disorder
Allergies: n/a
Diagnostic Lab Data: No health insurance and cannot afford a doctor.
CDC Split Type:

Write-up: After first dose I had tightness in chest and some heart papulations which eventually subsided after a week. Now after my second dose I had all of the common side effects but now also am experiencing chest tightness. I honestly wish I did not get the second shot now.


VAERS ID: 1520220 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 1 LA / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Cold sweat, Fatigue, Flushing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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: Adderall, Trintellix, Sodium Docusate
Current Illness: None
Preexisting Conditions: ADHD, PTSD, Tinnitus, IBS
Allergies: Penicillin
Diagnostic Lab Data: Scheduled to visit the doctor on August 10th - will update on any prognosis.
CDC Split Type:

Write-up: Intense abdominal cramps 30 minutes to an hour after eating or drinking (water, tea, juice), lasting throughout the day, subsiding by evening; exhaustion, weakness, occasional cold sweats, feeling flush at times; symptoms seemed to grow day to day, starting out moderate on Thursday, July 29th, really intense on Monday, August 2nd.


VAERS ID: 1520227 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Write-up: None stated.


VAERS ID: 1520235 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living       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: Hydrochlorothiazide, Ferrous Sulfate, Levothyroxine, Lovastatin, Doxazosin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1520236 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-07-24
Onset:2021-07-29
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Axillary pain, Dizziness, Joint range of motion decreased, Lymphadenopathy, Skin warm, Sleep disorder
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Probiotic, multivitamin, iron blend, magnesium/potassium, zinc, copper.
Current Illness: None
Preexisting Conditions: Asthma, eczema, Von Willebrand''s [type I]
Allergies: Ibuprofen [in excess, can affect Von Willebrand''s], tree/grass pollen, mold, all nuts except pecans, casein, kiwi, cherry, pineapple, pears.
Diagnostic Lab Data: TBD-will see healthcare provider in the next few days
CDC Split Type:

Write-up: Sharp pain/discomfort under right arm that began 5 days after receiving vaccine [7/29/21], then painful swelling of one supraclavicular lymph node right side 7/30/21 and a second swollen node above first one day after that [7/31/21]. Both also warm to the touch, felt slightly dizzy a few times, limited ROM and unable to sleep on right side due to it.


VAERS ID: 1520247 (history)  
Form: Version 2.0  
Age: 102.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living       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: Exforge plavix Synthroid
Current Illness:
Preexisting Conditions:
Allergies: Macrodantin Sulfate Letia
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1520257 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living       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: Aspirin Metoprolol Calcium Probiotic Glucosamine MSM Alendronate-sodium Potassium chloride Fish Oil Garlic Multivitamin Prenatal Simvastatin Tamoxifen Flaxseed Vitamin C Vitamin D3 Tums
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin Atenolol Cephalosporius Lisinopril sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1520460 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Migraine, Myalgia, Nausea, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Tinnitus, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Descovy 200 Mg-25 Mg Tablet, Finasteride 5 Mg Tablet, Spironolactone 100 Mg Tablet, Estradiol Valerate 40 Mg/ml Intramuscular Oil.
Current Illness: COVID-19 symptoms.
Preexisting Conditions: HRT Therapy
Allergies: unknown
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Fever or chills Cough Shortness of breath or difficulty breathing Fatigue Muscle or body aches Headache New loss of taste or smell Sore throat Congestion or runny nose Nausea or vomiting Diarrhea Migraine Tinnitus


VAERS ID: 1520513 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7585 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral, Arteriogram carotid, Burning sensation, Chest X-ray, Computerised tomogram head, Echocardiogram, Electrocardiogram, Facial paralysis, Full blood count, Magnetic resonance imaging, Metabolic function test, Paraesthesia, Transient ischaemic attack
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Iodine (iv)
Diagnostic Lab Data: CBC, CMP BLOOD PANELS, MRA OF HEAD AND NECK, MRI WITHOUT CONTRAST, CT SCAN OF HEAD, CHEST X-RAY, EKG, ECHOCARDIOGRAM
CDC Split Type:

Write-up: Patient reported the start of left side face tingling within 30 minutes of receiving the COVID 19 vaccine. patient called the pharmacy and was advised to go to the emergency room. Upon arrival to the emergency room patient started having left side face and neck burning and had left side face drooping. At the emergency room the patient was told that she had a TIA, and was hospitalized for several days.


VAERS ID: 1520718 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Fatigue, Headache, Hot flush, Injection site bruising, Injection site pain, Nasopharyngitis, Peripheral coldness, Peripheral swelling, Pyrexia, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 07/29/21 - About 15 minutes after the shot I felt woozy and started having hot flashes. After a few minutes it settled down. 7/30/21 - I woke up feeling just a little soreness where the shot was at and was relieved. No swelling or redness. Had lots of energy. After eating lunch, I suddenly felt tired and decided to lay down. By the time I did my hands turned cold. Within a few minutes I was freezing. My temp was 103.4 and I was shivering and shaking violently. Hardly able to even hold a bottle of water to my mouth. Took cool baths and Dayquil to bring my temp down. Massive headache. Felt like I had COVID all over again. 7/31/21 - After a rough night I woke up feeling weak, shakey, headache, and got out-of-breath easily after just being up for a few minutes. Stayed in bed most of day and slept. 8/1/21 - Woke up feeling o.k. Throughout the morning I felt more energetic only to get tired around 2 p.m. and felt the need to take a nap again. No fever or anything; just tired. Slight headache. Arm suddenly swollen and feverish feeling. 08/01/01 - Woke up feeling ready to go for the day again only to realize once I got up I was weak, shakey, and breathless again after just a few minutes. Ok as long as I sit but broke out in a sweat if I did much. Got dizzy when tilting my head back to look up. Huge bruise on my arm at site.


VAERS ID: 1520749 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: no adverse event noted at this time. patient is in good health standing


VAERS ID: 1520765 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 485 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diplopia, Eye disorder, Eyelid function disorder, Fatigue, Feeling abnormal, Hemiparesis, Paralysis, Sensory disturbance, Skin tightness, Speech disorder, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Within 2 hours of taking the vaccine, I experienced tightness and weakness on my left side. My left eye and left side of my mouth tightening up as if I was having a stroke or some type of Paralysis like Bell''s Palsy. Prior to the left side weakness/paralysis, it felt as if tiny balls or blood clots were going through my veins. I became very tired and as a result, I took a nap. I was awakened by the "pulling sensation" in my face. When I awakened, I couldn''t speak correctly or open my left eye all the way.. My daughter researched and brought cold water to me. it helped. I am reporting this on the 3rd day after the event. I am currently suffering from wheezing, exhaustion, double vision and brain fog.


VAERS ID: 1520964 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction, Limb discomfort, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: dizziness, headache immediately after vaccine, now with bilateral leg pain and heaviness


VAERS ID: 1521177 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Dyspnoea, Myalgia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Phazyme 250 mg capsule ("BEFORE MEALS" PO) Protonix 40 mg tablet,delayed release (QD PO) dicyclomine 20 mg tablet (QID PO) ibuprofen 800 mg tablet (BID or PRN PO) ropinirole 0.5 mg tablet (QHS PO)
Current Illness: NONE REPORTED
Preexisting Conditions: COPD; Migraines; Insomnia; Irritable Bowel; Anxiety; Depression; Neuropathy; Sarcoidosis; Neurosarcoidosis; Multiorgan Sarcoidosis;
Allergies: Demerol ((Symptom: [SOB] or [breathlessness] or [dyspnea]) or (breathlessness)); Dilaudid ((Symptom: [SOB] or [breathlessness] or [dyspnoea]) or (breathlessness)); codeine (Abdominal pain); morphine ((Symptom: [SOB] or [breathlessness] or [dyspnea]) or (breathlessness)); morphine (Acute chest pain (finding))
Diagnostic Lab Data: VITAL SIGNS ARE STABLE VITALS: Pulse: 76; Temp: 97; Ht: 67 in.; Wt: 214 lbs.; BMI: 33.51; Pulse Oximetry: 95%
CDC Split Type:

Write-up: PT STATES THAT SHE BEGAN TO EXPERIENCE SHORTNESS OF BREATH, MYALGIA, WEAKNESS AND THE INABILITY TO LIE FLAT THE EVENING OF THE VACCINE ADMINISTRATION. PT STATES THAT THE SYMPTOMS HAVE NOT IMPROVED SINCE THEY BEGAN, BUT THAT THEY HAVE BECOME MORE INTENSE.


VAERS ID: 1521912 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210800576

Write-up: ADMINISTRATION OF VACCINE NOT STORED PROPERLY (LEFT AT ROOM TEMPERATURE FOR UNKNOWN AMOUNT OF TIME); PRODUCT STORAGE ERROR; This spontaneous report received from a pharmacist concerned an adult 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 ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096, expiry: 03-SEP-2021) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced administration of vaccine not stored properly (left at room temperature for unknown amount of time). On 29-JUL-2021, the subject experienced product storage error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of vaccine not stored properly (left at room temperature for unknown amount of time) and product storage error was not reported. This report was non-serious.


VAERS ID: 1521922 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210801029

Write-up: ARM PAIN; HEADACHE; POSSIBLE FEVER THAT FELT HOT; PAIN IN BACK OF CALF AREA OF BOTH LEGS; This spontaneous report received from a patient concerned a 20 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: UNKNOWN) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced pain in back of calf area of both legs. On 30-JUL-2021, the subject experienced arm pain. On 30-JUL-2021, the subject experienced headache. On 30-JUL-2021, the subject experienced possible fever that felt hot. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and possible fever that felt hot on 30-JUL-2021, and had not recovered from pain in back of calf area of both legs, and arm pain. This report was non-serious.


VAERS ID: 1521924 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210801069

Write-up: ADMINISTERED A DOSE OF VACCINE THAT WAS OPENED FOR 18 HOURS; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced administered a dose of vaccine that was opened for 18 hours. On 29-JUL-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administered a dose of vaccine that was opened for 18 hours and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1522315 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-10
Onset:2021-07-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Chest X-ray, Chest discomfort, Electrocardiogram QT prolonged, Full blood count, Nausea, Troponin
SMQs:, Torsade de pointes/QT prolongation (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Conduction defects (narrow), Torsade de pointes, shock-associated conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D 5000 UNITS DAILY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CHEM PANEL, D DIMER, TROPONINE, CPK, CBC. CHEST X-RAY, EKG ON . THE EKG SHOWED AND ELONGATED QST WAVE.
CDC Split Type:

Write-up: AROUND 2100 MY SON C/O FEELING LIKE SOMEONE WAS SQUEEZING HIS HEART AND FEELING NAUSEATED. THE EKG ON HIS SMART WATCH WAS SHOWING SOME INVERTED, LONGATED WAVES. SO, I TOOK HIM TO THE HOSPITAL, EMERGENCY ROOM.


VAERS ID: 1522460 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-01
Onset:2021-07-29
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient hospitalized with COVID infection post vaccination.


VAERS ID: 1522674 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 AR / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1522677 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1522702 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site erythema, Injection site rash, Pain in extremity, Urine analysis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Fluticasone, Vitamin C, Vitamin D, Women''s Multivatims
Current Illness: None
Preexisting Conditions: Asthma, Allergies
Allergies: Nuts and peanuts
Diagnostic Lab Data: UTI urine test
CDC Split Type:

Write-up: Day after shot: Redness and bumps around injections site (went away after a few days). Pain on arm (went away after a few days). Persistent strong headache (still present). UTI symptoms (pending lab work).


VAERS ID: 1522715 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Hyperhidrosis, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (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: Amlodipine
Current Illness: None
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, sweating, pain in right arm, and not feeling himself for a few days. went to doctor 8/2/21 due to arm pain and not feeling right.


VAERS ID: 1522730 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein, Computerised tomogram neck, Computerised tomogram thorax, Full blood count, Hilar lymphadenopathy, Hypoaesthesia, Lung opacity, Lymphadenopathy, Metabolic function test, Oedema peripheral, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prolonged loss of taste and smell, fatigue following COVID-19 infection 12/2020.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC, CRP, CMP, CT chest with contrast, and CT neck with contrast performed 7/29/2021.
CDC Split Type:

Write-up: Right axillary, supraclavicular, cervical, precarinal and hilar lymphadenopathy with soft tissue swelling of the right axilla/chest wall, right upper lobe opacity, numbness of the right arm and right face. Improving as of 8/2/2021.


VAERS ID: 1522776 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Culture urine, Dizziness, Electrocardiogram, Full blood count, Headache, Laboratory test, Metabolic function test, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? No
Previous Vaccinations:
Other Medications: Losartan 25 mg
Current Illness: None
Preexisting Conditions: High Blood Pressure- not well controlled
Allergies: None
Diagnostic Lab Data: CBC CMP Urine-clean catch
CDC Split Type:

Write-up: 1025- Pt complained of headache, nausea. B/P 144/97 HR 105 Temp 97.7 Resp 22 1035- Pt continued to complain of headache and nausea despite interventions 1041- Pt states feeling lightheaded and dizzy. B/P 170/70 HR 108 Resp 30 1044- Rapid Response Called 1055- Arrived in ER 1104- ECG done in ER 1116- Rapid Response End 1120- Labs collected in ER 1121- IV Started 1244- Given Ketorlac tromehamine 30mg and Dexamethasone 10mg 1245- Given Diphenhydramine HCl 25mg and Prochlorperazine Edisylate 10mg 1246- Urine clean catch collected 1328- Pt discharged


VAERS ID: 1522816 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EQ0172 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Irritability, Mobility decreased, Nausea, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Succ ER 25 mg Fluoxetine HCL 20 mg Famotidine 40 mg Atorvastatin 10 mg Losartan Potassium 25 mg Estrogen-Methyltestos H.S. Xolair injections every 3 weeks Beginning allergy shots for desensitization to severe cat allergy
Current Illness: Severe allergy to cats
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: July 29. 2021 received a prescription from Dr. for Meclizine 25 mg for nausea and dizziness which helped minimally. Also tried Zofran and got better results for nausea. August 2, 2021 went to ENT Dr. suspecting vertigo, nausea and vomiting were caused by an inner ear issue. Exam, hearing test and Dix-Hallpike test which ruled out an inner ear problem. Hearing test indicated perfect hearing and Dix-Hallpike test show no indication of BPPV. A timeline of events for 1 week prior to the first shot leads us to believe that the my severe symptoms are directly related to the 1st dose of the vaccine.
CDC Split Type:

Write-up: Severe vertigo, nausea and vomiting started 7/29/21 around 7:00 a.m. Severe vomiting lasted 36 hours. Severe vertigo lasted 48 hours gradually getting better and completed resolved by 8/3/21. Vertigo persisted with any movement of my head resulting in severe nausea and severe vomiting. Unable to keep food or liquids down for at least 36 hours and was resolved by July 31. I was unable to get out of bed for 36 hours due to vertigo. Intense chills, sweating, fatigue, headache and irritability lasted through August 2, but gradually is getting better since August 2. Today, August 3, 2021, vertigo has subsided. As of today, August 3, 2021, nausea, fatigue, and headache is still present but continues to get better. Item 20 has been answered as "yes" because major adverse issues have resolved. Due to the severity of vertigo, nausea and vomiting, I am extremely concerned about adverse reactions to the 2nd dose of the vaccine. I am interested in receiving input on whether to continue forward with the next dose given the issues with the first dose. Background information on cat allergy: I have a history of anaphylaxis with direct exposure to the presence of cats. I have also had anaphylaxis with exposure to a cat owner as well as exposure to items such as paperwork that has been in an environment where a cat has been present.


VAERS ID: 1522843 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-07-22
Onset:2021-07-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 600mg/day N-Acetyl Cysteine (Nac), 1000mg/day Cod Liver Oil, 180mg Resveratrol Complex, Multivitamin Gummy, 565mg/day Hawthorn Berry, 800mg Quercetin, 165mg Bromelain, 435mg Gotu Kola. Taken for 3 months+ some daily some irregularly. Discon
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Numbness randomly on left side of body. Paresthesia under left side of chin, left leg, left arm, and left side of body. Have not seen doctor.


VAERS ID: 1522868 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-21
Onset:2021-07-29
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 125 mg tablet,chewable cholecalciferol, vitamin D3, (VITAMIN D3) 10 mcg (400 unit) capsule fexofenadine (ALLEGRA) 60 mg tablet multivitamin 400 mcg tablet
Current Illness:
Preexisting Conditions: Nervous Acute right ankle pain Respiratory Atopic rhinitis Circulatory Symptomatic PVCs Palpitations Digestive Adiposity BMI 40.0-44.9, adult (CMS/HCC) Obesity, morbid, BMI 40.0-49.9 (CMS/HCC) Endocrine/Metabolic Hyperlipidemia Other Depression Encounter for pre-bariatric surgery counseling and education Encounter for weight management Pre-bariatric surgery nutrition evaluation Preop pulmonary/respiratory exam Family history of premature coronary artery disease Hypersomnia Anxiety disorder, unspecified type
Allergies: NKA
Diagnostic Lab Data: 07/31/21 0954 POCT COVID-19 PCR Collected: 07/31/21 0954 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000268759 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 05/29/2022
CDC Split Type:

Write-up: Visit Diagnoses Contact with and (suspected) exposure to covid-19 URI, acute


VAERS ID: 1522914 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-09
Onset:2021-07-29
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pneumonia, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clots and pneumonia.


VAERS ID: 1522980 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-01
Onset:2021-07-29
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Atelectasis, COVID-19, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Crepitations, Dyspnoea, Exposure to SARS-CoV-2, Pneumonia, Productive cough, Pulmonary fibrosis, Pulmonary mass, SARS-CoV-2 test positive, Suspected COVID-19
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg tablet clindamycin (CLEOCIN) 300 mg capsule DULoxetine (CYMBALTA) 60 mg capsule ergocalciferol (VITAMIN D) 50,000 unit capsule esomeprazole (NexIUM) 20 mg capsule hydroxychloroquine (PLAQUENIL) 200 mg tablet i
Current Illness:
Preexisting Conditions: Nervous Cervical radiculopathy at C5 Greater trochanteric bursitis of left hip Lumbar radiculopathy, chronic Other chronic pain Neck pain Multiple joint pain Knee pain Respiratory Idiopathic pulmonary fibrosis (CMS/HCC) ILD (interstitial lung disease) (CMS/HCC) Obstructive sleep apnea syndrome SOB (shortness of breath) Chronic cough Respiratory bronchiolitis associated interstitial lung disease (CMS/HCC) Circulatory Aortic stenosis Mitral regurgitation Non-ischemic cardiomyopathy (CMS/HCC) Chronic systolic congestive heart failure (CMS/HCC) Benign essential hypertension LBBB (left bundle branch block) Raynaud''s disease Nonrheumatic aortic valve stenosis Digestive Dysphagia Vitamin D deficiency disease Nausea and vomiting, intractability of vomiting not specified, unspecified vomiting type Genitourinary CRD (chronic renal disease), stage III Anemia in stage 3 chronic kidney disease Other specified disorders of bladder Mixed stress and urge urinary incontinence Urethral hypermobility Musculoskeletal Bone disorder Osteopenia Cervical disc disease Lumbar spondylosis Osteoarthritis Protrusion of lumbar intervertebral disc Hidradenitis suppurativa Primary osteoarthritis of right knee Knee joint effusion Enthesopathy of hip region Degeneration of cervical intervertebral disc Presence of left artificial hip joint Closed fracture of multiple ribs of right side Endocrine/Metabolic Hyperlipidemia Exercise hypoxemia Elevated blood sugar Hematologic Anemia of chronic disease Platelets decreased (CMS/HCC) Immune Systemic lupus erythematosus (CMS/HCC) Scleroderma (CMS/HCC) Other S/P internal cardiac defibrillator procedure Depression Medicare annual wellness visit, subsequent Long term (current) use of anticoagulants Primary insomnia BMI 34.0-34.9,adult Never smoked cigarettes Fall (on) (from) other stairs and steps, initial encounter
Allergies: PenicillinsItching AmoxicillinItching, Rash NickelRash Zoster Vaccine Live (Pf)
Diagnostic Lab Data: Updated Procedure 08/01/21 1548 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/01/21 0842 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical Results X-ray chest 2 views Result Date: 8/1/2021 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 8/1/2021 9:15 AM Age: 72 years old Clinical indication: Patient HX: PT states that she has had a cough x couple days; Additional info: Shortness of breath TECHNIQUE: Imaging protocol: XR of the chest. Views: 2 views. Total images: 2 COMPARISON: 1. CR XR CHEST 2 VW 7/23/2021 8:41 AM 2. CT CHEST WO CONTRAST 5/24/2021. 3. CT HI RES CHEST WO CONTRAST 10/5/2020. FINDINGS: Tubes, catheters and devices: Implantable cardioverter-defibrillator (ICD) with leads in appropriate positions in the RA, RV and LV. The battery pack is at the left upper chest. Lungs: Stable chronic interstitial pulmonary fibrosis.. There is severe honeycombing throughout the basal segments of both lower lobes. There is no acute superimposed pulmonary consolidation or infiltrate. The previously described 6 mm pulmonary nodule in the superior segment of the left lower lobe is not conspicuous on this study. Pleural spaces: Unremarkable. No pleural effusion. No pneumothorax. Heart/Mediastinum: Heart size is within normal limits. Bones/joints: Healed fractures of the right 5th, 6th and 7th ribs. Soft tissues: Unremarkable. IMPRESSION: 1. Stable chronic interstitial pulmonary fibrosis. There is severe honeycombing throughout the basal segments of both lower lobes. There is no acute superimposed pulmonary consolidation or infiltrate. 2. No interval change when compared to most recent x-ray. 3. Healed fractures of the right 5th, 6th and 7th ribs. 4. The previously described 6 mm pulmonary nodule in the superior segment of the left lower lobe is not conspicuous on this study. Recommend follow-up chest CT in November 2021 (per chest CT report). THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED MD X-ray chest 2 views Result Date: 7/28/2021 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 7/23/2021 8:31 AM Age: 72 years old Clinical indication: Cough; Patient HX: Pneumonia follow-up from June, no chest complaints; Additional info: Pneumonia, unspecified organism TECHNIQUE: Imaging protocol: XR of the chest. Views: 2 views. COMPARISON: CR XR CHEST 2 VW 6/3/2021 12:34 PM FINDINGS: Lungs: Bibasilar parenchymal banding likely represents atelectasis and/or fibrotic scarring, similar to prior. Again noted are chronic prominent underlying interstitial markings likely related to chronic interstitial lung disease. No discrete focal consolidation is identified. Pleural spaces: No pleural effusion. No pneumothorax. Heart/Mediastinum: Stable cardiomediastinal silhouette. Diaphragm: There is nonspecific elevation of the right hemidiaphragm. Bones/joints: Redemonstrated are the right upper thoracic rib fractures with mild interval healing. IMPRESSION: Again noted are chronic prominent underlying interstitial markings related to chronic interstitial lung disease. No discrete focal consolidation is identified. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED BY MD I reviewed the x-ray images in the office today, as well as the radiologist report, and I discussed these results with the patient today.
CDC Split Type:

Write-up: Shortness of breath Suspected COVID-19 virus infection Contact with and (suspected) exposure to covid-19 MDM 72-year-old female with a history of pulmonary fibrosis presents with 3 to 4 days of a productive cough. I found her alert, oriented, nontoxic, well-appearing in no apparent distress. Her vital signs are stable. She is not hypoxic, tachycardic or hypotensive. She was noted to have bilateral crackles which she reports is baseline. Chest x-ray was obtained and she has no new findings. I discussed these findings with the patient and recommended supportive treatment, however discussed having a low threshold to return or follow-up with primary care should her symptoms worsen. She expresses understanding and agrees with this plan.


VAERS ID: 1522998 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-30
Onset:2021-07-29
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis
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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called pharmacy 8/2/21 to report she had been treated at hospital over the weekend for blood clots and was now back home. Hospital had requested patient report blood clots because they could not determine the reason for clots.


VAERS ID: 1523004 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: Unknown - patient stated that he wanted to get the third dose due to underlying medical conditions and doctors recommendation. He walked away without waiting the recommended period of time and any further discussion
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: A third dose of a vaccine was given to a patient upon request at the drop off window. Technician processed the vaccine under covid/flu/pneumonia as first dose and there were no rejections. The dose was administered to the patient and as we were making his vaccine card, we noticed via vaccine reporting system that he received the first two doses in January/February 2021. We spoke about how there was no clinical evidence supporting the need for a third dose. After approaching the patient about why he needed a third dose, he said "I know, I''m bad. My doctor told me to get a third dose because I have underlying medication conditions." The patient was satisfied with his decision and left the store without waiting the recommended period of time.


VAERS ID: 1523034 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-31
Onset:2021-07-29
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chest X-ray normal, Cough, Dyspnoea, Exposure to SARS-CoV-2, Fatigue, Headache, Influenza virus test negative, Productive cough, SARS-CoV-2 test positive, Streptococcus test negative, Tenderness
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingles shot 8/2020 - I did have fever, body aches, headaches - lasted 24 hours - that occurred with both doses of the Shingles
Other Medications: Ramipril - high blood pressure; Multi-Vitamin; Vit D; Vit C; Glucosamine; Fish Oil
Current Illness: no
Preexisting Conditions: high blood pressure - controlled by meds
Allergies: no
Diagnostic Lab Data: on Friday - COVID test - positive result and tested for flu and for strep - negative results for the latter two. X-rays of lungs - the X-rays came back negative
CDC Split Type: vsafe

Write-up: I didn''t have any immediate symptoms - if I pushed on my arm I could tell it was sore . Recently, I had headaches - I rarely get headaches. And feeling tired. I had a little bit of a dry cough. I knew people around people around the office had been exposed to COVID. I was tested. Labored breathing - but not bad. Tired and fatigues - a little bit of heachaches. Now I''m coughing up some phlegm but not a lot. On Sunday morning, I lost my sense of taste and smell. They gave me a five pack of antibiotics - Zithromax and gave me Albuterol inhaler. The doctor told me that what I was currently experiencing would probably be the extent of my symptoms except if my breathing became more labored then go straight to ER.


VAERS ID: 1523040 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-08
Onset:2021-07-29
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Computerised tomogram thorax, Cough, Dyspnoea exertional, Headache, Quarantine, SARS-CoV-2 test, SARS-CoV-2 test positive, Scan with contrast normal
SMQs:, Anaphylactic reaction (broad), Pulmonary hypertension (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: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet ARIPiprazole (ABILIFY) 30 mg tablet atorvastatin (LIPITOR) 10 mg tablet cloNIDine (CATA
Current Illness:
Preexisting Conditions: Nervous Trigeminal neuralgia Other polyneuropathy Chronic pain of right thumb Right carpal tunnel syndrome Left carpal tunnel syndrome Cubital tunnel syndrome, left Respiratory Chronic obstructive pulmonary disease Circulatory Essential hypertension Digestive B12 deficiency Vitamin D deficiency Esophageal stricture Irritable bowel syndrome Genitourinary Cervical metaplasia Musculoskeletal Arthritis of carpometacarpal (CMC) joint of right thumb Endocrine/Metabolic Hypothyroidism, unspecified type Pure hypercholesterolemia Immune Positive PPD Other Bipolar disorder PTSD (post-traumatic stress disorder) Status post total right knee replacement H/O: hysterectomy Attention deficit hyperactivity disorder (ADHD), combined type
Allergies: Chantix [Varenicline]Other (document details in comments) Insect VenomAnaphylaxis Sulfa (Sulfonamide Antibiotics)Anaphylaxis SulfamethoxazoleAnaphylaxis TrimethoprimAnaphylaxis DoxycyclineRash Erythromycin BaseNausea and Vomiting PenicillinsRash Bee Venom Protein (Honey Bee)Other (document details in comments)
Diagnostic Lab Data: 07/30/21 1402 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 07/29/21 1319 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 07/30/21 1402 COVID-19 PCR Collected: 07/29/21 1319 | Final result | Specimen: Swab from Nasopharynx CT angiogram chest pulmonary embolism with and without contrastPerformed 8/2/2021 Final result Study Result CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: No pulmonary embolus or other acute finding. RV/LV ratio: N/A END OF IMPRESSION: INDICATION: Chest pressure Assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstruction with MPR coronal, oblique and sagittal images were created. 3D shaded surface images also created on a separate workstation and permanently stored. CONTRAST: 80mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was adequate. COMPARISON: 6/21/2021 FINDINGS: No pleural or parenchymal abnormality is seen. Mediastinal and hilar regions are unremarkable. Attention is directed pulmonary arterial blood flow and no sign of pulmonary embolus is seen.
CDC Split Type:

Write-up: Pt tested positive for covid yesterday prior to her surgery. Her surgery was canceled. She has a cough and headache, a little SOB with activity (going up steps) this is no worse than her normal with COPD. Advised her to quarantine for 10 days and to go to ED with worsening SOB. She verbally understood and had no questions. Advised we will forward to PCP


VAERS ID: 1523058 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW01800 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Lethargy, Menstrual disorder, Nausea, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: menstrual cycle changes-Medium, Systemic: Nausea-Medium


VAERS ID: 1523086 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: alprazolam, metoprolol tartrate, digoxin, omeprazole, rosuvastatin
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: patient phoned today claiming to have had temporary paralysis from approximately 6pm (07/29) to 230am (07/30). she claims to be fine now.


VAERS ID: 1523118 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-25
Onset:2021-07-29
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Asymptomatic COVID-19, Cardiac telemetry, Chest X-ray normal, Computerised tomogram head normal, Condition aggravated, Dizziness, Echocardiogram normal, Ejection fraction decreased, Electrocardiogram T wave inversion, Exposure to SARS-CoV-2, Magnetic resonance imaging head normal, Presyncope, SARS-CoV-2 test positive, Troponin normal, Ultrasound Doppler
SMQs:, Cardiac failure (narrow), Anticholinergic syndrome (broad), Cardiomyopathy (narrow), Other ischaemic heart disease (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban (ELIQUIS) 5 mg tablet cholecalciferol, vitamin D3, 50 mcg (2,000 unit) capsule cyanocobalamin, vitamin B-12, (VITAMIN B-12 ORAL) dorzolamide-timoloL (COSOPT) 22.3-6.8 mg/mL ophthalmic solution latanoprost (XALATAN) 0.005 % ophthalm
Current Illness:
Preexisting Conditions: Nervous Cervicalgia Occipital neuralgia Arthralgia of lower leg Arthralgia of lower leg Pelvic pain in female Neck pain Circulatory Primary hypertension Transient ischemic attack Vertebral artery stenosis Venous insufficiency PAF (paroxysmal atrial fibrillation) (CMS/HCC) Hypertension Aortic valve regurgitation, acquired PAF (paroxysmal atrial fibrillation) (CMS/HCC) Venous insufficiency Digestive Obesity Constipation, unspecified constipation type Genitourinary Stage III chronic kidney disease CKD (chronic kidney disease) stage 3, GFR 30-59 ml/min Musculoskeletal Actinic keratosis Arthritis, degenerative Dermatitis Osteoporosis Skin neoplasm Alopecia Bug bite DDD (degenerative disc disease), cervical Rash Endocrine/Metabolic Disorder of carbohydrate transport and metabolism (CMS/HCC) Hyperlipidemia Secondary hyperparathyroidism (CMS/HCC) Hematologic Anemia Other Stenosis, cervical spine Edema Dizziness Lesion of nose Acute stress reaction Fatigue Memory loss Psychophysiological insomnia Dizziness Delusional disorder (CMS/HCC) Walker as ambulation aid
Allergies: CelecoxibHallucinations Meclizine HclHallucinations TramadolHallucinations Xarelto [Rivaroxaban]Hallucinations HydroxychloroquineOther (document details in comments) Nortriptyline HclOther (document details in comments) Sulfamethoxazole-trimethoprimRash ZaleplonOther (document details in comments)
Diagnostic Lab Data: SARS-CoV-2 (related to COVID-19) Onset date: 7/30/2021 Last indicated: 7/30/2021 Source: Medical Center Add: SARS-CoV-2 (related to COVID-19) Discard Add: Rule-Out COVID-19 and Respiratory Viruses Add: SARS-CoV-2 (related to COVID-19) Add: Rule-Out SARS-CoV-2 (related to COVID-19) Add: Probable COVID-19 New Results - Lab Updated Procedure 07/31/21 1608 COVID-19 EXTERNAL (NON WELLSPAN OR NON INTERFACED LAB) Collected: 07/30/21 1232 | Final result | Specimen: Swab COVID-19 Overall Result External DetectedCritical Hospital Course (1 Days): This is 90-year-old female who was admitted under observation initially for recurrent near-syncope episode at home and dizziness. Patient was monitor on telemetry. Patient has history of paroxysmal A-Fib but throughout the hospital stay patient was maintaining sinus rhythm. CT head was unremarkable but MRI of the brain did not show any acute findings but carotid duplex did not show significant carotid artery disease but echocardiogram showed preserved LVEF without significant valvular heart disease. Orthostatic vitals did not show orthostatic hypotension. Patient was given IV fluids but patient''s symptoms have now resolved. Patient reported that her caregiver was recently found to be positive for COVID-19 and she had exposure from her. Patient was tested positive for COVID-19 but she did not have any symptoms of COVID-19 infection, subsequently no therapeutic treatment initiated but patient is likely asymptomatic carrier at this point. She had received COVID-19 vaccine in the past. Patient is requesting for discharge to home but P.T. OT and social services consulted. Home health has been arranged as per patient''s request by social services. Patient needs to have follow-up with family physician in 1 week.
CDC Split Type:

Write-up: Admission 7/29/2021 Medical Center 4E Active Problems - documented as of this encounter (statuses as of 07/31/2021) Problem Noted Date COVID-19 virus detected 07/31/2021 Last Assessment & Plan: Formatting of this note might be different from the original. Asymptomatic COVID-19 infection Chest x-ray does not show any acute findings Patient does not have any fever or chills or nausea or diarrhea or shortness of breath or cough Vaccinated in the past No treatment indicated at this time Advice self quarantine at home for 2 weeks Near syncope 07/29/2021 Last Assessment & Plan: Formatting of this note might be different from the original. Patient with 3 episodes of near-syncope while at rest today and presently NIH 0 with no focal deficits and denies vertigo. Patient has been on Eliquis thus should have CT head rule out pathology such as subdural or infarct despite Eliquis therapy. Will monitor on telemetry to rule out for arrhythmia such as paroxysmal atrial fibrillation or bradyarrhythmia and will monitor hemodynamics as patient may have either elevation or low blood pressure as partial etiology for her dizziness as well. She does have T-wave inversion inferior leads and troponin undetectable patient denies chest pain. Case reviewed with Cardiology will trend troponins give single dose aspirin 81 mg and stress test in a.m.. 7/30- Improved symptomatically. Vitals stable. No significant arrhythmia on monitor. CT head no acute CVA. Echo- normal LV size, function and EF 60%. No regional wall motion abnormalities and Carotid ULS -no significant stenosis. MRI of the brain negative finding Negative for orthostatic hypotension Status as per patient''s request Patient''s symptoms of dizziness has resolved History of pulmonary embolism 07/29/2021 Last Assessment & Plan: Formatting of this note might be different from the original. Patient states she has been on Eliquis for years for paroxysmal atrial fibrillation and had episode of DVT pulmonary embolism over 10 years ago. She denies shortness of breath or chest discomfort and has been continued on Eliquis Continue Eliquis


VAERS ID: 1523291 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Nausea, unwellness.


VAERS ID: 1523344 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-01
Onset:2021-07-29
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Blood creatinine increased, Blood lactic acid, Blood pH decreased, Cardioversion, Catheterisation cardiac normal, Dyspnoea, Ejection fraction decreased, Extubation, Fall, Memory impairment, Restlessness, Resuscitation, Troponin increased, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Lactic acidosis (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Akathisia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (narrow), Depression (excl suicide and self injury) (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: likely none
Current Illness: none known
Preexisting Conditions: none known
Allergies: NKA
Diagnostic Lab Data: 7/29: EF<15%, troponin 2723, SCr 1.5, lactic acid 5, pH 7.16 8/2: EF 60-65%, SCr 1.57
CDC Split Type:

Write-up: Patient reports getting vaccine 4-5 months ago, unsure of exact date of vaccination. Wife reports in last 3 months patient has had memory issues and behavior disturbances, of note no diagnosis of PTSD or mood disorders. Has apparently had psychological stressors, unclear if alcohol or drugs involved. Per wife on 7/29, patient acted restless in bed then fell from bed with difficulty breathing. She started CPR, when EMS arrived he was found to be in Vfib - he subsequently received 7 shocks, multiple rounds of epi and amio finally reaching ROSC. Troponin found to be 2723, so patient was taken emergently to cath lab. No blockages were found, but EF was <15%. Since then, patient has been inpatient, went through targeted temperature management, extubated 7/30. EF from 8/2 is now 60-65% - planning to pursue further cardiac workup at outside hospital or get ICD. Neurologically intact with no signs of anoxic brain injury.


VAERS ID: 1523381 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Foetal placental thrombosis, Headache, Retroplacental haematoma, Ultrasound scan, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Promethazine
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Palmacourt, Cortisone
Diagnostic Lab Data: Ultrasound, internal exam
CDC Split Type: vsafe

Write-up: Fatigue, headache. Stood up and blood came out. I thought I was having a miscarriage. I had a blood clot and I have a hematoma on my placenta


VAERS ID: 1523394 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Parent gave an incorrect date of birth for their child, reporting them as 12 years old when they were actually 11 years old. Vaccine was given, no side effects or adverse events have been reported.


VAERS ID: 1523420 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOTHING IN PROFILE
Current Illness:
Preexisting Conditions:
Allergies: TETANUS TOXOID
Diagnostic Lab Data:
CDC Split Type:

Write-up: ARM PAIN AND NUMBNESS FROM SHOULDER TO ELBOW. FEELS WARM.


VAERS ID: 1523428 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 RA / IM

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

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

Write-up: Moderna first dose was given on 7/29/21: no adverse event (Additional covid vaccine) Janssen was given prior to admission to our facility on 7/21/21, but the prior facility failed to document or communicate that she had received the vaccine.


VAERS ID: 1523464 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Lymphadenopathy, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: synthroid, vit d, zyrtec, liothyronine
Current Illness: no
Preexisting Conditions: graves? disease
Allergies: sulfa, cephalosporins, tegretol, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever 102.5-103.1 for three days, fever 101-101.8 for 2 more days. (five straight days of 101+). terrible headache 1 day; chills, moderate headache, muscle aches, joint pain -i am on the sixth day of these. extreme fatigue. did not get out bed for three days other than bathroom. moved from bed to couch and sitting up on day 4. on day 5 got swollen lymph nodes in neck. have overall felt very unwell. much more extreme side effects than i could have imagined. six days in.


VAERS ID: 1523477 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), 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: Lisinopril, Synthroid, Advair, Ventolin, Vitamin D, Calcium
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin, Sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheaded and ringing in right ear. These symptoms have not subsided since vaccination. Never had tinnitus before vaccine


VAERS ID: 1523482 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I had taken Ibuprofen July 24-26 and then I stopped taking them and then I started taking them again on August 1-2.
Current Illness: I had none.
Preexisting Conditions: None.
Allergies: None that I know of.
Diagnostic Lab Data: EKG and my blood drawing was August 1, 2021
CDC Split Type:

Write-up: I received my first dose of Pfizer-BioNTech COVID-19 Vaccine EUA on July 21, 2021 at 2:15 PM. Between 6 and 7 PM that same day (July 29, 2021) I started experiencing chest pains. Then the following day (July 30, 2021) I continued having chest pains but now my heart was beating faster than normal. Both of this happened in the evening. On August 1, 2021 I decided to go to the hospital to be looked at. They gave me an EKG and took blood to do a test on my thyroid and electrolytes and all of them came back normal. Also when they listened in the stethoscope they said my heart sounded normal. But they monitored my heartbeat and it was often still pretty high. It is now August 3, 2021 and I am still having these feelings. I do think it has got a little better but it is still there.


VAERS ID: 1523894 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-29
Onset:2021-07-29
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: as above, positive COVID test at health center.
CDC Split Type:

Write-up: positive COVID disease, diagnosed 8/2/2021


VAERS ID: 1524135 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-07-29
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram, Ejection fraction normal, Hypoxia, Pulmonary embolism, Tachycardia, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit D2, Synthroid, Lisinopril-hydrochlorothiazide, Paroxetine
Current Illness:
Preexisting Conditions: Hypothyroidism, anxiety, depression
Allergies: none
Diagnostic Lab Data: CTA chest: moderate burden bilateral pulmonary emboli Transthoracic echo: normal RV function, normal LV systolic function with EF of 68%.
CDC Split Type:

Write-up: Shortness of breath and chest pain starting on 7/29/21, prompting ED visit on 7/31/21 where she arrived hypoxic, tachypnic, and tachycardic. She was found to have bilateral pulmonary emboli and was hospitalized until 8/1/21 for further evaluation and treatment. Patient was placed on 4L of oxygen via nasal cannula and given Lovenox in the hospital. A transthoracic echo was done and revealed no right heart strain. A 6-minute walk test prior to discharge was performed and resulted in patient requiring 2L/min of oxygen with exertion but not at rest. She was discharged with Eliquis, which she was advised to continue for 3 months, and home oxygen. It is important to consider patient''s sedentary lifestyle and recent 4-5hr road trips as potential provoking factors as well. She was stable upon discharge.


VAERS ID: 1524138 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

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

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

Write-up: Pt showed a slight swollen red patch at the site of injection indicating that there was a reaction to the vaccine. She mentioned it was also itchy. No other symptoms or sob.


VAERS ID: 1524320 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Sore arm; fatigue.


VAERS ID: 1524332 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Heart rate increased, Lymphadenopathy, Musculoskeletal discomfort, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None. Am not a patient of any traditional western doctor. Do not have a primary care doctor.
CDC Split Type:

Write-up: Rapid heart rate bursts occurred at random intervals starting several hours after the shot and continued through Saturday. Could not breath or move during each incident. Fainted on at least one occasion during heart rate burst. If sleeping, was woken up during the event. Swelling pressure inside of left side of chest, extending into left shoulder began Friday morning. Could not lay down without pressure pain from inside chest. Had to sleep sitting up. Unusually fatigued all day. Swollen lymph nodes in neck began Sunday morning. Sought acupuncture treatment for relief Tuesday evening. Swelling pressure inside of chest and shoulder decreased during treatment. Swollen lymph nodes in neck still present. But am able to lay down without pain after treatment. Will be returning for another acupuncture treatment as my chosen form of recovery.


VAERS ID: 1524796 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood immunoglobulin G, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: PREDNISONE
Current Illness: Gout
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: IgG; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210800851

Write-up: CONFIRMED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a patient concerned a 57 year old. The patient''s height, and weight were not reported. The patient''s concurrent conditions included gout. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1802070 expiry: 23-AUG-2021) dose was not reported,1 total, administered on 11-MAR-2021 10:03 vaccinated at left arm as prophylactic vaccination. Concomitant medications included prednisone 20 mg a day for gout. On 29-JUL-2021, the patient had confirmed immunological vaccine failure. Laboratory data included: IgG (NR: not provided) test that showed no antibodies. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of confirmed immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210800851-covid-19 vaccine ad26.cov2.s-Confirmed immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1524797 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1820096 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210800873

Write-up: ADMINISTRATION OF VACCINE LEFT AT ROOM TEMPERATURE FOR UNKNOWN AMOUNT OF TIME; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a 2 decade old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1820096 expiry: 03-SEP-2021) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced administration of vaccine left at room temperature for unknown amount of time. On 29-JUL-2021, the subject experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of vaccine left at room temperature for unknown amount of time and incorrect product storage was not reported. This report was non-serious. This case, from the same reporter is linked to 20210800576 and 20210800634.


VAERS ID: 1524804 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Heart rate, Heart rate increased, Hypertension, Insomnia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: JANUVIA [SITAGLIPTIN]; CINACALCET
Current Illness: Blood cholesterol abnormal (The patient was allergic only to statins for cholesterol); Drug allergy (allergic only to statins for cholesterol.); Osteoporosis; Type II diabetes mellitus
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 20210731; Test Name: Pulse rate; Result Unstructured Data: 114 (unit not reported); Test Date: 20210731; Test Name: Blood pressure; Result Unstructured Data: 185/97 (unit not reported)
CDC Split Type: USJNJFOC20210801196

Write-up: COULD NOT SLEEP WELL; ELEVATED PULSE; FELT LIKE HEARTBEAT WAS TOO FAST; ELEVATED BLOOD PRESSURE; FELT LIKE A FEVER; SORE BODY; This spontaneous report received from a patient concerned a 64 year old female. The patient''s weight was 120 pounds, and height was 62 inches. The patient''s concurrent conditions included diabetes type 2, osteoporosis, allergy to statins, and abnormal cholesterol, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: 21-SEP-2021) dose was not reported, administered on 28-JUL-2021 for prophylactic vaccination. Concomitant medications included sitagliptin for diabetes type 2, and cinacalcet for osteoporosis. On 29-JUL-2021, the subject experienced sore body. On 29-JUL-2021, the subject experienced felt like a fever. Treatment medications included: paracetamol. On 31-JUL-2021, the subject experienced could not sleep well. On 31-JUL-2021, the subject experienced elevated pulse. On 31-JUL-2021, the subject experienced felt like heartbeat was too fast. On 31-JUL-2021, the subject experienced elevated blood pressure. Laboratory data included: Blood pressure (NR: not provided) 185/97 (unit not reported), and Pulse rate (NR: not provided) 114 (unit not reported). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sore body, and felt like a fever on 29-JUL-2021, and the outcome of could not sleep well, elevated pulse, felt like heartbeat was too fast and elevated blood pressure was not reported. This report was non-serious.


VAERS ID: 1524817 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site pain, Oropharyngeal pain, Poor quality product administered, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210802801

Write-up: SORE THROAT; HEADACHE; FEVER; PAIN AT THE INJECTION SITE; VACCINES WERE GIVEN OUTSIDE OF THE 6 HOUR TIME FRAME; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced vaccines were given outside of the 6 hour time frame. On an unspecified date, the subject experienced sore throat, headache, fever, and pain at the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, sore throat, fever, pain at the injection site and vaccines were given outside of the 6 hour time frame was not reported. This report was non-serious. This case, from the same reporter is linked to 20210802909 and 20210803269.


VAERS ID: 1524820 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site pain, Oropharyngeal pain, Poor quality product administered, Product storage error, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210802909

Write-up: SORE THROAT; HEADACHE; FEVER; PAIN AT THE INJECTION SITE; VACCINE ADMINISTERED OUTSIDE OF THE 6 HOUR TIME FRAME OF STORAGE CONDITION; OUT OF SPECIFICATION PRODUCT USE; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced vaccine administered outside of the 6 hour time frame of storage condition. On 29-JUL-2021, the subject experienced out of specification product use. On an unspecified date, the subject experienced sore throat, headache, fever, and pain at the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, sore throat, fever, pain at the injection site, vaccine administered outside of the 6 hour time frame of storage condition and out of specification product use was not reported. This report was non-serious. This case, from the same reporter is linked to 20210802801.


VAERS ID: 1524946 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-21
Onset:2021-07-29
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210727; Test Name: Nasal Swab; Test Result: Positive ; Test Date: 20210729; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202100969981

Write-up: I tested Positive for CoVid 19 on July 29th.; I tested Positive for CoVid 19 on July 29th.; This is a spontaneous report from a contactable consumer (patient). A 23-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection; Lot number: EL3247, Expiry date: unknown) via an unspecified route of administration, administered in Arm Right on 21Apr2021 at 10:45 at the age of (23-years-old) as a single dose and received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection; Lot number: EL3247, Expiry date: unknown) via an unspecified route of administration, administered on 31Mar2021 at 15:45 at the age of (23-years-old) as a single dose for covid-19 immunisation. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had been tested for positive for COVID-19. Medical history included none. No known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination There were no concomitant medications. It was reported on 29Jul2021 at 09:30 the patient was tested positive for covid-19. The patient underwent lab tests and procedures which included on 27Jul2021 Nasal Swab test: positive, on 29Jul2021 Nasal Swab: positive. Case was reported as non serious. No treatment was received for adverse event (ae). The outcome of the event was unknown. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1524950 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-26
Onset:2021-07-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Gastrointestinal tract irritation, Heart rate increased, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 INC202100975590

Write-up: Patient had a lot of anxiety and a high heart rate. Patient stated that yesterday it was bad and they called emergency services and went to the ER; Patient had a lot of anxiety and a high heart rate. Patient stated that yesterday it was bad and they called emergency services and went to the ER; rash; beginning to have GI problems yesterday; This is a spontaneous report from a non-contactable consumer. This consumer (mother) reported for a 31-year-old female patient that: A 31-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 26Jul2021 as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date the patient experienced patient had a lot of anxiety and a high heart rate. Patient stated that yesterday it was bad and they called emergency services and went to the ER and rash. On 29Jul2021 the patient experienced, beginning to have GI problems yesterday. It was reported that, reporter was the mother of the patient who received the Pfizer COVID 19 vaccine dose 1 on Monday 26Jul2021. She stated that she had a rash that she was not sure it was from the vaccine or not. She reported beginning to have GI problems yesterday and again today. She stated that it is not nausea or diarrhea. Described that it was more of a knot in the stomach that was full of anxiety. She was having a lot of anxiety and a high heart rate. She stated that yesterday it was bad and they called# and went to the ER via ambulance. She relays that they did not do anything to help her. They did not give her any medicine or do any tests or bloodwork. We want to get this figured out and don''t want to go back to the ER if they were not going to help. She stated that they would like to know if these symptoms have been seen and how long they could last. Reporter did not report, if there a medication that can be given to reverse the vaccine or to counteract it. And can she take Benadryl to help with these symptoms. The patient visited to the emergency room. The patient did not receive treatment for the adverse events. The outcome of events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1525368 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-18
Onset:2021-07-29
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Diabetes, Hypertension
Allergies: Unknown
Diagnostic Lab Data: Covid 19 - Rapid Antigen
CDC Split Type:

Write-up: Case symptom onset 7/29/2021 which included headache and cough. He was tested by Rapid Antigen on 8/1/2021 and tested positive for Covid 19. At the time of case investigation 8/1/21 case was still symptomatic.


VAERS ID: 1525633 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-25
Onset:2021-07-29
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol 300 mg, indomethacin 50 mg and colchicine 0.6 mg prn
Current Illness: none
Preexisting Conditions: gout
Allergies: NKDA
Diagnostic Lab Data: positive COVID testing on 8/3/21
CDC Split Type:

Write-up: breakthrough COVID infection


VAERS ID: 1525664 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-22
Onset:2021-07-29
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028L20A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram, Back pain, Blood test, CSF white blood cell count, Central venous catheterisation, Chest pain, Computerised tomogram, Computerised tomogram head, HIV test, Headache, Herpes simplex test, Impaired work ability, Influenza virus test, Loss of personal independence in daily activities, Lumbar puncture abnormal, Magnetic resonance imaging, Meningitis aseptic, Metabolic function test, Migraine, Neck pain, SARS-CoV-2 test, Scan with contrast, Sexually transmitted disease test, Thinking abnormal, Venogram
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Vyvance, Aspirin 81mg, Armour thyroid, Vitamin c, Vitamin D, Vitamin E, Fish oil, Biotin, Pepcid, Probiotic, Estrogen, Claritin, Flonaze
Current Illness: No
Preexisting Conditions: No
Allergies: Penicillin, Codeine, Topamax
Diagnostic Lab Data: CVC w/ disk , CT of head & brain w/o contrast, CMP, PTPTT, CT w/ contrast , MRI, MRV, MRA, Blood Work, VDRL, HIV, COVID, FLU, HSV, Lumbar Puncture showed white blood cells in cerebral spinal fluid. Diagnosed with aseptic meningitis, only allowed to walk for 20 mins a day, hire someone to do things for her, out of work on leave till sept 19th.
CDC Split Type: vsafe

Write-up: I woke up the morning of the 29th, headaches, normal headaches, weird headache not a typical migraine, neck was sore, i kind of just thought I was achy and sore from work, as the day progressed the headache was more pronounced and weird, if i was laying on my left my head would hurt on the left, it was like whichever direction gravity was on my body, upper back was sore, pain in chest, heating pad and took pain relief, neck ache, headache worse, 30th neurologist suggested ER, went to ER, test done, took meds given, follow up with neuro july 2nd, went back to ER, thoughts weren''t as clear, discharged on the 3rd, goes back to neuro, five different test, ended up with a aseptic meningitis


VAERS ID: 1525767 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-22
Onset:2021-07-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Discomfort, Head discomfort, Muscle spasms, Muscle twitching, Musculoskeletal stiffness
SMQs:, Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tri-lo-Marzia birth control, seamoss, stool softeners.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Head and neck pressure/stiffness. Feels like my head was twitching or spasming. My gag reflex is gone. Chest pains.


VAERS ID: 1525860 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-21
Onset:2021-07-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Ear pain, Erythema, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR test done on 08/02/2021; positive
CDC Split Type:

Write-up: Ear ache, sore throat; redness


VAERS ID: 1525862 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Biopsy skin, Rash, Skin burning sensation, Skin reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (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: Armour Thyroid 90mg 4 days a week 120mg 3 days a week Multi Vitamin 1 x a day Vitamin D 5000IU 1 x a day B12 1000mcg 1 x a day
Current Illness: none
Preexisting Conditions: Hypothyroid
Allergies: Penecillin Shellfish
Diagnostic Lab Data: Since the largest hive did not disappear after 5 days I went to a dermatologist, They performed a biopsy, awaiting results. Also have a PCP appt on 8/10.
CDC Split Type:

Write-up: 24 hours after the vaccine I developed HIVES on my right LEG from buttocks to just above the knee .. hives subsided except for the largest one,.. turned bright red (almost looks like a burn) i have taken pictures of the progression each day. Also have a warming/burning type sensation on the inside of the same leg/thigh area.


VAERS ID: 1525866 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None. Not reported to occupational health as the vaccine once given, cannot be undone. Monitored self to determine if ER visit was necessary.
CDC Split Type:

Write-up: Required vaccination under threat of job termination. Received at occupational health. The afternoon after vaccination, experienced moderate to severe headache, nausea, fatigue and blurred vision. Headache and nausea persistent 4 days after, decreased slightly day of this report.


VAERS ID: 1525894 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oropharyngeal pain, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown. Patient indicated he was not sick at the time of vaccination.
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of an enlarged tongue and soreness of the throat that began 8 hours after vaccine administration (7/29/2021). Patient reported no difficulty breathing. The pharmacy reached out as a courtesy to check-in on patient. He informed the pharmacy of the symptoms described above. After consultation with the pharmacist, he was told to take 1 (one) cetirizine 10 mg tablet and 1 (one) famotidine tablet each day for relief of symptoms. Patient was instructed to call a physician or report to a hospital if symptoms did not resolve in 24 hours.


VAERS ID: 1525900 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 184288 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Impaired driving ability, Neck mass, Neck 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu shot, I had a rash all over my body, 20 years old
Other Medications: Celery seed, turmeric, cherry tart
Current Illness: None
Preexisting Conditions: Back problems and arthritis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: I got fever the next day and I could not drive back home. The following day I woke up to this pain and lump on my neck, where my neck and my shoulder are. It was feeling kind of sore but it was a soft lump. On Saturday I called a nurse and she told me to go to care. They did not do any medical tests or prescribed any medications because I did not get seen because they were taking too long and I had to go take care of my mom.


VAERS ID: 1525905 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 RA / IM

Administered by: Private       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: Sprintec QD
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccinated with Moderna at age 17; unauthorized for use in patients less than 18 years of age at this time


VAERS ID: 1525916 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye contusion, Fall, Head injury, Immediate post-injection reaction, Periorbital haematoma, Seizure, Skin discolouration, Skin laceration, Swelling face, Unresponsive to stimuli, Wound, Yellow skin
SMQs:, Cholestasis and jaundice of hepatic origin (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Periorbital and eyelid disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis
Allergies: None
Diagnostic Lab Data: None as of yet, doctor''s appointment on 8/5/2021, unless symptoms worsen.
CDC Split Type:

Write-up: Approximately one minute after receiving the shot, patient had a seizure. She fell, hit her head (repeatedly), and was unresponsive for less than a minute. Pharmacy staff offered an ice-pack and water, but then proceeded to walk her out of the store. They did not file a report at the time. They did not offer to call an ambulance. They did not offer to call someone to pick her up. Just walked her out. She got back to her vehicle, and proceeded to call her mother (who is a nurse). Her mom arrived to pick her up, and went in to ensure that a report would be filed. Her mother states that the staff had been unaware that there was a form to fill out, and that there had been a few other patients who had seizures (we assume these were not reported as they had not been aware of the proper forms). Initially, patient had a cut and swelling on her forehead from hitting her head. The swelling has reduced, but as of 8/3/21, patient has had discoloration around her eyes. This is indicated by what appears to be blood collecting in corner of her right eye socket on the bridge of the nose, bruising under the eyes, and yelling of the skin along her nose and center forehead, which may be indicative of a basal skull fracture. Patient has a doctor''s appointment scheduled for 8/5/21, and has stated that she will wait until her doctor''s appointment if the symptoms do not worsen for a proper diagnosis.


VAERS ID: 1525935 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

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

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

Write-up: Patient was under 18 at the time of vaccination. Notified the facility where the vaccine was given (the patents employer) and followed up with the patient. No adverse events or serious side effects reported.


VAERS ID: 1525947 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Chest discomfort, Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Fibrosis, Myocarditis, Pyrexia, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Elevated high sensitivity troponin. Echocardiogram showed mildly reduced ejection fraction (45-50%). Cardiac MRI consistent with myopericarditis- showed no ischemia, amyloidosis, sarcoidosis. Did show fibrosis occupying ~16% of left ventricular myocardium.
CDC Split Type:

Write-up: Patient developed fevers day after shot. Next day, started to have persistent chest pain/pressure, fevers resolved but chest pressure persists.


VAERS ID: 1525952 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-15
Onset:2021-07-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Dizziness, Fatigue
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had fatigue, elevated temperature, dizziness 2 weeks after the 1st dose


VAERS ID: 1526016 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Computerised tomogram neck, Musculoskeletal stiffness, Neck pain, Sleep disorder
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin c,zinc, d3,multi vitamin
Current Illness: allergy issues
Preexisting Conditions: Diabetic, high blood pressure, asthma
Allergies: Augmentim, sulfa
Diagnostic Lab Data: Ct scan of neck. Advise by ER Dr to follow up with primary care provider.
CDC Split Type:

Write-up: 2 days after vaccine, Stiff neck left side, sevier pain from left neck to shoulder down to arm. Unbearable pain that keeps me up at night. Went to ER on Saturday.


VAERS ID: 1526067 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-10
Onset:2021-07-29
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0189 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atomoxetine 80 mg. Acetaminophen.
Current Illness: None
Preexisting Conditions: Anxiety / Depression
Allergies: Claritin -D
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles


VAERS ID: 1526077 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

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

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

Write-up: Patient and mother came into pharmacy for a covid shot. Mother gave us patient''s date of birth as 11/21/2008, and he was a new patient so we assumed this was correct. Patient was given the shot and did not experience any adverse effects at the time of the shot. We were contacted by the immunization services on Monday 8/2/21 and they informed us the patient''s date of birth was actually 11/21/2009, we called the mother to confirm and she stated that it was supposed to be 2008, but did not want to provide a birth certificate to prove this, so we are left to believe that the Immunization Services are correct and that patient was too young to have received the shot.


VAERS ID: 1526104 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-07-29
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / UNK LA / IM

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

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

Write-up: Positive for Covid 7/30/2021


VAERS ID: 1526105 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-07
Onset:2021-07-29
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Feeling cold, Headache, Hypoaesthesia, Hypokinesia, Loss of consciousness, Peripheral swelling, Poor peripheral circulation, Sluggishness, Transient ischaemic attack
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: I gave a healthy 42 year old female a Janssen covid shot on 7-7-21. she was taken to the ER on 7-29-21 after experiencing dizziness, severe headaches and numbness and decreased motor movement on her left side. she was complaining to her mother on the phone that she didn''t feel right and she passed out. She woke up to emergency assessing her in her home. she declined transport to the ER and had a family member take her. She was assessed her and determined she may have had a TIA. She was prescribed Hydroxyzine HCl, Fioricet, lipitor and aspirin. A consult with a cardiologist and neurologist in a few weeks. On 8-4-21 she reports a sluggish feeling and swelling in her left leg and feels her leg might have decreased circulation and a cold feeling as well.


VAERS ID: 1526132 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Dizziness, Fatigue, Feeling abnormal, Headache, Hot flush, Insomnia, Mobility decreased, Pain, Pain in extremity, Pyrexia, Tinnitus, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR in early 1970s. Required hospitalization
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: MMR
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache lasting 4 days. Pain in left arm and limited motion without pain. Body felt like someone took a baseball bat to my body. 3 day fever. Upset stomach, Dizziness and feeling out of body for five days. Onset of hot flashes. Insomnia lasting 5 nights and daytime exhaustion. Ringing in ears and blurred vision.


VAERS ID: 1526173 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Chills, Feeling cold, Headache, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: scheduled to see physician 8/5 at 8:15 am
CDC Split Type:

Write-up: sore throat, headache, body aches, chills, "real cold" all night, chest pain that hurt all night and went into friday and saturday


VAERS ID: 1526197 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 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? 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: The patient did not suffer any adverse events as far as I know, they did however receive a dose of Pfizer under the guise of it being a first dose after having received the Janssen vaccination in April 2021


VAERS ID: 1526233 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

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

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

Write-up: Patient presented to the clinic requesting the Janssen vaccination. The location site was offering incentives for those getting vaccinated. It was later discovered that the patient had completed the Moderna series.


VAERS ID: 1526328 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: CDC guidelines were consulted and no further vaccine should be given. It was determined he would be considered fully vaccinated.
CDC Split Type:

Write-up: client was given his first vaccine on 6/23/2021 and it was a Pfizer vaccine. He was accidently given his second vaccine shot on 7/29/2021 of Moderna


VAERS ID: 1526492 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / UNK LA / IM

Administered by: Public       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? 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: No adverse reactions occurred, Moderna vaccine was given instead of Pfizer


VAERS ID: 1526510 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC Naproxen PRN (last taken 1 month ago)
Current Illness: None.
Preexisting Conditions: Migraines- 4-5 times per month.
Allergies: None
Diagnostic Lab Data: None. Neurologic testing on physical exam normal.
CDC Split Type:

Write-up: Constant mild headache on forehead and posterior head. Next day, had numbness/weakness on the entire left arm. This has almost resolved with residual numbness sensation on the left wrist dorsal aspect.


VAERS ID: 1526528 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Diarrhoea, Injection site pain, Injection site pruritus, Lymphadenopathy, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin /Advil/Tumeric/Benadryl
Current Illness: No
Preexisting Conditions: Sickle cell TRAIT
Allergies: Excedrin/Sinutab/plums/ sometimes cherries, pineapples, nuts.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills, loss of appetite and weakness started 2 pm 7/29- used advil and benadryl diarrhea started 7/31 itching over area of injection site -soreness / lymp nodes swollen under armpit of left hand large wheals and hives to two areas on lt hand and one area to rt hand-saw pharmacist who encouraged to keep hydrating and to use hydrocortisone ointment


VAERS ID: 1526766 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Aphasia, Arthralgia, Back pain, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Immediate post-injection reaction, Injection site pain, Lethargy, Myalgia, Nausea, Neck pain, Sleep disorder, Tachycardia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 150mg, Clonazepam 2mg, Melatonin 5mg.
Current Illness: Hypothyroidism, Insomnia, depression, anxiety, Migraine.
Preexisting Conditions: hypothyroidism, migraine, starting glaucoma
Allergies:
Diagnostic Lab Data: Not seen a doctor yet
CDC Split Type:

Write-up: Immediate burning in the injection area, dizziness, and nausea 15 min after injection. Consecutive vomiting 2 to 20 minutes after the injection and strong stomach pain. About an hour later confusion to come up with words and lethargic when I went to bed. The next day I had severe diarrhea, Since that day I have felt fatigued, tachycardic, muscle aches and joints, and extreme fatigue. On the night of August 3rd, during the night I felt short of breath and did not sleep due to strong muscle pain that persisted, neck are and back pain.


VAERS ID: 1526918 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram thorax abnormal, Hypothyroidism, Immediate post-injection reaction, Left ventricular hypertrophy, Palpitations, Sleep disorder
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypothyroidism (narrow), Hypersensitivity (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 20 mg Amoxicillin 500mg Clarithromycin 500mg
Current Illness: Hpylori
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan shows enlarge in left chamber, which differs from scan taken 3/2021 Chest x-ray normal Thyroid levels decreased
CDC Split Type:

Write-up: I had heart palpitations immediately after receiving the vaccination. The paramedics took my blood pressure and it was within normal range. That evening I have heart palpitations while sleeping. I would awake suddenly. This has happened every night since I receive the vaccine. I also have palpitations during the day.


VAERS ID: 1528148 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210803269

Write-up: VACCINES GIVEN OUTSIDE THE 6 HOUR TIME FRAME (PUNCTURED AT 13:00 ON 28-JUL-2021 AND ADMINISTERED NEXT DAY BETWEEN 10:00 TO 13:00); This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced vaccines given outside the 6 hour time frame (punctured at 13:00 on 28-jul-2021 and administered next day between 10:00 to 13:00). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccines given outside the 6 hour time frame (punctured at 13:00 on 28-jul-2021 and administered next day between 10:00 to 13:00) was not reported. This report was non-serious. This case, from the same reporter is linked to 20210802801 and 20210802909.


VAERS ID: 1528153 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804917

Write-up: RECEIVED A DOSE OF VACCINE DRAWN FROM A VIAL THAT WAS HELD IN THE FRIDGE FOR NEARLY 24 HOURS; This spontaneous report received from a patient concerned a 22 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours was not reported. This report was non-serious.


VAERS ID: 1528155 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804947

Write-up: RECEIVED A DOSE OF VACCINE DRAWN FROM A VIAL THAT WAS HELD IN THE FRIDGE FOR NEARLY 24 HOURS; PUNCTURED VIAL STORED IN FRIDGE FOR 24 HOURS; This spontaneous report received from a pharmacist concerned a 36 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 ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours. On 29-JUL-2021, the subject experienced punctured vial stored in fridge for 24 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours and punctured vial stored in fridge for 24 hours was not reported. This report was non-serious. This case, from the same reporter is linked to 20210804917 and 20210805634.


VAERS ID: 1528172 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210805634

Write-up: PUNCTURED VIAL STORED IN FRIDGE FOR 24 HOURS; RECEIVED A DOSE OF VACCINE DRAWN FROM A VIAL THAT WAS HELD IN THE FRIDGE FOR NEARLY 24 HOURS; This spontaneous report received from a pharmacist concerned a 29 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 ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, expiry: 07-AUG-2021) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced punctured vial stored in fridge for 24 hours. On 29-JUL-2021, the subject experienced received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the punctured vial stored in fridge for 24 hours and received a dose of vaccine drawn from a vial that was held in the fridge for nearly 24 hours was not reported. This report was non-serious. This case, from the same reporter is linked to 20210804947 and 20210804917.


VAERS ID: 1528176 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-07-01
Onset:2021-07-29
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Contusion, Diarrhoea, Feeling abnormal, Haemorrhage, Myalgia, Nausea, Overdose, Pain in extremity, Pyrexia, Vaccination error, Vaccination site mass
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Drug abuse and dependence (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: The injection site looks like there is half a soft ball under his skin; Feels like garbage; Diarrhea; Was given 1 ? of the dose he should had received.; Injected twice due to bad syringe and needle; sore arm; Nausea; Sore arm; Hot chills; Fever; Blood was dripping from the injection; Bruised arm; This spontaneous case was reported by a consumer and describes the occurrence of HAEMORRHAGE (Blood was dripping from the injection) in a 31-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 054C21A and 011D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 01-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Jul-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 29-Jul-2021, the patient experienced HAEMORRHAGE (Blood was dripping from the injection) (seriousness criterion medically significant), CONTUSION (Bruised arm), DIARRHOEA (Diarrhea), OVERDOSE (Was given 1 ? of the dose he should had received.), VACCINATION ERROR (Injected twice due to bad syringe and needle), NAUSEA (Nausea), MYALGIA (Sore arm), CHILLS (Hot chills) and PYREXIA (Fever). 29-Jul-2021, the patient experienced PAIN IN EXTREMITY (sore arm). On 30-Jul-2021, the patient experienced VACCINATION SITE MASS (The injection site looks like there is half a soft ball under his skin) and FEELING ABNORMAL (Feels like garbage). On 29-Jul-2021, OVERDOSE (Was given 1 ? of the dose he should had received.) and VACCINATION ERROR (Injected twice due to bad syringe and needle) had resolved. On 30-Jul-2021, DIARRHOEA (Diarrhea) had resolved. At the time of the report, HAEMORRHAGE (Blood was dripping from the injection), CONTUSION (Bruised arm), VACCINATION SITE MASS (The injection site looks like there is half a soft ball under his skin), FEELING ABNORMAL (Feels like garbage), PAIN IN EXTREMITY (sore arm), NAUSEA (Nausea), MYALGIA (Sore arm), CHILLS (Hot chills) and PYREXIA (Fever) outcome was unknown. No concomitant medications were given by the reporter. No Treatment information were provided by the reporter. Patient received his 2nd dose on 29JUL2021, she had issues with the syringe and needle that was initially used for his injection and had to be injected twice. The 1st time she tried to inject him, the rare part of the syringe was stuck, she pushed but it did not move. The needle and syringe were bad. When she pulled out the syringe, blood was dripping from the injection. She has had to use another needle and syringe to give him the dose. He believes he was given 1 ? of the dose he should had received. He stared to experience some side effects later in the day. These side effects include diarrhea , nausea , sore arm , bruised arm, hot chills, and fever . The injection site looks like there is half a soft ball under his skin. For the events Overdose and Medication Error causality is not applicable. For the remaining events, 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. This case was linked to MOD-2021-271640 Dose 1 (Patient Link).; Sender''s Comments: For the events Overdose and Medication Error causality is not applicable. For the remaining events, based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1528258 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 antibody test, Urinary tract infection
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: COVID-19; Test Result: Positive ; Comments: Tested positive for COVID-19 with a "1287" result of antibodies on her test.
CDC Split Type: USPFIZER INC202100975646

Write-up: Caller tested positive for COVID-19 with a "1287" result of antibodies on her test; Caller tested positive for COVID-19 with a "1287" result of antibodies on her test; a urinary tract infection; This is a spontaneous report from a contactable consumer or other non-health care professional (patient) via medical information team. A 70-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number: unknown, Expiration date not reported), via an unspecified route of administration, administered on an unspecified date in Feb2021(at the age of 70-year- old) as single dose and first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number: unknown, Expiration date not reported), via an unspecified route of administration, administered on unspecified date (at the age of 70 years old) for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Caller wants to know if the high COVID-19 antibody levels that she presented on her physical test could be due to a urinary tract infection that she developed recently. Caller and her husband received the second dose of the Pfizer COVID-19 vaccine on Feb, shortly after receiving the vaccine caller had no antibodies against COVID-19 and now a year later she resulted with a high level of antibodies relatively closely after experiencing a urinary infection. Caller will have a new medical test performed on Sep. As far as she knows she never had COVID-19. Caller heard that the type O blood is more protective with the vaccine. Caller also read that according to Pfizer withheld after 6 months of receiving the second dose of the vaccine patients have less immunity. E-transmitting neglected probable lack of efficacy. The patient tested positive for covid-19 with a 1287 result of antibodies on her test on 29Jul2021, and a urinary tract infection in 2021. The outcome of event urinary tract infection was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1528259 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-03
Onset:2021-07-29
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: 20210729; Test Name: PCR test; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210729; Test Name: Rapid COVID Test; Test Result: Positive
CDC Split Type: USPFIZER INC202100975737

Write-up: took COVID test and it came back positive; took COVID test and it came back positive; This is a spontaneous report from a contactable consumer (patient). A 50-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection Batch/Lot number: EJ1685, Expiration Date was not reported), via an unspecified route of administration, administered in left arm like the shoulder on 03Mar2021 (at the age of 50-years-old) as dose 1, single and received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection Batch/Lot number: EK5730, Expiration Date was not reported), via an unspecified route of administration, administered in left arm like the shoulder on 24Mar2021(at the age of 50-years-old) as dose 2, single for covid-19 immunisation at vaccination clinic. The patient medical history was none. There were no concomitant medications. It was reported that, the patient had the vaccine in Mar. He was a little stuffy this week and had mild symptoms. Down the street has COVID test. He took COVID test and it came back positive. Patient clarified yesterday, 29Jul2021, he had rapid COVID test and it was positive. PCR test was also done, but he hasn''t gotten the PCR results, that will take a couple of days. He took the test yesterday morning between 11:00AM or 11:30AM. His awareness date of testing COVID positive was yesterday, 29Jul2021. Patient states that he was stuffy, had a little cough, and didn''t feel right on Sunday 25Jul2021. He went to a drive up testing site. He was feeling off and had a cough. The patient underwent lab tests and procedures which included PCR test: unknown results on 29Jul2021, Rapid COVID Test: positive on 29Jul2021. The outcome of the events was unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1528375 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-03
Onset:2021-07-29
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Eye swelling, Lymphadenopathy, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Itching, swelling in the eye/ear area, lymphadenopathy


VAERS ID: 1528586 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Drainage, Headache, Immediate post-injection reaction, Induration, Influenza like illness, Injection site erythema, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Septra
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Immediate Headache that has now lasted over a week - LARGE lump under the skin after icing and heat that keeps draining, sore arm, Slight flu like symptoms, Red blotches on right arm at injection site


VAERS ID: 1528615 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-01-27
Onset:2021-07-29
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 in hospital Admitted to hospital and tested positive on 7/29/2021 Received Pfizer COVID vaccine on 1/7/2021 & 1/27/2021


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