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

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



Case Details (Reverse Sorted by Onset Date)

This is page 180 out of 6,611

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VAERS ID: 1528626 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Erythema, Skin warm
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: NOT KNOWN
Current Illness: NOT KNOWN, NO INJURY OR OPEN WOUND TO AFFECTED AREA.
Preexisting Conditions: NOT KNOWN
Allergies: NOT KNOWN
Diagnostic Lab Data: PATIENT EVALUATED IN AN OUTPATIENT FACILITY AND DIAGNOSED WITH CELLULITIS, GIVEN DOXYCYCLINE AND RECOVERED
CDC Split Type:

Write-up: PATIENT DEVELOPED CELLULITIS ON THE LEFT FOOT (SAME SIDE AS INJECTION) WITHIN 24 HOURS OF RECEIVING THE VACCINE. PATIENT SAID AREA WAS RED AND HOT TO THE TOUCH. PATIENT REPORTED NO PREVIOUS INJURY OR OTHER MEDICAL ISSUES RELATED. PATIENT REPORTED NO LOCAL INJECTION SITE REACTION OR OTHER ADVERSE EVENTS.


VAERS ID: 1528655 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-07-29
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID 19 positive 7/29/21
CDC Split Type:

Write-up: Patient was vaccinated with Moderna on 2/10/21 and 3/10/21. Patient was admitted to the hospital, COVID positive, on 7/29/21 for respiratory failure with hypoxemia secondary to COVID 19 pneumonia. Hospitalized for 5 days.


VAERS ID: 1528672 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-28
Onset:2021-07-29
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Diarrhoea, Headache, Influenza A virus test negative, Influenza B virus test, Lower respiratory tract infection, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Lisinopril, Metformin, Ferrous Gluconate, Glyburide
Current Illness: None
Preexisting Conditions: DM type 2, obesity, CKD stage 1, HTN
Allergies: No allergies
Diagnostic Lab Data: Jul 29, 2021@14:57:24 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE COVID-19 (CEPHEID) POSITIVEA*
CDC Split Type:

Write-up: head congestion, headache, chest cold, lost of taste and smell and had diarrhea x one day


VAERS ID: 1528736 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-21
Onset:2021-07-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

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

Write-up: After 9 days of the first pfizer covid 19 shot, i woke up having tinnitus(ringing in my ears), it goes away and come back every other day and lasts for the whole day even when distracted by other sounds! I have never been exposed to loud music and haven''t been hard on my ears. It is not a life threatening issue but it is so annoying!


VAERS ID: 1528786 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-07-29
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blood creatinine increased, Blood potassium increased, Breast pain, Breast swelling, Full blood count normal, Glomerular filtration rate decreased, Headache, Mammogram normal, Mastitis, Metabolic function test, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Functional lactation disorders (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium 600 + D(3) (calcium carbonate-vitamin D3) Vitamin C (Vitamin C)
Current Illness: N/A
Preexisting Conditions: Acquired thrombocytopenia, Anemia, B-cell chronic lymphocytic leukemia, Chronic kidney disease stage 3
Allergies: NKDA
Diagnostic Lab Data: Bilateral Mammogram was ordered 7/29/2021 for breast pain, results showed no sonographically defined mass or suspicious finding in either breast. There is bilateral duct ectasia. There is no axillary adenopathy. A complete blood count was ordered on 7/29/2021 for fever, results were normal. A comprehensive metabolic panel was ordered on 7/29/2021 for fever, results showed low GFR levels, high potassium and creatinine levels.
CDC Split Type:

Write-up: On 7/29/2021 patient reported headaches, fever of 101.4, stomach discomfort, swelling and painful breast and joint pain. On 7/29/2021 patient was diagnosed with acute mastitis was prescribed Bactrim DS tablet, 1 tablet by mouth every 12 hours as needed. Patient followed up in office today 8/05/2021 acute mastitis resolved.


VAERS ID: 1528800 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-25
Onset:2021-07-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphangitis
SMQs:

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

Write-up: Developed infectious lymphangitis a few days later to b/l axilla. Tx with Bactrim DS


VAERS ID: 1528810 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-23
Onset:2021-07-29
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram thorax abnormal, Pulmonary infarction, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Sertraline 15mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan and many blood draws 8/4 to 8/5
CDC Split Type:

Write-up: Blood clots bilateral lungs Wedge size Infarct to left lower lung


VAERS ID: 1528890 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-05
Onset:2021-07-29
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Hypoxia, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: COPD, HepB, Neuroopathy, Nephrolithiasis, Hysterectomy, Depression, R Calceneus Fx
Allergies: No known allergies
Diagnostic Lab Data: Lab test: 08/04/2021, COVID-19 (NAA), POSITIVE
CDC Split Type:

Write-up: Per CDPH, VAERS reporting is required if a person has COVID after fully vaccinated. This patient was diagnosed with COVID-19 8/4/2021 by the ED physician and required hospital admission for Hypoxemia. Admitted to Hospital


VAERS ID: 1528932 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Exercise tolerance decreased, Fatigue, Feeling abnormal, Menstruation irregular, Muscle fatigue, Muscle spasms, Muscle strain, Nausea, Pruritus, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR vaccine, 27 years old. Had jaw pain for 6 weeks after
Other Medications: None
Current Illness: None
Preexisting Conditions: Goiter
Allergies: Percocet
Diagnostic Lab Data: Haven''t seen a doctor
CDC Split Type:

Write-up: Muscle fatigue started a few hours after. Felt very weak and tired. Very drowsy. Day later woke up itching in my sleep. Took a anahistamine. Itching hasn''t come back. 48 hours after have pulled muscles easily trying to do various exercises I normally do very often. Pulled quads, groins, muscles in abdomen very easily. Have had nausea and drowsiness for a week. Started a menstrual cycle 4 days after taking vaccine and wasn''t suppose to till end of August. Have had lots of cramping for a week. Haven''t felt back to normal yet and it''s a week later.


VAERS ID: 1528990 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-01
Onset:2021-07-29
   Days after vaccination:58
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Dyspnoea, Fatigue, Lung opacity, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: breast cancer, nonmelanoma skin cancer, DM type 2, chronic V.fibb with RVR, PAD, s/p renal transplant lives at nursing home
Allergies: NKA
Diagnostic Lab Data: Diagnostic Results (07/29/2021 19:50 CDT XR Chest Portable) IMPRESSION: Subtle patchy groundglass opacities in the bilateral lungs, could represent radiographic findings of early COVID-19 pneumonia, given positive COVID-19 test.
CDC Split Type:

Write-up: Chief Complaint weakness and fatigue. Covid positive approx 1 week ago History of Present Illness Patient is a 81 year old female with past medical history of breast cancer, nonmelanoma skin cancer, DM type 2, chronic V.fibb with RVR, PAD, s/p renal transplant lives at nursing home, is a poor historian. She had one week of increasing fatigue and SOB with dry cough, first covid pcr was negative but second one was positive and was transferred to the UH ED. Per her recollection she had 2 shots of COVID vaccine, but does not remember when the second dose was administered. Patient denies headache, vomiting, diarrhea, chills, sweating.


VAERS ID: 1528999 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation 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: PFIZER VACCINE
Current Illness: N/A
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PFIZER VACCINE WAS DILUTED WITH STERILE WATER INSTEAD OF SODIUM CHLORIDE, NO SITE REACTIONS REPORTED. PATIENT CONTACTED SAME DAY AND INFORMED OF EVENTS. PATIENT FEELS FINE AND WILL NOT BE CONTACTING MD AT THIS TIME PHARMACIST WILL FOLLOW UP IN 14 DAYS


VAERS ID: 1529022 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
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: PFIZER VACCINE
Current Illness: N/A
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PFIZER VACCINE WAS DILUTED WITH STERILE WATER INSTEAD OF SODIUM CHLORIDE, NO SITE REACTIONS REPORTED. PATIENT CONTACTED SAME DAY AND INFORMED OF EVENTS. PATIENT FEELS FINE AND WILL NOT BE CONTACTING MD AT THIS TIME PHARMACIST WILL FOLLOW UP IN 14 DAYS


VAERS ID: 1529034 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
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: PFIZER VACCINE
Current Illness: N/A
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PFIZER VACCINE WAS DILUTED WITH STERILE WATER INSTEAD OF SODIUM CHLORIDE, NO SITE REACTIONS REPORTED. PATIENT CONTACTED SAME DAY AND INFORMED OF EVENTS. PATIENT FEELS FINE AND WILL NOT BE CONTACTING MD AT THIS TIME PHARMACIST WILL FOLLOW UP IN 14 DAYS


VAERS ID: 1529040 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
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: PFIZER VACCINE
Current Illness: N/A
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PFIZER VACCINE WAS DILUTED WITH STERILE WATER INSTEAD OF SODIUM CHLORIDE, NO SITE REACTIONS REPORTED. PATIENT CONTACTED SAME DAY AND INFORMED OF EVENTS. PATIENT FEELS FINE AND WILL NOT BE CONTACTING MD AT THIS TIME PHARMACIST WILL FOLLOW UP IN 14 DAYS


VAERS ID: 1529048 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product preparation issue
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: PFIZER VACCINE
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PFIZER VACCINE WAS DILUTED WITH STERILE WATER INSTEAD OF SODIUM CHLORIDE, NO SITE REACTIONS REPORTED. PATIENT CONTACTED SAME DAY AND INFORMED OF EVENTS. PATIENT FEELS FINE AND WILL NOT BE CONTACTING MD AT THIS TIME PHARMACIST WILL FOLLOW UP IN 14 DAYS


VAERS ID: 1529138 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AF7485 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Muscle rigidity, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: thumbs hurt when closing. 30 years, 7/27/2021 last vaccine Pfizer against COVID-19
Other Medications: Metformina 500mg
Current Illness: No
Preexisting Conditions: Diabetes
Allergies: No
Diagnostic Lab Data: Medical consultation 08/03/2021 Pharmacy
CDC Split Type:

Write-up: My thumbs hurt, I can''t squeezed without feeling pain, when I wake up my hands are numb and in pain. I have to open and close my hands to be able to have mobility since they remain rigid after waking up.


VAERS ID: 1529161 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-29
Onset:2021-07-29
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Albumin globulin ratio, Anticoagulant therapy, Arthralgia, Blood glucose increased, Blood ketone body, Blood magnesium, Blood potassium decreased, Body temperature increased, COVID-19, Chest X-ray abnormal, Chest pain, Condition aggravated, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Electrocardiogram T wave inversion, Electrocardiogram abnormal, Fatigue, Glycosylated haemoglobin, Headache, Hyperglycaemia, Hypokalaemia, Infection, Lung opacity, Myalgia, Respiratory viral panel, SARS-CoV-2 test positive, Sepsis, Tachycardia, Type 2 diabetes mellitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: METFORMIN HCL PO by mouth.
Current Illness:
Preexisting Conditions: DM
Allergies: NKDA
Diagnostic Lab Data: 7/30/2021 by Respiratory Pathogen Panel NAAT (Includes LAB5206) (Collected 07/29/21) - confirmed positive
CDC Split Type:

Write-up: Patient hospitalized due to breakthrough covid-19 infection from 7/29/21 to 7/30/21. Patient completed the Pfizer vaccine series in April. Below is copied from patient notes: Patient is a 24 y.o. female with a history of diabetes mellitus presented to the ED c/o shortness of breath, a non productive cough, loose non bloody stools, decreased appetite, chest pain, myalgias, arthralgias, headaches, and fatigue x 5 days. CXR showing bilateral airspace opacities. ECG SR with T wave inversions in III and AVF. Temp 100.3, mid 80s SpO2 on ambulation. K+ 3.2, glucose 245, AG 18, beta hydroxybutyrate 5.4. Pt given IVF and dexamethasone in ED. Sepsis due to COVID-19: - pt not requiring oxygen -Meeting sepsis criteria absed on fever, tachycardia and positive COVID 19 test - COVID-19 order set initiated -Sepsis order set started, check LA - hold further dexamethasone as patient is not on supplemental oxygen - anticoagulation with Loveonx 40mg SQ QD - supportive care with Tylenol for fevers, DuoNebs p.r.n., and dextromethorphan/guaifensin -Consider remdesevir in the future for borderline benefit if AKI, transaminitis$g 3ULN or $g10 days from onset of symptoms, or if requires oxygen later on Hyperglycemia Type 2 diabetes mellitus, uncontrolled - AG 18, beta hydroxybutyrate w mild elevation - hold metformin - add low dose sliding scale - A1c Hypokalemia - replete, recheck in am - check magnesium level Obesity, BMI of$g 40 -would benefit from lifestyles modifications regarding low fat diet, weight loss and daily excercise -F/U OPD with PCP


VAERS ID: 1529209 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-27
Onset:2021-07-29
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/06/21pfizer,Lot#EL3246 2nd dose: 01/27/21,Pfizer,Lot# EL9262 Diagnosed covid positive:07/29/21 Symptom onset:07/29/21 Exposure:WORK Symptoms:Cough, sore throat.


VAERS ID: 1529216 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-19
Onset:2021-07-29
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19
SMQs:, 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 05/29/21pfizer,Lot# 2nd dose: 06/19/21,Pfizer,Lot# Diagnosed covid positive:07/29/21 Symptom onset: Exposure: Community exposure Symptoms: Asymptomatic


VAERS ID: 1529218 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-07-29
   Days after vaccination:120
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/10/21pfizer,Lot#EN6206 2nd dose: 03/31/210,Pfizer,Lot# ER8733 Diagnosed covid positive:0 Symptom onset:07/29/21 Exposure:unknown Symptoms:runny nose, fever


VAERS ID: 1529221 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-07
Onset:2021-07-29
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/10/21Moderna lot#012L20A 2nd dose: 02/0721, Moderna lot#012M20A Diagnosed covid positive:07/29/21 Symptom onset:07/27/21 Exposure:Home exposure Symptoms:cough, runny nose, head ache


VAERS ID: 1529223 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-12
Onset:2021-07-29
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Diarrhoea, Fatigue, Myalgia, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/22/21, pfizer,Lot#EL9262 2nd dose: 02/12/21Pfizer,Lot# EM9810 Diagnosed covid positive:07/29/21 Symptom onset:07/26/21 Exposure:Home exposure Symptoms:cough, fatigue,muscle aches, fever, chills, diarrhea


VAERS ID: 1529229 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-11
Onset:2021-07-29
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19
SMQs:, 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/22/21,pfizer,Lot#EK9231 2nd dose:01/11/21,Pfizer,Lot# EK9231 Diagnosed covid positive:07/29/21 Symptom onset:Asymptomatic Exposure:unknown Symptoms:


VAERS ID: 1529239 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: No adverse reaction. Moderna vaccine given to a 17 year old


VAERS ID: 1529261 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / N/A LA / IM

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

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

Write-up: Vaccination Error. Patient needed Moderna Vaccine but received the Pfizer vaccine.


VAERS ID: 1529280 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, Wrong 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: Wrong vaccine administered. Patient received the first dost of Moderna. Pfizer was given 28 days later.


VAERS ID: 1529297 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain
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: Have not seen a doctor yet but I am going to. Headache not going away
CDC Split Type:

Write-up: I have experienced headache for a week and on and off body aches,excessive unexplained tiredness.


VAERS ID: 1529347 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenopia, Blepharospasm, Cerebral palsy
SMQs:, Congenital, familial and genetic disorders (narrow), Dystonia (broad), Corneal disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility 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: Tetrozine 100mg Latuda 40mg Trazadome 250mg Bivet 50mg Busprone 1omg
Current Illness:
Preexisting Conditions:
Allergies: Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that on the day of the vaccine she notice that her left eye got heavy and started twitching. Patient went to the Dr. On 8/5/2021 and was Diagnosed with Cerapasly. Patient is request a call back in regards to getting the second shot.


VAERS ID: 1529586 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Abnormal dreams, Asthenia, Chills, Depressed mood, Fatigue, Feeling hot, Headache, Lymph node pain, Lymphadenopathy, Malaise, Mastication disorder, Nausea, Oral herpes, Poor quality sleep, Restlessness, Sleep disorder, Suicidal ideation, Vaccination complication
SMQs:, Acute pancreatitis (broad), Suicide/self-injury (narrow), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal infections (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Depression (excl suicide and self injury) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Retinal detachment/ blind left eye since 2013. No current health issue regarding this .
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The first three days I felt sick, weak body, chills, nausea. Also felt very restless, unable to sleep. Dreams like I don?t usually have. Hot rush through my body. I am still very tired, not sleeping well. I feel very sad and down, no energy, I feel depressed. I also have a lump under my armpit (swollen lymph node) it?s painful. I spoke with my Dr this morning and she said I was correct in that it?s a reaction of the vaccine. I have never felt like this before. Never have suffered from any kind of depression or thoughts of wanting to be dead. I don?t have any thoughts to harm myself, again I?ve always been a very happy person . I have constant headaches now. Cold sores in my mouth and on my lips. It makes it hard to eat. I hope I am feeling better soon. I do not wish to get the second dose. I probably sound a little crazy but this just isn?t like me and it makes me very sad. I feel like I?ve managed through the pandemic, never had COVID and then I decide to get the vaccine and it just ruins who I am.


VAERS ID: 1529737 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, 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: prednisone 30 mg daily
Current Illness: poison ivy dermatitis diagnosed 7/19
Preexisting Conditions: n/a
Allergies: guaifenesin-codeine, cipro
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient had had poison ivy dermatitis diagnosed 7/19 and treated with prednisone taper. Rash was improving. 7/28 she received her vaccine, and the next day her poison ivy rash dramatically worsened.


VAERS ID: 1529855 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-07-29
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi vitamin Probiotic Vitamin D Spironolactone Omeprazole Linzess
Current Illness: None
Preexisting Conditions:
Allergies: Aspirin Ibuprofen Penicillin Sulfur Keflex Levaquin Prednisone Lamotrigine Bacitracin Neomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pulmonary embolism


VAERS ID: 1530473 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Body temperature, Feeling abnormal, Feeling cold, Feeling drunk, Heart rate, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Heart rate; Result Unstructured Data: 61; Test Date: 20210729; Test Name: Body temperature; Result Unstructured Data: Low, 97.6; Test Date: 20210729; Test Name: Heart rate; Result Unstructured Data: 76
CDC Split Type: USJNJFOC20210805268

Write-up: 6 SHARP PAINS IN MY LEFT POSTERIOR BACK MEDIAL OF MY FLOATING RIBS; MUSCLE PAIN ON TOUCH FROM THE SHOT; FEELING COLD; FEELING OF BEING INTOXICATED; FELT LIKE SUPERWOMAN/URGENCY TO TAKE OFF RUNNING; 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) dose was not reported, administered on 29-JUL-2021 14:21 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced feeling of being intoxicated. On 29-JUL-2021, the subject experienced felt like an urgency to take off running. On 29-JUL-2021, the subject experienced feeling cold. Laboratory data included: Body temperature (NR: not provided) Low, 97.6, and Heart rate (NR: not provided) 76, 61. On 30-JUL-2021, the subject experienced 6 sharp pains in my left posterior back medial of my floating ribs. On 30-JUL-2021, the subject experienced muscle pain on touch from the shot. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the feeling of being intoxicated, felt like an urgency to take off running, feeling cold, muscle pain on touch from the shot and 6 sharp pains in my left posterior back medial of my floating ribs was not reported. This report was non-serious.


VAERS ID: 1530499 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache
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: USJNJFOC20210808361

Write-up: SEVERE HEADACHES; 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 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced severe headaches. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headaches. This report was non-serious.


VAERS ID: 1530595 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Test Date: 202107; Test Name: Body temperature; Result Unstructured Data: Test Result:97.2; Comments: Normal resting temperature is 97.2.; Test Date: 202107; Test Name: Body temperature; Result Unstructured Data: Test Result:98.6; Comments: Temperature 30 minutes after taking Tylenol and his temperature was 98.6
CDC Split Type: USPFIZER INC202100969814

Write-up: fever; sore throat; chills/woke up today shivering; Chill/woke up today shivering; This is a spontaneous report from a contactable consumer (patient). A 37-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: FA7485) via an unspecified route of administration, administered in Deltoid Left on 28Jul2021 at 14:00(age at time of vaccination 37-years-old) as dose 2, single dose for covid-19 immunisation. The patient had no other medical history and no concomitant medications. The patient previously received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0202) via an unspecified route of administration, administered in Deltoid Left on 07Jul2021(age at time of vaccination 37-years-old) as dose 1, single dose for covid-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Caller stated that on 29Jul2021 the patient experienced chills, fever and sore throat after receiving second dose Pfizer Covid 19 Vaccine. The caller also stated that woke up today shivering, 29JUL2021. The caller took his wife to work at the hospital at 0700 and the shivering started off pretty, well wouldn''t say horrible but decent. The caller stated that he took Tylenol and Ibuprofen and four hours later the chills started getting really bad again. caller stated that he was watching the time. He took second dose of Tylenol and this seems to have curved the chills. The patient took his temperature after taking Tylenol. Caller''s normal resting temperature was 97.2. The patient took his temperature 30 minutes after taking Tylenol and his temperature was 98.6. The caller is assuming the temperature was 99 but doesn''t know to be honest. The patient did not visit Emergency Room/Physician Office. Therapeutic measures were taken as a result of events included treatment with Tylenol 500mg took twice, once in the morning and once at 14:00 (lot number: 1683583, Expiration: Mar2023) and Ibuprofen 400mg, took twice, 1600 and before bed last night (Lot number: P88291, Expiration: FEB2016). The caller stated that Ibuprofen may have been super week because the expiration date was 2016 and he stated the Ibuprofen worked but seemed too maybe be weaker. The patient underwent lab tests and procedures which included body temperature: 97.2 on Jul2021 Normal resting temperature is 97.2, body temperature: 98.6 on Jul2021. The outcome of the events fever, sore throat, chills was not recovered and woke up today shivering was unknown.


VAERS ID: 1531260 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Medication 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: MRNA 1273
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804993

Write-up: PATIENT RECEIVED MODERNA DOSE AFTER JANSSEN VACCINE; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received COVID-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included mrna 1273 for prophylactic vaccination. On 29-JUL-2021, the subject experienced subject received moderna dose after janssen vaccine. The action taken with COVID-19 vaccine ad26.cov2.s was not applicable. The outcome of patient received moderna dose after janssen vaccine was not reported. This report was non-serious.


VAERS ID: 1531471 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Pain in extremity, Vaccination site mass, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill. Omeprazole 20 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe leg pain in both legs the night of vaccine. Severe arm pain the day after vaccine. Red, warm, itchy lump at vaccine site 1 week after vaccine.


VAERS ID: 1531611 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-07-15
Onset:2021-07-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram abnormal, Arthralgia, Chest X-ray abnormal, Cough, Deep vein thrombosis, Fibrin D dimer increased, Haemoptysis, Musculoskeletal chest pain, Pulmonary embolism, Ultrasound Doppler abnormal, Ultrasound chest
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Arthritis (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HYDROXYCHLOROQUINE SULFATE, DULOXETINE, PEG, ALBUTEROL, CARBOXYMETHYLCELLULOSE NA OP SOLN, CLOBETASOL PROPIONATE CREAM,
Current Illness: LUPUS
Preexisting Conditions: LUPUS, ASTHMA,
Allergies: GABAPENTIN, VARENICLINE, PCN, BEE STINGS, ZOLMITRIPTAN, CONTRAST MEDIA, ESCITALOPRAM
Diagnostic Lab Data: positive D-dimer 7/31/21, CT ANGIO CHEST 7/31/21, VENOUS DUPLEX LEGS BILATERAL 8/1/21, XR CHEST AND CHEST US 8/3/21, XR CHEST 8/4/21
CDC Split Type:

Write-up: She had a L knee injury on 7/8/21 and was seeking medical care for that. She presented to this clinic for evaluation of L knee pain and was given Covid vaccine at that visit per her request. She was observed for 30 minutes after due to allergy history without incident. Pt presented to ER on 7/31/21 with complaints of cough, bloody sputum, L sided rib pain. She was diagnosed with L popliteal DVT, positive D-dimer with suspected PE.


VAERS ID: 1531636 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol, flecainide, daily nutritional supplement
Current Illness: none
Preexisting Conditions: A fib
Allergies: penicillin, sulfur, sensitivity to gluten
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had a weird throbbing sensation in right hand, it then started tingling, and went to left hand also and to my feet. The the tingling started coming up my legs and down my arms after a couple of days. Then my face started tingling. Now it is up my back and there is now a tingling sensation basically over my entire body. I tried taking Benadryl and it has not helped.


VAERS ID: 1531767 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: Patient developed left arm pain and left leg pain that self resolved following administration of Johnson and Johnson vaccination. It was determined by the vaccination Clinic provider, who administered the vaccination, that the patient did not qualify for the Johnson and Johnson vaccination, after this was administered. I then evaluated the patient in the urgent care department later that afternoon.


VAERS ID: 1531815 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-22
Onset:2021-07-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Immunoglobulin therapy, Petechiae, Platelet count decreased, Purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient presented 1 week after COVID with petechiae and purpura. She had platelet count <2,000 that has been refractory to ITP front line treatments including IVIG x 2, corticosteroids and romiplostim.


VAERS ID: 1532030 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-19
Onset:2021-07-29
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: U07.1 - COVID-19 virus infection


VAERS ID: 1532042 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. T026323 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U6951AA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U6900AA / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphonia, Lip swelling, Oropharyngeal discomfort, Rash, Tongue pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Rash on face and neck, swollen lips, itchy tongue, voice alteration and throat discomfort.


VAERS ID: 1532078 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-04-28
Onset:2021-07-29
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol/moringa/keto fat burner pills
Current Illness: N/A
Preexisting Conditions: Joint/chronic pain in my neck/lower back pain foot injury/Head on collision.
Allergies: N/A
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Left arm is in pain three months later and it is currently disabling and handicapping my arm actions and I took Tylenol to relieve the pain but that does not help and I just started experiencing these arm disabling handicaps.


VAERS ID: 1532211 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-15
Onset:2021-07-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: Dexmethylphenidate 25 mg QD, Oxcabazepine 150 mg BID,
Current Illness:
Preexisting Conditions: ADHD
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: Bell''s Palsy Patient received Pfizer COVID-19 Vaccine on 7/15/2021. Patient presented to the ED on 7/29/2021 at 1248 with a right-sided facial droop. Physical exam: PERRL. EOMI without nystagmus. Facial sensation intact in V1-V3 distributions. Uvula and palate raise is symmetrical. Tongue protrusion is midline. Normal shoulder shrug bilaterally. Patient with right-sided facial droop. Decreased right-sided eyebrow raise. Patient treated with prednisone and Lacri-lube.


VAERS ID: 1532214 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Brain natriuretic peptide normal, Bundle branch block right, C-reactive protein increased, Chest X-ray normal, Chest pain, Condition aggravated, Electrocardiogram abnormal, Headache, Myocarditis, Palpitations, Peripheral swelling, Red blood cell sedimentation rate normal, Troponin
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: he reports feeling ill since his first COVID vaccination 3 weeks prior with loose stools, body aches, congestion, and cough. He had been tested for COVID twice in the last month and it was negative.
Preexisting Conditions: He had Lyme disease in 2016, high cholesterol, chest pain, tobacco use, urticaria
Allergies: acyclovir, coconut, contrast dye, licorice, polypropylene glycol
Diagnostic Lab Data: ESR 19, CRP <4, BNP 22.5, Chest xray normal, EKG IRBB, Trop 20 on 8/6/2021
CDC Split Type:

Write-up: Arm swelled up, severe headache, 1 day later he got chest pain and palpitations and blood pressure shot up. New EKG findings of myocarditis


VAERS ID: 1532243 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Heart rate increased, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue, nausea, malaise, shortness of breath, rapid heart rate


VAERS ID: 1532268 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: the next day and until today my vision is blurry


VAERS ID: 1532636 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-19
Onset:2021-07-29
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / UNK LA / IM

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

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

Write-up: tested positive for covid after completing covid vaccine series


VAERS ID: 1533996 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood pressure measurement, Body temperature, Dizziness, Hypersomnia, Influenza like illness, Pain in extremity, Panic attack
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to antibiotic; Allergy to metals
Preexisting Conditions: Comments: Patient is allergic to pain medications.
Allergies:
Diagnostic Lab Data: Test Date: 20210729; Test Name: Body temperature; Result Unstructured Data: 99 F; Test Date: 20210729; Test Name: Blood pressure; Result Unstructured Data: normal, 98/58 mmHg
CDC Split Type: USJNJFOC20210810385

Write-up: PANIC ATTACK; KNEE PAIN; PAIN AROUND THE BRA STRAP IN THE BACK; SLEPT ALL DAY; ARM HURTING FROM THE INJECTION; FLU LIKE SYMPTOMS; DIZZINESS/FELT DIZZY; This spontaneous report received from a patient concerned a 57 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included antibiotic allergy, and metal allergy, and other pre-existing medical conditions included patient is allergic to pain medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 29-JUL-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced dizziness/felt dizzy. On 29-JUL-2021, the subject experienced flu like symptoms. Laboratory data included: Blood pressure (NR: not provided) normal, 98/58 mmHg, and Body temperature (NR: not provided) 99 F. On 30-JUL-2021, the subject experienced slept all day. On 30-JUL-2021, the subject experienced arm hurting from the injection. Treatment medications included: ibuprofen. On 03-AUG-2021, treatment medications included: ondansetron. On 05-AUG-2021, the subject experienced pain around the bra strap in the back. On 05-AUG-2021, the subject experienced knee pain. On an unspecified date, the subject experienced panic attack. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from flu like symptoms, panic attack, knee pain, and pain around the bra strap in the back, and the outcome of dizziness/felt dizzy, arm hurting from the injection and slept all day was not reported. This report was non-serious. This case, from the same reporter is linked to 20210810461.


VAERS ID: 1534009 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, Fatigue, Injection site pain, Lethargy, Musculoskeletal stiffness, Pain, Sensitive skin
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), 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:
Current Illness: Chronic migraine
Preexisting Conditions: Medical History/Concurrent Conditions: Myocarditis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210811163

Write-up: SKIN SENSITIVITY OVER RUBBING OR TOUCHING CLOTHES; LOWER BACK PAIN; FEELS LETHARGIC; STIFF MUSCLES FEELS LIKE PUTTING EXTRA LABOR TO MOVE ARMS; LOW ENERGY; VERY BAD BODY ACHES; GENERAL FATIGUE (FEEL VERY TIRED); PAIN AT SITE OF INJECTION; This spontaneous report received from a patient concerned a 29 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included myocarditis, and concurrent conditions included chronic migraines. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 29-JUL-2021 19:00 for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, the subject experienced general fatigue (feel very tired). On 29-JUL-2021, the subject experienced pain at site of injection. On 30-JUL-2021, the subject experienced very bad body aches. On 02-AUG-2021, the subject experienced skin sensitivity over rubbing or touching clothes. On 02-AUG-2021, the subject experienced lower back pain. On 02-AUG-2021, the subject experienced feels lethargic. On 02-AUG-2021, the subject experienced stiff muscles feels like putting extra labor to move arms. On 02-AUG-2021, the subject experienced low energy. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from general fatigue (feel very tired), very bad body aches., skin sensitivity over rubbing or touching clothes, lower back pain, feels lethargic, stiff muscles feels like putting extra labor to move arms, pain at site of injection, and low energy. This report was non-serious.


VAERS ID: 1534130 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No, Comment: Patient History: No
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100976015

Write-up: her heart was going fast; This is a spontaneous report from a contactable consumer (patient''s mother). A 13-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm on 28Jul2021 (at the age of 13-year-old), as a single for COVID-19 immunization. No medical history and concomitant medications were reported. No investigation assessment. On 29Jul2021, her heart was going fast. It was reported that, mother calling on behalf of daughter, aged 13-year-old, received first dose of the Pfizer BioNTech Covid 19 vaccine on 28Jul2021. That evening in the middle of the night when she got home, her daughter was crying because she said her heart was going fast, similar to if she had just been exercising. Her daughter told her that she''s not in pain but still having these symptoms of a fast heartbeat now. She tried calling the doctor but was unable to make an appointment. The patient took Pfizer COVID-19 vaccine "They want to prevent getting sick from school". No product quality complaints were reported. The outcome of the event was not resolved. The lot number for the vaccine, bnt162b2, was not provided and will be requested during follow up.


VAERS ID: 1534142 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fatigue, Muscular weakness, Myalgia, Thrombosis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XARELTO
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Thrombosis leg (Verbatim: Blood clot in leg Blood clot in leg (From: Unspecified To: Unspecified))
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202100981430

Write-up: Feeling weak, no energy; Muscle aches; Fatigue; Muscle weakness; I got HDV /I have got blood clot on my leg; This is a spontaneous report from contactable consumer (patient) from a Pfizer Sponsored Program. A 73-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FA7485), via intramuscular route administered in left arm on 29Jul2021 (at the age of 73-years-old) as dose 1, single for COVID-19 immunization. Medical history included Blood clot in leg. Concomitant medications included rivaroxaban (XARELTO) 5mg, once in a day, oral taken for Blood clot in leg since 3 years. The patient did not receive any other vaccine within 4 weeks prior to COVID-19 vaccine. It was reported that patient got HDV or got blood clot on his leg. He was on Xarelto for 3 years. On an unspecified date, patient experienced blood clot on his leg. On 29Jul2021, couple of hours after vaccination, the patient experienced feeling weak, muscle aches, fatigue, muscle weakness and No energy. No investigation assessment. Patient would like to know if he should receive the medical attention and how long this would last and he was still experiencing the side effects (at the time of report). The outcome of events was not recovered. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1534759 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7845 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Cough, Electrocardiogram, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Chest x Ray. EKG. 08/06/2021
CDC Split Type:

Write-up: Fever. Body ache. Cough. Chest pain.


VAERS ID: 1535043 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-11
Onset:2021-07-29
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zytiga,prednison ,Daliresp,atenolol, lipitor, norvasc, ProtonixAmiodrone,pradaxa
Current Illness: CAD, emphysema oxygen dependant,A.fib,HTN, met prostate cancer
Preexisting Conditions: see above
Allergies: Sulfa, levofloxacin
Diagnostic Lab Data: positive covid pcr
CDC Split Type:

Write-up: hosp due to covid infection


VAERS ID: 1535271 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-18
Onset:2021-07-29
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Bronchiolitis, COVID-19, Computerised tomogram thorax abnormal, Cough, Diarrhoea, Lung opacity, Malaise, Pneumonia, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Florastor 250 mg PO BID, Tramadol 50 mg PO q6h PRN, Estradiol 10 mcg vaginally twice weekly, Fluticasone nasal 2 sprays in each nostril daily, Gabapentin 300 mg PO daily, Mirtazapine 15 mg PO daily at bedtime, Cholestyramine 4 g PO daily, A
Current Illness: None known
Preexisting Conditions: GERD, angioedema, anxiety/depression, h/o breast and ovarian cancers, CLL (2016), HLD, hypothyroidism, lung adenocarcinoma (surgical resection 4/2021), renal stones
Allergies: None
Diagnostic Lab Data: CT chest (8/5) with newmild peribronchial groundglass opacities in the right upper lobe suspicious for an infectious bronchiolitis/bronchopneumonia
CDC Split Type:

Write-up: Patient tested positive for COVID-19 after vaccination. She reported to the ED "not feeling well" with worsening cough and congestion and diarrhea. Once she spiked a fever, she presented to the ED per the recommendation of her PMD and oncologist. She was started on 2 L of oxygen by nasal cannula which she is still continued on.


VAERS ID: 1535454 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-07-15
Onset:2021-07-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004D21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: moderna 1st dose-muscle weakness vaccinated in 05/17/2021
Other Medications: not sure if taking any
Current Illness: he stated he had muscle weakness prior from the first covid shot
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: none that I''m aware of
CDC Split Type:

Write-up: patient stated that he blistered on the injection site while mowing. He wasn''t aware of the blister until a family member brought to his attention. he also reported that he had developed muscle weakness with the first shot, but he was regaining strength. he did not seek any treatment as the area was healing. however he had initially applied aloe vera which aggravated the area and increased the redness.


VAERS ID: 1535568 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-07-29
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
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: Penicillin
Diagnostic Lab Data: Urgent Care Appointment 8/2/21
CDC Split Type:

Write-up: Severe Shingles type skin rash on groin and buttocks x 7+ days.


VAERS ID: 1535946 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Inflammation
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: Severe Inflammation to the neck occurring after receiving mandatory H1N1 vaccine in 2009, inflammation to neck occurs after rece
Other Medications: Amlodipine
Current Illness:
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Severe inflammation to neck within 1.5-2 days after receiving shot. Inflammation has now lasted for 2 weeks as of the time of this posting.


VAERS ID: 1535982 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / SYR

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

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

Write-up: Pt was only 13, not eligible for Janssem. Monitored and no other adverse outcome noted thus far. Reported as a med error through internal event reporting.


VAERS ID: 1535983 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / UNK - / SYR

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

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

Write-up: Pt was only 13, not eligible for Moderna. Monitored and no other adverse outcome noted thus far. Reported as a med error through internal event reporting.


VAERS ID: 1536032 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Pain in extremity, Palpitations, Rash
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, ibuprofen
Current Illness: none
Preexisting Conditions: allergic rhinitis, anxiety
Allergies: none
Diagnostic Lab Data: EMT - EKG reported; local ER - CXR reported
CDC Split Type:

Write-up: day after vaccine, develop rash bilateral hands/forearms and face; entire arm pain; 8/3 chest pain and heart racing


VAERS ID: 1536033 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Confusional state, Decreased appetite, Diarrhoea, Fatigue, Sleep disorder, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: fatigue, cant sleep, no apetite, abdominal pain, diarrhea, weight loss, confusion


VAERS ID: 1536130 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Pyrexia, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 07/28 patient had moderna vaccine. husband called 8/9/21 stated day after shot, patient started getting headache that lasted 2 days, then coughing, sneezing, fever, and high temperature. decided to go to to ER 08/07/21 and tested positive for covid.


VAERS ID: 1536593 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-06
Onset:2021-07-29
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: COVID-19, Cough, Dizziness, Exposure during pregnancy, Fatigue, Headache, Mobility decreased, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Augmentin
Diagnostic Lab Data: Covid test- positive 07/30/2021
CDC Split Type: vsafe

Write-up: It was hard to distinguish if the symptoms were because of Covid or because of my pregnancy, but I became more congested, I had a headache and sore throat, I was very very fatigued, basically I spent 10 days in my bed, I never had a fever, I had a minor cough and a little bit of dizziness. I took Tylenol and Aspirin and Benadryl. I got the Covid test trough Keiser on 07/30/2021 and on 08/02/2021 they contacted me because I had an OBGYN appointment and I told them to switch them because I did not want to infect anybody else. I still feel very tired and pretty congested but it is definitely getting better at this point, Pregnancy history: first time being pregnant, healthy for the most part, I am due on 08/15/2021


VAERS ID: 1536666 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

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

Write-up: red circle at injection site, itching and a full red circle that does not dissapear.


VAERS ID: 1536699 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Contusion, Dizziness, Dyspnoea, Eczema, Fall, Haematuria, Neuropathy peripheral, Rash
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arthritis; Cirrhosis of liver; Diabetic; Eczema; Gastrooesophageal reflux disease; Hypertension; Marijuana abuse; Memory impairment; Neuropathy; Pain of lower extremities; Smoker (2-3 cigarettes per day)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210808496

Write-up: BRUISING; BLOOD IN URINE; HEAVY BREATHING; DIZZY AND LIGHT HEADED; FLARED ECZEMA ON SIDE OF THUMB, FORE FINGER AND MIDDLE FINGER OF RIGHT HAND; RASH LIKE MOSQUITO BITES; NEUROPATHY IN FEET,NECK AND HIP; FALL; This spontaneous report received from a patient concerned a 62 year old Aboriginal and African American male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included smoker (2-3 cigarettes per day), marijuana abuse, street drugs abuse, diabetic, hypertension, memory issues, cirrhosis of liver, acid reflux, neuropathy, arthritis, and pain in ankle and legs and eczema. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: not reported) dose was not reported, 1 total, administered on 29-JUL-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 29-JUL-2021, after the vaccination patient laid down, half asleep and half awake and fell down. Patient nose, mouth, face, neck and shoulder hits on the floor. Patient experienced the neuropathy in feet. Patient reported that, he had the more pain in feet after the vaccination. On an unspecified date, patient experienced the bruising, rash like mosquito bite randomly on body, blood in urine, heavy breathing, dizzy and light headed. Patient had the asthma pump to use when he felt like short of breath. Patient reported that, he experienced the pain in left side of hip and not able to move. Patient did some stretching to lower the pain. He also experienced the neuropathy in hip, sharp pain in neck like sticking an ice pick and flared eczema on side of thumb, fore finger and middle finger of right hand. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from blood in urine, had not recovered from bruising, rash like mosquito bites, heavy breathing, dizzy and light headed, neuropathy in feet, neck and hip, and flared eczema on side of thumb, fore finger and middle finger of right hand, and the outcome of fall was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 20210808496-covid-19 vaccine ad26.cov2.s-Neuropathy.Peripheral 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: MEDICAL HISTORY


VAERS ID: 1540107 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperglycaemia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: Systemic: hyperglycemia-Severe, Additional Details: patient''s father came in 8/9/21, said his son''s blood glucose level went up to 400 about 6 hours after getting 1 vaccine pfizer


VAERS ID: 1540320 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injected limb mobility decreased, Injection site pain, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Unable to operate muscles around injection site to the same extent as prior to vaccination.-Severe, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1540404 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-08
Onset:2021-07-29
   Days after vaccination:82
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Allergy to arthropod bite
SMQs:

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

Write-up: What I have noticed since taking the Pfizer vaccine is that when I now get a bug bite, I am getting severe reactions, such as large areas of redness and itching. This has never happened before being vaccinated. I would only get a mild reaction to a bug bite. It appears to be an overaggressive immune response from the vaccine. In fact, I''ve been using over-the-counter cortisone cream to calm the areas down, which I''ve never had to use before getting vaccinated. It makes me wonder if the vaccine is changing my immune response. This needs to be monitored.


VAERS ID: 1540720 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-03
Onset:2021-07-29
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Computerised tomogram head, Ischaemic stroke, Magnetic resonance imaging head
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Astrovastatin 40mg, Omeprazole 40mg, Trazadone 50mg, Venlafaxine 75mg, Metformin 500mg, Zinc, B12 and Vitamin d
Current Illness:
Preexisting Conditions: Diabetes and depression
Allergies: Phenobarbotol
Diagnostic Lab Data: All on 7/29/21 CT, MRI, Blood Work, TPA was administered
CDC Split Type:

Write-up: I suffered a schematic stroke


VAERS ID: 1540800 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Day after shot, began having very mild spotting every day. Then, 13 days after shot, got a period (had just finished a period 2 weeks before).


VAERS ID: 1540902 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-02-03
Onset:2021-07-29
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Exposure to SARS-CoV-2, Fatigue, Malaise, 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:
Current Illness:
Preexisting Conditions: TYPE 2 DIABETES, CAD S/P CABG 2001, HYPERLIPIDEMIA, DEPRESSION, GLAUCOMA
Allergies: NKDA
Diagnostic Lab Data: 072921: COVID-19 Abbott ID NOW (+)
CDC Split Type:

Write-up: Pfizer COVID-19 EUA: Fully vaccinated patient presented on 072921 with severe fatigue and "just feeling sick". He reported a COVID-19 exposure on 071621. Also reported having a dry cough.


VAERS ID: 1541069 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Headache, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Benzoyl Peroxide 5%, Desogestrel-Ethinyl Estradiol 0.15-0.03mg, Minocycline 50mg, Sulfacetaminde Sodium 10%
Current Illness: No know illnesses
Preexisting Conditions: None
Allergies: Penicillins
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt presents to clinic for 1st COVID vaccine. Consent signed--on consent form pt check yes to having a serious allergic reaction or anaphylaxis due to food/meds/etc. When asked, pt states she gets a rash from Penicillin. Informed pt I will observe her for 30 mins after receiving vaccine. Vaccine given at 0953. At 1019, mom informed me that pt''s chest and throat were itchy--no rash noted. Pt states she maybe felt a little SOB. Spoke with Doctors--gave Benadryl 50mg at 1020. See vitals in vitals tab above. At 1025, pt stated she had a headache and still had a itchy throat. See vitals above. At 1027, pt stated she felt better, itching in her throat was going away. Vitals taken at 1030--see vitals above. At 1031, pt states no more itching on chest or throat. Denis any SOB. At 1040, pt reported her face felt itchy. No rash noted. See vitals above. Spoke with Dr--continue to monitor pt. No need for more meds at this time. Monitor for another 1-2 hrs. At 1140, Spoke with mom and pt. Pt denied any itching and states throat feels ok. Informed mom to call clinic if anything changes or report to ER if difficulties with breathing. Mom asked about giving another dose of Benadryl if needed. Nurse told her she could give another dose if itchiness or rash occur. See vitals above. Pt''s mom wanted provider be aware of situation. Mom questioning if pt should receive 2nd dose of COVID vaccine or not. Task sent to provider to review upon her return.


VAERS ID: 1541635 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Asa, Lopressor, Cymbalta, vit d, vit c, Tylenol, Ibuprofen, Tamoxifen, multivit
Current Illness: Tamoxifen for breast cancer
Preexisting Conditions: Atrial fibrillation Prolonged QT interval Anxiety and depression Breast Cancer Alcoholism ( recovery since 2014)
Allergies: Sulfa, hydromorphone, tuberculin ( Mantoux solution)
Diagnostic Lab Data: August 6th Emergency Room....CT of the head negative for clot or aneurysm , IV medications (Benadryl, Reglan and Toradol with a liter of fluids) August 10th follow up with NP.... increasing Gabepentin and OTC vitamins
CDC Split Type:

Write-up: Continous headache that started 3 to 4 hours after my second Covid shot on July 29th. Would go between a 2 and an 8 on the pain scale. Never would go completely away. On August 6th the pain was so bad had to go to the Emergency Room for a CT scan and medications ( Benadryl, Toradol, Reglan and IV fluids) and today followed up in my Probst clinic. Day 12 of headaches... got medication adjustment and increased medications


VAERS ID: 1542045 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Pain in extremity
SMQs:, Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Arm pain persisting since July 29th administration from the moment of injection in the left arm.


VAERS ID: 1544881 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Injection site pain, Lymphadenopathy, Musculoskeletal stiffness, Myalgia, Oedema peripheral, Rash, Rash erythematous
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Headache, fatigue, muscle/joint pain
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache for several hours. Increased joint/muscle pain. Slight pain at injection site when touched. Left arm starting locking down, could only raise 90 degrees for about 34-36 hours. Slight swelling under left arm pit. Swollen lymph node on right side of neck under chin for about 1-2 days. Slight fatigue. Rash started with red marks on skin, turning into red bumps (mainly on left arm - started about a week after this injection). No itch to rash, just bumps. They are going down in size, but not gone yet.


VAERS ID: 1545031 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-16
Onset:2021-07-29
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea exertional
SMQs:, Anaphylactic reaction (broad), Pulmonary hypertension (broad)

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

Write-up: Dyspnea on exertion , cough,


VAERS ID: 1545063 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysgeusia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (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: Acetaminophen 1000mg (every 4 hours as needed) Xarelto 20mg (once daily) Oyster Shell Calcium with Vitamin D 1000mg (once daily) Vitamin C 1000 mg (once daily) Ortho biotic (once daily)
Current Illness: None
Preexisting Conditions: Autoimmune Disorder Arthritis Blood Clotting Disease
Allergies: Penicillin Sulfa EES latex Vicrel Most medical adhesives
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within 5 minutes of vaccine she received a metallic taste in her mouth, arm, back, back head, feet and neck has been itching consistently, rash on back


VAERS ID: 1545140 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-07-29
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Fatigue, Lung opacity, Malaise, Pain, SARS-CoV-2 test positive, Ventilation/perfusion scan
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: self reported covid positive 8/10 lung scan showing ground glass opacities
CDC Split Type:

Write-up: Patient presented to Emergency on 8/9/21 , Patient states he tested positive 4 days prior to admission, and had been feeling sick for about a week. we do not have a copy of the lab report, unknown source. patient presents with symptoms of fatigue, body aches, and shortness of breath. no hypoxia


VAERS ID: 1545316 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-21
Onset:2021-07-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Pain in extremity, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: HSV-2
Allergies: nuts- anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient described 1 week of sore arm which felt weird after the vaccination. Then, eight days after the shot, her hand was shaking for a few minutes and she could not stop it. Symptoms resolved by themselves.


VAERS ID: 1545354 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Lymph node pain, Lymphadenopathy, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Almost immediately b felt some numbness and pins and needles type feeling in opposite hand and forearm. This persisted for approximately three days. Also, the day after vaccination, noticed a sore enlarged lymph node just below collarbone on injection site. This has not gone away.


VAERS ID: 1545508 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-29
Onset:2021-07-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Fatigue, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: About 5 hours after administration: light headedness- 2 episodes about a day apart, chills- intermittent for about 24 hours, fatigue- about 2 days, nausea and inappetance- about 2 days, injection site pain- about 3 days


VAERS ID: 1545517 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Intensive care, Shock
SMQs:, Anaphylactic reaction (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: xanax, gabapin, metformin, metoprolol, celexsa,
Current Illness: was sick 3wks before the vaccine
Preexisting Conditions: anxiety
Allergies: no
Diagnostic Lab Data: yes
CDC Split Type:

Write-up: woke up and right arm felt like it was on fire, went to the ER and blood pressure was 68/40 she went into shock in IUC


VAERS ID: 1545619 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-28
Onset:2021-07-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Visual impairment, Xanthopsia
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine 100mg BID, Asmanex inhaler
Current Illness:
Preexisting Conditions: Celiac disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient described altered vision, "like looking through yellow glasses" for approximately 12 hours the following day.


VAERS ID: 1545664 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-29
Onset:2021-07-29
   Days after vaccination:122
Submitted: 0000-00-00
Entered: 2021-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Echocardiogram, Exposure during pregnancy, Foetal cerebrovascular disorder, Foetal malformation, Magnetic resonance imaging, Ultrasound antenatal screen abnormal, Uterine dilation and evacuation
SMQs:, Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)

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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: Was unaware I was pregnant at time of first injection/vaccine. At anatomy scan discovered baby had liquid in brain, double cleft lip and cleft palate. Was referred to fetal health. Went the following week and had MRI, echocardiogram, high tech ultrasound, bloodwork. Discovered in addition to above baby did not have a brain cerebellum or corpus collosum. It would be very likely baby would need breathing machine and g tube it?s entire life, would not be mobile, have any motor function, not able to communicate or possibly process thoughts. Due date was 12-16-2021. Had D&E on 8-10-2021.


VAERS ID: 1548762 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-20
Onset:2021-07-29
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Seizure-Mild, Additional Details: patient was on flight with mom and developed a seizure 9 days after receiving seizure. Patient had no prior history of seizures. Seziure lasted no more than 5 minutes. luckily a few doctors and nurses were on flight and they handeled the situation.


VAERS ID: 1548993 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-07-17
Onset:2021-07-29
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaemia, Back pain, Blood pressure increased, Burning sensation, Chills, Electric shock sensation, Facial paralysis, Fatigue, Feeling abnormal, Full blood count, Headache, Mean cell haemoglobin concentration increased, Mean cell haemoglobin increased, Monocyte percentage increased, Monocytosis, Muscle spasms, Myalgia, Neck pain, Neuralgia, Neurological symptom, Pain, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hearing impairment (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica tramadol Vancomycin
Current Illness: Lyme disease, bartonellosis, Migraines, chronic C diff infection, no acute illness
Preexisting Conditions: See above
Allergies: Multiple medication allergies
Diagnostic Lab Data: Nl CBC except monocytosis with 10% monocytes, also elevated MCHC, MCH and mild anemia
CDC Split Type:

Write-up: She had the covid vaccine 7/17/21 Moderna. 022C21A.She started to feel bad around 7/30/2021, with elevated BP, increased nerve pain, drooping face, severe headache, and muscle pain. After her last visit she took claritin on 8/2/21, then on 8/3/21 when she took her lyrica and had really weird flare of her neurologic symptoms. She stopped the claritin and continued to be tired and achy. Then she started with a fever as well as more severe nerve pain, her neck went into spasm. She had chills and her body felt like it was on fire. She had radiating electrical like pain down her neck and back. She also had fever 99.7 and 100.7 starting August 3rd. The fever continued until now. She also had periods of severe tremors which made it impossible to use the computer. The headache is ongoing but improving slightly. She did see her regular doctors yesterday, he was at a loss.


VAERS ID: 1549129 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-26
Onset:2021-07-29
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Gait disturbance, Gait inability, Impaired work ability, Muscle spasms
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none reported
Preexisting Conditions: unknown
Allergies: none reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was administered the Moderna vaccine on 7/26/2021 his mother contacted our clinic earlier in the week to report that "after my son received the vaccine we had to take him to the ER due to severe muscle spasms causing him not to be able to work for four days due to inability to walk." Upon obtaining additional information regarding the event, we learned that 2 days after receiving the Moderna vaccine Pt assisted with moving an older couch. Mom informed us that she took her son to the hospital and was seen by Dr. who diagnosed Pt with a severe back spasm. The mom then informed us that four days after ER visit Pt''s gait "was unsteady and he was falling around". Dr. was contacted with the description of events and instructed nurse to educate mom that we will defer to his physician and reassess when his second dose is due. Mom was contacted via phone with the follow up education and instruction. Mom continues to be unsure if she will follow up with 2nd vaccine for son, reports "I''ll let him decide."


VAERS ID: 1549254 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-07-29
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: POCT SARS-COV-2 RAPID - Detected 7/29/2021
CDC Split Type:

Write-up: Patient is a 25 yo female s/p full Pfizer COVID vaccination: dose 1 on 3/4 and dose 2 on 3/25. Patient is an employee at this institution and reports new onset sore throat and congestion/runny nose on 7/29. Denies known exposure to COVID-19. Rapid test results back positive on 7/29.


VAERS ID: 1549304 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-01
Onset:2021-07-29
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Injection site pain, Injection site pustule, Injection site scab, 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: LOSARTAN 50 MG TABLET 90 Tablet 0 6/1/2021 Sig : TAKE 1 TABLET BY MOUTH ONCE DAILY Class : e-Prescribing Order# : 286273995 ATORVASTATIN 20 MG TABLET 90 Tablet 2 3/4/2021 Sig : Take 1 Tablet by mouth once daily Class : e-Prescribi
Current Illness: none
Preexisting Conditions: Hypertension
Allergies: No Known Allergies
Diagnostic Lab Data: BINAXNOW COVID-19 AG CARD POCTCollected 8/12/2021 Final result, Abnormal Component Ref Range & Units 9:32 AM SARS COV 2 AG Negative POSITIVEAbnormal INTERNAL CONTROL PASS PASS
CDC Split Type:

Write-up: Patient tested positive for COVID-19 on 8/12/2021. Received Pfizer vaccine, completed series on 4/1/2021. Approximately 2 weeks prior to testing positive, he did have soreness in injection site. and developed pustule at the site. Site continues to be scabbed over and sore.


VAERS ID: 1549332 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-03
Onset:2021-07-29
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA156051 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PAA156051 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose decreased, COVID-19, COVID-19 pneumonia, Intensive care, SARS-CoV-2 test positive, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: carvedilol 25 mg PO BID oxybutynin 5 mg PO at bedtime NIFEdipine 90 mg oral tablet, extended release 90 mg PO qDay rosuvastatin 10 mg PO at bedtime
Current Illness:
Preexisting Conditions: DM, HTN
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7/29/21: Patient arrived at the ER due to being found unresponsive with low blood sugar. Patient tested positive for COVID on 7/29/2021. Diagnosed with COVID-19 pneumonia Note: patient previously vaccinated with Pfizer COVID-19 vaccine (2nd dose in Feb 2021) 8/8/21: patient transferred to ICU 8/12/21: patient still admitted at the time of this report submission. Please note: Patient received First dose of Pfizer COVID-19 vaccine on 1/14/2021, followed by the second dose on 2/3/2021 (confirmed through database)


VAERS ID: 1549385 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-07-21
Onset:2021-07-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MOD-008C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Injected limb mobility decreased, Injection site swelling, Injection site warmth, Insomnia, Rash, Rash pruritic, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: * days after getting my first Moderna shot, I woke up with a swollen left arm at the injection site. It was hot and I couldn''t lift my arm above my chest. By the end of the day, I had a SEVERE welted rash ALL over my body. You could feel it though my clothing. The rash proceeded to spread and it hot and itchy beyond anything able to describe. You just can''t itch it deep enough. I took Benadryl but it did nothing. We called my dermatologist who suggested Zyrtec and Cortisone cream for the rash. It helped alleviate the initial, itch for a little bit, but it was still welted and hot and spreading. I have tried other creams, and was given a prescription of prednisone. The rash has mostly subsided but the UNCONTRLLABLE itch is still there. It''s a deep itch that you can''t seem to get to. Unable to sleep because of the itching, and discomfort has been a huge issue for me. My question is, how long is this expected to last, is there anything else I should be doing or doing different, and should I proceed with the second shot???


VAERS ID: 1549397 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-02-04
Onset:2021-07-29
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Malaise, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2nd Shingles shot - 2021 - after the second COVID Pfizer vaccine - I got really sick - I took Aleve. I had a low fever. Bad body
Other Medications: Blood pressure medicine; Bystolic; Triamterene; Amlodipine; Blood thinner - Clopidogrel; Also: Pantoprazole. Nasal sprays and seasonal inhaler - as needed
Current Illness: no
Preexisting Conditions: Multiple Sclerosis; Heart disease - 3 coronary artery stents; High Blood pressure controlled by meds
Allergies: Pain killers: Demerol; Codeine; etc Lactose Intolerance
Diagnostic Lab Data: At Urgent Care - COVID test - rapid test: negative
CDC Split Type: vsafe

Write-up: Low grade fever - 99-100; body aches and headaches - general malaise and not feeling well. It''s usually at night that I feel this. It''s associated with nighttime. Urgent Care. Drinking fluids and take Tylenol and Ibuprofen as needed. I''m still having these symptoms at night - the last few nights for sure. I have had to take Tylenol for it the last few nights. I am feeling tired, too. Note: I had my second shingles shot after the second Pfizer vaccine - not that long after it- it took me down. I was so very sick after it.


VAERS ID: 1549660 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-22
Onset:2021-07-29
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Positive Covid by PCR on 7/29/21
CDC Split Type:

Write-up: Covid like symptoms started on 7/26/21


VAERS ID: 1549690 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-23
Onset:2021-07-29
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/02/21pfizer,Lot#EL0142 2nd 01/23/21dosePfizer,Lot#EL9262 Diagnosed covid positive:08/02/21 Symptom onset:07/29/21 Exposure:unknown Symptoms:cough,fatigue,Loss of smell/taste, runny nose.


VAERS ID: 1549700 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-07
Onset:2021-07-29
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Antibody test positive, Brain natriuretic peptide increased, Cardiac dysfunction, Cardiogenic shock, Congestive cardiomyopathy, Coronary artery dilatation, Decreased appetite, Ejection fraction decreased, Fatigue, Kawasaki's disease, Multisystem inflammatory syndrome in children, Nausea, Pyrexia, Respiratory viral panel, SARS-CoV-2 antibody test negative, Troponin increased, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Toxic-septic shock conditions (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), Vasculitis (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Respiratory viral panel was negative Elevated Troponin and BNP Nucleocapsid antibodies for Covid 19 were negative Anti-spike antibodies were positive
CDC Split Type:

Write-up: one week before the admission (07-29-2021), he reported being fatigued, poor appetite, fever, nausea and vomiting and abdominal pain. During admission he was found to be in cardiogenic shock, with evidence of poor cardiac function (EF 25%), that required Milrinone and Epinephrine drip and Solumedrol. he was also started on ASA because of evidence of a dilated RCA. He improved after several days and was transitioned to oral medications (Lisinopril, Prednisone and ASA and was discharged home one week after being admitted with normal cardiac function. Dx: Dilated cardiomyopathy (cardiogenic shock) secondary to Atypical Kawasaki vs MIS-C


VAERS ID: 1549702 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-04
Onset:2021-07-29
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Positive Covid PCR on 7/29/21
CDC Split Type:

Write-up: Covid like symptoms began 7/28/21


VAERS ID: 1549723 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-14
Onset:2021-07-29
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Hydrops foetalis
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)

Life Threatening? No
Birth Defect? Yes
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: G1P0, currently pregnant at 12w3d (EDD: 02/21/2022) with fetal hydrops, patient not delivered


VAERS ID: 1549828 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-27
Onset:2021-07-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Brain natriuretic peptide normal, C-reactive protein normal, Chest pain, Cytomegalovirus test positive, Differential white blood cell count, Dyspnoea, Eating disorder, Echocardiogram normal, Electrocardiogram normal, Epstein-Barr virus antibody positive, Full blood count, Fungal test, Lymphocyte count increased, Nausea, Neutropenia, Palpitations, Respiratory viral panel, SARS-CoV-2 antibody test negative, SARS-CoV-2 test negative, Tonsillar exudate, Troponin increased, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: Evaluation was done under guidance of cardiology and infectious disease specialists. Workup was done that showed elevated troponins (troponin 29 on 8/6/21, troponin 48 on 8/8/21). CRP initially 0.7 (8/6/21). Patient seen by cardiologist. Normal EKG''s on 8/6/21 and 8/9/21. Normal echocardiogram 8/10/21. Normal BNP 149 (8/10/21). Normal troponin 11 (8/10/21). Normal CRP 0.3 on 8/10/21. Had tonsillar exudates. Infectious workup was sent and was positive for CMV IgM, EBV IgM, IgG (8/10/21). CBC diff with elevated lymphocytes and mild neutropenia (8/6/21). Covid swab negative (8/8/21). Covid IgG negative (8/8/21). Respiratory pathogen panel swab indeterminate (8/10/21). Coccidiomycosis in process (8/8/21).
CDC Split Type:

Write-up: 2 days after receiving first Pfizer Covid 19 vaccine, patient developed chest pain, shortness of breath, nausea, vomiting, difficulty eating, weakness, palpitations. Patient presented for medical evaluation 1 week later. Was still having intermittent symptoms but mild. Soon resolved. Evaluation was done under guidance of cardiology and infectious disease specialists. Also noted to have tonsillar exudates.


VAERS ID: 1550076 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-07-29
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210804014

Write-up: SORE THROAT; HEADACHE; FEVER; PAIN AT THE INJECTION SITE; POOR QUALITY DRUG ADMINISTERED; INCORRECT STORAGE OF DRUG; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 29-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 29-JUL-2021, the subject experienced poor quality drug administered. On 29-JUL-2021, the subject experienced incorrect storage of drug. On an unspecified date, the subject experienced sore throat, headache, fever, and pain at the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the poor quality drug administered, sore throat, headache, fever, pain at the injection site and incorrect storage of drug was not reported. This report was non-serious. This case, from the same reporter is linked to 20210802801 and 20210803269.


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