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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 18 out of 4,799

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VAERS ID: 1463756 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

Write-up: 1st dose pfizer vaccine was given to patient on 07/08/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window. We reached out to pt on 07/10/21 to get the 1st dose again. Patient will return to the pharmacy to repeat dose on 07/12/21.


VAERS ID: 1463887 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-07-08
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210718922

Write-up: INAPPROPRIATE AGE AT VACCINE ADMINISTRATION; This spontaneous report received from a consumer concerned a 16 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: 1820095 expiry: 18-AUG-2021) dose was not reported, administered on 08-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-JUL-2021, the subject experienced inappropriate age at vaccine administration. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of inappropriate age at vaccine administration was not reported. This report was non-serious.


VAERS ID: 1463956 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-07-08
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt admitted to the hospital for COVID 19 post vaccination.


VAERS ID: 1463977 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Heart rate increased, Hypotension, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Netoprololer Losartan
Current Illness: no
Preexisting Conditions: recovered from heart failure Had Covid in 2019
Allergies: Codeine
Diagnostic Lab Data: on 07/10 patient went to Urgent Care reported low blood pressure and adv him that since he already has the virus his symptoms will pass
CDC Split Type:

Write-up: Patient reported that his heart rate has increased to 150 pm since the shot, also had shaking chills and 103 fever, severe headache for 3 days


VAERS ID: 1464028 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-15
Onset:2021-07-08
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0470B21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram thorax, Echocardiogram, Myocarditis, Troponin increased, Ultrasound Doppler
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sildenafil
Current Illness: None
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: CXR (7/8/2021) CT chest without contrast (7/8/2021) Echocardiogram (7/8/2021) LE duplex (7/10/2021)
CDC Split Type:

Write-up: Acute Myocarditis - no etiology identified on discharge from hospital however few viral studies were pending. Pt admitted with chest pain and elevated troponin.


VAERS ID: 1464103 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Flushing, numbness and tingling;


VAERS ID: 1464107 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Flushing, numbness and tingling;


VAERS ID: 1464108 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Flushing, numbness and tingling;


VAERS ID: 1464126 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal, birth control, tylenol as needed, unisom as needed
Current Illness: my period was just ending (should''ve ended)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have been experiencing heavy period like bleeding and cramping. Not painful but uncomfortable.


VAERS ID: 1464146 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Breast mass, Chest pain, Chills, Dizziness, Headache, Hyperhidrosis, Muscle spasms, Nausea, Pain in extremity, Palpitations, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metsormin np thyroid omeprazole tranadol
Current Illness: no
Preexisting Conditions: PCOS Hypo thyrod
Allergies: penicillin efron xopenex peanuts
Diagnostic Lab Data: no
CDC Split Type:

Write-up: Patient report that after 20 mins of the vaccine she had a serve headache and nausea...next day felt pain all over her chest and arm and develop lumps under her breast and on her left arm... bad cramping, light headed and dizzy, heart was racing, chills and sweats


VAERS ID: 1464154 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscular weakness, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Ventolin HFA 1-2 puffs q4-6 hrs prn wheeze, Meloxicam 15mg tabs 1 po q day arthritis, Heather 0.35mg tabs1 po q day, Sertraline 25mg 1 q day, Topamax 75mg bid, hydroxazine 25mg 1 tab tid prn panic, Famotadine 20mg 1 tab bid prn gerd.
Current Illness:
Preexisting Conditions: arthritis in rt shoulder, seizure disorder, gerd
Allergies: strawberries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Side effects started Thursday 7/8/21 after receiving vaccine on Wednesday 7/7/21. Patient states she felt "achy" and then had muscle weakness in her legs which intensified over the weekend. She states she went to the ER on Sunday and states she was diagnosed with myalgia and instructed to take acetaminophen or ibuprofen for symptoms. She states she is having to use a walker to ambulate because she is so weak today. She was scheduled for an appointment with PCP for follow up 7/12/21


VAERS ID: 1464156 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphthous ulcer, Headache, Nausea, Pyrexia, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Nausea Headache Fever Vaginal bleeding Mouth aphtha


VAERS ID: 1464230 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-24
Onset:2021-07-08
   Days after vaccination:106
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyanocobalamin, Montelukast, Buspirone, Mometasone, Lisinopril, Lo/Ovral, Ibuprofen
Current Illness: None
Preexisting Conditions: Adjustment disorder, allergic rhinitis, menorrhagia, anxiety disorder, psoriasis, HTN, atrial paroxysmal tachycardia
Allergies: Erythromycin
Diagnostic Lab Data: 07/08/21: Positive SARS-CoV-2 RNA.
CDC Split Type:

Write-up: 07/08/21: Cough.


VAERS ID: 1464237 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 RA / IM

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

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

Write-up: Bilateral numbness, tingling and pain to arms that started the same day he received his 2nd dose. Patient did not have information on 2nd dose of vaccine he received, however states that it was the 2nd dose . Dose was given on 7/8/2021. on left deltoid. He also kept stating it was Moderna? He did not have proof of 2nd dose, only card showing first dose. This report and information on vaccine dose was made with the only information he had at this time.


VAERS ID: 1464392 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Injection site bruising, Injection site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: trazodone 50mg one at bedtime venlafaxine 37.5 mg one daily buspirone 10mg one twice
Current Illness: nki
Preexisting Conditions: depression and anxiety
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient said it was bleeding for 2 days then turned into deep bruising and pain down arm and under breast getting worse. Can''t afford to go to MD. Will monitor and keep posted.


VAERS ID: 1464409 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After the vaccination was administered, it was discovered that the patient had received a full, two dose course of the Pfizer Covid 19 vaccine on 2/27/21 & 3/20/21.


VAERS ID: 1464491 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram abnormal, Pain in extremity
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: chest pain and left arm pain


VAERS ID: 1464507 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Cough, Dizziness, Gait inability, Heart rate increased, Hypoaesthesia, Hypoaesthesia oral, Paraesthesia oral, Pharyngeal swelling, Rash, Respiratory tract oedema, Taste disorder
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: UTI on Macrobid 100mg
Preexisting Conditions: Backpain
Allergies: Penicillin (Rash)
Diagnostic Lab Data: BP 140/90 mmHg
CDC Split Type:

Write-up: After Moderna shot on 7/8/21 around 6:55p.m., patient complained throat swelled up, numbness of face and tongue, airway closing up, fast heart rate (heart rate went from 80 to 144bpm in a few minutes). Benadryl 50mg was given around 7:05pm but patient did not feel better. Epinephrine 0.3mg was injected around 7:15p.m. Patient felt better. Around 9 p.pm, patient felt hurt in stomach and dizzy that she could not walk and needed to be escort on wheelchair. With patient''s agreement, I called 911 and ambulance came. BP measured 140/90mmHg. Patient was escorted her to the hospital. On 7/9/21, pharmacy manager called to follow up and patient was doing fine with no symptom. On 7/12/21@12:31p.m, pharmacist called to follow up, patient complained patient has mild rash on skin and leg, light cough, chest pain, slight tingling on tongue and weird taste. Patient will visit her primary care doctor on 7/13/21.


VAERS ID: 1464618 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Gaze palsy, Generalised tonic-clonic seizure, Malaise, Muscle contracture, Sinus rhythm, Thirst, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA, NKA
Diagnostic Lab Data: Unable to obtain details, pt discharged from ED few hours after being taken by EMS.
CDC Split Type:

Write-up: Within minutes of receiving vaccination, pt stated he was hot and thirsty, became unrepsonsive to verbal stimuli. Pt proceeded to have tonic-clonic seizure lasting 25 seconds. Pt lowered to the ground by staff, monitored VS. No incontinence, no biting of tongue. pt regained consciousness, and oriented x3. VSS. pt reported he felt light-headed. When attempted to place in chair, symptoms returned, and pt was placed back in supine position. EMS arrived, and after VS established, EKG indicated sinus rhythm, placed in chair. Pt stated he did not feel good, and similar symptoms began with eyes rolling back and contractures. Pt taken to hospital.


VAERS ID: 1464705 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-28
Onset:2021-07-08
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Fatigue, Headache, Injection site erythema, Lymphadenopathy, Tinnitus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hearing impairment (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: Synthroid, Estrace, Singulair, Fioricet Vitamins C, D3, B12, Multi
Current Illness: Fluid in ear
Preexisting Conditions: Asthma
Allergies: NSAIDS, Aspirin, Ceclor, EES, Ancef, Levaquin
Diagnostic Lab Data: Bloodwork was drawn for several different test and I was given a steroid shot to help with the reaction on my arm July 12, 2021. I was also given an antibiotic and something for the headache. I was to,d that if things worsened to go to the ER.
CDC Split Type:

Write-up: Started with a red patch on injection arm midway between elbow and shoulder July 8, 2021. The red patch continued to grown until it was 6 inches long and 3 inches wide as of July 12, 2021. Started with a headache July 8, 2021 and continued until July 12, 2021, with severe ringing in my ears. I also have a lymph node behind left ear that is swollen. I?ve been tired as well since July 8th. I did take Benadryl hoping it would help with the red patch as well as medication for the headache, but it never helped. Things got progressively worse.I called the CDC and they advised seeking medical attention which I did today, July 12, 2021. When I arrived at the doctor my blood pressure was 130/100, no fever, pulse ox was 99. My doctor felt it was a reaction from the vaccine and began a course of treatment to relieve the symptoms.


VAERS ID: 1464719 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-17
Onset:2021-07-08
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Cyst, Fatigue, Oral mucosal eruption, Pain in extremity, Paraesthesia, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamin, Sertraline, Fish Oil, Alprazolam, Potassium, Cetirizine, Cyclobenzaprine
Current Illness: None
Preexisting Conditions: Allergies, neck pain
Allergies: Mold, Dust Mites
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cyst under right arm pit, Knee/toe/back pain, right arm tingling (falling asleep) at night, red painful bumps on legs, bumps in mouth, tired. Doxycycline started on 09Jul21. X-rays and bloodwork scheduled.


VAERS ID: 1464747 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-05
Onset:2021-07-08
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 - / -

Administered by: Pharmacy       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:
CDC Split Type:

Write-up: Patient received (COVID-19) Ag [Presence] in Respiratory specimen by (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay test on 7/8/2021 and came back positive. Case investigation interview with patient has not been performed at the time of this note.


VAERS ID: 1464767 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-05
Onset:2021-07-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anosmia, COVID-19, Fatigue, Headache, Malaise, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Based on documentation from case manager during case investigation interview, "CT stated they were visiting family up north when she started feeling ill." As of 7/8/2021 symptoms include headache, fatigue, loss of smell. Received SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay~SARS-CoV+SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay on 7/9/2021 and came back positive.


VAERS ID: 1464777 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness bilateral, Dizziness, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL,IBUPROFEN, EAR DROPS,PREDNISONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: STRICT BEDREST.
CDC Split Type:

Write-up: FEVER ,DIZZINESS, BILATERAL DEAFNESS, TINITUS TREATMENT - PREDNISONE, EAR DROPS, IBUPROFEN STRICT BED REST.


VAERS ID: 1464843 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Write-up: Patient came in to receive her COVID vaccination and received the Janssen (J&J) vaccination this morning. Patient confirmed that she had not received a vaccination previously but after administering the J&J vaccination, pulled out a completed vaccination card for both doses of Moderna completed in February 2021.


VAERS ID: 1464855 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins and minerals; bio-identical hormones (estradiol/progesterone creams); no prescription meds.
Current Illness: None
Preexisting Conditions: None
Allergies: Anaphylactic shock while hospitalized (seizure, HR, BP, breathing required Code Blue/epi): indocin suppository (1992); anaphylactic reaction: breathing, HR, BP: cleocin antibiotic (2006); anaphylactic reaction (rash, breathing) penicillin (2015); adverse reaction (HR, confusion, BP) xylocaine (2017)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Large asymmetrical rash appeared next day 7/8. Red, hot to touch, swole , very painful. Day 7/9: same symptoms, but worse. Rash was larger, and slightly itchy, very painful to touch. 7/10: redness stated to subside, still painful, slightly itchy. 7/11: symptoms lessening, but tender; 7/12: mostly gone, slight pain still noticeable . Was this a Type III Hypersensitivity or Allergic Arthus Reaction? ?Covid arm??


VAERS ID: 1465384 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Vaccination complication
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient called and said she had "covid arm" per ER. Her arm began swelling approximately two days after vaccine and she went to er. They treated with iv antibiotics.


VAERS ID: 1465598 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-07-08
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Haemoglobin decreased, Iron deficiency anaemia, Serum ferritin decreased
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Possible undiagnosed autoimmune issue
Allergies: None
Diagnostic Lab Data: Lab results: Anemic?iron deficiency low ferritin (6) and low hemoglobin levels (I?ve never been anemic before this)
CDC Split Type:

Write-up: Been feeling dizzy for the last few months. Thought I was just exhausted from teaching.


VAERS ID: 1465765 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Venous Doppler left lower extremity
CDC Split Type:

Write-up: Patient had left lower extremity pain x 4 days with left lower extremity swelling x 2 days. Patient diagnosed with an extensive deep vein thrombosis in left lower extremity.


VAERS ID: 1466246 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-08
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Feeling abnormal, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210723033

Write-up: FEEL LIKE GOT RAN OVER BY A CAR/DAY BEING ROUGH; SORENESS EVERYWHERE; LIGHTHEADED; SHORTNESS OF BREATH; REALLY BAD CHILLS; This spontaneous report received from a patient 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 07-JUL-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 08-JUL-2021, the subject experienced feel like got ran over by a car/day being rough. On 08-JUL-2021, the subject experienced soreness everywhere. On 08-JUL-2021, the subject experienced lightheaded. On 08-JUL-2021, the subject experienced shortness of breath. On 08-JUL-2021, the subject experienced really bad chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feel like got ran over by a car/day being rough, soreness everywhere, lightheaded, shortness of breath, and really bad chills. This report was non-serious.


VAERS ID: 1466491 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-05
Onset:2021-07-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Dyspnoea, Electrocardiogram abnormal, Fatigue, Heart rate increased, Hypoaesthesia, Nausea, Presyncope, Tachycardia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: iodine, Wellbutrin
Diagnostic Lab Data: EKG- tachycardia Blood work
CDC Split Type: vsafe

Write-up: 4 days after the 2nd dose, I started having dizziness, heart rate increase and I almost passed out. I also started getting numbness in my right hand. I worked at the hospital and I was brought downstairs. I was given fluids and they did an EKG which detected tachycardia. I was discharged with instructions to follow up with PCP. The next couple of days, I felt tired and a couple of episodes of nausea. I decided to go back to work on 7/12/2021. At around 8PM I felt my heart rate increasing and I sat down and my co worker took me downstairs to the ER. I felt nausea and felt like I was going to pass out. I was given fluids and my tachycardia did not go down. My heart rate was as high as 120-150. I was admitted to the hospital for rapid heart rate. I was given Metoprolol to bring down my heart rate. Currently, I am still in the hospital. I still have tachycardia, fatigue, SOB and numbness in my right hand. I will be here another night to run more tests and more blood work.


VAERS ID: 1466507 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-01
Onset:2021-07-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trileptal, keppra, sodium, daily Vitamin
Current Illness:
Preexisting Conditions: Epilepsy
Allergies: Peanut allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low grade fever, seizure 25 hours after shot


VAERS ID: 1466644 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Feeling hot, Flushing
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (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: Losartan, omeprazole, amlodpine
Current Illness: NA
Preexisting Conditions: Hypertension, Anxiety
Allergies: Keflex, Haldol
Diagnostic Lab Data: Vitals taken, EKG
CDC Split Type:

Write-up: SOB, Elevated BP, Face flushed and warm, fatigue, chest pain


VAERS ID: 1466714 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose, Blood potassium normal, Blood sodium normal, Blood urea normal, Carbon dioxide normal, Chest pain, Fatigue, Feeling cold, Feeling hot, Full blood count, Haematocrit normal, Haemoglobin normal, Headache, Metabolic function test, Platelet count normal, Somnolence, White blood cell count normal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, famotidine, fluticasone propionate, ProAir
Current Illness:
Preexisting Conditions: asthma, anxiety, GERD, obstructive sleep apnea
Allergies: Advil/ibuprofen, amoxicillin, clindamycin, codeine, diclofenac, Flexeril, fluocinonide, gabapentin, Iodinated Contrast Media, Montelukast, peanut, shellfish
Diagnostic Lab Data: Results Laboratory List Name Date Basic Metabolic Panel (BMP (Basic Metabolic Panel)) 7/8/21 CBC with Differential 7/8/21 Sodium Level Most recent to oldest [Reference Range]: 1 Sodium Level [136-145 mMol/L] 137 mMol/L (7/8/21 12:16 PM) Potassium Level Most recent to oldest [Reference Range]: 1 Potassium Level [3.6-5.1 mMol/L] 4.1 mMol/L (7/8/21 12:16 PM) Chloride Level Most recent to oldest [Reference Range]: 1 Chloride Level [98-107 mMol/L] 103 mMol/L 1 (7/8/21 12:16 PM) 1Result Comment: Performed at: LAB Carbon Dioxide Level Most recent to oldest [Reference Range]: 1 Carbon Dioxide Level [22-32 mMol/L] 28 mMol/L (7/8/21 12:16 PM) BUN Most recent to oldest [Reference Range]: 1 BUN [8-20 mg/dL] 12 mg/dL (7/8/21 12:16 PM) Creatinine Most recent to oldest [Reference Range]: 1 Creatinine [0.66-1.30 mg/dL] 0.63 mg/dL *LOW* (7/8/21 12:16 PM) Calcium Total Most recent to oldest [Reference Range]: 1 Calcium Total [8.9-10.3 mg/dL] 9.7 mg/dL (7/8/21 12:16 PM) Glucose Level Most recent to oldest [Reference Range]: 1 Glucose Level [70-99 mg/dL] 93 mg/dL 1 (7/8/21 12:16 PM) 1Result Comment: ***Updated ADA Reference Range*** A normal fasting glucose concentration is less than 100 mg/dL. An impaired fasting glucose concentration is 100-125 mg/dL. A provisional diagnosis of diabetes mellitus can be made when a fasting glucose concentration is greater than 125 mg/dL. WBC Count Most recent to oldest [Reference Range]: 1 WBC Count [4.6-10.2 thou/mcL] 9.7 thou/mcL 1 (7/8/21 12:16 PM) 1Result Comment: Performed at:LAB Hemoglobin Most recent to oldest [Reference Range]: 1 Hemoglobin [12.0-16.0 gm/dL] 13.7 gm/dL (7/8/21 12:16 PM) Hematocrit Most recent to oldest [Reference Range]: 1 Hematocrit [35.0-45.0 %] 38.4 % (7/8/21 12:16 PM) Platelet Count Most recent to oldest [Reference Range]: 1 Platelet Count [142-424 thou/mcL] 332 thou/mcL (7/8/21 12:16 PM)
CDC Split Type:

Write-up: patient in for second covid vaccine with in 5-10 minutes after administration patient c/o feeling chilled in her toes and moving up her knees temp 98.8 temporal artery patient asked for a drink of water upon returning w request patient stated sx of coldness and now tingling had moved all the way up her chest and she was also experiencing a sensation of warmness denied chest pain denied trouble breathing reported a sudden onset of headache back of head 5/10 says she does normally have headaches but did not come in with one moved patient to exam room so she could lie down dr notified patient bp initally 130-140/103 pulse 80s o2 on room air 98 EKG completed and was normal SR reviewed by dr patient c/o some off and on chest pain upper L chest BP recheck 160s/106 pulse still 80s 2l o2 applied via nasal cannula 99% patient shaky benadryl 25mg admin per verbal order from dr epi pen on stand by patient c/o sleepy patient alert and oriented throughout 911 dispatched for patient to be taken to ED for observation patient denied trouble breathing throughout she did report she had taken her daily allergy medication zyrtec today when questioned by dr patient did report a typical immune like response to the first dose of the vaccine which included fatigue body aches and nausea but didn''t occur until around 5 hours after administration of the vaccine at time of EMS arrival patient still c/o headache c/o fatigue/sleepiness trouble keeping her eyes open appeared shaky BP taken by EMS was 180s/106 Patient transported to Emergency Department, by EMS.


VAERS ID: 1466732 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Dyspnoea exertional, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (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: unsure pt only mentioned lasix not a regular patient
Current Illness:
Preexisting Conditions: severe copd (on 3L oxygen) and heart condition mentioned
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt called to report shortness of breath with limited activity (on o2, her sats drop to 85) since her shot last thursday; also reports worsens when lying down, did report to her doctor and has appt tomorrow


VAERS ID: 1466808 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-07-08
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dyspnoea, Laboratory test, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I currently take Levothyroxine; Singulair; Sucralfate; Calcium; Vitamin D; Vitamin C; Methocarbamol; Zyrtec; Trazodone; Linzess.
Current Illness: None
Preexisting Conditions: I have IBS; Scoliosis of the spine; Osteopenia.
Allergies: I am allergic to Sulphur and Flagyl.
Diagnostic Lab Data: I had labs performed and intravenous antibiotics and saline.
CDC Split Type: vsafe

Write-up: After receiving the vaccination I started experiencing a dry cough and problems breathing 3 months after. I visited the ER for the severe symptoms and was tested for COVID 19 to ensure I did not have another variant. I tested negative.


VAERS ID: 1466825 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-15
Onset:2021-07-08
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Diplegia, Dizziness, Urticaria, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: hives, vertigo, dizziness, knee pain, paralysis of knees down. severe stomach pain.


VAERS ID: 1466826 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Conjunctival haemorrhage, Gingival bleeding, Heavy menstrual bleeding, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gingival disorders (narrow), Thrombophlebitis (broad), Conjunctival disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sep 2020 flu shot reaction swelling on left side of throat, mouth, and headache, nausea and vomiting
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to azithromycin (rash), celexa (suicidal ideation), codein (rash), allegra allergy (blurred vision and flu-like symptoms), doxycycline (rash, swelling, redness), hydroxyzine hcl (rash, swelling)
Diagnostic Lab Data: I did see a doctor to have the eye checked out and discuss other symptoms. I was told that I had "just popped a blood vessel" in my eye and that it was nothing to worry about and it would heal on its own. I was told the heavy bleeding was due to my age (I am 45). And nothing was said at all about the bleeding gums.
CDC Split Type:

Write-up: Unexpected menorrhagia (heavy menstrual bleeding) with large (larger than half dollars) clots within 12 hours of receiving both the 1st and the 2nd Pfizer covid vaccine shots. (My periods are typically mostly normal and even though I have had heavy bleeding in the past on a few occasions, I''ve never experienced anything like this before.) After the 2nd shot, in addition to the menorrhagia, I also woke up the next morning with a large (about the size of a dime) subconjunctival hemorrhage in my right eye, at the top center portion of the sclera. It is mostly hidden underneath my eyelid, but is visible when I pull my eyelid back or when I look down or to the sides. (I have never had one of these before and it scared me, so I made an appointment to have it checked out.) Also, after the second shot, I have been experiencing bleeding gums when I brush or floss my teeth, which is also something new and unexpected and not something I typically or have ever experienced. It has now been 6 days since the second shot and I am still bleeding (heavy period bleeding with large clots), my right eye still has the large bloody spot (about the size of a dime), but thankfully my gums have stopped bleeding.


VAERS ID: 1466926 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

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


VAERS ID: 1466937 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

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


VAERS ID: 1466967 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

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

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

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


VAERS ID: 1466986 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Advil
Current Illness: Headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Phone appt 07/12/2021 Dr prescribed antibiotics told to take Zyrtec allergy medicine also using advil and benadryl getting now relieve.
CDC Split Type:

Write-up: Swellenband painful lymph nodes behind ears. Fever rash over 100%of body . Started day two after vaccine it is now day 7post vaccine rash getting worse


VAERS ID: 1467006 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-02
Onset:2021-07-08
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

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

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

Write-up: In reviewing the system - it was discovered that based on documentation patient may have received a mixed series of COVID vaccine. The patient is documented in our computer system to have received Pfizer Covid Vaccine Lot EN6206 on 3/12/21 and Moderna Covid Vaccine Lot 021B21A on 4/2/21. Only Pfizer was administered in clinic on 3/12/21 and Both Pfizer and Moderna were being administered in clinic on 4/2/21. Patients vaccine care noted pfizer for both doses but lot numbers were as above with Moderna lot as second dose. The patient was notified of this and was consulted by our ID physician. Many checks and balances are in place to prevent such errors ? but based on documentation feel patient may have received a mixed series.


VAERS ID: 1467017 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-02
Onset:2021-07-08
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21 / 2 RA / -

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

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

Write-up: In reviewing Immunization Information System - it was discovered that based on documentation patient may have received a mixed series of COVID vaccine. The patient is documented in our computer system to have received Pfizer Covid Vaccine Lot EN6206 on 3/12/21 and Moderna Covid Vaccine Lot 021B21A on 4/2/21. Only Pfizer was administered in clinic on 3/12/21 and Both Pfizer and Moderna were being administered in clinic on 4/2/21. Patients vaccine care noted pfizer for both doses but lot numbers were as above with Moderna lot as second dose. The patient was notified of this and was consulted by our ID physician. Many checks and balances are in place to prevent such errors ? but based on documentation feel patient may have received a mixed series.


VAERS ID: 1467049 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0584 / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe, Additional Details: PATIENT REPORTED SMALL RED DOTS ON HER EXTREMITIES (ARMS AND LEGS) ON DAY 2, BY DAY 3 SHE WAS HAVING THEM ON HER CORE (FRONT AND BACK). BY THE 4TH DAY SHE REPORTED THEY STARTED TO BREAK OUT ON HER FACE AND IN HER EAR. SHE REPORTED SOME OF THEM RUPTURED WITH A LITTLE PUSS. WHEN SHE CAME TO THE PHARMACY, IT LOOKED LIKE SEVERE ROSACEA OR ACNE


VAERS ID: 1467148 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure abnormal, Electrocardiogram abnormal, Fatigue, Feeling cold, Headache, Heart rate increased, Heart rate irregular, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Woke up on morning after shot with uncontrollable shaking. I ended up needing to lay under several blankets in order to feel warm and stop shaking. My temperature was normal and shaking was not due to a fever. The shaking stopped about 15 hours after I received the shot but then I continued to have a headache and extreme fatigue. The following day (about 48 hours after injection) I had an extremely high pulse. I took both my blood pressure and was able to take an EKG using a EKG recorder. Both devices came back that I was having an irregular heartbeat. I repeated both tests about a half dozen times and they kept coming up the same indicating an irregular heartbeat. I have never had an irregular heartbeat before in the past. Finally after a couple of hours my heart rate slowed and the irregular heartbeat went away. As of right now (6 days post injection) it has not come back.


VAERS ID: 1467207 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-07-01
Onset:2021-07-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood thyroid stimulating hormone, Electrocardiogram abnormal, Fibrin D dimer increased, Full blood count abnormal, Sinus tachycardia, Thrombocytosis, Troponin normal
SMQs:, Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline ethinyl estradiol-norgestimate
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data: As above
CDC Split Type:

Write-up: One week after receiving the second Pfizer vaccine, patient began having tachycardia, at one point measured at 160 bpm. Seen in ED. Other than sinus tachycardia, no other cause found. ECG showed sinus tach only, troponin neg, TSH normal. CBC showing mild thrombocytosis, Chem unremarkable other than mild d-dimer elevation (CT angio negative)


VAERS ID: 1467279 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 LA / IM

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

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

Write-up: DOSE ADMINISTERED AFTER IMPROPER STORAGE AND HNDLING(E.G.MORE THAN ALLOWED TIME AFTER FIRST VIAL PUNCTURE)


VAERS ID: 1467285 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

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

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

Write-up: NONE


VAERS ID: 1467292 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

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

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

Write-up: NONE


VAERS ID: 1467297 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

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

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

Write-up: NONE


VAERS ID: 1467536 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-05
Onset:2021-07-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Pruritus, Rash
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: Vitamin D Metoprolol succinate 25mg 2x daily Hyvaar 50-12.5mg Tylenol Motrin Vitamin C Murlax Robintussin Senna Gappentin 100 mg flonase
Current Illness: a cold/flu
Preexisting Conditions: High blood pressure heart murmor Had a tumor removed Blood clot in the lungs Constipation issues
Allergies: Nitroixide
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient woke up at one Am she was itching. She notice she was itching and noticed red spots. She took some medicine and went to the ER. When patient woke up on 7/12/21 her lip was swollen. The rash comes randomly and flares up.


VAERS ID: 1467537 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-07-08
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0150 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0175 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Injection site pain, SARS-CoV-2 test positive
SMQs:, Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Tested Positive for COVID 7/8/2021 at Urgent Care with PCR (molecular, RNA) test.
CDC Split Type:

Write-up: Two adverse events: 1) Caught COVID 7/8/2021 after being fully Pfizer vaccinated in April 2021. 2) Injection site muscle soreness 7/13/2021 after being fully vaccinated in April 2021.


VAERS ID: 1468372 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       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:

Write-up: 1st dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468373 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       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:

Write-up: 1st dose pfizer vaccine was given to patient on 07/06/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1468376 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       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:

Write-up: 2nd dose pfizer vaccine was given to patient on 07/08/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1469625 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-08
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210708; Test Name: COVID-19 virus test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210720833

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a female of unspecified age race and ethnic origin. 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, intramuscular, batch number: unknown) dose, frequency 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 08-JUL-2021, the patient and her daughter were tested covid-19 positive (suspected clinical vaccination failure and suspected covid-19 infection). Laboratory data included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected clinical vaccination failure and suspected covid-19 infection was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210718648.; Sender''s Comments: V0:20210720833- Covid-19 vaccine ad26.cov2.s- Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) 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(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1469638 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-08
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USJNJFOC20210724059

Write-up: BAD FEVER; This spontaneous report received from a patient via a company representative 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 08-JUL-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up was requested for this case. No concomitant medications were reported. On 08-JUL-2021, the subject experienced bad fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from bad fever. This report was non-serious.


VAERS ID: 1469696 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-13
Onset:2021-07-08
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Joint stiffness, Musculoskeletal stiffness, Neck pain, Pain in extremity, Polymyalgia rheumatica
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vasculitis (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PEPCID AC; LOSARTAN; CALCIUM 600+VIT D; VITAMIN D3; CREON; IPRATROPIUM BROMIDE; IMODIUM; ZYRTEC R
Current Illness:
Preexisting Conditions: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: stiffness in her both shoulders ,hip, neck,hand; Pain in hand; stiffness in her both shoulders ,hip, neck,hand; Pain in neck; 1-2 week after 1st dose, she started with pain in both shoulders,pain in hip; Doctor diagnosed her with polymyalgia Rheumatica; This spontaneous case was reported by a consumer and describes the occurrence of POLYMYALGIA RHEUMATICA (Doctor diagnosed her with polymyalgia Rheumatica) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was reported. Concomitant products included FAMOTIDINE (PEPCID AC), LOSARTAN, CALCIUM, ERGOCALCIFEROL (CALCIUM 600+VIT D), COLECALCIFEROL (VITAMIN D3), PANCREATIN (CREON), IPRATROPIUM BROMIDE, LOPERAMIDE HYDROCHLORIDE (IMODIUM) and CETIRIZINE HYDROCHLORIDE (ZYRTEC R) for an unknown indication. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Jul-2021, the patient experienced POLYMYALGIA RHEUMATICA (Doctor diagnosed her with polymyalgia Rheumatica) (seriousness criterion medically significant). On an unknown date, the patient experienced MUSCULOSKELETAL STIFFNESS (stiffness in her both shoulders ,hip, neck,hand), PAIN IN EXTREMITY (Pain in hand), JOINT STIFFNESS (stiffness in her both shoulders ,hip, neck,hand), NECK PAIN (Pain in neck) and ARTHRALGIA (1-2 week after 1st dose, she started with pain in both shoulders,pain in hip). The patient was treated with IBUPROFEN at a dose of UNK dosage form; PARACETAMOL (TYLENOL) at a dose of UNK dosage form; MELOXICAM at a dose of UNK dosage form; CELECOXIB (CELEBREX) at a dose of UNK dosage form and METHYLPREDNISOLONE at a dose of UNK dosage form. At the time of the report, POLYMYALGIA RHEUMATICA (Doctor diagnosed her with polymyalgia Rheumatica), MUSCULOSKELETAL STIFFNESS (stiffness in her both shoulders ,hip, neck,hand), PAIN IN EXTREMITY (Pain in hand), JOINT STIFFNESS (stiffness in her both shoulders ,hip, neck,hand), NECK PAIN (Pain in neck) and ARTHRALGIA (1-2 week after 1st dose, she started with pain in both shoulders,pain in hip) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No laboratory was given. Very limited information regarding these events has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.


VAERS ID: 1470168 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 023C21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: A 17 year old received the Janssen vaccine No adverse events were reported


VAERS ID: 1470170 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       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:

Write-up: 1st dose pfizer vaccine was given to patient on 07/08/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1470176 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       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:

Write-up: 2nd dose pfizer vaccine was given to patient on 07/08/2021. We found out on 07/09/2021 vaccine was stored outside the recommended 31 day expiration window.


VAERS ID: 1470193 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Anticoagulant therapy, Antiplatelet therapy, Asthenia, Condition aggravated, Diastolic dysfunction, Dizziness, Drug abuse, Echocardiogram abnormal, Ejection fraction, Embolic stroke, Embolism, Gait disturbance, Headache, Hypoaesthesia, Hypokinesia, Ischaemic cardiomyopathy, Magnetic resonance imaging abnormal, Muscular weakness, Musculoskeletal stiffness, Myalgia, Peripheral ischaemia, Pyrexia, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% nebulization albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler amLODIPine (NORVASC) 5 MG tablet aspirin 81 MG chewable tablet atorvastatin
Current Illness: NSTEMI, s/p CV left heart cardiac catheterization, coronary angiogram (7.7.21)
Preexisting Conditions: Type 1 diabetes mellitus with hyperglycemia, bilateral peripheral neuropathy and gastroparesis Tobacco abuse disorder Leukocytosis Hypophosphatemia Hypertension COPD (chronic obstructive pulmonary disease) (HCC) Back pain Depression Depression, major, recurrent (HCC) Syncope Subacute maxillary sinusitis Epigastric pain NSTEMI (non-ST elevated myocardial infarction) (HCC) Polysubstance abuse (HCC) Diabetic ulcer of toe of left foot associated with type 1 diabetes mellitus, with fat layer exposed (HCC) Weakness Coronary artery disease of native artery of native heart with stable angina pectoris (HCC) Ischemic cardiomyopathy Cocaine use
Allergies: Shellfish, bee, Jardiance, seafood, sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7.8.21: Patient reported weakness, lightheadedness, fever, possible numbness/tingling (also s/p heart cath) 7.9.21: Presented to ED - fever, headache, myalgia, neck stiffness, weakness in lower legs, difficulty walking, numbness - left AMA 7.9.21: Presented to ED - with generalized weakness - He was discharged on 7/7. He had noted BLE weakness during his admission and noted worsening of his weakness following his discharge. He returned to the ER on 7/8 but left AMA. He presented to ER on 7/9 with right arm and BLE weakness and MRI showed numerous small acute ischemic foci bilaterally. CTA was negative for significant stenosis or occlusion. He was evaluated by Neurology and felt that there was a high likelihood of cardioembolism as the etiology of his strokes vs cocaine. They recommended cardiac monitoring for evidence of afib as well as DAPT x 21 days followed by ASA monotherapy. He was noted to have an elevated troponin on admission and was placed on a Heparin drip. Cardiology did not feel that repeat cardiac cath was warranted. An Echo with bubble study was performed and showed EF 45-50%, diffuse hypokinesia, mild DD and no evidence of shunting. He has been accepted at hospital with plan for transfer there today. Assessment / Plan Multifocal stroke - suspect shower embolism vs r/t cocaine use - Echo - no evidence of shunt - per Neuro - DAPT x 21 days followed by ASA monotherapy - 30-day cardiac monitor at discharge Elevated troponin Recent IWMI CAD Ischemic CM - EF 45-50%, diffuse hypokinesia Cocaine use with possible vasospasm - s/p Heparin drip - no indication for repeat cardiac cath per Cardiology - ASA, Plavix, Metoprolol, Lisinopril, Lipitor - Norvasc - counseled on cocaine cessation


VAERS ID: 1470341 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Hyperhidrosis, Pain, Vaccine positive rechallenge
SMQs:, Neuroleptic malignant syndrome (broad), Arthritis (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: Neurontin Baclofen Niacin Vitamin E
Current Illness: Neuropathy Borderline High Cholesterol
Preexisting Conditions: See above
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Began having joint pain and body aches along with sweating as if breaking a fever the morning following the vaccination as he did with the first dose. Currently still having but it is not worse than that after his first vaccine. Symptoms from the first vaccine resided after approximately two weeks.


VAERS ID: 1470415 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-07-08
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B2A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis, C-reactive protein increased, Condition aggravated, Joint swelling, Red blood cell sedimentation rate increased, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza vaccination 2019
Other Medications: At the time of vaccination I was on a sulphur medication and multivitamin.
Current Illness: No illnesses at the time of vaccination.
Preexisting Conditions: Rheumatoid Arthritis.
Allergies: No known drug allergies or food allergies.
Diagnostic Lab Data: My physician ordered a C-reactive protein and Sedreate as both levels increased. Results from the labs are not available.
CDC Split Type: vsafe

Write-up: After receiving the vaccination I experienced severe arthritis and swelling in my elbow, knees, and neck.


VAERS ID: 1470525 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Confusional state, Dizziness, Drug screen negative, Emotional distress, Hypersensitivity, Lacrimation increased, Lip erythema, Lip swelling, Ocular hyperaemia, Oral pain, Presyncope, Swelling, Swollen tongue, Syncope, Tongue erythema, Tracheal stenosis, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CETIRIZINE 10MG, SIG: 1HS. IBUPROFEN 600MG, SIG: 1TID PRN
Current Illness: Dental extraction same day: 07/08/21. Seasonal allergic rhinitis, epigastric pain, headache, change in bowel habits.
Preexisting Conditions: Allergic rhinitis
Allergies: None at time of encounter.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt is a 26 yo M w/ a PMH of COVID 19 infection (resolved), seasonal allergies, and head trauma (2019). He arrived at Facility on 6/15/21. On 7/8/21, pt had his tooth extracted (#30) at 0930 without complication. At 1200 same day, he received the first dose of the COVID-19 Moderna vaccine. At 1323, the pt was found lying on couch in dorm c/o pain in dental area, dizziness, and lightheadedness (BP 150/77, HR 91, RR 18, O2sat 99%). Heart sounds normal, breath sounds absent on auscultation. Pt was confused and in distress. (unable to respond verbally). His eyes were red and tearing. Tongue and lips appeared red and were mildly swollen. RN was unable to visualize throat in dorm. Epipen was administered at 1340 which resulted in an immediate decrease in symptoms. Pt was calmer and in less distress. Normal uvula with some narrowing of airway noted. He was then taken to clinic and was calm but shaking with an open airway and mild swelling noted; VS wnl. He left via EMS in stable condition to ED at 1400 for evaluation. Pt returned from ED same day in no acute distress but still c/o dental pain (5/10). He was last evaluated by provider on 7/9/21 and is asymptomatic. Denies swelling, SOB, or fatigue. No bleeding or swelling at dental extraction site noted. Pt evaluated by dental on 7/12/21. No swelling, erythema, exposed bone, or signs of infection noted. Area appears to be following normal post-operative course. Pt remains asymptomatic. ED summary- Medical Center (7/8/21): Pt sent to ED for allergic reaction/near-fainting (vagal reaction); Assessment: ?Most likely the syncopal episode was due to vasovagal syncope. Cannot rule out allergic reaction to the COVID 19 vaccination?. Drug screen negative. Discharged on 7/8/21.


VAERS ID: 1470553 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: PATIENT RECEIVED ONE DOSE OF PFIZER IM INJECTION TO HER RIGHT DELTOID @ APPROXIMATELY 11:25 A.M. @ 11:30 A.M. PATIENT COMPLAINED OF A "SCRATCHY" THROAT WITHIN 5 MINUTES OF RECEIVING THE VACCINE. PATIENT DID NOT HAVE ANY DIFFICULTIES SWALLOWING OR BREATHING. PATIENT DID NOT HAVE ANY VISIBILE FACIAL EDEMA. PATIENT WAS PROVIDED WATER TO DRINK AND WAS ABLE TO SWALLOW WITHOUT ANY ISSUES. PATIENT WAS PROVIDED 12.5 MG LIQUID ORAL BENADRYL. PATIENT STATED HER SYMPTOMS RESOLVED WITHIN 15 MINUTES AFTER RECEIVING THE ORAL BENADRYL.


VAERS ID: 1470557 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Lacrimation increased, Musculoskeletal stiffness, Neck pain, Throat irritation
SMQs:, Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Lacrimal disorders (narrow), Arthritis (broad)

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

Write-up: 7/8/21 itching throat, watery eyes, headaches, neck stiffness started next morning after 2nd dose, 7/14/21 continues to have symptoms of headaches, neck pain and stiffness


VAERS ID: 1470678 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth, Pruritus, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 reported pain in left deltoid that radiated to L elbow, shoulder and collar bone. Pain resolved 7/9/21. Lightheadedness after vaccine about 30 minutes after vaccine. Itching, rash and warmth on under arms, injection site, upper torso area 2 hours after vaccine. Rash resolved 7/12/21 and itching resolved 7/13/21.


VAERS ID: 1470773 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Chest X-ray, Dyspnoea, Electrocardiogram, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Chest X-ray 07/11/2021 EKG 07/11/2021
CDC Split Type:

Write-up: Pt. states after receiving the J&J Janssen 07/08/2021 started experiencing shortness of breath and arm pain. Urgent Care visit 07/11/2021 diagnosed with Bronchitis and prescribed Inhaler (Albuterol). Another visit planned for 07/15/2021 still experiencing shortness of breath.


VAERS ID: 1474171 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-16
Onset:2021-07-08
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Covid swabs x2
CDC Split Type:

Write-up: Breakthrough Covid disease


VAERS ID: 1474243 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-27
Onset:2021-07-08
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Lymphadenopathy, Swelling, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: asthma
Allergies: Amoxicillin, Levofloxacin and Meropenem
Diagnostic Lab Data: Blood works, CXR and ultrasound done 7/8/21 at ER.
CDC Split Type:

Write-up: R neck got swollen 11 days after vaccine. Went to Urgent care and was transferred to ER. Diagnosed with lymphadenopathy


VAERS ID: 1474261 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dysstasia, General physical health deterioration, Mobility decreased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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:
Current Illness: COVID-19 June 26, 2021
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Husband reported weakness in left arm the evening of vaccination. Patient''s health has declined. She now needs assistance with moving from chair to bed. She can walk once she is on her feet, but cannot get to her feet by herself. Just very week.


VAERS ID: 1474275 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Inadvertently, an individual under the age of 18 was given a Moderna covid vaccination. Patient was not harmed.


VAERS ID: 1474312 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-07-08
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Protein total increased
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: numbness in right leg progressively loss feeling, high protein,


VAERS ID: 1474486 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto 20 MG, Flecainide 50MG, Vit C, D3, B''s, Zinc, Magnesium, Betaine HCL, CoQ10, Nucleo Immune, Xeno Stat for Thyroid, Omega 3 DHA, Adrena Ven for Adrenal Support, Prosta Ven for prostate support,
Current Illness: I am in A-Fib being treated by a Cardiologist
Preexisting Conditions: Ectopic heart beat that went into A-Fib when a doctor overdosed me on Synthroid per my Cardiologist, Stasis Dermatitis Right leg wear compression stockings,
Allergies: Keflex, Azithromycin, Flomax, Synthroid I have Celiac Disease No Gluten
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received shot Tuesday July 6. On Thursday July 8 at 11pm I woke up with a terrible case of itching . I got up looked in the mirror and found five to six red bumps (size from a head of an eraser to a quarter (coin) in the area of my waist to 4 inches above my knee. I put on Cortisone cream 1% and the itching stopped. Went back to bed and a hour later was woke up with more bumps itching put on cream this went on the rest of the night. Got up around 3am Friday and they were all gone. I had no problems until 4pm Friday and the bumps came back. Friday night was like Thursday night. Saturday got up all gone, I went to Urgent Care and saw a Dr. who told me I was one out of a hand full to react this way to the shot. He told me to continue with the cream and take 12.5 mg of Benadryl. Saturday at 4pm a few bumps appeared so I put the cream on them and took the Benadryl. I was not woken up by the bumps all Saturday night. Got up Sunday all gone. Sunday, Monday and Tuesday evening I took the Benadryl with no bumps. Last night Wednesday July 14 I did not take the Benadryl and had no problems. Tuesday I did see my Primary Care Doctor about whether I should receive the second shot. I said this is all to new to give me an answer told me to contact CDC for an answer. Should I receive the Second Shot as scheduled on August 3


VAERS ID: 1474554 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-04
Onset:2021-07-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Hypoaesthesia, Tongue discomfort
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 850mg Prozac 10mg Vitamin D3 5000iu Super B complex
Current Illness: None
Preexisting Conditions: PCOS insulin resistance due to pcos
Allergies: Penicillin Morphine
Diagnostic Lab Data: I went to a neurologist where he diagnosed me with Bells Palsey. Dr put me on steroids and antiviral meds as well as put in a referral for an MRI.
CDC Split Type:

Write-up: 3 days after my first vaccine my tongue started to feel like it was burnt. The Sunday after my first vaccination I woke up with the right side of my face was numb and not functioning.


VAERS ID: 1474792 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FW0164 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Chest discomfort, Condition aggravated, Dyspnoea, Feeling hot, Flushing, Pruritus, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Asthma worsened after receiving flu vaccine but unclear if it''s directly related to the vaccine. Last flu shot was 15+ years ago
Other Medications: Albuterol Symbicort Azelastine Hydrochloride and Fluticasone Propionate Allegra
Current Illness: Asthma Allergies
Preexisting Conditions: Asthma Allergies
Allergies: Naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7/8/21: Around 4:30pm became flushed and hot. 30 minutes later minor wheezing followed by itching on neck and upper back. Took 2 Benedryl and symptoms resolved. 7/10/21: Began experiencing tightness in chest, difficulty taking a deep breath. Asthma hasn''t been this bad in well over a decade. Albuterol provided only short term relief. Benedryl provided more relieve and for longer period but symptoms persisted. 7/14/21: Met with doctor. Switched from Allegra to Zyrtec. Added Qvar on top of Symbicort. Will have checkin in a few days. If there''s no improvement, the plan is to start prednisone.


VAERS ID: 1474805 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Restless legs syndrome
SMQs:

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

Write-up: A vaccine administration error occurred. The patient had received their first dose of the COVID19 vaccine on 6/24/21 and received their second dose 14 days later on 7/8/21. The patient states that she felt "very sick" on Friday, 7/9 (e.g., "felt like a truck hit her" and "had symptoms of restless leg syndrome all over") and started only feeling remotely better on Sunday. She states that she has not felt 100% until today (7/15) but was still able to come back into work on Tuesday (she had to call off on Friday).


VAERS ID: 1474817 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alopecia
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: pt reporting significant hair loss beginning 2 days after shot


VAERS ID: 1475180 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Fatigue, Headache, Influenza virus test negative, Nausea, Pain, Pyrexia, Rash, SARS-CoV-2 test negative, Streptococcus test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Janumet Rosuvastatin Lisinopril
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: None
Diagnostic Lab Data: Flu-negative Strep-negative Over the counter covid test-negative
CDC Split Type:

Write-up: On day 3 I started having severe body aches and started running a 102.7 fever. Day 4 severe headache and ear ache, nausea and throwing up. The following Monday I went to the doctor and was teated negative for flu and strep. Still have body aches, nausea, headache, and fatigue. Today I broke out in a rash all over my body.


VAERS ID: 1459401 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-08
Onset:2021-07-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Aphasia, Feeling abnormal, Injection site pain, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Sore arm at site of injection Brain fog? hard to focus and concentrate. Loss of words and short term memory loss.


VAERS ID: 1459662 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-07
Onset:2021-07-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Crustaceans; Scopolamine; Metamizole
Diagnostic Lab Data: None. I was only treated with an antihistamine and topical cream to calm the pruritis. I am passing this information along to see if it is of interest to you and your investigation. I am fine and the pruritis was mild and controlled.
CDC Split Type:

Write-up: Pruritis. On the evening of July 8th presented with itching on my left hand on the side where I received the vaccine. Today, on this July morning, I started having pruritis on my neck. The day the vaccine was applied, I broke out with small pruritis in the stomach area, but it was just a short time and did not itch- but the pruritis from last night and this morning did. I am only sharing this information to help analyze and see if there is an existing correlation. I have been fine up until now and have not had any severe reaction.


VAERS ID: 1461994 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-07-05
Onset:2021-07-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Blood electrolytes, Chest X-ray, Electrocardiogram, Full blood count
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient using Ventolin prn as needed
Current Illness: None
Preexisting Conditions: Similar episode in Jan 2021 after first vaccination
Allergies: Patient denies
Diagnostic Lab Data: CBC, Lytes , CXR and ECG
CDC Split Type:

Write-up: Patient developed an acute Asthma Excacerbation


VAERS ID: 1468397 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-07-06
Onset:2021-07-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Dizziness, Dyspnoea, Echocardiogram, Erythema, Fatigue, Heart rate increased, Hyperhidrosis, Migraine, Pain, Paraesthesia, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? Yes
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: Congenital heart defect asthma
Preexisting Conditions: Congenital heart defect asthma
Allergies: Sulpha
Diagnostic Lab Data: Antihistamine or elevationMedical facilities sent me a way to get blood work done echo cardio gram awaiting results
CDC Split Type:

Write-up: Pain swelling sweats racing heart beat redness tingling in both legs swelling from thigh to toe purple red skim on legs feeling light headed faint fatigue grasping for are if I did any sort of movement like walking out of breath severe migraines was given prescription for mint furosemide 40 mg because swelling didn?t subside with Antihistamine or elevation


VAERS ID: 1453519 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Fatigue, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Slight fever, body aching especially in injection site and back, general fatigue


VAERS ID: 1454064 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-05
Onset:2021-07-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

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

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

Write-up: Patient woke up with a mild rash around her face 2 days following vaccine administration.


VAERS ID: 1454068 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Pt is 36 year old female. Shortly after receiving pfizer vaccine pt reported dizziness and slight tightness of the throat. Lungs clear to auscultation. BP and HR within normal limits 118/72, HR 64. No known allergies. Pt is stable after relaxation techniques were implemented.


VAERS ID: 1454073 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angina pectoris
SMQs:, Other ischaemic heart disease (narrow)

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

Write-up: Heart pain which intensifies during breathing


VAERS ID: 1454076 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Back pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: Mild rash on lower back at age 15 after taking first dose of oral vaccine for typhoid fever
Other Medications:
Current Illness:
Preexisting Conditions: Major clincial depression coupled with chronic insomnia, mild anxiety disorder Both manifest themselves in physical ways such as pain
Allergies: Mild cashew allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm on side of injection Tender armpit on side of injection Woke up with fever day after injection Pain in middle of back similar day after injection


VAERS ID: 1454114 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 RA / IM

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

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

Write-up: patient given dose that was unknowingly expired


VAERS ID: 1454118 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-06
Onset:2021-07-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Hyperhidrosis
SMQs:, Neuroleptic malignant 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: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient started experiencing periods of sweating and cold/hot sweats with visible beads of sweat on his face.


VAERS ID: 1454166 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations: Flu shot, 2006 developed the flu vaccine.
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Latex, Crab Meat
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states received Phizer 07/07/2021, at 7:00pm experienced extreme dizziness lasting until 11:00pm while entering bed. No other symptoms reported.


VAERS ID: 1454189 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-07
Onset:2021-07-07
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dyspnoea, Fatigue, Impaired work ability, Pulmonary embolism, SARS-CoV-2 test negative, Vaccination complication, X-ray
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: B Complex, Alegra, Sudafedrin, Vicanicen (All for allergies)
Current Illness: N/A
Preexisting Conditions: Environmental Allergies, mild arthritis, chronic sinusitis
Allergies: N/A
Diagnostic Lab Data: Rapid Test Covid and PCR (both negative). X-ray, CAT scan
CDC Split Type: vsafe

Write-up: Day after vaccine had extreme version of usual vaccine reactions, took Tylenol, still lingering effects the next day, extremely winded while trying to walk, several weeks later symptoms worsened. Extreme fatigue. 2 weeks after shot, was at elevation and extremely winded (usually not someone with respiratory issues). Missed work, drove to ER, lungs clotted. Doctor did not find any clot in legs, assumed it was Covid but did not have any other symptoms of Covid and negative covid test. 6 month recovery expected. Taking Xarelto coagulant, initially was on Eliquis, but responded poorly now on Xarelto.


VAERS ID: 1454218 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKDA
Diagnostic Lab Data: 7/7/21 @ 9:29am BP: 100/60 HR: 74 O2: 99%
CDC Split Type:

Write-up: The patient passed out about 12 minutes after receiving second dose of Pfizer covid vaccination. The patient''s mother got the attention of the monitoring nursing staff at which time the patient was alert and staff elevated patients lower limbs, checked BP, HR, pulse ox, and provided cold compresses and water for patient. After about 5 minutes patient also vomited. The patient was monitored for an additional 20 minutes at which time patient felt better and was able to walk out without assistance.


VAERS ID: 1454232 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-07-07
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Military       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: none
Current Illness: None noted
Preexisting Conditions: None noted
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 N Gene Swab on 7July2021 Virus Detected
CDC Split Type:

Write-up: Pt Tested positive for COVID-19 after vaccination with Janssen Vaccine and is symptomatic for COVID-19.


VAERS ID: 1454248 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 LA / ID

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Pharyngeal paraesthesia
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: 1110am pt c/o numbness, tingling to back of throat denies tightness, water given, BP116/81 P90 SpO2 97%, 1122am pt states"better" B/P 109/73 P 80 R16 SpO2 97%,


VAERS ID: 1454253 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-07-07
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Military       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: none noted
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: none
Diagnostic Lab Data: SARS-CoV-2 N Gene Swab 07July2021 Virus Detected
CDC Split Type:

Write-up: Pt Contracted COVID-19 on 07Jul2021


VAERS ID: 1454280 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

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

Write-up: she started to feel dizziness, sweating, and eyes were rolling upward.


VAERS ID: 1454333 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-07-07
Onset:2021-07-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Dizziness, Hyperhidrosis, Hypotension, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient said he couldn''t hear. He felt dizzy, nauseas, and was sweating. Blood pressure was taken it was low. Gave patient water to drink. Took blood pressure repeatedly. Gave patient something to eat (said he hadn''t eaten & that could be cause of nausea). Patient''s blood pressure went back up to normal. Patient felt fine before he left. I had patient sit longer than the 15 minutes, it was at least 30 minutes.


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