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

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



Case Details (Reverse Sorted by Onset Date)

This is page 180 out of 3,232

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VAERS ID: 1282898 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypotension, Presyncope
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Vasovagal event with hypotension and dizziness after vaccine (patient stated did not eat that morning)


VAERS ID: 1282926 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-23
Onset:2021-05-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein decreased, Chest X-ray normal, Chest pain, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: protonix 20mg daily
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: 5.3.2021 Troponin 9016 (normal range less that 20) elevated on 5.2.21 too; CRP 0.5 (normal range less than 1.0); CXR normal; echo pending
CDC Split Type:

Write-up: chest pain diagnosed with myocarditis relating to vaccine administration


VAERS ID: 1282943 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-19
Onset:2021-05-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Catheterisation cardiac normal, Cerebral palsy, Echocardiogram normal, Troponin increased, Vaccination complication
SMQs:, Myocardial infarction (narrow), Congenital, familial and genetic disorders (narrow)

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

Write-up: NOTIFIED BY A NURSE AT HOSPITAL. THAT PATIENT WAS TRANSFERRED TO THEM FROM HOSPITAL WITH CP 5/2/21. STATES PATIENT RECEIVED 2ND PFIZER BY COUNTY HD ON 4/19/21. STATES PATIENT HAD CP AND ELEVATED TROPONINS. ECHO AND HEART CATH NEGATIVE SO MD STATES IT WAS A BAD REACTION TO THE VACCINE.


VAERS ID: 1282981 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204 A 21 A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, Red Yeast Rice CoQ10 Omega 3 ,Azo Cranberry25000mg, Potassium 60mg, B-12 1000 mcg, Zinc 50mg, mulit vit, Lutein 20mg, D3 50mcg Vit C, Collagen Peptides 20mg, Propranolol 60mg
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: At ~ 3:00 pm next day heart palpitations started, Heart would beat normal then a sudden hard beat, It kept this up the remainder of the day till Monday 5/3/21 at around 9:00 am. Most of the weird heart beat was standing or binding over, Sitting position was better.


VAERS ID: 1282995 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, D3 supples
Current Illness: Latent tetany, Gilbert syndrome
Preexisting Conditions: As above
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (39,6 C), chills, headache, feeling of asteny


VAERS ID: 1283016 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Cold sweat, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Glaucoma (broad), Optic nerve 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: not known
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: na
CDC Split Type:

Write-up: on the patients PQCF every question was a no,pt showed no fears for needles or signs of aversion,afetr administeru=ing the vaccine pt was waiting for 15 mins sitted ,after 5 mins or more he stated that he could not see,he went blind momentarily, would not blink after a waved my hands across his eyes,we initiated a call to 911 and made him comfortable no other signs of syncope was observed ,he was very aware and calm,after acouple more minutes he regained his sight and at this time he broke out in sweat and was clammy, he felt a lot better with the fan on him and drank some water and ate some chocolate and after a couple more mins he was good to go home,checked up him again the next day and everything is normal


VAERS ID: 1283117 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no known
Current Illness: not known
Preexisting Conditions: not known
Allergies: NKDA or other allergens listed on consent form
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had vasovagal syncope reaction to a Janssen Covid 19 vaccine. Patient was waiting in a chair in the pharmacy''s waiting area where he fainted a few minutes after receiving his vaccine. The pharmacist rushed to assist the patient while staff called EMS. Patient recovered and was aware of where he was and what happened. Patient was pale and sweating. Patient was given a few sips of water and concentrated on deep breathing. Shortly after this, patient fainted again while waiting on ambulance. Patient was lucid and conscious when paramedics arrived. The paramedics checked patient vitals and took patient away by ambulance.


VAERS ID: 1283138 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac telemetry, Cardiovascular evaluation, Chest X-ray, Chest discomfort, Electrocardiogram, Fibrin D dimer, Full blood count, Metabolic function test, Troponin
SMQs:, Anaphylactic reaction (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: BABY ASPIRIN DAILY
Current Illness: NO ACUTE DISEASE
Preexisting Conditions: HX TETRALOGY OF FALLOT S/P 2 PRIOR CARDIAC SURGERIES
Allergies: NONE
Diagnostic Lab Data: CARDIAC EVALUATION, EKG, CARDIAC TELEMETRY, CBC, CMP, D-DIMER, TROPONIN, CHEST X RAY
CDC Split Type:

Write-up: CHEST PRESSURE


VAERS ID: 1283201 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Hypersensitivity, Suffocation feeling
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe allergic reaction Suffocating and not being able to swallow Had to go to emergency room Injected with steroid anti inflammatory, Benadryl and pepsid


VAERS ID: 1283212 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram, Loss of consciousness, Musculoskeletal discomfort, Pain, Pyrexia, Skin discolouration, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, vitamin D, junel
Current Illness: None
Preexisting Conditions: None
Allergies: No allergies
Diagnostic Lab Data: Chest x-ray, bloodwork, EKG at ER on Sunday May 2nd in the morning.
CDC Split Type:

Write-up: At 7;30 am on May 2nd, I had blurry vision, dizziness, pressure on my chest and neck and difficulty breathing, ?blue? face color. My entire body was painful when moving. Difficulty breathing became extreme and I passed out. My husband called 911. I regained consciousness and was breathing with difficulty when paramedics arrived. Symptoms disappeared without treatment shortly after I was admitted to the ER around 8:20 am. After an additional day of fever and body aches, all symptoms have now disappeared.


VAERS ID: 1283361 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Amlodipine, Venlafaxine, Montelukast
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None, seasonal/environmental
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 102? for 2+ days, body aches, severe headache, extreme fatigue


VAERS ID: 1283441 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Echocardiogram, Headache, Laboratory test, Magnetic resonance imaging, Photopsia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3 50,000 taken on Saturdays
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Cat Scan, MRI, and echo. Lab work
CDC Split Type:

Write-up: lightning streaks in right eye, followed by headache and black spot in vision


VAERS ID: 1283494 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 025A21A / 1 LA / IM

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

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

Write-up: Patient under the age of 18 (17 year old) received the Janssen vaccine


VAERS ID: 1283661 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW8735 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood pressure increased, Blood test normal, Discomfort, Electrocardiogram normal, Palpitations, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PEPCID COMPLETE, MULTIVITAMIN, VITAMIN D3, PROBIOTIC
Current Illness: HEP B
Preexisting Conditions: PAT (Paroxysmal Atrial Tachycardia), very infrequent and usually mild.
Allergies: NIACIN, SULFITE
Diagnostic Lab Data: X-RAY NORMAL. BLOOD TEST NORMAL. WAS TOLD EKG WAS NORMAL DURING EMERGENCY ROOM.
CDC Split Type:

Write-up: PERNICIOUS PALPITATIONS (RACING HEARTBEAT, 130/MIN?), ABOUT 5 EPISODES IN 5 HOURS. THE SECOND EPISODE WAS THE WORST. ELEVATED BLOOD PRESSURE (180/110?) DURING PALPITATIONS. OVERALL DISCOMFORT IN WHOLE BODY. STAYED IN EMERGENCY ROOM FOR ABOUT 5+ HOURS. EVEN AFTER DISCHARGE, MUCH MILDER EPISODES LASTED THROUGHOUT THE NIGHT. EMERGENCY ROOM TREATMENT WAS ONLY SALINE. PATIENT TOOK 160 MG MAGNESIUM AFTER SECOND EPISODE. AT HOME PATIENT TOOK SOME MORE MAGNESIUM (~50 MG) AND VERAPAMIL (~60MG). 30 HOURS AFTER THE INCIDENT, MOSTLY RECOVERED BUT FEELING WEAK.


VAERS ID: 1283677 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Hypoaesthesia, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I had a numbness in my hands and sharp pains from my lower back to my feet. Soreness all over to where it hurt to move


VAERS ID: 1283971 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Head injury, Loss of consciousness, Skin abrasion
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: I administered first dose of Pfizer covid 19 0.3 ml via intramuscular route to this patient. About 2 minutes after the administration, the patient had syncope for a second. When I arrived to the scene, the patient was conscious. When he passed out, he felt and landed on his head. He had an abrasion. He stated ?he felt hot and dizzy?. He hasn?t had anything to eat all day. Due to the abrasion, he was rushed to the hospital About 3 hours later, I called to check on the patient. At the time of calling, the patient was discharged from the hospital in good condition. He stated he felt perfectly ok and wasn?t sure what had happened.


VAERS ID: 1284286 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 1 RA / IM

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

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

Write-up: Patient who is 4 months short of 18 years old received Moderna Covid Vaccine indicated for 18 years and older. After administration of vaccine, realised while data entry of the age. Rph immediately contacted the Clinical Team and Pharmacy District Manager and notified them. Right after that, Rph also called the Patient''s mom and left a message to call back. Mother called in approximately 30 minutes. I sincerely apologised and told her upfront what had happened and enquired how patient was doing and reasured her that i will contact their Dr first thing monday morning when they opened and keep her updated. She said patient was doing well and asked if she needs to keep their second appointment. I told her i will check with their Dr and our Clinical team and get back to her promptly.Followed up with their Dr and RN on behalf of the Dr and our Clinical team said as per CDC guidelines to give her the second moderna covid shot as scheduled for 5/30/21. Left 2 messages for mom to call us. Will follow up tomorrow.


VAERS ID: 1284466 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048D21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Headache, Injection site pruritus, Injection site urticaria, Injection site warmth, Nausea, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: None
CDC Split Type:

Write-up: Huge red welt at injection site that has continued to grow larger 2 days later. Hot to touch and starting to itch 2 days later. Nausea for 2 days that has now started to subside. Low grade fever. Fatigue. Brain fog. Minor congestion. Sever sever headache primarily behind both eyes constant.


VAERS ID: 1284479 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-26
Onset:2021-05-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / SYR

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

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

Write-up: 5-inch diameter itchy rash at injection site developed 6 days after shot. The internet tells me this is "covid arm."


VAERS ID: 1284484 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Electrocardiogram, Feeling abnormal, Heart rate increased, Immediate post-injection reaction, Muscle tightness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), 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: 1000mg vit d daily
Current Illness: None
Preexisting Conditions: None
Allergies: Iodine contrast (ct scan) Thimerosol
Diagnostic Lab Data: Paramedics came and did vitals ekg, bp, oxygen and checked visual no swelling or throat closure.
CDC Split Type:

Write-up: Right after receiving the vaccination began to develop very high resting heart rate(150bpm), along with dizziness and some mild shortness of breath, along with an out of body feeling. Some muscle tightness in neck. Took one benadryl after 15min, began feel better after 1hr. Then had more common reactions later that evening. Regular bpm is 55-60.


VAERS ID: 1284493 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA
Current Illness: N/A
Preexisting Conditions: NOT ON PATIENT PROFILE
Allergies: NKDA
Diagnostic Lab Data: PER PATIENT, RECIEVED "FILLERS" BUT TREATMENT HAS BEEN YEARS AGO
CDC Split Type:

Write-up: SWOLLEN FACE OCCURED THE MORNING AFTER VACCINE RECIEVED. TODAY, PATIENT STATED THAT SWELLING HAS GOTTEN WORSE. PER PATIENT, NO TROUBLE BREATHING AND NO SWELLING OF THROAT/TONGUE/MOUTH. ADVISED HER TO SEE DOCTOR SINCE SWELLING HAS GOTTEN WORSE


VAERS ID: 1284495 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: Covid Arm, 7inX2in rash on arm of injection site


VAERS ID: 1284831 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Headache, Insomnia, Lymph node pain, Malaise, Pain, Skin warm
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: site soreness only
Other Medications: daily multi vitamin, glucosamine, tumeric, calcium
Current Illness: none
Preexisting Conditions: arthritis
Allergies: none
Diagnostic Lab Data: none, did not need to go to doctor, all symptoms went completely away within 24 hours.
CDC Split Type:

Write-up: cold sweats (skin very hot, I assume I had a fever, though was too sick to check it) sleeplessness aches all over body, pain not quellable with Tylenol headache sensitive glands all lasting about 12 hours this was my 2nd dose, first dose had no effects except for site soreness


VAERS ID: 1284835 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Chest pain, Chills, Dyspnoea, Electrocardiogram abnormal, Heart rate increased, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative, Urinary tract infection, Urine analysis abnormal, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: zyrtec, 20mg fluoxetine, 150mg bupropion, Fluticasone
Current Illness: none
Preexisting Conditions: none
Allergies: apples, birch pollen, jackfruit, pollen
Diagnostic Lab Data: All tests done on 05/02/2021: blood test, urine samples, stethoscope, EKG, chest x rays, vitals, negative Covid rapid test. Doctor told me most of these tests came back negative except irregular EKG results and UTI in urine. I was told to schedule follow up with cardiologist about EKG results.
CDC Split Type:

Write-up: Approximately 12 hours after I received my second Moderna vaccine dose (around 4:30am EST), I began having chills, fever, body aches, nausea, moderate chest pain/discomfort, vomiting, and shortness of breath. I called 911 and asked for an ambulance because of difficulty breathing. Arrived at Hospital Center ER around 5:00am, given oxygen and several tests (blood, urine, EKG) and also IV fluids in my left arm. Vomited a second time around 8:00am. Continued difficulty breathing until around 11:00am and chest pain improved somewhat. Got chest x rays done and monitored until I could breathe more regularly without oxygen. Discharged around 12:26pm. Heartbeat was abnormally fast for this whole duration and did not return to resting heart rate until about 5:00pm later that evening, 24 hours after vaccine. All symptoms subsided within 48 hours. Diagnosis was nonspecific chest pain and UTI.


VAERS ID: 1285148 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Decreased appetite, Gastrooesophageal reflux disease, Headache, Hyperhidrosis, Insomnia, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pristique, Dymista, Cingular, Atorvastain, Folic Acid Supplement, D3 Supplement, Advair
Current Illness:
Preexisting Conditions: Asthma and Sinusitis
Allergies: Allergic to Aspirin and Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stopped breathing in a sleep apnea type of scenario from approx 5:30a - 11a on May 2nd. Extreme body aches and headache for two days. Fever and way overheated for three days. Sweating profusely from 5:30a and still occuring today three days after shot. Intense chest pain 1:50a Tuesday morning 5/4 along with acid reflux and body aches continuing. Insomnia started 30 hrs after injection and has lasted two days. Loss of appetite started 5/3 all day.


VAERS ID: 1285197 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: This client reports entire upper arm redness, soreness, and swelling. She reports this redness/swelling then migrated approximately 1" below injection site to the elbow.


VAERS ID: 1285250 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Headache, chills, sweating, extreme fatigue


VAERS ID: 1285272 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, losartin, lexapro,
Current Illness:
Preexisting Conditions: Type 2 diabetes
Allergies: Penicillin, pneumonia vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a high fever, 102. A lot of body aches. Took Tylenol for the fever to little effect. The fever disappeared late the next day but the body aches still remains.


VAERS ID: 1285512 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

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

Write-up: Fever fluctuating between 100 and 103 lasting 3 day now; does not go away after taking acetaminophen or ibuprofen. Strange pains come and go in different parts of the body (arms, legs, back, chest)


VAERS ID: 1285580 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature increased, Fatigue, Headache, Hot flush, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: FIRST VACCINE WAS ON 04/11/21 NO SIDE EFFECTS. SECOND VACCINE WAS ON 05/02/2021 AND HAD THE FOLLOWING SIDE EFFECTS: HEADACHE, STOMACH ACHE, HOT FLASHES, NAUSEA, FATIGUE, FEVER 101


VAERS ID: 1286169 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-01
Onset:2021-05-02
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Computerised tomogram abdomen, Computerised tomogram abnormal, Computerised tomogram thorax abnormal, Confusional state, Lethargy, Nausea, Pain, Pulmonary embolism
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None - no PMH or PSH per patient & patient''s niece
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with no reported past medical history or past surgical history presented to ED and found to have massive bilateral pulmonary embolism. Upon presentation, patient was confused and lethargic. The morning of the event, niece reports that patient was in her usual state of health this am and had gone downstairs to the kitchen this afternoon, when she was downstairs she began complaining of nausea and generalized back pain. Her niece went to grab her things to take patient to the hospital but when she returned she found the patient laying on the floor due to weakness and pain, no reported fall or trauma. Chest/Abd/Pelvis CT Angio was significant for large PE in R and L main pulmonary arteries. No family history of DVT/PE.


VAERS ID: 1286413 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site pain, Injection site rash, Injection site warmth, Rash papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol as needed for ankle pain
Current Illness: Ankle fracture 3/1/2021
Preexisting Conditions: Obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: ?COVID arm? with raised welt near the injection site that has spread out to 3 inches in diameter to the surrounding tissue. Similar to hives but long lasting. The welt has lasted several days with pain when the arm moves as well as painful to the touch. The area is hot to the touch. Headache the day after the injection.


VAERS ID: 1286414 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Write-up: patient was 17 years old when receiving vaccine indicated for 18 and older. No adverse reaction occurred. Reporting due to age restriction guideline violation


VAERS ID: 1286471 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Conduction disorder, Echocardiogram, Ejection fraction normal, Electrocardiogram abnormal, Myocarditis, Scan myocardial perfusion, Troponin I increased, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 05/04/21 Troponin I 7.05 EKG with RV conduction delay Echo normal EF, no pericardial effusion NM stress test normal
CDC Split Type:

Write-up: Myocarditis, elevated troponin


VAERS ID: 1286584 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Pharmacy       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT RECEIVED THE PFIZER COVID-19 VACCINE ON 4/29/2021. SHE THEN DEVELOPED BELL''S PALSY WITHIN 36 HOURS AFTER THE VACCINE WAS GIVEN. SHE IS BEING TREATED WITH PREDNISONE STARTING ON 5/3/2021.
Current Illness: NONE
Preexisting Conditions: DYSAUTONOMIA
Allergies: NONE
Diagnostic Lab Data: BELL''S PALSY
CDC Split Type:

Write-up: DEVELOPED DROOPINESS ON THE RIGHT SIDE OF FACE.


VAERS ID: 1287657 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Lightheadedness, shortness of breath, and I passed out and had to go to the ER.


VAERS ID: 1287875 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site nodule, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Redness at injection site, itchy, subcutaneous nodule at injection site, warm at touch


VAERS ID: 1287949 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: 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: Abstains from alcohol; Drug allergy; Non-smoker; Sulfonamide allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Comments: The patient had no history of drug abuse or illicit drug use. The patient had allergies of muscle and horseradish.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502589

Write-up: ACHY; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included asthma, and concurrent conditions included sulfonamide allergy, isocyanide allergy, non alcoholic, and non smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. the patient had allergies of muscle and horseradish. The patient experienced drug allergy when treated with doxycycline. 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 02-MAY-2021 12:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-MAY-2021, the subject experienced achy. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from achy. This report was non-serious.


VAERS ID: 1287960 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Illness, Musculoskeletal stiffness, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503048

Write-up: SICKNESS; MUSCLE STIFFNESS/NECK STIFFNESS; SHOOTING PAIN BESIDE THE NECK AND FACE; SORE ARM; FEVER; HEADACHE; TIREDNESS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not 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 02-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-MAY-2021, the subject experienced sickness. On 02-MAY-2021, the subject experienced muscle stiffness/neck stiffness. On 02-MAY-2021, the subject experienced shooting pain beside the neck and face. On 02-MAY-2021, the subject experienced sore arm. On 02-MAY-2021, the subject experienced fever. On 02-MAY-2021, the subject experienced headache. On 02-MAY-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore arm, shooting pain beside the neck and face, fever, muscle stiffness/neck stiffness, headache, and sickness, and the outcome of tiredness was not reported. This report was non-serious.


VAERS ID: 1288026 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and had no history of drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503997

Write-up: CHILLS; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 31 year old female. The patient''s weight was 76.5 kilograms, and height was 168 centimeters. The patient''s concurrent conditions included alcohol use 2 drinks per week, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies and had no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, expiry: UNKNOWN) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-MAY-2021, the subject experienced chills. On 02-MAY-2021, the subject experienced fever. On 02-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, fever, and headache on 03-MAY-2021. This report was non-serious.


VAERS ID: 1288035 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-24
Onset:2021-05-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergies
Preexisting Conditions: Major depression, anxiety, panic dissorder
Allergies: None to knowledge
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Raised swollen and firm semi circle at the injection site. Tender to touch but no real pain or heat from the location. Was gone within 24 hours at an estimate.


VAERS ID: 1288072 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Metformin, spironolactone, montelukast, cetirizine, rosuvastatin, paroxetine
Current Illness: N/a
Preexisting Conditions: Pcos
Allergies: Seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after vaccine: chills, headache, muscle aches, fatigue, symptoms resolved within 8hrs of onset. 48 hours after vaccine localized swelling at injection site continuing for 3+ days


VAERS ID: 1288080 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210504154

Write-up: ARM HURT; FEVER; HEADACHE; FATIGUE; This spontaneous report received from a patient via a company representative concerned an 18 year old female. The patient''s weight, height and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 202A21A expiry: 01-JUN-2021) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-MAY-2021, the subject experienced arm hurt. On 02-MAY-2021, the subject experienced fever. On 02-MAY-2021, the subject experienced headache. On 02-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from arm hurt, fever, headache and fatigue on 03-MAY-2021. This report was non-serious.


VAERS ID: 1288480 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-24
Onset:2021-05-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Injection site warmth, Neuralgia, Rash papular
SMQs:, Peripheral neuropathy (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: none
Current Illness: none
Preexisting Conditions: Occasional Gerd symptoms
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have a large raised red rash near the injection site. It is itchy and hot. I have also had nerve pain in that arm.


VAERS ID: 1288526 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503791

Write-up: RASH ON BOTH ARMS (GOTTEN A LITTLE BIGGER); ARM ITCHING; RASH ON BOTH ARMS (ARM CREASES IN THE FRONT AND IT IS OVAL SIZE AND ABOUT 3 INCHES LONG); This spontaneous report received from a patient concerned a 45 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported batch number: 202A21A expiry: 23-JUN-2021) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-MAY-2021, the subject experienced arm itching. On 02-MAY-2021, the subject experienced rash on both arms (arm creases in the front and it is oval size and about 3 inches long). Treatment medications included: cortisone. On 03-MAY-2021, the subject experienced rash on both arms (gotten a little bigger). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on both arms (arm creases in the front and it is oval size and about 3 inches long), arm itching, and rash on both arms (gotten a little bigger). This report was non-serious.


VAERS ID: 1288558 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Systemic: Dizziness / Lightheadness-Severe


VAERS ID: 1288655 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature abnormal, Dizziness, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503933

Write-up: DIZZY; TEMPERATURE; LEG MUSCLES REMAIN WEEK; This spontaneous report received from a patient concerned a 61 year old male. The patient''s weight, height, and medical history were not 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 01-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-MAY-2021, the subject experienced dizzy. On 02-MAY-2021, the subject experienced temperature. On 02-MAY-2021, the subject experienced leg muscles remain week. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizzy, and temperature on MAY-2021, and had not recovered from leg muscles remain week. This report was non-serious.


VAERS ID: 1288656 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503950

Write-up: FEVER; BODY ACHES; CHILLS; HEADACHE; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On 02-MAY-2021, the subject experienced body aches. On 02-MAY-2021, the subject experienced chills. On 02-MAY-2021, the subject experienced headache. On 03-MAY-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills, body aches, headache and fever was not reported. This report was non-serious.


VAERS ID: 1288692 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210506902

Write-up: HIVES ON SKIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-MAY-2021, the subject experienced hives on skin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of hives on skin was not reported. This report was non-serious.


VAERS ID: 1288858 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN AD4A21A / 1 LA / SYR

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

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

Write-up: Approximately 5 hours I started with a alight itch and later that night i itched more and I call the pharmacy and was told to it would go away after a few hours nevertheless it didn''t with me being a medical professional I have been haling benedrayl and oatmeal baths and this is the. 3rd day and in still have this body itch .... Im subject to go to the emergency room but I don''t have insurance its bad and I mean really bad


VAERS ID: 1288993 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-04
Onset:2021-05-02
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site haemorrhage, Injection site pain, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl last use April 28 2021 Allergies bad
Current Illness:
Preexisting Conditions: Asthma
Allergies: sulfur / strawberries/ coffee/ mushrooms / cats dogs
Diagnostic Lab Data: None -Visit (5/5/21) to my Surgeon who looked at it. Told me it''s blood from pricked blood vessel. Swelling black & blue. Soreness. Lucky did not prick my artery really. Use cold compress and no heavy lifting. Nothing for now. Watch it.
CDC Split Type:

Write-up: It seem injection site was placed wrong and a blood vessel prick and redness has occurred. Blood gathered around site. Swelling. Soreness. Pass 2 days... Today 3rd day went see my MD. @ 6:50am then to work. I am 65+....


VAERS ID: 1289004 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-05-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Feeling hot, Joint swelling, Limb discomfort, Sleep disorder
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), 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: ibuprophen
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3 days after the injection, I was fatigued, and my joints in my arms and legs were sore. My arms felt so heavy I felt it was an effort to lift them. This was identical to the way I felt after my first vaccine on 3/11/21. However, I developed an additional symptom of pain in my right knee. It became swollen, warm, and there was pain on the backside of the knee as well as the kneecap area. This became so severe that I could not put any weight on this knee on Sunday afternoon ( 3 full days after shot). I know I didn''t injure the knee because on Saturday we drove and I was just in the car for 2 days. It hurt to extend the knee but felt better to elevate it. A knee brace was not helpful. IThe pain woke me up almost every night for the last 3 weeks. Ibuprofen barely helps. For a couple of days last week, the knee would crack with every step. This was painful, so I limited walking. I have been staying off of this leg ever since and am waiting for an appointment with an orthopedist on the 20th. It is just starting to feel better. It is still warm but yesterday I finally saw the kneecap peek out. I am not certain this is from the vaccine and i can only find one journal article describing a "flare up" of rheumatoid arthritis following the shot. I do not have arthritis (yet) so the article was not helpful. I have had bursitis in my hip twice but not for over 10 years. I am getting an Xray tomorrow.


VAERS ID: 1289028 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-16
Onset:2021-05-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Nivolumab (Immunotherapy for Melanoma - 5th month) Multi-vitamin
Current Illness:
Preexisting Conditions: Hypothyroidism caused by Immunotherapy treatment. First diagnosed Dec 2020
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheadedness / slight dizziness persistent throughout much of the day. Began approximately 2 weeks after first injection. Hasn''t yet subsided. Has not worsened either


VAERS ID: 1289096 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Fatigue, Headache, Lymphadenopathy, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Other Medications: Lexapro 20 mg Lexothyroxine 88mcg
Current Illness: None
Preexisting Conditions: Depression, anxiety
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm extremely sore, full body aches, joint pain all over, nausea, fever, headache, extreme fatigue. Lasting 36 plus hours. Left arm still extremely painful 3 days later. About 24 hours later I also noticed a very sore left armpit and sort of lump., probably a lymph node..still sore 48 plus hours later.


VAERS ID: 1289118 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Headache, Heart rate irregular, Pyrexia, Urine analysis normal, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Asthma.
Allergies: None.
Diagnostic Lab Data: All tests came back normal. Lung x-rays, EKG''s, blood and urine and everything was normal.
CDC Split Type:

Write-up: He got the vaccine, at first for about 6 hours he felt okay, did not feel anything, felt fine. Then that day he started getting a headache, feverish, took Tylenol and felt better. The next day he noticed his heart rate would not go down, it will not go down below 100, will shoot up to 130. He went to the ER and at one point went to 150. They prescribed him some medicine to lower his blood pressure and he has been taking that and it has not been helping. He also went to his doctor and told him that it was probably anxiety, and his heart rate will still not go down. He has not had any other reactions other than this and he''s scared.


VAERS ID: 1289194 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-27
Onset:2021-05-02
   Days after vaccination:64
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute myocardial infarction, Coronary artery disease
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for STEMI due to multi vessel CAD


VAERS ID: 1289204 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-03
Onset:2021-05-02
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Cardiac failure congestive, Condition aggravated, Pneumonia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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:
CDC Split Type:

Write-up: COVID+ Pneumonia and CHF exacerbation


VAERS ID: 1289285 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-28
Onset:2021-05-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral atrophy, Cerebral infarction, Cerebral small vessel ischaemic disease, Cerebrovascular accident, Magnetic resonance imaging head abnormal, Vascular occlusion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and 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: None
Current Illness: Diabetes
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: MRI 4/2/21
CDC Split Type:

Write-up: Stroke. Foci of acute/subacute infarction in the right putamen/corona radiata, right insular cortex, right superior frontal gyrus, and left occipital periventricular white matter. No evidence of hemorrhagic transformation or petechial microhemorrhage. No associated mass effect, midline shift, or herniation. Generalized cerebral volume loss on a background of chronic microvascular ischemic changes.


VAERS ID: 1289314 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Burning sensation, Chills, Dyspnoea, Gait disturbance, Hyperhidrosis, Migraine, Neck pain, Pain, Pain in extremity, Pyrexia, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: After 12 hrs severe chills teeth chattering could not get warm aches burning in leg arms head hot arm severe pain 2 days felt like I had surgery on arm severe back neck pain, breathing had to use inhalers 5 times in the night I could not move or walk could not sleep all night migrain head ache same on both shots thought I was not going to make it this time, kept praying all night had severe sweats when 104 fever broke that lasted 8 hours


VAERS ID: 1289494 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-23
Onset:2021-05-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Pulmonary embolism, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: melatonin, omega3 fatty acids
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Lower extremity doppler and CT Angiogram of the chest showing multiple blood clots.
CDC Split Type:

Write-up: Patient was hospitalized with lower extremity DVT and bilateral pulmonary emboli. He is young and previously very healthy and has no risk factors for venous thromboembolism.


VAERS ID: 1289517 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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

Write-up: Patient falsified DOB when registering for vaccination,. Guardian,consented to the vaccination. Department of Health verified with statistical records that the patients which made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1289847 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Fever, Headache, Body aches, Fatigue


VAERS ID: 1289954 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-27
Onset:2021-05-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest discomfort, Cough, Dizziness, Dyspnoea, Ear pain, Electrocardiogram normal, Nausea, Oxygen saturation decreased, Pulmonary congestion, SARS-CoV-2 test negative
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Respiratory failure (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: albuterol, guaifenesin, levothyroxine, sumatriptan
Current Illness:
Preexisting Conditions: Hyperlipidemia; mild intermittent asthma with acute exacerbation; migraine without aura and with status migrainosus, not intractable;
Allergies: biaxin, soy
Diagnostic Lab Data: Covid antigen test 5/5 negative, ECG normal
CDC Split Type:

Write-up: Pt reported ear pain, nausea, and dizziness, along with chest congestion ("inflamed" per pt) feeling and cough. Pt stated she "feels like her wind pipe is inflamed." Feels SOB, eases some when she coughs. Pt was instructed to go to the ED on 5/5, where she was found to have oxygen saturations in the mid 80% range. Pt was diagnosed with "pneumonia due to COVID-19 virus" and admitted.


VAERS ID: 1289966 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Vaccine positive rechallenge
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First dose
Other Medications: Evekeo, 10 mg Vitamin B complex, Vitamin D3
Current Illness: First dose of Pfizer was gotten on Apr 9, 2021, severe nose bleeding happened on second day, then happened on different days randomly. The nose bleeding occurred again after receiving second dose on May 1
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe nose bleeding happened after both doses vaccination and randomly continued


VAERS ID: 1289980 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 5R8731 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Electroencephalogram, Seizure, Urine analysis
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flexeril 10 MG as needed Melatonin 5 mg as needed
Current Illness:
Preexisting Conditions: hyperflexibility disorder, muscle spasms from an injury
Allergies: sulphur, latex
Diagnostic Lab Data: EEG, bloodwork, urinalysis
CDC Split Type:

Write-up: non-epileptic seizures onset 3 days after 2nd dose. 5-6 hours in the ER, trying to figure out if it was epilepsy, then 48 hours of observation once valium was given to calm the muscle spasms down. 5-5-2021 patient still has seizures less frequently, but they still occur. patient did not have these prior to 2nd dose of vaccine.


VAERS ID: 1289987 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Dyspnoea, Electrocardiogram abnormal, Fatigue, Headache, Myocarditis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec, Vitamin D and Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin 7 at Hospital and now 19.43 Awaiting cardiac MRI
CDC Split Type:

Write-up: The day following the vaccine c/o tactile fever, headache, stomach ache and fatigue (on 5/2). On 5/4 developed chest pain and shortness or breath. Reported to the ER with concerning EKG and troponin levels and therefore transferred where he has been admitted for myocarditis.


VAERS ID: 1290102 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Angiogram pulmonary normal, Blood iron decreased, Blood thyroid stimulating hormone normal, Brain natriuretic peptide normal, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Echocardiogram, Electrocardiogram abnormal, Full blood count normal, Hypoaesthesia, Lipids decreased, Lymphadenopathy, Magnetic resonance imaging heart, Myocarditis, Nausea, Paraesthesia, Pericardial effusion, Red blood cell sedimentation rate normal, Right ventricular ejection fraction decreased, SARS-CoV-2 test negative, Transferrin saturation decreased, Troponin I increased, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: men''s multivitamin, "acid suppression"
Current Illness: none reported
Preexisting Conditions: hypertension- never treated with medication
Allergies: yeast, gluten
Diagnostic Lab Data: In the ED: CBC, TSH, BNP, and electrolytes: within normal ranges Troponin I: 1.21, 2.81 ng/mL High-sensitivity troponin I: 3443.8 ng/L SARS-CoV-2 RNA: negative ECG: Sinus rhythm, borderline left axis deviation Chest x-ray: no acute cardiopulmonary process On admission: Iron: 33 ug/dL Iron % saturation: 11% ESR: 11 mm/hr CRP: mg/L Lipid panel: HDL 33 mg/dL, rest within normal ranges TTE: grossly preserved LV function, no wall abnormalities CTA chest: No acute pulmonary embolism, left axillary adenopathy could be related to recent COVID vaccination Cardiac MR: Findings consistent with punctate focal myocarditis although cannot exclude an embolic light etiology; normal left ventricular size and systolic function, LVEF 62%; normal right ventricular size and systolic function, RVEF 52% ; evidence of pericardial effusion.
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: three days after vaccination patient presents to emergency department (ED) reporting sudden onset severe chest pain, emesis, numbness/tingling of arms, and nausea. Initial vital signs: pulse = 90 beats per minute, blood pressure 142/100 mmHg, oxygen saturation 95% on room air. Patient admitted for management of NSTEMI: differential includes myocarditis.


VAERS ID: 1290307 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood urine present, Incontinence, Intra-abdominal pressure increased, Micturition urgency, Pain, Thrombosis, Urine analysis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: omeprazole, propranolol, oxcarbazepine, azenapine, doxycycline, bupropioon, bupirone, topiramate, benztropine, testosterone
Current Illness: tested postive for covid on April 9th 2021 tested negative for covid on April 30th 2021
Preexisting Conditions: Bipolar I, Arnold Chiari Malformation, Gerd, Parkinsonism
Allergies: sulpha
Diagnostic Lab Data: Urinalysis. Doctor discovered that bleeding and clots were due to vaccination.
CDC Split Type:

Write-up: I woke up at approximately 9:30 AM the morning of Sunday May 2nd 2021 the day after getting my covid vaccine and had to rush to the bathroom. I proceeded to have blood and blood clots come out my urethra very urgently. I had abdominal pain and pressure. I proceeded to need to urinate blood and blood clots for approximately 4 hours urgently. I could not go far from the bathroom without having to return quickly to the toilet. I wet myself several times. The clots stopped coming around 1:30 PM. I proceeded to have to have no control over urination urge and could not leave the bathroom. Around approximately 2:00 PM I could leave the bathroom without fear of wetting myself. I continued to have a small amount of a mix of blood and normal urine passing for another hour or so. I have a picture of the blood and clots that came out of my urethra. I continue to have dull pain and pressure in my abdomen.


VAERS ID: 1290330 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Blood pressure decreased, Body temperature increased, Confusional state, Cyanosis, Headache, Sepsis
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad)

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

Write-up: Patient was given the Moderna covid 19 vaccine on the morning of Saturday May 1. His wife came in to the pharmacy today (5/5/21) and explained his adverse reaction which started Sunday evening. His symptoms included high temp (102.8), confusion, blue lips, bad headache, decrease in blood pressure He was taken by his wife to local hospital then transferred to another facility. His wife said he had sepsis. He was treated and released from hospital. She said he still had a headache.


VAERS ID: 1290335 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-29
Onset:2021-05-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram abdomen, Dyspnoea, Fatigue, Nausea, Pain, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Centrum vitamin 500 mg. Turmeric
Current Illness: None
Preexisting Conditions: None
Allergies: Sensitive to codeine in pain-medication
Diagnostic Lab Data: CT Abdomen and Pelvis with intravenous contrast. 05/03/2021. 00:45
CDC Split Type:

Write-up: Day 2 & 3 after my vaccine, I had fatigue & shortness of breath. On Day 3 , it began with a little nausea that became worse, along with shortness of breath. Ado I also pain followed, & no medication or rest with a heating pad helped. After 7 hrs. I sought treatment at Emergency Room. After several tests, and an abdominal cat-scan, it revealed that I had appendicitis, and would need an appendectomy soon. At 5:30 am I received an appendectomy from . I stayed overnight in the hospital.


VAERS ID: 1291526 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

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

Write-up: Severe arm pain. Throbbing. Muscle spasms at injection site. Numbness and tingling in fingers on affected side. No treatment appears to improve conditions.


VAERS ID: 1291600 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207421A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Contusion, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRILOSEC [OMEPRAZOLE]; FLONASE [FLUTICASONE PROPIONATE]; SYMBICORT; CARDIZEM [DILTIAZEM]; IBUPROFEN
Current Illness: Abstains from alcohol; Asthma; Blood pressure high; Smoker (A couple cigarettes per day)
Preexisting Conditions: Medical History/Concurrent Conditions: Pancreas cyst (A couple of months ago); Comments: The patient had no known allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210507330

Write-up: STOMACH HURTS; BODY ACHES; HIVES ON BOTH LEGS; BRUISE ON LEFT WRIST; This spontaneous report received from a patient concerned a 66 year old female. The patient''s weight was 107 pounds, and height was 61 inches. The patient''s past medical history included cyst on pancreas, and concurrent conditions included severe asthma, high blood pressure, non alcoholic, and smoker, and other pre-existing medical conditions included the patient had no known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207421A, and batch number: 207421A expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. Concomitant medications included fluticasone propionate for drug used for unknown indication, omeprazole for drug used for unknown indication, ibuprofen for pain, budesonide/formoterol fumarate for severe asthma, and diltiazem. On 02-MAY-2021, the subject experienced bruise on left wrist. On 03-MAY-2021, the subject experienced hives on both legs. On 04-MAY-2021, the subject experienced stomach hurts. On 04-MAY-2021, the subject experienced body aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hives on both legs, bruise on left wrist, stomach hurts, and body aches. This report was non-serious.


VAERS ID: 1291808 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Decreased appetite, Feeling cold, Nausea, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient is having fever, chills, nausea, and feeling of coldness now 5 days after receiving the second dose of Pfizer vaccine. He has been unable to eat much food and unable to sleep much due to feeling cold and having a fever.


VAERS ID: 1291814 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Flushing, Hyperhidrosis, Injection site erythema, Lethargy, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Redness at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Weakness-Severe, Additional Details: Patient stated it felt just like having COVID allover again for 48 hours (patient tested positive on December 7th).


VAERS ID: 1291894 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-25
Onset:2021-05-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymphoedema
SMQs:, Retroperitoneal fibrosis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: 1 week post vaccination, patient developed 1 left anterior cervical lymph node edema. Patient went to the ER because she was concerned and was seen/treated there and was told this can be a side effect of the vaccination and was told to come to the place she obtained the vaccine and report it. Patient reported event to urgent care clinic on 5/5/21. Reports the lymph node edema has decreased and she is in no pain, has no concerns or issues currently.


VAERS ID: 1291907 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-29
Onset:2021-05-02
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tacrolimus ointment, amlactin cream
Current Illness: none
Preexisting Conditions: hemorrhoids, cherry angioma, actinic keratoses, acne rosacea, seborrheic keratotis, osteopenia, melanocytic nevi, neoplasm of skin, xerosis cutis, basal cell carcinoma skin, hyperlipidemia, bursitis shoulder
Allergies: adapalene - rash lexapro - mental status changes, constipation
Diagnostic Lab Data: 5/4/2021 COVID-19 PCR positive
CDC Split Type:

Write-up: Patient received COVID vaccines 1/29/2021 and 1/8/2021. On 5/2/2021 developed body aches, cough, headache, rhinorrhea, sore throat. Tested positive for COVID.


VAERS ID: 1291948 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Hunger, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site vesicles, Nausea
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: not hungry, then very hungry but nauseous-Medium, Systemic: Nausea-Medium, Additional Details: Patient arrived to store to show a blister/rash that appeared to be from the bandaid as it was not directly by the injection site. She had made an appointment for store for Janssen/J&J vaccine. After talking to the patient, she thought she signed up for Pfizer, which my store does not carry.


VAERS ID: 1292064 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-06
Onset:2021-05-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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: unknown
Current Illness: diabetes, migraines, cardiac
Preexisting Conditions: diabetes, migraines, cardiac
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient''s son called pharmacy on 5/4/21, stating patient had a stroke and is in hospice care now. un-sure if it is vaccine related or not however in light of johnson and johnson news we wanted to report this


VAERS ID: 1292274 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-08
Onset:2021-05-02
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heparin-induced thrombocytopenia test positive, Mental status changes, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ? insulin aspart U-100 (NovoLOG Flexpen U-100 Insulin) Insulin Pen Inject 0-10 Units subcutaneously 3 times daily (before meals). ? metFORMIN XR (Glucophage XR) 500 mg Tablet Sustained Release 24 hr Take 2 tablets by mouth daily. ? acetam
Current Illness: obesity, hypertension, OSA intolerant of BPAP, RLS, CAD with recent CABGx3 4/15/21 and post-op atrial fibrillation started on amiodarone and eliquis
Preexisting Conditions: obesity, hypertension, OSA, RLS, CAD
Allergies: NKDA
Diagnostic Lab Data: Heparin-induced platelet antibody positive (5/3/21)
CDC Split Type:

Write-up: Altered Mental Status and Acute Thrombocytopenia


VAERS ID: 1292654 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0451321A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chills, Echocardiogram, Electrocardiogram, Heart rate abnormal, Nausea, Pain, Pericarditis, Pyrexia, Troponin, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram 10 mg / daily
Current Illness: None
Preexisting Conditions: Hemochromatosis
Allergies: None
Diagnostic Lab Data: EKG at 12:00 AM on May 3rd; Chest X-Ray at around 2:00 AM on May 3rd; Echocardiogram at 1:00 PM on May 3rd; Bloodwork to ensure Troponin levels falling.
CDC Split Type:

Write-up: I arrived at the ER complaining of tightness in the chest and nausea, having vomited an hour earlier. At triage, the EKG showed a weak heart rate. This was two and a half days after receiving the shot, and having had other symptoms including fever, chills, general soreness, all of which may have obscured an earlier onset of tightness in the chest. Eventually I was diagnosed with acute Pericarditis and prescribed Colchicine by mouth 2 times a day. I''ll need to have follow-ups with a cardiologist, continue taking the Colchicine, and go easy on the heart for 6 weeks to 3 months. Long-term, it''s expected I''ll make a full recovery.


VAERS ID: 1292761 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-0580-15 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Immediate post-injection reaction, Malaise, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram, 20 mg once, nightly
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Jenssen COVID-19 Vaccine EUA My left arm was quite sore immediately after the shot. I started to feel achy after I went to bed at 10 p.m. The next morning I felt very nauseous for the whole day and my arm was very sore. I had no appetite and just felt icky; like I might be coming down with something. I tried some ginger ale on Wednesday since Pepto Bismol wasn''t helping and felt some relief instantly. This nausea and icky feeling continued every day until today, Thursday, May 6th.


VAERS ID: 1292799 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

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

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

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1292860 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

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

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

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1292870 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

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

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

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1293094 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

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

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

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1293124 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Diluent Administered Instead of Vaccine


VAERS ID: 1293226 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-19
Onset:2021-05-02
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sumatriptan
Diagnostic Lab Data: SARS-COV-2, QUALITATIVE, NAA (COVID-19), KP LAB Component 2 d ago Comments SP SOURCE NP/OP CORONAVIR PAN 2019-NCOV, NAA, QL COVID DETECTED Abnormal See comments Specimen Collected: 05/04/21 10:07 AM
CDC Split Type:

Write-up: Patient was diagnosed and tested Positive for Covid 19 despite receiving vaccine on 3/19/2021 SARS-COV-2, QUALITATIVE, NAA (COVID-19), KP LAB Component 2 d ago Comments SP SOURCE NP/OP CORONAVIR PAN 2019-NCOV, NAA, QL COVID DETECTED Abnormal See comments Specimen Collected: 05/04/21 10:07 AM


VAERS ID: 1294489 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0120A / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Immediate post-injection reaction, Tinnitus
SMQs:, Hearing impairment (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mild tinnitus
Allergies:
Diagnostic Lab Data: Spoke with my primary doctor and Will be making appointment with ENT Doctor
CDC Split Type:

Write-up: Noticed my Tinnitus was worse during March after first vaccine (but didn?t even think of it as a side effect b/c I never heard of that side effect) and then realized when I got the 2nd vaccine and my tinnitus got immediately worse right after the vaccine and it was then I realized it was a side effect of the vaccine that made my tinnitus worse.


VAERS ID: 1294496 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Full blood count abnormal, Heavy menstrual bleeding
SMQs:, Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (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: Aygestin, Chlortrimeton, propranolol, magnesium, iron, melatonin
Current Illness: None
Preexisting Conditions: I have fibroids, adenomyosis, and menorrhagia for which I take Aygestin (norethindrone) to control bleeding
Allergies: None
Diagnostic Lab Data: CBC test on May 5 to determine anemia level, I''m being treated with additional iron supplements
CDC Split Type:

Write-up: Heavy menstrual bleeding occurred about 12 hours after my vaccinne (at both first and second doses). My heavy bleeding consisted of emptying a 50 ml mentual cup every 1/2 hour to every hour for two-three days after onset. I became extremely amemic and could not get out of bed. Increasing my Aygestin dose to the maximum recommended dosage daily has stopped the excessive bleeding.


VAERS ID: 1294528 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-23
Onset:2021-05-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Dysgeusia, Pain in extremity
SMQs:, Taste and smell disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Covid long haul symptoms since February
Preexisting Conditions: None. Well, maybe Covid long haul counts as one
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sense of taste completely destroyed. Meat tastes like sulfur or metal. Rancid. It?s lasted for at least 5 days so far. Can?t eat meat because of it. Can?t taste the majority of vegetables. The only things that taste good/normal are sweets, because of course Aching pain in right calf/hamstring but not in left


VAERS ID: 1294775 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-01
Onset:2021-05-02
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Feeling abnormal, Hyperhidrosis, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (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: Shingrix shingles. Very similae symptoms but lasted one day. After my second dose
Other Medications: Blood pressure medication. Multy vitamin and viramin d
Current Illness: Healthy. I had my yearly phisical on 4/27/2021
Preexisting Conditions: No
Allergies: I had complications with my second dose of shingles vaccine.
Diagnostic Lab Data: None yet i didnt know how to go about this. I need help please. Its miserable!
CDC Split Type:

Write-up: Chills body swats extreme aches and fatgue loss of appetite brain fog. Sleeplessness Started 05/02 and continues today. It hasnt gotten better


VAERS ID: 1294820 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-02
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Body temperature, Fatigue, Myalgia, Pruritus, Pyrexia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Social drinker approximately 3 or 4 days per month.); Non-smoker
Preexisting Conditions: Comments: Patient had no known allergies, no drug abuse or illicit drug usage and no pertinent medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: Body temperature; Result Unstructured Data: 37.4 to 37.8 C
CDC Split Type: USJNJFOC20210506533

Write-up: HIVES ON LEGS AND RIGHT ARM; PRURITIS; JOINT PAIN; GENERAL MUSCLES ACHES; FATIGUE; FEVER; This spontaneous report received from a patient concerned a 35 year old female. The patient''s weight was 62 kilograms, and height was 166 centimeters. The patient''s concurrent conditions included alcohol user, and non-smoker, and other pre-existing medical conditions included patient had no known allergies, no drug abuse or illicit drug usage and no pertinent medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 01-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-MAY-2021, treatment medications included: paracetamol. On 02-MAY-2021, the subject experienced pruritis. On 02-MAY-2021, the subject experienced joint pain. On 02-MAY-2021, the subject experienced general muscles aches. On 02-MAY-2021, the subject experienced fatigue. On 02-MAY-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 37.4 to 37.8 C. On 03-MAY-2021, treatment medications included: camphor/diphenhydramine hydrochloride/zinc oxide. On 03-MAY-2021 13:00, the subject experienced hives on legs and right arm. Additional treatment medications (dates unspecified) included: mometasone furoate, levocetirizine dihydrochloride, and loratadine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from joint pain, general muscles aches, fatigue, and fever on 02-MAY-2021, and had not recovered from pruritis, and hives on legs and right arm. This report was non-serious.


VAERS ID: 1295046 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

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

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

Write-up: Client verbalized feeling light headed after receiving the vaccine Client stated, "I passed out, but this is normal for me after receiving any shots or seeing blood." Client refused medical evaluation from Fire Rescue. Client was educated on the importance of a full evaluation by rescue. Client exit location at 12:20pm.


VAERS ID: 1295285 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site warmth, Lethargy
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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: Penicillin, early 20''s, itchy all over body rash
Other Medications: Vitamin D, iron, zinc, omega 3.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type: CVS9528

Write-up: Heat & soreness at injection site. Then muscle ache at the site. Heat disappeared overnight. 20 hrs later lethargy and headache. Continued muscle ache, but 12 hrs later feeling normal again. 24 hrs after that injection site area red/hot and redness in both armpits .. not itchy or problematic. Disappeared overnight. Arm muscle continued to be tender to the touch.


VAERS ID: 1295308 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-20
Onset:2021-05-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Allergies to morphine, penicillin, Jurgens lotion, mango and shell-fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Single hive that appeared at 1"x0.5" and irregular shape on upper left arm near to injection site. Despite regular dosing of 10mg Cetirizine and application of 1% Hydrocortisone cream grew over the next 3 days to a diameter of roughly 3"x2". Intense itching, swelling at the hive site and moderate heat from the hive. Resolved slowly over the next several days. 98% gone by day 7.


VAERS ID: 1295323 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram abnormal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: EKG with signs of pericarditis. Troponin 2.5 and 7 on repeat. All done on 5/2/2021
CDC Split Type:

Write-up: Two days after vaccine suddenly had sever central chest pain worse with lying flat. Ultimately EKG showed pericarditis. Troponins were done which showed significant elevations. Patient diagnosed with myopericaditis, likely 2/2 vaccine. No other illness whatsoever. Further diagnostic tests were ordered, patient unfortunately left AMA before further workup was completed.


VAERS ID: 1295373 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, Syringe issue
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: Per Vaccinator, , while attempting to administer vaccination, needle separated from syringe and vaccine sprayed out. Due to less than half of the vaccine being received (vaccinator and patient agreed that it seemed that very little if any of the dose was received), a replacement dose was administered.


VAERS ID: 1295508 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Feeling abnormal, Headache, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (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: Polycythemia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Foggy mentally. Slowed thought process. Dull headache. Back of head lower. Sides of head above ears. Seemed harder to focus mentally and visually. Aspirin works but symptoms still coming back after 4-6 hours when aspirin wears off.


VAERS ID: 1295686 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu shot, unknown kind, similar adverse event, several years ago
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Arm soreness, fever, chills, body aches, and headache. All occurred throughout the night and improved by the following morning.


VAERS ID: 1296035 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-05-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PCR COVID 19 test on 5/5/2021 at Pharmacy.
CDC Split Type:

Write-up: Tested PCR positive for COVID on 5/5/2021, Symptom onset 5/2/2021.


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