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From the 10/15/2021 release of VAERS data:

Found 800,916 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 188 out of 8,010

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VAERS ID: 1713374 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pharyngeal swelling, Rash, Rash papular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cyclobenzaprine, pantoprazole, Ibuprofren
Current Illness: none reported
Preexisting Conditions: Depression with anxiety, Chronic Pain, GERD, and history of iron deficiency
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt triaged by RN on 9/16/21 with oversight from Doctor for diffuse popular rash on abdomen, chest and back without shortness of breath and mild throat swelling - Benadryl 50 mg at night, Hydrocortisone Cream 1% twice a day for no more than 3 days after warm showers. Increase intake of water. Apply Bacitracin to any broken areas of skin from scratching. Follow up with provider on 9/20/21 scheduled. Pt advised to seek emergency LOC if rash worsens with any concurrent SOB, worsening swelling of face or throat. He agreed.


VAERS ID: 1713440 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-09-14
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Alopecia, Amylase abnormal, Anaemia, Blood immunoglobulin G, Blood thyroid stimulating hormone increased, Differential white blood cell count, Double stranded DNA antibody, Fatigue, Full blood count abnormal, Glycosylated haemoglobin, Hypothyroidism, Injection site pain, Lipase abnormal, Mean cell haemoglobin concentration decreased, Metabolic function test, Pancreatitis, SARS-CoV-2 antibody test
SMQs:, Acute pancreatitis (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Hypothyroidism (narrow), Hyperthyroidism (broad), 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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Vaccine 2012 - GBS
Other Medications:
Current Illness:
Preexisting Conditions: Lupus
Allergies:
Diagnostic Lab Data: 2/27/2021 - CMP, CBC, A1C ALL normal 5/11/2021 - CMP, CBC, A1C, Lipase, Amylase: Not normal (low MCHC, TSH 8) 7/5/2021 - CMP, CBC, other tests: Low MCHC, elevated TSH 8/22/2021 - CMP, CBC, A1C, DSDNA, IgG levels, COVID-19 Antibody test: TSH normal, low MCHC, antibody test showed high number of spike proteins.
CDC Split Type:

Write-up: 4/14 - Fatigue, extreme muscle pain at injection site; 4/24 - Pancreatitis, continued pain at injection site (steroids, low fat diet); 5/14 - Hair loss; 6/5 - TSH 8, Hypothyroidism, hair loss, anemia (125mcg Synthroid, iron supplementation); 9/5 - Hair loss (TSH normal, MCHC low, continued thyroid hormone and dietary supplementation); Present - Physicians do NOT recommend booster or further vaccination at present, will monitor CBC with Diff, CMP, and other labs for further treatment needs.


VAERS ID: 1713451 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / UNK RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / UNK LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH JO1JOBA / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Erythema, Extra dose administered, Paraesthesia, Paraesthesia oral, Rash, Swollen tongue, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: explained in previous page
Other Medications:
Current Illness: listed below
Preexisting Conditions: Hypertension Achalasia CHF CAD Renal Disease Kidney Stones Heart Attack Hernia
Allergies: Amoxicillin Bactrim Bystolic Ceftriaxone Doxycycline Effient Flagyl Iodine and Iodine contrast Levaquin Metoclopramide Morphine Nebicalol Nitrofurantoin Suffamethoxazole Tobramycin Vancomycin Can take with 75mg of IV Benadryl
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dose 1 my face and lips became tingly the back of my tongue swelled but sideways like it was in my teeth other then that nothing Dose 2 same as dose 1 but a bit more of my face then about 5 hours later my chest became red with bumps went to the ER received Benadryl went home Booster shot : my lips were tingly my tongue swelled the back of my throat felt itchy I could not swallow due to my Achalasia so they called a Rapid Response on me took me to the ER gave me IV Benadryl and Epranehrim got discharged after awhile and took Benadryl.


VAERS ID: 1713471 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-01
Onset:2021-09-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle spasms, Pain in extremity
SMQs:, Dystonia (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: Lexapro fluconazole montelukast
Current Illness: None
Preexisting Conditions: Good
Allergies: Erythromycin
Diagnostic Lab Data: Non yet
CDC Split Type:

Write-up: Shingle like pain from ankle through calf and thigh Severe. Began suddenly and unrelentingly. Leg cramp. No rash.


VAERS ID: 1713509 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

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

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

Write-up: Hives. One hive on day 1 then covered in hives from head to toes and still not resolved at time of filing report


VAERS ID: 1713519 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-04
Onset:2021-09-14
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Ear pain, Facial paralysis, Headache
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

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

Write-up: Symptoms of Bells Palsy. Facial paralysis on the left side of my face. Cannot smile on the side and some slight drooping. Mild pain behind my ear and a headache only in the left temple area. Odd mouth sensations as well.


VAERS ID: 1713533 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Decreased appetite, Dehydration, Diarrhoea, Dizziness, Dyspnoea, Ear pain, Fatigue, Feeling abnormal, Feeling of body temperature change, Headache, Hyperhidrosis, Movement disorder, Myalgia, Pyrexia, SARS-CoV-2 test, Visual impairment, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none reported
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: covid 19 test
CDC Split Type:

Write-up: Patient called pharmacy 9/14/21@9:30 am and stated that he just cooked eggs around 9:00 and about 20 minutes later he was having SOB. He could only take about 1/4 breath, vision was not normal, couldn''t move, went to ER. ER did not think this was related to shot though. However, Patient believes it is related to shot. The ER diagnosed him with dehydration and sent him home. Followed up with patient on 9/15/21 @7pm and he said that overnight has had fever from 101-102, hot and cold, sweats, joint pain, back pain, diarrhea, dizzy, tired, muscle aches, no appetite, throwing up, headache, ear pain, very foggy brain, lightheaded, his primary doctor made an appointment for him for 5 days, they require a negative covid test to be seen. I called Moderna also to report and was given a case # MOD21-143961, patient was not interested in calling the company to update them on his symptoms. Patient was ok with Moderna dose #1, just happened with #2.


VAERS ID: 1713547 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Lip exfoliation, Lip swelling, Myalgia, Presyncope, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None at time of vaccine Didn?t take any of my daily medications that day
Current Illness: No new illnesses one month prior
Preexisting Conditions: Bovine Arch Heart Abnormality Leaky heart valves Hypertension ? Crohns
Allergies: Cipro Amoxicillin
Diagnostic Lab Data: Went to Clinic negative Covid test 9/18 and Rx Zofran. Tyl for days Supplemental vitamin C
CDC Split Type:

Write-up: SOB, lips swollen and peeled, felt like I had swallowed acid. My heart rate has been in the 50?s for days (have photo on my pulse ox), fever and chills first 3 days with muscle aches fatigue and feeling like I want to pass out.


VAERS ID: 1713610 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Dehydration, Dysphagia, Ear discomfort, Feeling abnormal, Flank pain, Nasal congestion, Paranasal sinus discomfort, Rhinorrhoea, Swelling, Tongue blistering, Vertigo
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (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), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (narrow), Dehydration (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: similar but milder to Pfizer dose 1. Seizure to Tdap as child
Other Medications: Adderall 20mg qD, cyclobenzaprine 10mg TID PRN, escitalopram 20mg qD, fexofenadine 180mg qD, Probiotic, meloxicam 15mg qD PRN, propranolol 20mg qD
Current Illness:
Preexisting Conditions: Seasonal Allergies, BPPV, generalized anxiety disorder, major depression, spinal osteoarthritis, history of partial seizures
Allergies: Pertussis vaccine, sulfa, topiramate, Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ear fullness, blister on thongeue, nsal congestion and drainage, sinus pressure. + vertigo. L flank pain. Feels constantly dehytdrated. Taking ibuprofen and Tylenol. Everything feels really puffy. 1st COVID shot gave her some joint pain, malaise, vertigoe but was just exacerbation of the usual stuff. Hasn''t taken allergy meds the Last couple of days since feeling so misserable. Swallowing is difficult.


VAERS ID: 1713642 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Gait disturbance, Pain, Pain in extremity, Swelling, X-ray
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, D, Zinc, Probiotics
Current Illness: None
Preexisting Conditions: Lychon Planus
Allergies: None
Diagnostic Lab Data: X-rays were taken 10/16/21 awaiting results
CDC Split Type:

Write-up: Received shot on Friday with typical expected sore arm over the weekend. However, while making dinner on Tuesday, I started feeling pain in my left hip. This pain continued to increase up until I sat down for dinner when I had a shooting pain so sharp I let out an audible yelp. I have seen my PCM and a Physical Therapist. They have stated swelling in the area and ordered an x-ray. As of 4 days since onset of pain, I still have trouble walking due to pain with regular usage of naproxen.


VAERS ID: 1713672 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Painful respiration
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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: quercertin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Chest pain post 5th day of second shot - pain worse with deep breaths - started late afternoon, went on until I went to bed and resolved next day- Pain level of 4/10 - I did not seek medical attention


VAERS ID: 1713844 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint swelling, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Probiotics, birth control pill
Current Illness:
Preexisting Conditions: Henoch-Scholein Purpura
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pain and joint swelling, rash covering back, chest, arms, scalp, and neck


VAERS ID: 1713889 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Muscle spasms
SMQs:, Dystonia (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: No known allergies
Diagnostic Lab Data: None. These possible side effects aren''t seemingly at dangerous levels.
CDC Split Type:

Write-up: Muscle spasms in left triceps. They last from 2 to 5 minutes and have continued intermittently since onset. Increased muscle cramping. I exercise regularly and hydrate well. I am waking up with minor cramping that is unusual for me. Thighs, calves, biceps.


VAERS ID: 1713891 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-12
Onset:2021-09-14
   Days after vaccination:245
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 AR / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Ageusia, Deafness unilateral, Ear pain, Facial paralysis, Fall, Herpes zoster, Hypoaesthesia, Impaired work ability, Loss of consciousness, Magnetic resonance imaging head, Pain, Paraesthesia, Sensory loss, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nivolumab, Dexilant. Fish Oil. Multi Vitamin .Hydroxychoriquin. Prednisone. Clonazepam. Lisinopril
Current Illness: None
Preexisting Conditions: 12/08 RA. 12/17 Anal melanoma
Allergies: Sulfa, eggs, grass, mussels, birch and maple trees.
Diagnostic Lab Data: Brain MRI ordered by ENT to rule out tumor pressing on facial nerve.
CDC Split Type:

Write-up: Right ear pain started on 1/16/21. I was diagnosed with right sided facial nerve shingles on 1/20/21 at regular oncology appointment. 10/10 pain. I blacked out and drove off the road, fell down a flight of stairs. Rapid onset of pain. Infectious disease MD placed me on Valtex and Gabapentin. I missed 2 weeks of work. I am still on the Valtrex 9 months later and Infectious Disease feels that med will be needed at least until 1/22. I have lost some hearing in my right ear in addition to feeling/taste buds on the entire right side of my face. The vision deficit on the right side cleared after about a month. Right sided numbness, tingling, loss of sensation continue. Acute pain has subsided.


VAERS ID: 1713897 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Back pain, Diarrhoea, Headache, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Allergic to coconut
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Constant headache for the past five days. Nausea. Upset stomach (diahrrea) for the past five days straight. Unable to keep food in. Had severe fever for two days. Extreme lower back pain that lasted for two to three days.


VAERS ID: 1713928 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: Ultrasound, blood tests 9.14.2021
CDC Split Type:

Write-up: Started bleeding the morning of 9.14.2021 - miscarriage occurred. Approximately 5 weeks and 4 days pregnant. Due date 5.13.2022?


VAERS ID: 1713932 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Arthralgia, Back pain, Fatigue, Flank pain, Headache, Myalgia, Nausea, Neuralgia, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 40 mg Adderal 24hr release, spironolactone, birth control
Current Illness: None
Preexisting Conditions: None
Allergies: Toradol
Diagnostic Lab Data:
CDC Split Type:

Write-up: 72 hours immediately following injection: Headache, nausea, inability to stay awake, debilitating muscle pain, severe kidney/back/flank pain, heart/chest pain. Severe, sharp joint/nerve pain in both knees, left an cle, both elbows, and hips.


VAERS ID: 1714013 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 050E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, Pruritus, Rash erythematous, Skin warm
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: unknown
Current Illness: Yes, stated "immunocompromised" no other details about condition provided
Preexisting Conditions: stated "immunocompromised" on intake form with no other details provided but marked no to chronic conditions
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red circular rash, warm to touch, and patient reported pain and itching. I recommended a visit to urgent care or providers office to be evaluated. In the meantime, I told pt to use cold compress, benadryl, and tylenol.


VAERS ID: 1714047 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Chills, Coordination abnormal, Gait disturbance, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Body ache, fever, chills, impaired balance, difficulty walking , impaired coordination.


VAERS ID: 1714050 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Feeling abnormal, Memory impairment, Migraine, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: clustered migraine on one side of head, fogginess and forgetfulness, muscle aches, pressure similar to muscle ache or muscle sprain near chest area.


VAERS ID: 1714081 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH MLS-319813_R / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: 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: Omeprazole alaporozam
Current Illness:
Preexisting Conditions: Ulcerative colitis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache and fever


VAERS ID: 1714143 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.


VAERS ID: 1714155 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.


VAERS ID: 1714167 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax 150mg, Metformin 550mg, Trileptal 300mg
Current Illness: None
Preexisting Conditions: Epilepsy, anxiety disorder, Polycystic ovary syndrome
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.


VAERS ID: 1714176 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.


VAERS ID: 1714185 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Unknown  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.


VAERS ID: 1714197 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine 09/14/2021. No adverse reactions noted.


VAERS ID: 1714232 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-22
Onset:2021-09-14
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6200 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6207 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chest pain, Cough, Dyspnoea, Fatigue, Myalgia, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: fever, cough, SOB, loss of taste and smell, sore throat, congestion, chest pain, wheezing, (difficulty breathing), fatigue and muscle aches.


VAERS ID: 1714288 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-13
Onset:2021-09-14
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6206 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: pneumonia
Preexisting Conditions: hypertension
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: cough, SOB, pneumonia


VAERS ID: 1714306 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

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

Write-up: Started my menstrual cycle 6 days earlier. I started on the 14th, 24 hours after I received the vaccine. I normally start on the 20th of each month.


VAERS ID: 1714396 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site pain, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Pain at injection site- 4 days, headache -still going and blurry vision- still going


VAERS ID: 1714407 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Expired product administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: Vaccinated with expired vaccine of 14 days. No adverse reactions noted.


VAERS ID: 1714480 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 3 - / -

Administered by: School       Purchased by: ?
Symptoms: Abdominal distension, Anion gap, Anti-islet cell antibody, Asthenia, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium decreased, Blood sodium normal, Blood urea normal, Carbon dioxide decreased, Diarrhoea, Electrocardiogram normal, Extra dose administered, Fall, Haematocrit decreased, Haemoglobin decreased, Joint injury, Loss of consciousness, Metabolic function test normal, Nausea, Renal function test normal, Sinus rhythm, Syncope, Tibia fracture, Vomiting, X-ray limb abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Medication errors (narrow), Hypoglycaemia (broad), Hypokalaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin; Levetiracetam; Levothyroxine; Lisinopril; Metoprolol Succinate; Ondansetron; Pantoprazole; Sertraline
Current Illness: None
Preexisting Conditions: Bladder Cancer in remission Hypothyroidism, Hyperlipidemia, CVA, Seizure Disorder, Chronic anemia
Allergies: NKDA
Diagnostic Lab Data: Glucose 126; BUN 19; Creatine 0.9; Na 139; K 3.4; cL106; TCO2 21; Angap 17; ICA 1.21; HCT 33; Hb 11.2; EKG demonstrated Normal Sinus Rhythm without ectopy and no ischemic changes.
CDC Split Type:

Write-up: Patient received her vaccination on 914. Patient started developing her symptoms that evening including significant abdominal bloating along with diarrhea. Patient had persistent diarrhea the following day along with nausea and vomiting. When walking back from a bowel movement from the restroom the patient had a syncopal episode and was caught by her husband. She had a loss of consciousness for about 30 seconds. She resumed consciousness without complication she had no seizure like activity. She was able to return to her bed. She was evaluated. A basic metal panel was performed she had no evidence of dehydration and had normal renal function. We provided normal saline infusion and Zofran for nausea. Pt had and xray performed for her ankle as she twisted it when she collapsed. She was noted to have a distal tibia fracture. Patient is tolerating food and fluids at this time but still has persistent diarrhea and generalized weakness. She is will be evaluated and treated by orthopedics for her ankle fracture.


VAERS ID: 1714523 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Ear pain, Hyperhidrosis, Migraine, Nausea, Neck pain, Pulmonary congestion, Sinus disorder
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: clopidegrel, amalodipine, armour thyroid, carbamazapine, trazodone, hydroxizine, hydrochlorithyzide (HTZ), prozac, singulair, meloxicam, flexiril, aspirin, metformin
Current Illness: none
Preexisting Conditions: heart issues, hbp, high cholesterol, bipolar, thyroid dz, copd, chronic sinus issues, arthritis, back and neck pain
Allergies: morphine (no derivatives), actos, lisinopril, all cholesterol medication/shots
Diagnostic Lab Data: none
CDC Split Type:

Write-up: migraine headache, severe neck pain, nausea, sinus issues, ear pain, joint pain, chills, sweating . symptoms started on 9/14/2021 and are still ongoing with just sinus issues and chest congestion that just started. Worst of symptoms occurred for 5 days.


VAERS ID: 1714524 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-08-29
Onset:2021-09-14
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Capillary nail refill test abnormal, Cyanosis, Dyspnoea, Feeling cold, Flushing, Hyperhidrosis, Petechiae, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
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: Lisinopril
Current Illness: none
Preexisting Conditions: HTN
Allergies: poison oak
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Arrived home from work on 9/14/2021. Sat down. He had been chilled all day. Face was flushed he started to drip with sweat. Stated " I can''t breath". VS 114/78,89 T unreadable due to sweat. RR 22, Spo2 91% Room air. Red, peticial rash noted on chest and abdomen. He quickly became centrally cyanotic. Cap refill to fingers delayed. Lips dusky. Dr called. Medicated with Benadryl 50mg (chewed), Pepcid 20mg PO, Zyrtec 10mg, Prednisone 20mg PO. After about 10 minutes his fingers started to pink. Cap refill slowly improved. The central cyanosis didn''t resolve for about an hour. Prednisone taper obtained from pharmacy. An additional Prednisone 40mg PO given for a total of 60mg. After the additional 40mg given the rash resolved.


VAERS ID: 1714525 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

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

Write-up: Stiffness and soreness of shoulder


VAERS ID: 1714694 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Neck pain, Pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitaful, probiotics, Restasis, Zyrtec
Current Illness: Preeclampsia due to pregnancy. Had baby.
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 week after the shot, symptoms are worse with the pain in left arm & neck & back. Also have pain behind my left knee. Still experiencing radiating pain from the area where the shot was received. Been using heat/ice/tylonel.


VAERS ID: 1714939 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-09-11
Onset:2021-09-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Anticoagulant therapy, Cerebral arteriosclerosis, Hemiparesis, Vertebral artery occlusion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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: smokes cigarettes
Current Illness: none known
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: IMPRESSION: (CTA) 1. Occlusion or dissection of the right vertebral artery shortly after the origin with reconstitution of the cervical V3 segment at the C2 level. There is asymmetric diminished attenuation of the V4 segment. 2. Left posterior cerebral artery P1 segment moderate atherosclerotic disease.
CDC Split Type:

Write-up: Patient woke with left hemiparesis went to the emergency room at Hospital. patient received IV heparin with resolution of hemiparesis. Medical records show that patient was advised hospitalization is stroke center declined and left against medical advice. On my evaluation on September 20, 2021 there have been no recurrence of symptoms


VAERS ID: 1714961 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-09-14
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Gastrointestinal haemorrhage, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), 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? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine (NORVASC) 5 MG tablet aspirin (HALFPRIN) 81 MG tablet hydrochlorothiazide (HYDRODIURIL) 12.5 MG tablet levothyroxine (SYNTHROID) 137 MCG tablet metoprolol tartrate (LOPRESSOR) 50 MG tablet Pantoprazole (PROTONIX) 40 MG EC tablet
Current Illness: None known
Preexisting Conditions: Hypothyroidism, heart disease, hypertension, hyperlipidemia
Allergies: None known
Diagnostic Lab Data: COVID-19 test positive on 9/14/2021.
CDC Split Type:

Write-up: Patient presented to the emergency department on 9/7/2021 with a GI bleed and was admitted for further management. Upon screening for discharge to a skilled nurse facility, was found to be COVID-19 positive. Patient experience no symptoms associated with COVID-19 infection during admission. Patient was discharged on 9/17/2021 to a skilled nursing facility.


VAERS ID: 1715016 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Nodule, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu: Breathing Difficulties
Other Medications: None
Current Illness: Breathing Difficulties
Preexisting Conditions: Breathing Difficulties Blood clot in leg
Allergies: Penicillin Benadryl Strawberries Oatmeal
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen arm with a knot at the bottom part from elbow on up. Later on the entire left side became swollen from neck to foot. Stayed that way until 09/19/2021.


VAERS ID: 1715100 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-14
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F2RA / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D and B gummies
Current Illness: None
Preexisting Conditions: Pin hole in heart at birth and occasional heart palpitations
Allergies: Opioid based medications
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart palpitations continued throughout the night and stopped sometime after falling asleep that night then started again the following day around 4 in the afternoon and did not stop until after going to bed that night and again on the next day started around 5 or 6 in the evening and did not stop until going to bed that night. Heart palpitations have been very sporadic since lasting5-30 minutes


VAERS ID: 1715107 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Cellulitis, Contusion, Dyspnoea, Erythema, Fatigue, Nasopharyngitis, Paranasal sinus discomfort, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: covid-19 infection on Aug 4, 2021
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling, redness, and heated area on upper arm On Friday, 09/17 developed cellulitis of upper arm. Pain in armpit (both) and appearance of dark bruises. On Sun 9/19 extreme fatigue and shortness of breath On Mon 9/20 cold symptoms, sinus pressure, and fatigue


VAERS ID: 1715177 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Discomfort, Fatigue, Headache, Hypoaesthesia, Myalgia, Nausea, Pain in extremity, Pyrexia, Seizure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra (levetiracetam) 1000 mg Lamotrigina 100 mg Levotiroxina 125 mcg Acetaminof?n 500 mg Salbutamol inhalator
Current Illness:
Preexisting Conditions: Epilepsy, Thyroid, Asthma
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started getting pain in the arm type 10 at night I already had body discomfort, fever, nausea, muscle pain, chills, strong pain in the head, by the second day the pains became stronger and I was very tired and discomfort. By the third day, Saturday, I had a convulsion attach where I could only stay home since I am in the country as a tourist. On the sixth day, I woke up with a headache and nausea, seventh day, Monday September 20, I still have a lot of head pain and nausea with certain numbness in the body as if I were going to start a convulsive attack but they go away and then they come back. Honestly it scares me a lot to be like this.


VAERS ID: 1715184 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Dizziness, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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: Tylenol, ascorbic acid, DM/PE/ acteaminophen/doxylamine, echinacea, multivitamin, zinc
Current Illness: None
Preexisting Conditions: none
Allergies: Banana, Penicillin
Diagnostic Lab Data: Random glucose.
CDC Split Type:

Write-up: Within 15 minutes of receiving vaccination patient experienced low BP and dizziness. Patient was then transferred over to the ER for further management of symptoms. In the ER patient received normal saline bolus with normalization of BPs.


VAERS ID: 1715219 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-09-14
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Covid positive worker


VAERS ID: 1715221 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-11
Onset:2021-09-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: Concussion
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dose 2 was given at day 14 ( 1st dose 08/28 2nd 09/11). Patient parent called on 09/14 to report the error and stated patient was hospitalized with concussion like symptoms. Unclear weather vaccine error resulted in symptoms or if patient had some other concurrent medical problem.


VAERS ID: 1715243 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-09-14
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Cough, Decreased appetite, Dyspnoea, Nausea, Pain, Positive airway pressure therapy, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: obesity, COPD, hypertension, hyperlipidemia, CAD status post AICD placement, chronic CHF likely systolic, AAA, lumbar spinal stenosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 79 y.o. male who presents with on 9/14 to an outlying facility with complaints of generalized body aches, nausea, loss of appetite, progressive dyspnea, cough dry nonproductive. Symptom onset was 9/9/2021, date of positive test is 9/14/2021. Fully vaccinated in March. He was started on COVID supplement, IV Decadron, baricitinib and remdesivir with minimal improvement of respiratory status. His oxygen requirement increased and he was placed on BiPAP. He developed new onset A. fib with RVR, started on Cardizem drip. He was transferred to a higher level of care on 9/19/2021.


VAERS ID: 1715290 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Condition aggravated, Dizziness, Dyspnoea, Electrocardiogram abnormal, Migraine, Tachycardia, X-ray
SMQs:, Anaphylactic reaction (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 (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Endometriosis, interstitial cystitis, chronic migraines
Allergies: None.
Diagnostic Lab Data: Unsure what blood tests they did, X-ray, EKG.
CDC Split Type:

Write-up: Day after injection around 8:09pm, I suddenly started having chest pain, tachycardia of 130-160?s, shortness of breath, onset of a migraine, and lightheadedness. I had to be transported by ambulance to the local ER after not seeing any improvement in my condition. I was given 4 baby aspirin, 1 sublingual nitroglycerin, and oxygen. On the EKG they took, I kept showing clear signs of tachycardia. The biggest issue is that I?ve had a TIA (mini stroke) due to the oral contraceptive I was taking when I was 16. At the hospital, they just monitored me and gave me fluids before sending me home. This was about three hours after the onset of symptoms. I still have lingering chest pain that comes and goes. I?ve never had this type of reaction before other than when I was 16.


VAERS ID: 1715356 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-12
Onset:2021-09-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Headache, Lymphadenitis, Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, Quetiopine ER, Hydroxychloriquine, Levothyroxine, Rosuvastin, vitamin D, Trazodone.
Current Illness: No
Preexisting Conditions: I have fibromyalgia and connective tissue disorder and I''ve been in a flair up for over a month
Allergies: Iodine, indoor and outdoor allergies
Diagnostic Lab Data: Friday 9/17 Covid 19- negative Negative for Stretp I''ve never had the flu so no test No fever
CDC Split Type:

Write-up: After receiving the Pfizer vaccine on Sunday 9/12 I had a headache for two days. Tues 9/14 I felt my throat hurt a little but I thought it was my allergies. By Wednesday 9/15 my right side glands were swollen. I was unable to get an appointment with my Dr or City MD. By Friday I was unable to swallow. My lymphnodes were so swollen when I swallowed it was like knives in my throat. I went to City MD where they diagnosed me with lymhonitis. I had a rapid covid test and negative for strep plus no fever. They prescribed antibiotics. Later on that Friday I was able to get an appointment with my Dr who agreed that my symptoms was a reaction to the vaccine and it was common but at that time I felt so horrible. I slept the rest of the weekend. Today Monday 9/20 I feel 80% better. My glands still hurt and my neck is tender.


VAERS ID: 1715398 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Chest discomfort, Dyspnoea, Electrocardiogram, Fatigue, Feeling abnormal, Headache
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (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: HepB vaccine 1998, respiratory distress/ illness and eczema
Other Medications: Flonase, flovent
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Zyrtec, environmental allergies
Diagnostic Lab Data: Intake, EKG & blood pressure monitor
CDC Split Type:

Write-up: Heart fluttering, tightness in chest, mild shortness of breath, major headache, fatigue, significant brain fog lasting over 6 days


VAERS ID: 1715416 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / IM

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

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

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Chills-Mild, Systemic: Fever-Mild, Systemic: moderate arm soreness-Mild


VAERS ID: 1715418 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (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: Tamsulosin, Proscar, ASA, Atorvastatin, Allopurinol, Lisinopril, HCTZ, Tramadol
Current Illness: None
Preexisting Conditions: Hyperlipidemia, HTN, Prediabetes, osteoarthritis, Gout, Obesity, BPH, Stage 3 CKD
Allergies: Zocor, Percocet
Diagnostic Lab Data: None, Pt. was not evaluated following this event until 9/20/2021 and symptoms have resolved at this time.
CDC Split Type:

Write-up: Patient reports he received injection around 12:30pm on 9/14/21 then went home and felt dizzy. He states he checked his blood pressure and it was 70/40. He states he believes that he may have passed out for a few minutes. Patient states symptoms resolved later that day with no treatment. No ongoing concerns or symptoms.


VAERS ID: 1715574 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-11
Onset:2021-09-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia
SMQs:, Peripheral neuropathy (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Patient states she has an unknown nervous system disorder
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states that she is having a shooting nerve type pain in her right leg and right arm. She said it started a few days after receiving the vaccine.


VAERS ID: 1715617 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / UNK - / IM
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Dizziness, Extra dose administered, Fall, Head injury, Mobility decreased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), 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: MYCOPHENOLATE 250MG CAPS, SIROLIMUS 1 MG, PREDNISONE 5MG, AND OTHERS NOT KNOWN BY PHARMACY
Current Illness:
Preexisting Conditions: HISTORY OF KIDNEY TRANSPLANT
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient called the pharmacy to report a bad reaction from an injection last week. Last Monday he had both the flu ad seasonal flu vaccine and his 3rd dose of Moderna Covid-19 vaccine as he is a transplant patient. He stated the following morning he got dizzy and sat down in a chair. Then fell out of the chair hitting his head but was ok from that. When he went to get up he could not move his arms and legs to roll over. He called for his wife and laid there for a while until he could work his way up to a stool and eventually a chair. He was extremely weak in his arms and could not even hold his upper body up. After about 18 hours and calling his doctor, he started to feel better. He called today a week later to report the effect. No history of bad reaction like this from previous vaccinations


VAERS ID: 1715633 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-15
Onset:2021-09-14
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 RA / IM

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

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

Write-up: Patient had a positive covid test on 9/14/2021


VAERS ID: 1715634 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-19
Onset:2021-09-14
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Laboratory test abnormal, SARS-CoV-2 test positive, Thrombotic microangiopathy
SMQs:, Embolic and thrombotic events, arterial (narrow), Renovascular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/14/2021- SARS CoV-2 RNA, TMA Detected
CDC Split Type:

Write-up: Tested positive for COVID on 9/14, was admitted to the hospital on 9/17/21


VAERS ID: 1715650 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 2 RA / SYR

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

Write-up: My period came the day after I got the second Covid vaccine which was 2 weeks early.


VAERS ID: 1715706 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078F21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Influenza like illness, Pain, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: peripheral neuropathy
Allergies: Sulfur
Diagnostic Lab Data:
CDC Split Type:

Write-up: about 12 hours after the shot i was very achy and threw up once, I felt like I had the flu. I had a small fever and was very cold. A couple of days after that I developed a rash starting in the middle of my neck and went around my chest on one side.


VAERS ID: 1715780 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-05
Onset:2021-09-14
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progestin oral birth control pills
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I got tested at a state testing site on 9/15, received positive result on 9/17.
CDC Split Type:

Write-up: I developed a cough on 9/14 after being exposed to an individual on 9/10 and 9/12 who tested positive for covid on 9/13. I then developed congestion, loss of taste and smell, headache, and fatigue. I tested positive for covid on 9/15 via PCR test.


VAERS ID: 1715785 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-04
Onset:2021-09-14
   Days after vaccination:102
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucosamine Chondroitin cyclobenzaprine 10mg HS PRN for spasms gabapentin 60mg TID levothyroxine 150mcg daily multivitamin naproxen PRN for pain omeprazole 20mg PRN for pain Aspercreme 10% topical
Current Illness: None documented
Preexisting Conditions: Hypothyroidism, Scoliosis, Radiculopathy,
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1715825 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood glucose decreased, Blood test, Chest X-ray, Chest pain, Dizziness, Fatigue, Heart rate abnormal, Migraine, Muscle twitching, Nausea, Pain, Pain in extremity, Pyrexia, Syncope, Ultrasound scan, Urine analysis, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, ClonazePam, Seroquil, Woman''s Daily Multi-Gummy
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: chest x-ray, urine specimen, blood work, ultrasound of internal organs; All in the ED on 09/16/2021
CDC Split Type:

Write-up: severe migraine, light headedness, fever, nausea, vomiting, extreme fatigue, arm soreness, twitching fingers in hand of arm Vaccine given, low blood sugar, chest pains through into the back, abnormal heart rate, fainting


VAERS ID: 1715902 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperaesthesia, Injected limb mobility decreased, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (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: omeprazole
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Pain at injection site. Sensitive to touch and movement of arm. Pain occurred sometime after midnight 9-14 and lasted until night of 9-16. Administered 600 mg ibuprofen each night.


VAERS ID: 1716368 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Dizziness, Fatigue, Headache, Influenza like illness, Injection site swelling, Injection site warmth, Limb mass, Mobility decreased, Myalgia, Nausea, Pain, Pain in extremity, Pain of skin, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (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: Zoloft Kenelog antihistamine shot given a week prior
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Significant swelling began around 5 am the day after my shot. Not just around the injection area, but around my whole upper arm. About 5 inches in diameter. The injection site was warm to the touch for about 3-4 days after. Pain in both my muscle and on the skin surface lasted for about a week after the shot. I could not easily move, touch or use my left arm the day after. My shot arm had a very noticeable lump for a few days. Flu-like symptoms began exactly at the 24 hour mark after the vaccine shot. Body ache all over (especially in my lower back and down my legs) paired with nausea, dizziness and fatigue lasted until I went to bed that night (9/14). When I woke up the next day most the symptoms were gone. I have had a sporadic headache ever since the shot, however.


VAERS ID: 1716558 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-12
Onset:2021-09-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Diarrhoea, Influenza like illness, Mouth swelling, Peripheral swelling, Pharyngeal swelling, Pyrexia, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (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? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: berinert iv , icatibant, cinryze
Current Illness: none
Preexisting Conditions: C1- Esterase Inhibitor Deficiency ( Hereditary Angio Edema)
Allergies: iibuprofen , hydrocodine
Diagnostic Lab Data: HAE protocol, Hereditary angio edema medications to stop and reverse swelling in all locations.
CDC Split Type:

Write-up: First woke with flu like symptoms, with small fever, next day woke up with left foot swollen, abdomen swollen, vomiting and diarrhea, inside of mouth swollen, throat swollen.


VAERS ID: 1716583 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-12
Onset:2021-09-14
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 024M20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Haemorrhagic stroke, Hemiplegia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pt still being treated
CDC Split Type:

Write-up: Pt suffered an nontramatic hemorrhagic right side stroke - Pt currently suffering left hemiplegia. Pt extremely healthy with no underlining comorbidities to contribute to this condition.


VAERS ID: 1716771 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-11
Onset:2021-09-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Pityriasis rosea, Rash, Rash erythematous, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control, Lutera. Cetirizine. Daily multivitamin.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No formal tests were completed. A diagnosis was given based on the appearance of the rash on my body.
CDC Split Type:

Write-up: Began to notice a small rash developing on the trunk of my body in Monday. There were a few larger red patches and a few small red bumps. Tuesday the small red bumps began to spread more and continued to each day. By Saturday, my entire chest, stomach, and back was covered in the itchy rash and it was spreading up my neck, down my legs and arms, and onto my forehead. My back has most of the larger red spots and the small red spots are everywhere. The rash is very itchy. I then made an appointment and was diagnosed with Pityriasis Rosea on Sunday.


VAERS ID: 1716786 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac discomfort, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Haven''t consulted medical at the moment
CDC Split Type:

Write-up: Prolong headache and heart discomfort (after more than a week from the vaccination date).


VAERS ID: 1716902 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Pregnancy test negative
SMQs:, Fertility disorders (broad)

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

Write-up: Missed menstrual cycle-was supposed to begin cycle 9/14/21. It is now 9/21/21 and still have not started cycle. Took 3 different pregnancy tests- all negative. My cycle is regular and occurs ever 5 weeks. I have never skipped a monthly cycle.


VAERS ID: 1716936 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B,C,D Probiotics Zinc Magnesium Fish oils CoQ10
Current Illness: None
Preexisting Conditions: None
Allergies: Penecillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have never skipped/missed s period or been more than 2 days late . I am now a week late with my period.


VAERS ID: 1717875 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-09-14
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Hypoaesthesia, Nausea, Panic attack, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Brain injury (When the patient was younger); Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210936210

Write-up: DIZZY; FELT TO GET A PANIC ATTACK (HYPERVENTILATE, TIGHTNESS OF CHEST, SHORTNESS OF BREATH); FINGERS STARTED TO GET NUMB (FEELING BECAME WORSE THEN BETTER AND NOT CONSTANT); VOMITING/ THREW UP; NAUSEOUS; FELT WEIRD (FEELING BECAME WORSE THEN BETTER AND NOT CONSTANT); This spontaneous report received from a patient concerned a 27 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: brain injury, and other pre-existing medical conditions included: The patient had no known allergies. 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 14-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-SEP-2021, the patient experienced felt weird (feeling became worse then better and not constant). On 14-SEP-2021, the patient experienced nauseous. On 17-SEP-2021, the patient experienced dizzy. On 17-SEP-2021, the patient experienced felt to get a panic attack (hyperventilate, tightness of chest, shortness of breath). On 17-SEP-2021, the patient experienced fingers started to get numb (feeling became worse then better and not constant). On 17-SEP-2021, the patient experienced vomiting/ threw up. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from nauseous, dizzy, vomiting/ threw up, fingers started to get numb (feeling became worse then better and not constant), felt weird (feeling became worse then better and not constant), and felt to get a panic attack (hyperventilate, tightness of chest, shortness of breath). This report was non-serious.


VAERS ID: 1718350 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise, Speech disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101206975

Write-up: Feels sick; She cant even talk right; This is a spontaneous report from a contactable consumer or other non-HCP (patient herself). A 35-year-old female patient received second dose of BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EW0177) via an unspecified route of administration in left arm on 13Sep2021 at around 10:30 - 11:00 as dose 2, single (at the age of 35-years-old) for COVID-19 immunization. Patient medical history (including any illness at time of vaccination) was reported as none. Vaccine was not administered at military facility. The patient was not diagnosed with COVID-19, prior to vaccination. Since the vaccination, the patient had not been tested for COVID-19. There were no concomitant medications. The patient did not receive any other vaccines within four weeks prior to the vaccination. Historical vaccine included first dose of BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number- FC3180) via an unspecified route of administration in left arm on 23Aug2021 15:00 as dose 1, single for COVID-19 immunization and experienced change in her menstrual cycle as it was longer and heavy than normal. On 13Sep2021 she took her second shot for Covid and was tell the person that helped when she got her second shot, that after the first shot she experienced a changed in her menstrual cycle. After the first vaccine it came early. She went to the bathroom and was like there it is. Then it was 1.5 days with no blood. After that, it came really strong and heavy, lasting for another 6 days. So it was longer and heavy than normal, from the first signs of blood it was 9 days total instead of the 4-5 days it normally lasts. Her normal period was 4-5 days and started low with a small amount in the first day, then on the second and third day was heavy, then the last days was just a small portion of blood. She was also very regular it comes every 27-28 days. She marked her calendar as it started on 30Aug2021 but it was the 28Aug2021 when she had the first sign and nothing until the 30Aug2021, she did not have accidents anymore, she was too regular. This time there was no sign and she was surprised. The patient experienced feels sick, she could not even talk right, she woke up today feeling that way on 14Sep2021. The adverse events did not result in emergency room or physician office visit. She felt fine yesterday. The outcome of the event was unknown. Follow-Up (16Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1718374 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Lymphadenopathy, Off label use
SMQs:, Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Immunocompromised
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101218829

Write-up: bottom half of arm pit that his lymph node was swollen about the size of a fist; he received his third Pfizer BioNtech covid 19 vaccine on 14SEP2021 due to be immunocompromised; he received his third Pfizer BioNtech covid 19 vaccine on 14SEP2021 due to be immunocompromised; This is a spontaneous report from a contactable consumer or other non hcp (Patient). A 44-years-old male patient received third dose of bnt162b2 (BNT162B2, PFIZER-BIOTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Right on 14Sep2021 as single dose for covid-19 immunization. Medical history included immunocompromised from an unknown date and unknown if ongoing. The patient concomitant medications were not reported. Historical vaccine included first and second dose of BNT162B2 for covid-19 immunization. It was reported that patient received his third Pfizer BioNtech covid 19 vaccine on 14Sep2021 due to be immunocompromised. patient reports that last night he noticed that underneath his right arm between the pectoral and bottom half of arm pit that his lymph node was swollen about the size of a fist. patient also reports that it is rather large and noticeable. This is the same arm he received the vaccine in. Wondering if this is a normal side effect. The outcome for the event was reported as unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1718386 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Middle insomnia, Nausea, Restless legs syndrome, Sensory loss
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; TYLENOL; TURMERIC [CURCUMA LONGA]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breast cancer (Breast cancer survivor); Chronic back pain; Sulfonamide allergy (Known allergies: sulfa drugs)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101224182

Write-up: Awakened from normal sleep by something similar to restless leg syndrome (which "I" don''t have) accompanied by pain all over body; Awakened from normal sleep by something similar to restless leg syndrome (which "I" don''t have) accompanied by pain all over body; Couldn''t find any position that "I" could stay in for more than a few seconds. "I" couldn''t tolerate the pressure of the bed on any part of body; Felt acute pain in the rib area of back on both sides; Mild nausea; This is a spontaneous report from a contactable consumer, the patient. A 75-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration in the right arm on 14Sep2021 at 10:15 (at the age of 75-years-old) as a single dose for COVID-19 immunisation. Medical history included breast cancer survivor, chronic back pain, and allergy to sulfa drugs. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications included acetylsalicylic acid (ASPIRIN), paracetamol (TYLENOL), and curcuma longa (TURMERIC), unspecified vitamins and minerals; all taken for unknown indications from unknown dates and unknown if ongoing. The patient previously received hydrochlorothiazide (HCTZ) on an unknown date for unknown indication and experienced drug allergy. On 14Sep2021, the patient experienced mild nausea, which the patient had since getting the shot. On 16Sep2021 at 00:00, the patient was awakened from normal sleep by something similar to restless leg syndrome (which the patient did not have) accompanied by pain all over the body, the patient could not find any position that the patient could stay in for more than a few seconds. The patient could not tolerate the pressure of the bed on any part of the body and the patient felt acute pain in the rib area of the back, on both sides. The patient tried walking in place, back, stretching exercises, etc but nothing worked. The patient finally tried autogenic relaxation focused on the brain, the patient''s brain was calm and was able to fall asleep. The patient estimated that this lasted about 30 minutes. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event nausea. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events awakened from normal sleep by something similar to restless leg syndrome (which the patient did not have) accompanied by pain all over body, could not find any position that could stay in for more than a few seconds could not tolerate the pressure of the bed on any part of body, felt acute pain in the rib area of back on both sides, and mild nausea was unknown at the time of this report.


VAERS ID: 1718749 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

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

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

Write-up: Shoulder pain similar to impingement that''s worsened over time. Pain is now constant.


VAERS ID: 1718777 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-09-14
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood culture negative, COVID-19, COVID-19 pneumonia, Computerised tomogram thorax abnormal, Deep vein thrombosis, Legionella test, Lung opacity, Metabolic function test, Musculoskeletal chest pain, Peripheral swelling, Pulmonary mass, SARS-CoV-2 test positive, Swelling, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pneumonia due to COVID-19 virus U07.1 -COVID-19 PCR positive. Neg urine Legionella. -CT chest PE on 9/16 no PE, bilateral patchy opacities w/ pulmonary nodules, concern for metastases. -LLE venous doppler on 9/14 showed an occlusive LLE DVT. -On Dexamethasone, Remdesivir, Cefepime + Azithromycin. PLAN: -Continue steroids -continue on Remdesivir based on O2 requirements -daily CMP on the Remdesivir -if O2 requirements continue to increase, will add Baricitinib (Olumiant). -OK with above antibiotics -Following the blood cx : NGTD
CDC Split Type:

Write-up: Patient is a 76 years old male who only speaks a foreign language. Patient lives in a private house and is able to do activities of daily living. His family member for/cousins who take care of him on a daily basis speak our language. Patient has no other immediate family. Patient was recently diagnosed to have cancer most likely in the form of gastric cancer and is undergoing radiation and chemotherapy as an outpatient. Patient usually follows with cancer centers and apparently was recently diagnosed to deep vein thrombosis of the left lower extremity. Worth mentioning is the patient is status post amputation of the right lower extremity. His left lower extremity was noted to be swollen and was diagnosed to have DVT and was started on Eliquis as an outpatient by his cancer doctors however he continued to have worsening symptomatology with increasing swelling and rib pain for which reason he was sent to the hospital by his cancer centers and is recommended admission. He denies any fevers or chills. Denies any palpitations. Denies any chest pains. He denies any relieving or aggravating factors otherwise. He has no radiation of pain either.


VAERS ID: 1718865 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-04
Onset:2021-09-14
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / UNK - / -

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

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

Write-up: Onset 09/14/21 and tested Covid +


VAERS ID: 1718950 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site pain, Ultrasound Doppler, Ultrasound Doppler normal, Vessel perforation
SMQs:, Extravasation events (injections, infusions and implants) (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: Unknown
Current Illness: Denies long-term health conditions
Preexisting Conditions: Denies.
Allergies: None reported.
Diagnostic Lab Data: 9/15/21 Left upper expremity venous doppler ultrasound
CDC Split Type:

Write-up: Client reports around 11:00pm of the day he received the vaccine he developed a "blood clot" at the left AC area. He called Health Department on 9/15/21 at 10:22am to report the incident. He had tried to call his doctor that morning and did not get in touch with them. Health Department staff encouraged him to go to the urgent care. Client went to facility on 9/15/21. A left upper extremity venous doppler ultrasound was performed and the impression was "No deep vein thrombus in the left upper extremity." Client reports they told him it must have been a burst blood vessel. He denies pain or swelling of the mentioned site. His deltoid is sore at the vaccine injection site.


VAERS ID: 1718969 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-14
Onset:2021-09-14
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ENG6208 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock, Burning sensation, Dyspnoea, Erythema, Fatigue, Unresponsive to stimuli, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None.
Preexisting Conditions: None
Allergies: Penicillin, statins, codeine, Teriparatide, Alendroni c acid, beer, red wine extract
Diagnostic Lab Data: Check with my doctor.
CDC Split Type:

Write-up: Shortly after receiving second shit I broke out with hives on the inside of my lower left arm,. I had a burning/light redness to my face and stomach., this lasted for about four hours and then subsided. The following day spine a fever to 103.3 and unresponsive. The following days I became fatigued and experiencing shortness of breath.. symptoms continue to date. In July was seen at Urgent Care, PCP and twice in the ER. I experienced a horrific outbreak with hives, , went into anaphylactic shock . I had the hives for fourteen straight days. ( have pictures of this). I was seen by allergist. Was informed by docking the presence of my boyfriend that the shot elevated my immune system.. I came into contact with alcohol which resulted in the hives. I am now on an inhaler .


VAERS ID: 1718984 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Fatigue, Headache, Hyperaesthesia teeth, Migraine, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: severe body ache, muscle ache, elevated temp. 37.6C, headache. Second day - right side migraine, severe sensitivity on the right side of the head and face, toothache ( all teeth) on the right side of the face, fatigue.


VAERS ID: 1719044 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ear pain, Headache, Hyperhidrosis, Musculoskeletal stiffness, Neck pain
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penacillian
Diagnostic Lab Data: None, I do not have Healthcare insurance. This is a major reason I was not wanting to get the vaccine.
CDC Split Type:

Write-up: Major sweating, major headaches, stiff neck pain and ear pain (right ear only). Still experiencing symptoms.


VAERS ID: 1719095 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-20
Onset:2021-09-14
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Fatigue, Headache, Infusion, Ocular discomfort, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xeljanz; hydroxychloroquine; vit C; zinc; D3; calcium; Armor thyroid
Current Illness: No
Preexisting Conditions: RA; Hypothyroidism
Allergies: Codeine; Demerol
Diagnostic Lab Data: COVID-19-positive
CDC Split Type: vsafe

Write-up: I had no AE to the vaccine, but early in the morning on 9/14 I developed a scratchy, dry cough which went to pressure on the eyes and a very bad headache. I developed chills and a fever. Lost of taste and smell and congestion. I also developed extreme fatigue and was extremely tired. The next day on 9/15 I tested positive for COVID-19. Still to date I am still having the headaches, the couch is still here, my taste and smell comes and goes and I am still a little fatigued, but no fever. 9/18 I got a regenerome infusion which did make a lot of the congestion and mucus loosen up and I began to feel a little better.


VAERS ID: 1719209 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-09-14
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Blood lactate dehydrogenase increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Fatigue, Lung opacity, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, glimepiride, losartan-hydrochlorothiazide, metformin, rosuvastatin
Current Illness:
Preexisting Conditions: T2DM, hypertension, hyperlipidemia, obesity, osteoarthritis
Allergies: Percocet
Diagnostic Lab Data: 9/20/21 Rapid COVID-19: Positive CRP: 92.9 LD: 307 Chest X-ray: bilateral opacities concerning for pneumonia
CDC Split Type:

Write-up: Patient reports symptoms began on 9/14/21 with cough, shortness of breath, fatigue, and weakness. Also reports loss of taste and smell. Patient is receiving remdesivir and dexamethasone and is requiring O2 at 5 L/min via nasal cannula to maintain O2 sat $g90%. Patient is admitted to the hospital.


VAERS ID: 1719233 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Condition aggravated
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: about 3 hours after vaccine was administered i noticed lower back pain, over the course of about 3 days the pain became so severe that i had to go to the ER. I have had back pain in this location before but never so severe nor has it lasted as long as this did. i also noticed a very sharp pain in my abdomen. after consulting with my PCM he said he did not know why, but to come back in 2 weeks.


VAERS ID: 1719242 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

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

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

Write-up: patient came into a mobile clinic organized at college where he was asked by registration staff if he had received any other COVID-19 vaccine, client denied ever receiving any previous COVID vaccine. When Client preceded to RN for his vaccine RN also asked him if he had received any other COVID-19 vaccine, again patient denied ever receiving any other COVID vaccine prior to the dose being administered on the day of the mobile clinic at College. Client also marked no for ever receiving any other COVID-19 vaccine on his registration form. after gathering his information RN proceeded to administer Janssen vaccine to the patient. During the registry entry process he was found to have received a Pfizer vaccine (04/23/2021) prior to the Janssen vaccine given by Public Health according to registry. RN attempted to call Patient multiple times on 2 different occasions. When calling clients number on his registration form the person answering the phone would hang up on RN as soon as the RN identified himself.


VAERS ID: 1719283 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Diagnosed shingles on upper left back, prescribed Valtrex and as of 09/21 rash is still present, fatigue is still present.


VAERS ID: 1719309 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-09-14
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

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

Write-up: Positive for leg swelling Positive for shortness of breath


VAERS ID: 1719310 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 RA / IM

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

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

Write-up: Patient under the age of 18 when he received the Moderna COVID vaccine. Patient had no adverse side effects or symptoms.


VAERS ID: 1719324 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Herpes zoster, Paraesthesia, Rash vesicular
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Pt experienced vesicular rash with burning/tingling on right lower back and right thigh consistent with shingles 1 week after he received his first COVID vaccine. Symptoms are improving 1 week following the onset of the rash, but symptoms have not resolved yet.


VAERS ID: 1719412 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-14
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Sinus arrhythmia
SMQs:, Anaphylactic reaction (broad), Disorders of sinus node function (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG and Chest X ray. Diagnosed with sinus arrhythmia. Recommend for Exho Cardio graph and awaiting the results.
CDC Split Type:

Write-up: Had chest pain while exercising. Lack of being able to breathe.


VAERS ID: 1719511 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-20
Onset:2021-09-14
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Chest pain, Computerised tomogram, Cough, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C; Zinc; Collagen; Multi-Vitamin; Thera-M (for memory); occasionally I take CBD powder - protein drink with CBD in it.
Current Illness: no
Preexisting Conditions: UTIs; incontinence - bladder problems
Allergies: Adhesive tape
Diagnostic Lab Data: CAT scan and chest x-ray - and gave an IV with steroids. My husband went with me and he has COVID also.
CDC Split Type: vsafe

Write-up: I started having a cough and then I had worse headache that I''ve ever had. I had a little fever. I had body aches all over. I went to ER - They gave me an IV with steroids in it. They gave me a CAT scan and chest x-ray and they sent me home with cough medicine. I took little Perl cough drops, too. They gave me a breathing treatment at hospital and an inhaler. Reglan (METOCLOPRAMIDE) and tylenol and they gave me Decoron Phosphate and Iopamidol for cough at the hospital. I have been very tired and I''m still hurting. I have used the Albuterol inhaler a few times but not today. My chest is hurting and I still get headaches. COVID positive test at ER. I have noticed that I do feel like I am improving some - I''m not coughing as much - don''t have to take the cough drops as much - just in morning and at night.


VAERS ID: 1719546 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-07
Onset:2021-09-14
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Confusional state, Diarrhoea, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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

Write-up: diarrhea weakness confusion and difficulty walking


VAERS ID: 1719569 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 49LC5 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Loss of consciousness, Tremor
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), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin Bisoprolol Aspirin Folic Acid Niacin
Current Illness:
Preexisting Conditions: History of Myocarditis History of Heart Failure
Allergies: Nimesulide Ketoprofen
Diagnostic Lab Data: HR 60 Sat 99 BP 130/94. BP lowered to 118/64 after 15 minutes rest lying down.
CDC Split Type:

Write-up: Vaccine administering nurse observed 5-15 second loss of consciousness along with mild tremors all over body. Did not collapse on floor from chair; did not bite tongue or urinate.


VAERS ID: 1719594 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

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

Write-up: This patient came in requesting a Flu vaccine. She was administered a Pfizer Covid19 vaccine in error.


VAERS ID: 1719617 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asa, hctz, metformin, prenatal
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None all manageable symptoms at home
CDC Split Type:

Write-up: Severe body aches, temp reaching 102.8 for 24 hours regardless of alternating tyl and ibu.. next day was 101 temp and by Thursday I was afebrile except severe sharp pain up through my head. By Friday it was like nothing ever happened


VAERS ID: 1719626 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-09-10
Onset:2021-09-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE2587 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Epistaxis, Fatigue, Impaired work ability, Influenza like illness, Oropharyngeal pain, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: VIT D
Current Illness:
Preexisting Conditions:
Allergies: PENICILLIN
Diagnostic Lab Data: COVID test came back negative 9/20/2021
CDC Split Type:

Write-up: Patient states to have flu like symptoms. They did not start until 5 days after shot. Sore throat, coughing, extreme fatigue, blooding recent bloody nose(but he''s not sure if it''s from constant blowing). Patient went to an urgent care and was tested for COVID. Results came back 9/20/2021 negative. Patient states he is starting to feel improvement. He''s not going into work and just resting.


VAERS ID: 1719656 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / UNK OT / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Extra dose administered, Fatigue, Incorrect dose administered, Incorrect route of product administration, Interchange of vaccine products
SMQs:, Anaphylactic reaction (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mycophenalate Mofetil Fexofenadine Fluticasone Propionate Flovent Escitalopram Montelukast Sodium Famotidine Trazodone Sprintec ? Norgestimate and ethinyl estradiol tablets USP Vitron C Vitamin D Cromolyn Sodium Gabapentin Ajovy Propranol
Current Illness:
Preexisting Conditions: Migraine Mast cell activation syndrome Alpha tryptasemia
Allergies: Xolair Plaquenil Methotrexate Ketotifen Flu shot Zyflo
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the third dose of the Covid-19 vaccine in my doctor''s office due to having allergic reactions to the previous two doses of the vaccine (Moderna and J&J). She administered it in four doses in alternate arms, increasing the dose with the second two doses. After the first dose, I started having chest pain, shortness of breath, and a barking cough. We continued the full dosing under observation. She treated me with albuterol, budesonide, and ipratropium, which helped to some degree. I continued to have the symptoms for the rest of the day along with fatigue. A week out, I have still had some intermittent episodes of coughing and shortness of breath, but am otherwise feeling much better. This way of administering the vaccine caused less intense symptoms than I experienced with the previous two doses.


VAERS ID: 1719746 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Burning sensation, Dizziness, Dyspnoea, Feeling abnormal, Headache, Nausea, Oropharyngeal pain, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Flu vaccine (hive like issue), 35 years old
Other Medications: None
Current Illness: None
Preexisting Conditions: Depression, anxiety
Allergies: Pollen, Sudafed decongestant
Diagnostic Lab Data: I spoke to Dr on 9/16/21 he is convinced this is normal but hasn''t heard of all these reactions related to Janssen vaccine. States this vaccine is a cold virus that could be making me feel this way. I will be notifing him again.
CDC Split Type:

Write-up: Headache, nausea, dizzy/foggy feeling, unfocused, sore throat, upper back/shoulder pain and burning feeling, randome pinch like feeling in different places on body from legs, abdomen, arm, short of breath at different times all between 9/14/21 to present day


VAERS ID: 1719823 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-14
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0202*SRC ADUL / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, 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: Yes, on imatinib
Current Illness: leukemia
Preexisting Conditions: colon cancer s/p colectomy; has active leukemia and undergoing chemo
Allergies: NKDA
Diagnostic Lab Data: pending
CDC Split Type:

Write-up: b/l LE pain and weakness with tingling


VAERS ID: 1720037 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, Urticaria, Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling
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: Amiloride
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site of the vaccine began to swell, turned red and severe itch 9 days after vaccination. Tonight, 9/22 at 7:35 PM, severe redness, itch and welts developed spontaneously on booth knees/thighs.


VAERS ID: 1720045 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site pain, Insomnia, Neck pain, Tinnitus
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Arthritis (broad), Noninfectious diarrhoea (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: Melatonin; Quercetin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus slowly got worse over the first few days. By night four, it caused severe insomnia. Other side effects include: sore arm at injection site; sore neck opposite side of injection site; diarrhea (day 3); fatigue.


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