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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 203 out of 8,010

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VAERS ID: 1715386 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-03
Onset:2021-09-12
   Days after vaccination:193
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: Blood test, Dyspnoea, Pulmonary embolism, Vena cava filter insertion
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALPRAZolam 0.25 mg tablet TAKE 1 TABLET 3 TIMES A DAY AS NEEDED ANXIETY codeine 10 mg-guaifenesin 100 mg/5 mL oral liquid Take 10 mL by oral route. dexAMETHasone 2 mg tablet See Instructions, taper as follows: 4mg (2 tabs) po TID x 2
Current Illness: acute headache balanced autosomal translocation cerebral hemorrhage cortical hemorrhage expressive dysphasia history of craniotomy malignant melanoma malignant melanoma of skin uofm mass lesion of brain oligomenorrhea polycystic ovary syndrome secondary malignant neoplasm of brain tetrahydrofolate methyltransferase deficiency heterozygote
Preexisting Conditions: None
Allergies: Penicillin--rash
Diagnostic Lab Data: Blood work and IVC Filter placement
CDC Split Type:

Write-up: ** I DO NOT HAVE Lot number or expiry date of Vaccine--we were not the issuing facility --this should be available to you under the CDC reporting sheet that those who vaccinate fill out and send to CDC. Pt. began having SOB on 9/12 and was admitted to hospital on 9/14 with Multiple Subsegmental Pulmonary Emboli


VAERS ID: 1715389 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-02
Onset:2021-09-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Laboratory test
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: Cyanocobalamin 1000mcg (once daily) Levothyroxine NA 50mcg (once daily) Baby Aspirin 81mg (once daily) Metformin 1000mg (twice daily) Glipizide 10mg (twice daily) Losartan 50mg (once half tablet once a day)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Various test performed
CDC Split Type:

Write-up: Blood pressure reached 238/121. He went into the emergency room for testing. At the time of release blood pressure dropped down to 197/100.


VAERS ID: 1715427 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Resuscitation, Ultrasound scan abnormal, Unresponsive to stimuli, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sertaraline
Current Illness: None
Preexisting Conditions: Depression
Allergies: Medical tape PCN Azithromycin Clindamycin Tapentadol
Diagnostic Lab Data: Abnormal EKG and U/S,
CDC Split Type:

Write-up: Employee apparently tolerated second Pfizer vaccination but was found unresponsive and in V-fib at home four days later. Was revived and transferred to hospital for care.


VAERS ID: 1715436 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-27
Onset:2021-09-12
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft; Tematazan; Ometrazole; Simbastatin; Plavix; Baby Aspirin.
Current Illness: no.
Preexisting Conditions: no.
Allergies: no.
Diagnostic Lab Data: 1 1/2 day stay at the hospital after the stroke.
CDC Split Type:

Write-up: Patient reported that on 09/12 (3weeks after the vaccine) she had a stroke.


VAERS ID: 1715469 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram, Fibrin D dimer normal, Full blood count normal, Metabolic function test, Pericarditis, Troponin
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 20 mg QD Buspirone 15 mg BID
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Troponin <6 D-dimer: negative CBC and CMP WNL Echocardiogram Cardiologist follow up
CDC Split Type:

Write-up: Chest pain, shortness of breath. Treatment consistent with pericarditis; NSAIDS; Ibuprofen 800 q8; prednisone 500 qd x 5 days


VAERS ID: 1715473 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 FA2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient contacted pharmacy the day after receiving immunization stating he could not move his arm. Patient contacted physician''s office on the following Monday. By that time and after us contacting patient his pain and immobility had gotten much better and his physician was informed.


VAERS ID: 1715504 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2020-12-30
Onset:2021-09-12
   Days after vaccination:256
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Computerised tomogram abdomen abnormal, Nausea, Ovarian vein thrombosis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Welbutrin, Synthroid
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: CT scan done while in ER with severe lower abdominal pain and nausea
CDC Split Type:

Write-up: I had a Ovarian Vein Thrombosis


VAERS ID: 1715601 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Arthralgia, Disturbance in attention, Dizziness, Feeling abnormal, Headache, Hypersomnia, Impaired work ability, Loss of personal independence in daily activities, Mobility decreased, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit. D3 - 5000iu PM, 1 benadryl PM, Gabapentin 1600mg/2x day, Hydroxyzine HCL 50 mg PM, Bupropion XL 300mg AM, Oxcarbazepine 150mg 2/x day, Cephalexin 500mg 3x/day
Current Illness: paronychia in 2 toes
Preexisting Conditions: arthritis in back & neck trauma but no health issues
Allergies: none
Diagnostic Lab Data: none. I contacted nurse from my doctor office about my chest hurting. They said it was normal and I''d be fine after a day
CDC Split Type:

Write-up: About 9pm 9/11/21 my heart started hurting. Felt like how my heart feels when I have a panic attack but I wasn''t having a panic attack. 9/12/21 sore arm (expected), every muscle and joint in my body hurt, I was dizzy and could not think clearly, bad headache, low grade fever randomly. I tried morning routine and gave up and went to bed after two hours of pushing it. I slept all day 9/12 then couldn''t even get out of bed for dinner. My family brought me food in bed and I ate some then went back to bed until the next day. On Monday 9/13 I still felt really bad. I still had all the symptoms but the joint and muscle pain weren''t quite as severe as Sunday. I couldn''t mentally keep things straight to work. Normal simple task that would have taken 1 minute, took 10 and I even doubted what I was doing then. I laid down about 2 and rested the rest of the day. On Wednesday 9/14, all symptoms were gone except the headache. By noon the headache went away and I was back to normal.


VAERS ID: 1715641 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-09-12
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180508 / 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 contact unknown


VAERS ID: 1715892 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-12
   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 FF2587 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Atrial fibrillation, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Turmeric, magnesium
Current Illness: suspected pericarditis from first covid vaccination on August 20th 2021
Preexisting Conditions: None, full health.
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Pericarditis, AFib


VAERS ID: 1716115 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-13
Onset:2021-09-12
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Blood sodium decreased, COVID-19, Chest X-ray normal, Condition aggravated, Hypomagnesaemia, Hyponatraemia, Monoclonal antibody unconjugated therapy, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALPRAZolam (XANAX) 0.5 MG tablet amLODIPine (NORVASC) 5 MG tablet aspirin (ASPIRIN LOW DOSE) 81 MG tablet atenolol (TENORMIN) 50 MG tablet escitalopram (LEXAPRO) 5 MG tablet furosemide (LASIX) 20 MG tablet hydrALAZINE (APRESOLINE) 25 MG tab
Current Illness: Chronic renal insufficiency, stage 3 (moderate)
Preexisting Conditions: Respiratory DOE (dyspnea on exertion) Circulatory Hypertension, benign Digestive GERD (gastroesophageal reflux disease) Vitamin D deficiency Infectious/Inflammatory COVID-19 virus infection Nervous Chest pain, unspecified type Genitourinary Chronic renal insufficiency, stage 3 (moderate) Endocrine/Metabolic Hyperlipemia Hyponatremia Hypomagnesemia Other Osteopenia Generalized weakness
Allergies: No Active Allergies
Diagnostic Lab Data: DR CHEST SINGLE VIEW [244473878] Resulted: 09/12/21 1152 Order Status: Completed Updated: 09/12/21 1154 Narrative: EXAMINATION: Single View Chest EXAM DATE: 9/12/2021 11:35 AM TECHNIQUE: Portable upright AP view. INDICATION: URI symptoms COMPARISON: 3/29/2013 ENCOUNTER: Not applicable _________________________ FINDINGS: There is cut off of the right lateral angle. Chin dominant positioning limits detail at the thoracic inlet. The heart is normal in size. There is no pulmonary vascular congestion. No effusion, pneumothorax or acute pulmonary process is seen. _________________________ Impression: Negative for acute cardiopulmonary process. Procedure Component Value Ref Range Date/Time COVID-19 PCR, Rapid [244473868] (Abnormal) Collected: 09/12/21 1113 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 09/12/21 1128 COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. Covid 19 Result Comment See Comment Comment: COVID-19 results reported as "detected" means COVID-19 positive. Positive patients should self-isolate for 10 days or 24 hours after fever resolves and other symptoms are improving, whichever is longer: - Stay home except to get medical care and wear a facemask if you must leave - Separate yourself from other people in your home, known as home isolation - Cover your coughs and sneezes - Wash your hands often - Avoid sharing household items - Clean high-touch surfaces everyday - If you have a medical emergency and need to call 911, notify dispatch personnel that you may have COVID-19 and put on a facemask before emergency medical services arrive. If the result is "inconclusive" or "invalid" and you have not been contacted by a medical professional from us about your result or if you have questions about COVID-19, your symptoms, or need a return to work/school note, please contact your primary care provider (PCP).
CDC Split Type:

Write-up: Patient is a 92-year-old female who presented with weakness. The patient has a history of HTN, CKD 3, GERD. In the ER the patient was found to be COVID positive, she is fully vaccinated. She did not have any hypoxia. Her labs showed hyponatremia with sodium of 126, AKI and hypomagnesemia. The patient had a CXR which was negative. She was admitted for further management. The patient was agreeable to monoclonal antibody therapy and this was completed on 9/12. She was given some IVF and her renal function normalized. On the morning of discharge she was feeling much better. Her sodium level had improved. She worked with OT who recommended home with home health PT/OT and nursing. The patient''s daughter agreed to stay with her initially and make sure things were continuing to go well at home. Care management helped arrange home health care for the patient. The patient was advised to follow up with her PCP after discharge and discharged home in stable condition with her daughter.


VAERS ID: 1716323 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-09-12
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Aortic arteriosclerosis, Asthenia, Bacterial test positive, COVID-19, Cerebral small vessel ischaemic disease, Chest X-ray abnormal, Computerised tomogram abnormal, Computerised tomogram head abnormal, Condition aggravated, Cough, Culture urine positive, Dystrophic calcification, Fall, Fatigue, Haemorrhage intracranial, Head injury, Klebsiella test, Lung opacity, Osteoarthritis, SARS-CoV-2 test positive, Scoliosis, Spinal osteoarthritis, Urinary tract infection, White matter lesion
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alpha-Lipoic Acid 200 MG TABS apoaequorin (PREVAGEN) 10 MG CAPS capsule atenolol (TENORMIN) 25 MG tablet B Complex Vitamins (VITAMIN B COMPLEX) TABS celecoxib (CELEBREX) 200 MG capsule Cholecalciferol (VITAMIN D3) 2000 UNITS TABS gabapentin
Current Illness:
Preexisting Conditions: Respiratory Nasal congestion Circulatory HTN (hypertension) Digestive GERD (gastroesophageal reflux disease) Diarrhea Infectious/Inflammatory UTI (urinary tract infection) COVID-19 Nervous Neuropathy Post-polio syndrome Essential tremor Genitourinary CKD (chronic kidney disease) Endocrine/Metabolic Hyperlipidemia Other Osteoarthritis Risk and functional assessment Edema Weakness
Allergies: Lisinopril [Ace Inhibitors]Cough Hydrocodone-acetaminophenGI Upset LisinoprilCough Meperidine Morphine Propoxyphene N-apapGI Upset Statins
Diagnostic Lab Data: DR CHEST SINGLE VIEW [340531708] Resulted: 09/12/21 1556 Order Status: Completed Updated: 09/12/21 1558 Narrative: EXAMINATION: Single View Chest EXAM DATE: 9/12/2021 2:21 PM TECHNIQUE: Single view chest INDICATION: cough, covid+ COMPARISON: Chest radiograph 4/19/2017 ENCOUNTER: Not applicable _________________________ FINDINGS: Multiple overlying leads. Heart is normal in size for technique. Atherosclerotic calcification of the aorta. Perihilar opacities are similar to prior study likely related to chronic change. Hazy medial left upper lobe opacity. No large pleural effusion or pneumothorax. Degenerative changes of the glenohumeral joints, progressed from prior study. Ovoid hyperdensity projecting over the right scapula, stable and related to dystrophic calcification when compared to prior CT. Degenerative changes of the spine with upper thoracic dextroscoliosis. _________________________ Impression: Hazy left upper lobe opacity may relate to summation artifact or consolidation. CT HEAD WITHOUT IV CONTRAST [340531711] Resulted: 09/12/21 1508 Order Status: Completed Updated: 09/12/21 1510 Narrative: EXAMINATION: CT Head without Contrast EXAM DATE: 9/12/2021 2:20 PM TECHNIQUE: Multiple axial noncontrast images of the brain were obtained and reformatted according to the standard protocol. QPP DOCUMENTATION: At least one of the following dose reduction techniques was utilized: Iterative reconstruction, and/or Automatic Exposure Control, and/or mA/kV adjustment based on body size. INDICATION: fall, head injury COMPARISON: None HAND DOMINANCE: Unknown ENCOUNTER: Not applicable ____________________ FINDINGS: Intracranial hemorrhage: None. Infarct/Vascular: No CT evidence of acute infarct. A few small areas of hypoattenuation are noted within the periventricular and subcortical white matter, nonspecific but consistent with mild chronic small vessel ischemic changes. Intracranial Mass: No evidence of intracranial mass. CSF Spaces: The ventricles, sulci, and cisterns are normal. Calvarium and Scalp: Unremarkable. Paranasal Sinuses and Orbits: Visualized paranasal sinuses are clear. Orbits are unremarkable. ____________________ Impression: 1. No acute intracranial abnormality. Procedure Component Value Ref Range Date/Time Urine Culture [340531718] (Abnormal) Collected: 09/12/21 1616 Order Status: Completed Specimen: Urine, clean catch Updated: 09/14/21 0831 Bacterial culture, urine $g=100,000 CFU/mL Klebsiella pneumoniae Abnormal Susceptibility Klebsiella pneumoniae Not Specified Ampicillin Resistant Ampicillin/sulbactam Resistant Cefazolin Susceptible 1 Ceftriaxone Susceptible Ciprofloxacin Susceptible Gentamicin Susceptible Nitrofurantoin Susceptible Tobramycin Susceptible Trimethoprim/Sulfamethoxazole Susceptible 1 For uncomplicated UTIs due to E. coli, K. pneumoniae, and P. mirabilis, cefazolin predicts susceptibility to oral cephalosporins including cephalexin, cefpodoxime, cefprozil, cefdinir, and cefuroxime. Linear View COVID-19 PCR, Rapid [339140887] (Abnormal) Collected: 09/12/21 1258 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 09/12/21 1310 COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. Covid 19 Result Comment See Comment Comment: COVID-19 results reported as "detected" means COVID-19 positive. Positive patients should self-isolate for 10 days or 24 hours after fever resolves and other symptoms are improving, whichever is longer: - Stay home except to get medical care and wear a facemask if you must leave - Separate yourself from other people in your home, known as home isolation - Cover your coughs and sneezes - Wash your hands often - Avoid sharing household items - Clean high-touch surfaces everyday - If you have a medical emergency and need to call 911, notify dispatch personnel that you may have COVID-19 and put on a facemask before emergency medical services arrive. If the result is "inconclusive" or "invalid" and you have not been contacted by a medical professional from us about your result or if you have questions about COVID-19, your symptoms, or need a return to work/school note, please contact your primary care provider (PCP).
CDC Split Type:

Write-up: Patient is an 84-year-old female who presented for evaluation due to fatigue and weakness. The patient was found to be COVID positive in the ER (she is fully vaccinated). She was found to have a UTI as well. She did not have any leukocytosis or hypoxia. She was admitted for PT/OT evaluation. On the day of discharge, the patient was feeling much better. The patient continued to maintain her saturations on room air. She was given monoclonal antibodies for COVID and treated with keflex for her UTI. OT evaluated the patient and recommended that she have home health PT. Care management helped arrange for this. The patient was given a prescription for keflex at discharge to complete her course of antibiotics. She was encouraged to follow up with her PCP for continued monitoring after discharge


VAERS ID: 1716393 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 - / 2 RA / SYR

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

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

Write-up: Next day after 1st shot, right calf was sore for 1-2 days. Next day after 2nd shot, right calf was sore again. This did not go away but worsened until swollen and painful. An ultrasound about 6 days after the 2nd shot showed negative for DVT. Swelling & pain got much worse over the weekend. An emergency room visit on 9/20 found a DVT just under the right knee.


VAERS ID: 1716398 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-12
   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 FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Muscle tightness, Pain in extremity, Paraesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: On the morning of September 12, I began to notice pain in my left calf. It came and went over the following week feeling like a tight muscle and like it was about to cramp but didn''t . I also had some joint pain in my hip, knee, ankle, and throughout my foot. On September 20 at approximately 11:45AM , I began to experience numbness and "pins and needles" from my knee down and throughout my foot right to the tips of my toes. I reported to my PCP, went to Urgent Care. They referred me to local Hospital where I received an ultrasound for blood clots and told I had none and was released. As of 9:30PM on September 20th I am still experiencing the symptoms.


VAERS ID: 1716559 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Hypertension, Productive cough
SMQs:, Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest X-ray clear, given IV fluids to hydrate and Tylenol.
CDC Split Type:

Write-up: Chest pains and violent pflemy cough, tachycardia, high blood pressure.


VAERS ID: 1716581 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-12
   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 30130BA / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Echocardiogram normal, Electrocardiogram normal, Pain in extremity, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA but environmental allergies to dust, mold, and various seasonal allergies related to grass and trees.
Diagnostic Lab Data: Troponin level 9/12/21 (on presentation): 0.13 9/12/21 6 hrs later after presentation: 10.38 9/15/21 (on discharge home): 0.85 Imaging: EKG on presentation on 9/12/21: Normal sinus rhythm Echocardiogram on 9/13/21 and 9/15/21 normal
CDC Split Type:

Write-up: Patient presented with mid sternal chest pain and pressure and associated left arm/shoulder pain on 9/12/21 (2 days after receiving the second dose of the Pfizer COVID-19 vaccine). Troponin level was slightly elevated (0.13) on presentation but peaked at 10.38 6 hrs later. The patient was closely monitored without the need for intervention with medications. He was discharged home on 9/15/21 with resolution of his chest pain. Troponin level on discharge was 0.85.


VAERS ID: 1718152 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-01-01
Onset:2021-09-12
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Test Date: 20210912; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: had vaccine January and February, tested positive for covid; Diagnosed positive covid-19 yesterday; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Diagnosed positive covid-19 yesterday) and DRUG INEFFECTIVE (had vaccine January and February, tested positive for covid) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced COVID-19 (Diagnosed positive covid-19 yesterday). On an unknown date, the patient experienced DRUG INEFFECTIVE (had vaccine January and February, tested positive for covid). At the time of the report, COVID-19 (Diagnosed positive covid-19 yesterday) outcome was unknown and DRUG INEFFECTIVE (had vaccine January and February, tested positive for covid) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. Concomitant medication was not provided. Treatment information was not provided. Reporter did not allow further contact


VAERS ID: 1718365 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
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: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101217986

Write-up: Cardiac Arrest; This is a spontaneous report from a contactable consumer. A 21-years-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 10Sep2021 at age of 21-years-old as dose number unknown, single for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced cardiac arrest (hospitalization, disability, life threatening) on 12Sep2021. The event resulted in Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event), Disability or permanent damage. Therapeutic measures were taken as a result of cardiac arrest. The outcome of the event was not recovered. Prior to vaccination, it was unknown if the patient diagnosed with COVID-19. Since the vaccination, it was unknown if the patient been tested for COVID-19. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.


VAERS ID: 1718385 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-12
Onset:2021-09-12
   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 - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Cardiovascular disease, unspecified (Cardiovascular disease)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101223874

Write-up: Mild rash on left chest, same side as injection; This is a spontaneous report from a contactable consumer. A 52-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown) via an unspecified route of administration on 12Sep2021 (at the age of 52-years-old) as a single dose for COVID-19 immunisation. Medical history included cardiovascular disease. It was unknown if the patient had any known allergies. 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 vaccination. Concomitant medications were not reported. On 12Sep2021 the patient experienced mild rash on left chest, same side as injection. The events did not result in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken for the event mild rash. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event mild rash on left chest, same side as injection was resolving at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1718965 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 FF2587 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pruritus, Eye swelling, Headache, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Emergen-C, Elderberry gummies, Biotin, Women''s daily vitamins
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa
Diagnostic Lab Data: I have had no tests, I have handled the reactions via OTC Benadryl
CDC Split Type:

Write-up: Received shot in right arm on 9/11/21. On 9/12/21, my left eyelid and underneath my eye began swelling. I took Benadryl by capsule, and rested all day. The swelling was decreased somewhat by Monday, 9/13/21, but still present. Swelling abated by Tuesday, 9/14. However, I woke up with swelling in both eyelids on Monday, 9/20/21. The right eye began to itch (inside) at about 3 p.m., and a large bump appeared on the inside of the right eyelid. I took Benadryl again, and the bump went away several hours later. I am still somewhat swollen in both eye areas as of Tuesday, 9/21/21. I also have had a headache for the past two days, which may or may not be related to the vaccine reaction.


VAERS ID: 1719172 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-12
Onset:2021-09-12
   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 FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Discomfort, Dizziness, Dry mouth, Dyspnoea, Fatigue, Feeling abnormal, Headache, Heart rate increased, Malaise, Mastication disorder, Pain in jaw, Panic attack, Pharyngeal swelling, Swelling, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (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), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Received shot at 2:00 pm felt fine. 8:00 pm felt jaw pain. Hurt to chew. 1:00 pm woke up with vomiting diarrhea , rapid heart rate, throat felt swollen 09/13/21 2:00 pm rapid heart rate, dizziness, headache, throat felt swollen, felt like i was having a hard time taking breaths, back of neck extremely swollen 5:00 still not feeling good called an ambulance given oxygen on the way to hospital.Blood pressure high At ER I was given a steroid and hydroxyzine felt better 09/14/21 3:00 pm felt sick again took hydroxy. felt a little better 9:00 pm took one more hydroxy before bed. ER Dr suggested to help sleep 11:00 pm woke up mouth extremely dry and felt fatigued and felt like my body was extremely .heavy 9/15/21 finally got into family Dr told I had a panic attack and was given zoloft. Said I had a bad reaction to hydroxy and said I had to wait to wear off so I can feel better. I continued to feel very weak and extremely fatigued. Still very dizzy. I never took zoloft and I am finally feeling a little better. Very hard to do certain tasks because I feel so weak.


VAERS ID: 1719205 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-12
Onset:2021-09-12
   Days after vaccination:243
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: 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? 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: 9/15- antigen test @ Minute Clinic- positive
CDC Split Type:

Write-up: EE tested positive for COVID $g 14 days after vaccine completion


VAERS ID: 1719231 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-01-11
Onset:2021-09-12
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Breath sounds abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications apixaban (ELIQUIS) 5 MG tablet aspirin EC 81 MG enteric coated tablet dulaglutide (TRULICITY) 4.5 MG/0.5ML injection empagliflozin (JARDIANCE) 10 MG tablet insulin degludec (TRESIBA) 100 UNIT/ML vial insulin lispro (H
Current Illness: 9.12.21 - COVID-19 positive 9.12.21 - Went to ED = Shortness of breath; pneumonia due to COVID-19 virus; Patient signed out to me by Dr. pending monoclonal antibody treatment for COVID pneumonia. Patient developed a fever while in the emergency department. He was given Tylenol. He appears well on my re-evaluation. He saturates well on room air. He received the monoclonal antibody infusion. We discussed return precautions for worsening symptoms. He is discharged in stable condition. This is a 73-year-old man presenting with worsening dyspnea over the last 1 week. He was recently diagnosed with COVID-19. On exam he has some coarse breath sounds consistent with COVID-19 pneumonia. Chest x-ray also shows findings consistent with COVID-19 pneumonia. He would be a candidate for monoclonal antibodies given his age. Ambulatory oxygen saturation was 95%. Patient has some mild tachypnea but no severe respiratory distress. We will order monoclonal antibodies and I anticipate he will be discharged home. My shift and the patient was endorsed to Dr.
Preexisting Conditions: DM II (diabetes mellitus, type II), controlled (HCC) Hgb A1c 7.5 5/21 HTN (hypertension) Hyperlipidemia LDL 32, HDL 57, Trigl 162 5/21
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.14.21); COVID-19 positive (9.12.21); fully vaccinated Discharge Provider: DO Primary Care Provider: None Physician, MD Admission Date: 9/14/2021 Discharge Date: 9/20/2021 Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 09/14/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1] HOSPITAL COURSE: PT is a 73 y.o. male family medicine physician whom is relatively healthy with past medical history significant for HTN, HPL, and DM 2 that was admitted for COVID 19 PNA and associated acute hypoxic respiratory failure. He was fully vaccinated with 2 doses of Pfizer 19 COVID vaccination. He was started on supplemental O2, His therapies included Decadron, Remdisivir, Lovenox, IS, Acapella, Mucinex, Proning He was gradually weaned off supplemental oxygen and began feeling better 9/20/2021 Pt S+E. Alert, NAD, VSS on RA. Stable at discharge Rx for prednisone and Eliquis sent to his pharmacy Patient in agreement with instructions to pick up prescribed medications and take as directed.


VAERS ID: 1719289 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-12
Onset:2021-09-12
   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 FD8448 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DCIS genetic mutation STK11 gene
Allergies: Contrast Dye Orange soap seasonal allergies dust mites
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: 45 minutes after receiving the vaccine, I developed a rash on my upper chest, left side of my stomach, and my face around the cheeks. The areas was red, warm to the touch, and itchy. It was especially more itchy on my belly. I went back to the site where I got vaccinated. I was triaged by a nurse who confirmed that I was having an allergic reaction. They told me to take Benadryl and Pepcid OTC and follow up with my PCP if needed or go to the ER if symptoms got worse. I took the medication and then the reaction on my skin did not go away completely. It will come and go. I still took the medication. That same day when I got the vaccine, at night i called my doctors office. The nurse told me to follow up with my PCP and I was given an appointment. I saw the doctor on a video visit and she told me to go in person to one of the offices and to take pics of the rash so she could send them to the dermatologist. I went to do that and waited for a call from them and they did not get back to me. So I called them almost everyday. I finally got to talk to someone and they prescribed me with a cream for the rash, but no clear answer was given to me when I asked if it was safe to get the 2nd vaccine. I was told to complete the treatment with cream for 1 to 2 months before they could make a decision. I told them that I couldn''t wait because at my job HR was asking for the 2nd vaccine because of them possibly letting people go if they weren''t fully vaccinated or have a medical exception. I guess they are really busy so I never got an answer back that I had asked them about. I went to urgent care trying to get an answer and they told me to wait for another appointment with the dermatologist. Someone told me they would call me back from the dermatologist department. I got a message from a dermatologist from my online application from Kaiser and the provider said I needed to continue with the treatment with the cream. She said she was going to refer me to an allergy specialist. On September 20, 2021 I had the appointment with the allergy doctorand he gave me a letter saying that he does not recommended that I get the 2nd vaccine. However, he said to continue with the treatment with the cream and follow up with the dermatologist for 1 to 2 months to reassess the situation. I''m not sure if that means they will give me the okay in the future to take the 2nd dose, and I am afraid that I will get laid off if I don''t get the 2nd dose. I do want to get protected but if the doctor is saying that I shouldn''t because of the reaction that I had, I am not sure what to do as of now. I sent a message to my PCP yesterday trying to get all of the information all in one place because I had been getting different answers when I was trying to talk to the dermatology department. They would just tell me they don''t know if the reaction was significant to the vaccine and that''s why they wanted me to finish the treatment for the cream. I''m not sure if they are sure on what is going on with me. I am kind of going in circles with being told to continue to use the cream because the doctors are telling me to go to one specialists to another each time.


VAERS ID: 1719329 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 - / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Fibrin D dimer, Full blood count, Metabolic function test, SARS-CoV-2 test, Troponin
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data: 9/17: CBC, CMP, d-dimer, troponin, EKG, covid PCR
CDC Split Type:

Write-up: Shortness of breath/inability to take a complete breath. Started 1 day after vaccine-present


VAERS ID: 1719330 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Hyperacusis, Migraine, Photosensitivity reaction
SMQs:, Systemic lupus erythematosus (broad), Hearing impairment (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: MMR vaccine, March 2020, upper body rash w/itching
Other Medications: Amlodipine, Wellbutrin, Lexapro, Claritin
Current Illness: none
Preexisting Conditions: HTN, depr/anx
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Severe migraine with photo sensitivity and sound sensitivity that lasted 6 days Severe fatigue that lasted $g12hrs


VAERS ID: 1719365 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
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: Cough, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (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: Chlorthalidone 25 mg daily, lisinopril 10 mg daily, Metformin 1 g twice daily, Actos 30 mg daily, atorvastatin 20 mg daily
Current Illness: None
Preexisting Conditions: Type 2 diabetes, mixed hyperlipidemia, essential hypertension, BMI 32.7
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 rapid test (-) 2021-09-21; patient sent for chest x-ray, not yet available
CDC Split Type:

Write-up: Patient has nonproductive cough without other symptoms, and without any history of respiratory problems. Patient tested negative for SARS-CoV-2 today in the office


VAERS ID: 1719489 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   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 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fibrin D dimer, Gait disturbance, Joint swelling, Mobility decreased, X-ray
SMQs:, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: arthritis
Allergies: no
Diagnostic Lab Data: x-rays of knee and d-dimer blood test to check for blood clots.
CDC Split Type:

Write-up: On Saturday, I was able to walk fine with no knee pain. When I woke up Sunday, I had severe pain behind my right knee, swelling, and I couldn''t put weight on my right leg, or straighten my knee. I wasn''t able to walk for 7 days, on day 10 I am able to walk without assistance. I had to elevate my knee, apply heat and ice, and take pain medication for 7 days.


VAERS ID: 1719540 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-15
Onset:2021-09-12
   Days after vaccination:209
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: Cough, Decreased appetite, Fatigue, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fatigue fever slight cough Runny nose decreased appetite


VAERS ID: 1719560 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-12
   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 - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Headache, Intensive care, Jugular vein thrombosis, Transverse sinus thrombosis, Venogram abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fiber powder supplement
Current Illness: none
Preexisting Conditions: hemorrhoids
Allergies: none
Diagnostic Lab Data: Nonocclusive small but long right transverse sinus, right sigmoid sinus, and right upper internal jugular vein thrombosis. Nonocclusive tiny left medial transverse sinus thrombosis. MRV showed right transverse and sigmoid sinus thrombosis.
CDC Split Type:

Write-up: Patient developed 1 week of headache, had CT head which showed venous sinus thrombosis. She was admitted to ICU for anticoagulation and Q1h neuro checks. Required full stroke workup and


VAERS ID: 1719780 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049621A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hallucination, Mobility decreased, Pyrexia, Seizure like phenomena, Speech disorder, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Extremely high fever, 104+ for over 8 hours, hallucinations, entire body almost seizing. Couldn?t move arms or legs at times. Could not get out of bed or even reach for my phone, was difficult to talk from body uncontrollably shaking. Took Advil 2 right after the shot, 3 around 9pm 3 around midnight another 3 at 4 am. Nothing brought down the fever.


VAERS ID: 1721498 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Maine  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasionally); Non-smoker; Pollen allergy; Ragweed allergy
Preexisting Conditions: Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210916; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210937243

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient (Company representative) concerned a 48 year old male of unspecified ethnic origin. The patient''s weight was 190 pounds and height was 70 inches. The patient''s concurrent conditions included: ragweed allergy, pollen allergy, alcohol use (Occasionally), and non-smoker, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 204B21A, expiry: UNKNOWN) dose was not reported, 1 total administered on 18-AUG-2021 for prophylactic vaccination. No concomitant medications were reported. Starting on 12-SEP-2021 (reported as Sunday night) through the week of report, the patient had stuffy nose, sneezing, loss of sense of smell, and was more tired than normal. On 16-SEP-2021, the patient was tested for COVID19, and received positive result on 17-SEP-2021 (Suspected covid-19 infection and suspected clinical vaccination failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This case was associated with Product Quality Complaint.; Sender''s Comments: V0: 20210937243-covid-19 vaccine ad26.cov2.s-Suspected clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1721527 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal faeces, Fatigue, Headache, Myalgia, Odynophagia, Oropharyngeal pain, Peripheral coldness
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (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: NICOTINE; METOPROLOL
Current Illness: Alcoholic (2 beer per day); Blood pressure high; Marijuana abuse; Smoker (The caller used to smoke and now he uses Nicotin gum 2mg (6-7 pieces per day).)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Covid-19 symptoms on and off for 6 months); Comments: The patient had no known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210939153

Write-up: WHEN SLEPT ON RIGHT HAND FELT EXTREMELY COLD (FREEZING COLD) FROM FINGER TIPS TO THE MIDDLE OF THE ARM; THROAT MUSCLE PAIN (AROUND THROAT MUSCLES) / THROAT GOT SORE (CONTINUED TO GET SORE); WHEN SWALLOWS THROAT AND HEADACHE PAIN INCREASES FROM THE LOWER EAR TO THE SHOULDERS AND UP TO THE CRANIUM / WHEN SWALLOWS FEELS LIKE PULLED MUSCLE; MUSCLE ACHE THAT STRETCHED FROM SHOULDER TO HIS NECK; HEADACHE; EXTREME FATIGUE; NO NORMAL BOWEL MOVEMENT SINCE VACCINATION; This spontaneous report received from a patient concerned a 65 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included: contracted covid-19 (experienced headache, nausea, fatigue which lasted off and on), and concurrent conditions included: high blood pressure, sometimes smokes marijuana, alcoholic, and smoker, 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: 205A21A, expiry: 21-SEP-2021) dose was not reported, administered on 12-SEP-2021 for prophylactic vaccination. Concomitant medications included metoprolol for high blood pressure, and nicotine for smoker. On SEP-2021, treatment medications included: paracetamol. On 12-SEP-2021, the patient experienced no normal bowel movement since vaccination. On 15-SEP-2021, the patient experienced headache. On 15-SEP-2021, the patient experienced extreme fatigue. On 16-SEP-2021, the patient experienced throat muscle pain (around throat muscles) / throat got sore (continued to get sore). On 16-SEP-2021, the patient experienced when swallows throat and headache pain increases from the lower ear to the shoulders and up to the cranium / when swallows feels like pulled muscle. On 16-SEP-2021, the patient experienced muscle ache that stretched from shoulder to his neck. On 17-SEP-2021, the patient experienced when slept on right hand felt extremely cold (freezing cold) from finger tips to the middle of the arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, and the outcome of extreme fatigue, throat muscle pain (around throat muscles) / throat got sore (continued to get sore), when swallows throat and headache pain increases from the lower ear to the shoulders and up to the cranium / when swallows feels like pulled muscle, when slept on right hand felt extremely cold (freezing cold) from finger tips to the middle of the arm, muscle ache that stretched from shoulder to his neck and no normal bowel movement since vaccination was not reported. This report was non-serious.


VAERS ID: 1721626 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-29
Onset:2021-09-12
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PAROXETINE
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Less than 25 days since first shot; This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 25 days since first shot) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 052E21A and 052E21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included PAROXETINE for an unknown indication. On 29-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 12-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 25 days since first shot). On 12-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Less than 25 days since first shot) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications includes blood pressure medicine. No treatment medications are provided.


VAERS ID: 1721658 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-25
Onset:2021-09-12
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fall, Fatigue, Feeling abnormal, Hyperhidrosis, Limb discomfort, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROVIGIL [MODAFINIL]; XTAMPZA ER; OXYCODONE HCL; PREDNISONE; ALEVE; TYLENOL
Current Illness: Diabetes mellitus; Ehlers-Danlos syndrome (Autoimmune Disorder); Multiple sclerosis (remitting Multiple Sclerosis)
Preexisting Conditions: Medical History/Concurrent Conditions: Knee replacement
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: last night her arm locked up and didn''t move so she manually unlocked it; broke out in a horrible sweat after going back from the Market when all she did was sit under the umbrella with her dog and the temperature outside was not even too hot; brain fog/ noticed momentarily waking up with a bottle of drink clasp in her hands/don''t entirely feel good/ I feel horrible/ feel like hammered shit.; She think she fall out as she noticed momentarily waking up with a bottle of drink clasp in her hands; tendons are swelling up; in a lot of pain (patient had knee replacement); tired all the time; This spontaneous case was reported by a consumer and describes the occurrence of LIMB DISCOMFORT (last night her arm locked up and didn''t move so she manually unlocked it), HYPERHIDROSIS (broke out in a horrible sweat after going back from the Flea Market when all she did was sit under the umbrella with her dog and the temperature outside was not even too hot), FEELING ABNORMAL (brain fog/ noticed momentarily waking up with a bottle of drink clasp in her hands/don''t entirely feel good/ I feel horrible/ feel like hammered shit.), FALL (She think she fall out as she noticed momentarily waking up with a bottle of drink clasp in her hands) and SWELLING (tendons are swelling up) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Knee replacement. Concurrent medical conditions included Multiple sclerosis (remitting Multiple Sclerosis), Diabetes mellitus and Ehlers-Danlos syndrome (Autoimmune Disorder). Concomitant products included MODAFINIL (PROVIGIL [MODAFINIL]), OXYCODONE (XTAMPZA ER), OXYCODONE HCL, PREDNISONE, NAPROXEN SODIUM (ALEVE) and PARACETAMOL (TYLENOL) for an unknown indication. On 25-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, the patient experienced LIMB DISCOMFORT (last night her arm locked up and didn''t move so she manually unlocked it), HYPERHIDROSIS (broke out in a horrible sweat after going back from the Flea Market when all she did was sit under the umbrella with her dog and the temperature outside was not even too hot), FEELING ABNORMAL (brain fog/ noticed momentarily waking up with a bottle of drink clasp in her hands/don''t entirely feel good/ I feel horrible/ feel like hammered shit.), FALL (She think she fall out as she noticed momentarily waking up with a bottle of drink clasp in her hands), SWELLING (tendons are swelling up), PAIN (in a lot of pain (patient had knee replacement)) and FATIGUE (tired all the time). At the time of the report, LIMB DISCOMFORT (last night her arm locked up and didn''t move so she manually unlocked it), HYPERHIDROSIS (broke out in a horrible sweat after going back from the Flea Market when all she did was sit under the umbrella with her dog and the temperature outside was not even too hot), FEELING ABNORMAL (brain fog/ noticed momentarily waking up with a bottle of drink clasp in her hands/don''t entirely feel good/ I feel horrible/ feel like hammered shit.), FALL (She think she fall out as she noticed momentarily waking up with a bottle of drink clasp in her hands), SWELLING (tendons are swelling up), PAIN (in a lot of pain (patient had knee replacement)) and FATIGUE (tired all the time) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. .


VAERS ID: 1721737 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Insomnia, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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? 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: USMODERNATX, INC.MOD20213

Write-up: I am tired from not sleeping; Body hurt; 101 degrees fever; Started to feel bad; Could not sleep that night; This spontaneous case was reported by a consumer and describes the occurrence of FEELING ABNORMAL (Started to feel bad), INSOMNIA (Could not sleep that night), FATIGUE (I am tired from not sleeping), MYALGIA (Body hurt) and PYREXIA (101 degrees fever) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 12-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced FEELING ABNORMAL (Started to feel bad), INSOMNIA (Could not sleep that night), MYALGIA (Body hurt) and PYREXIA (101 degrees fever). On 13-Sep-2021, the patient experienced FATIGUE (I am tired from not sleeping). At the time of the report, FEELING ABNORMAL (Started to feel bad), INSOMNIA (Could not sleep that night), FATIGUE (I am tired from not sleeping), MYALGIA (Body hurt) and PYREXIA (101 degrees fever) outcome was unknown. Not Provided Concomitant medication information was not provided by the reporter. Treatment information was not provided by the reporter. Patient started to feel somewhat better after lunch on 13 Sep 2021. This case was linked to MOD-2021-311034 (Patient Link).


VAERS ID: 1721747 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Multiple myeloma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Her arm feels sore after vaccination; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Her arm feels sore after vaccination) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Multiple myeloma. On 09-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, the patient experienced MYALGIA (Her arm feels sore after vaccination). At the time of the report, MYALGIA (Her arm feels sore after vaccination) outcome was unknown. Concomitant medication was not provided. no treatment medication was provided. patients sated that she was wanted to know if she could take Tylenol or apply heat to the site of the injection.


VAERS ID: 1721753 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chest discomfort, Headache, Hyperhidrosis, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sulfonamide allergy (sulfa based drug)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210912; Test Name: Body temperature; Result Unstructured Data: 101.3F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Drenched in sweat; Feels like there was an elephant sitting on her chest; Tremors; Head hurt; Every part of the body hurts; Fever at 101.6F at 3am - current temperature now is at 101.3F; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Drenched in sweat), CHEST DISCOMFORT (Feels like there was an elephant sitting on her chest), TREMOR (Tremors), HEADACHE (Head hurt) and MYALGIA (Every part of the body hurts) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Sulfonamide allergy (sulfa based drug). On 11-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, the patient experienced HYPERHIDROSIS (Drenched in sweat), CHEST DISCOMFORT (Feels like there was an elephant sitting on her chest), TREMOR (Tremors), HEADACHE (Head hurt), MYALGIA (Every part of the body hurts) and PYREXIA (Fever at 101.6F at 3am - current temperature now is at 101.3F). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date for Adverse event, at a dose of 2 tabs and IBUPROFEN SODIUM (IBUPROFEN [IBUPROFEN SODIUM]) ongoing since an unknown date for Adverse event, at a dose of 2 tabs. At the time of the report, HYPERHIDROSIS (Drenched in sweat), CHEST DISCOMFORT (Feels like there was an elephant sitting on her chest), TREMOR (Tremors), HEADACHE (Head hurt), MYALGIA (Every part of the body hurts) and PYREXIA (Fever at 101.6F at 3am - current temperature now is at 101.3F) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Sep-2021, Body temperature: 101.3f (High) 101.3F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported.


VAERS ID: 1721760 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Gastric ulcer, Muscle spasms, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Gastrointestinal ulceration (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Stomach ulcer (he had been diagnosed with a stomach ulcer in March 2021)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Stomach ulcer came back; Had been throwing up and was throwing up again; Back spasms; This spontaneous case was reported by a consumer and describes the occurrence of GASTRIC ULCER (Stomach ulcer came back) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Stomach ulcer (he had been diagnosed with a stomach ulcer in March 2021) in 2021. On 11-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, the patient experienced MUSCLE SPASMS (Back spasms). On 13-Sep-2021, the patient experienced GASTRIC ULCER (Stomach ulcer came back) (seriousness criterion medically significant) and VOMITING (Had been throwing up and was throwing up again). The patient was treated with IBUPROFEN (ADVIL [IBUPROFEN]) for Stomach ulcer, at an unspecified dose and frequency; ALUMINIUM HYDROXIDE GEL, DRIED, MAGNESIUM HYDROXIDE, SIMETICONE (MYLANTA [ALUMINIUM HYDROXIDE GEL, DRIED;MAGNESIUM HYDROXIDE;SIMETICONE]) for Stomach ulcer, at an unspecified dose and frequency and FAMOTIDINE (PEPCID [FAMOTIDINE]) for Stomach ulcer, at an unspecified dose and frequency. At the time of the report, GASTRIC ULCER (Stomach ulcer came back), MUSCLE SPASMS (Back spasms) and VOMITING (Had been throwing up and was throwing up again) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. concomitant drug details not provided. Company Comment: This case concerns a 59-year-old, male patient with relevant medical history of stomach ulcer, who experienced the unexpected event of stomach ulcer The event occurred approximately 3 days after the first dose of Spikevax. The rechallenge was not applicable, as the event happened after the first dose. The event was considered related to the product per the reporter''s assessment. However, the patient''s medical history and concomitant use of Advil, remains a contributory factor. The benefit-risk relationship of Spikevax is not affected by this report.; Sender''s Comments: This case concerns a 59-year-old, male patient with relevant medical history of stomach ulcer, who experienced the unexpected event of stomach ulcer The event occurred approximately 3 days after the first dose of Spikevax. The rechallenge was not applicable, as the event happened after the first dose. The event was considered related to the product per the reporter''s assessment. However, the patient''s medical history and concomitant use of Advil, remains a contributory factor. The benefit-risk relationship of Spikevax is not affected by this report.


VAERS ID: 1721804 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-13
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? 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: USMODERNATX, INC.MOD20213

Write-up: Fever; my body hurt; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever) and MYALGIA (my body hurt) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 13-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced PYREXIA (Fever) and MYALGIA (my body hurt). At the time of the report, PYREXIA (Fever) and MYALGIA (my body hurt) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications provided. No treatment medications provided.


VAERS ID: 1721926 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-09-12
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bradycardia, Heart rate, Heart rate decreased, Ligament sprain, Vital signs measurement
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210912; Test Name: Heart rate; Result Unstructured Data: Test Result:45; Test Date: 20210912; Test Name: vital signs; Result Unstructured Data: Test Result:Unknown result
CDC Split Type: USPFIZER INC202101193586

Write-up: has bradycardia; sprained his ankle; his heart rate was 45/had a slow heart rate/he has never had a slow heart rate like that; This is a spontaneous report from a contactable consumer or other non-healthcare professional (parent). A 14-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number was not reported), via an unspecified route of administration on an unspecified date in Aug2021 as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experienced has bradycardia. On an 12Sep2021, the patient sprained his ankle and his heart rate was 45/had a slow heart rate/he has never had a slow heart rate like that. The reporter stated, the 14 years old son received the Pfizer vaccine the first dose about three weeks ago and he received the first dose in a Vaccine three weeks ago, he was healthy with no medical history and today he sprained his ankle, so we had to take him to the ER and they took his vital signs and his heart rate was 45 and he is never had a heart condition or abnormal heart rate. So he was due to get the second dose of the vaccine. The reporter enquired if that was the side effect bradycardia or heart arrhythmia. The reporter asked if this was a side effects heard before. The reporter stated, the reporter don''t know if it was a side effect of the Pfizer vaccine but he has never had a slow heart rate like that. So the reporter was supposed to take him for the second dose actually today and was not doing that. The reporter asked for opinion and recommendation as what should be the next step. The report was not related to a study or programme. On 12Sep2021, the patient underwent lab tests and procedures which included heart rate: 45 and vital signs: unknown result. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


VAERS ID: 1721945 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-05
Onset:2021-09-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
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 INC202101219871

Write-up: Shingles; This is a spontaneous report from a contactable consumer, the patient. A 28-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3183) via an unspecified route of administration in the left arm on 05Sep2021 at 11:00 (at the age of 28-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. 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 vaccination. Concomitant medications were not reported. On 12Sep2021 at 13:00, the patient experienced shingles. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of the event which included treatment with an unspecified medication. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event shingles was resolving at the time of the report.


VAERS ID: 1722558 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-09-12
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hypertension
Preexisting Conditions: Sigmoid diverticulosis
Allergies: NKA
Diagnostic Lab Data: 9/12/2021 PCR positive for COVID 19
CDC Split Type:

Write-up: Patient tested positive for COVID 9/12/2021


VAERS ID: 1722683 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-04
Onset:2021-09-12
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Pyrexia, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: breakthrough COVID - cough, fever, SOB, loss of taste/smell


VAERS ID: 1722718 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Erythema, Fatigue, Headache, Impaired work ability, Injection site pruritus, Injection site rash, Muscle spasms, Myalgia, Nausea, Pain in extremity, Pruritus, Pyrexia, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: delayed rash to injection site
Other Medications: Estradiol TD system 0.1mg, progesterone 200mg, meclizine HCL 25mg as needed, Ambien 5mg, Fiorinal for headaches as needed
Current Illness: None
Preexisting Conditions: headaches and insomnia
Allergies: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Severe muscle pain and spasms, extreme fatigue, nausea, headache, joint pain, abdominal pain, fever 100.7 and slight rash around injection site started late evening/early morning on Sunday 9/12. Rash around injection site left upper arm increased in size spreading down toward elbow (pain, redness, swelling, warm to tough and itching). Muscle pain, fatigue, headache, fever and rash continued through Weds 9/15. I made contact with PCP on Tuesday 9/14 and Medrol Dose pack called in and I started taking on 9/15 with last dose 9/21. I was not able to work or function as normal from 9/12 through 9/19. I returned to work on Monday 9/20 but as of today 9/22 I continue to have moderate to extreme fatigue, muscle aches and daily headaches; rash has resolved but still have some residual itching sensation near injection site.


VAERS ID: 1722856 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Neck pain
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: No
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: I haven?t followed up with anyone yet.
CDC Split Type:

Write-up: Has been over two weeks now and I am having arthritis symptoms in my left elbow elbow, and now in my neck. I?ve never had any of those type of symptoms call mom and I haven?t done anything outside of my normal routine. Elbow has a constant bad ache.


VAERS ID: 1723012 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-09-12
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anticoagulant therapy, Asthenia, Cough, Nausea, Oxygen saturation decreased, Pyrexia, Renal impairment, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to the ED with weakness,cough, and nausea/vomitting. Patient had fever at home but was afebrile at ED. O2 sat dropped down to 61% on room air so was given oxygen Was given decadron, albuterol, pulmicort, vitamin D, zinc, and melatonin. Remdesevir was not given due to renal function Was discharged home with oxygen tank, steroids, and anticoagulation.


VAERS ID: 1723087 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-26
Onset:2021-09-12
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6203 / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough
SMQs:, Anaphylactic reaction (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: Alzheimer''s dementia
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Symptom onset 9/12 with coughing. Admitted to hospital on 9/15 with worsening symptoms but currently doing much better and discharged planned tomorrow for rehab


VAERS ID: 1723120 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-02
Onset:2021-09-12
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: N/A
Preexisting Conditions: Unknown
Allergies: N/A
Diagnostic Lab Data: MRI 09/12/2021 Cat-Scan 09/12/2021 Ultrasound 09/12/2021 Blood Lab 09/12/2021
CDC Split Type:

Write-up: Pt.''s Caretaker states that after receiving the 2nd dose of Moderna 05/02/2021, started experiencing symptoms 09/12/2021 of Positive Covid + 09/20/2021, 09/12/2021 Acute Ascemic Temperal Lobe Stroke, 09/22/2021 home-care.


VAERS ID: 1723151 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA D14F21A / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Gait disturbance, Headache, Injection site erythema, Injection site reaction, Muscular weakness, Nausea, Pyrexia, Rash papular, Tenderness, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily medications
Current Illness: No
Preexisting Conditions: Severe pain, glaucoma, RA, sirasis, bipolar
Allergies: Strawberries, penicillin, sulfur, depacoat
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: I had arm tenderness, body very weak couldn''t walk, headache, nausea, muscle weakness, vertigo, redness the size of my hand on right arm at injection site started to get a raised appearance. I was told by my doctor to use Benadryl lotion cream that helped clear the rash. I had a fever 99.3. I''m still having headache off and on everything else has cleared up.


VAERS ID: 1723250 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-07
Onset:2021-09-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Mouth ulceration, Oral pain, Pain in extremity, Scar, Stomatitis, Tenderness
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 1 month old, severe reaction to pertusis vaccine, fever of 105 degrees
Other Medications: Tramadol 50mg, Lyrica 75mg
Current Illness: Covid positive test 16 days prior to vaccination, Asymptomatic.
Preexisting Conditions: Small fiber neuropathy bilateral in lower legs and feet
Allergies: Pertussis vaccine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 5 minutes after administration of vaccine in upper right arm, right thumb joint pain began and lasted 20 minutes or so, next morning upper arm was extremely sore and tender to touch, 4 days later on September 12th, developed mouth ulcers, one on upper gums and one on base of tongue. Mouth sore on upper gum grew quite large (1/4 inch in diameter) and became extremely painful. Hard to talk and eat for 5 days, then began to heal, the sore on my upper gum left a red scar. Along with the sores, on the same day i developed sharp shooting headaches behind my eyes that only lasted 1 day.


VAERS ID: 1723307 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Pt had 5/10 pain in arm upon palpation for x6 days, diarrhea on 2nd day after shot, fatigue x5 days. treatment was rest and good diet with probiotics.


VAERS ID: 1725311 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Discomfort, Myalgia, Nausea, Therapeutic response unexpected
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: today she is fine; horribly in discomfort; arm is extremely sore; nausea/all those symptoms that were on the website; chills/all those symptoms that were on the website; This spontaneous case was reported by a consumer and describes the occurrence of THERAPEUTIC RESPONSE UNEXPECTED (today she is fine), DISCOMFORT (horribly in discomfort), MYALGIA (arm is extremely sore), NAUSEA (nausea/all those symptoms that were on the website) and CHILLS (chills/all those symptoms that were on the website) in a 76-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 11-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced DISCOMFORT (horribly in discomfort), MYALGIA (arm is extremely sore), NAUSEA (nausea/all those symptoms that were on the website) and CHILLS (chills/all those symptoms that were on the website). On 13-Sep-2021, the patient experienced THERAPEUTIC RESPONSE UNEXPECTED (today she is fine). At the time of the report, THERAPEUTIC RESPONSE UNEXPECTED (today she is fine), DISCOMFORT (horribly in discomfort), MYALGIA (arm is extremely sore), NAUSEA (nausea/all those symptoms that were on the website) and CHILLS (chills/all those symptoms that were on the website) outcome was unknown. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1725324 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-09-12
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0 21B21A / 2 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PREDNISONE; OXYCODONE
Current Illness: Psoriatic arthritis (Psoratiac Arthritis); Seasonal allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Very sore at site of injection; extreame fatigue; a little headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Very sore at site of injection), FATIGUE (extreame fatigue) and HEADACHE (a little headache) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0 21B21A) for COVID-19 vaccination. Concurrent medical conditions included Seasonal allergy and Psoriatic arthritis (Psoratiac Arthritis) since 01-Jan-1999. Concomitant products included PREDNISONE from 01-Jan-1999 to an unknown date and OXYCODONE from 01-Jan-1999 to an unknown date for Psoriatic arthritis. On 01-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced PAIN IN EXTREMITY (Very sore at site of injection), FATIGUE (extreame fatigue) and HEADACHE (a little headache). The patient was treated with IXEKIZUMAB (TALTZ) from 04-Jul-2021 to 07-Jul-2021 for Psoriatic arthritis, at a dose of 1 dosage form. On 13-Sep-2021, PAIN IN EXTREMITY (Very sore at site of injection) and FATIGUE (extreame fatigue) had resolved. On 14-Sep-2021, HEADACHE (a little headache) had resolved. Most recent FOLLOW-UP information incorporated above includes: On 16-Sep-2021: The follow-up document received contain ne Information (medical history, concomitant meds) On 17-Sep-2021: Follow- up document received contain significant information - New events added and dosage information updated.


VAERS ID: 1725449 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Muscle contractions involuntary
SMQs:, Dystonia (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 known.
Preexisting Conditions: None.
Allergies: No known allergies.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Patient has been experiencing fasciculations of her face in front of her left ear area since 2-3 days after she received the vaccine. No numbness, tingling or weakness is present.


VAERS ID: 1725558 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Connecticut  
Vaccinated:2021-02-16
Onset:2021-09-12
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN; PROVIGIL [MODAFINIL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 20210731; Test Name: Antigen COVID-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210806; Test Name: Antigen COVID-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210911; Test Name: Antigen COVID-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20201222; Test Name: qRT-PCR COVID-19; Result Unstructured Data: Test Result:Negative; Comments: Nasal swab; Test Date: 20210727; Test Name: qRT-PCR COVID-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210901; Test Name: qRT-PCR COVID-19; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210915; Test Name: qRT-PCR COVID-19; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101219472

Write-up: Breakthrough COVID infection; Breakthrough COVID infection; This is a spontaneous report from a contactable consumer (patient). An adult male patient of unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EL3247) via intramuscular, administered in left arm on 16Feb2021 as DOSE 2, SINGLE, and first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EL3247) via intramuscular, administered in left arm on 26Jan2021 as DOSE 1, SINGLE for covid-19 immunisation. The medical history included hypertension. The concomitant medication(s) included losartan (LOSARTAN) and modafinil (PROVIGIL [MODAFINIL]) taken for an unspecified indication. The patient had known allergies to amitriptyline and flagyl. On 12Sep2021, the patient experienced breakthrough covid infection. Patient was not tested for covid prior to vaccination. The patient underwent lab tests and procedures which included qRT-PCR COVID-19 test nasal swab on 22Dec2020 with result negative, qRT-PCR COVID-19 test nasal swab on 27Jul2021 with result negative, antigen COVID-19 test nasal swab on 31Jul2021 with result negative, antigen COVID-19 test nasal swab on 06Aug2021 with result negative, qRT-PCR COVID-19 nasal swab on 01Sep2021 with result negative, antigen COVID-19test nasal swab on 11Sep2021 with result negative, and qRT-PCR COVID-19 test nasal swab on 15Sep2021 with result positive. Patient did not receive treatment for the event. The outcome of the events was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained. Follow-Up (22Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1725603 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-22
Onset:2021-09-12
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea
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: Medical History/Concurrent Conditions: Nickel sensitivity (Known allergy: Nickel)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101227923

Write-up: First menstrual period after the vaccine has been full of the worst pain/have cramped intensely for several days; This is a spontaneous report from a contactable nurse. A 23-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FA7485) via an unspecified route of administration in the left arm on 22Jul2021 (at the age of 23-year-old) as a single dose for COVID-19 immunisation. Medical history included allergy to nickel. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medication was reported as not applicable (as per source document). The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FW0181) via an unspecified route of administration in the left arm on 30Jun2021 (at the age of 23-year-old) as a single dose for COVID-19 immunisation. On 12Sep2021, the patient experienced her first menstrual period after the vaccine had been full of the worst pain, the patient have had since she started her period 12 years ago. The patient had cramped intensely for several days. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the reported event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event first menstrual period after the vaccine has been full of the worst pain/have cramped intensely for several days was recovering at the time of this report.


VAERS ID: 1725607 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (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: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101228548

Write-up: Paining like a hit by something at the left side back shoulder; This is a spontaneous report from a contactable consumer, the patient. A 50-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 11Sep2021 at 17:00 (at the age of 50-years-old) as a single dose for COVID-19 immunisation. Medical history included covid-19. The patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. On 12Sep2021, the patient had paining like a hit by something at the left side back shoulder and the pain was there for three days. The event 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. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event paining like a hit by something at the left side back shoulder was resolved on 15Sep2021. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1726234 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-22
Onset:2021-09-12
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and hospitalized with COVID while fully vaccinated.


VAERS ID: 1726286 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthma, Chest discomfort, Condition aggravated, Cough, Diarrhoea, Diverticulitis, Dyspnoea, Headache, Impaired work ability, Inhalation therapy, Loss of personal independence in daily activities, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (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: Tetanus shot
Other Medications: Zyrtec, Singulair, multi vitamin, zinc, turmeric, fish oil, quercetin, glucosamine chondroitin, vit c, d3 and k2.
Current Illness: None
Preexisting Conditions: Heart murmur, asthma
Allergies: Penicillin, amoxicillin and all derivatives of, Sensitive to anesthesia
Diagnostic Lab Data: Asthma- nebulizer treatment, steroid shot and prednisone pack for 5 days Diverticulitis (if related) - 2 antibiotics, anti-diarrhea meds, CT scan scheduled for Monday and follow up appt in 2 weeks
CDC Split Type:

Write-up: Started with a sore throat and slight headache within 2 hours after shot, went away within the day. Cough started by 7 pm the same night with slight asthma symptoms. Woke up at 7 am with an asthma attack. Tried treating it with my inhaler - it was ineffective. By 8:30 went to urgent care for an asthma attack. Nebulizer helped. Needed my inhaler each day for almost a week (Saturday 9.19 was last inhaler use) due to tightness in chest and difficulty breathing. Only needed to take 1 day off work but was unable to fully do physical therapy or my usual work outs during that time. I don''t know if this is related but I started having diarrhea Sunday 9.20 that is still ongoing. Went to a different dr Wed (9.22) for that an abdominal pain. Diagnosed with diverticulitis and put on antibiotics. Will get a CT scan of abdomin on Monday. Also have a dr''s appt on Saturday to check up on my asthma.


VAERS ID: 1726382 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C214 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Drooling, Facial paralysis, Headache, Inflammation, Magnetic resonance imaging head normal, Pain in extremity, Vaccination complication
SMQs:, Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI - for ears, nose. everything was fine.
CDC Split Type: vsafe

Write-up: My arm hurt, it got big, my head hurt, by Monday water was coming out of my mouth and I look in the mirror and I saw that my face had turned to the right side. I called my children and they took me to the doctor, and the said it was a side effect of the vaccine. He gave me medicine to reduce the inflammation of the face and antibiotic. Yet I have a turned face and a small eye.


VAERS ID: 1726385 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Ageusia, Anosmia, Headache, Hyperhidrosis, Loss of consciousness, Myalgia, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: fever, loss of taste and smell for a little bit. Headaches. Sweating, muscle aches, stomach aches. Maybe diarrhea? Passed out for a few seconds


VAERS ID: 1726438 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Pruritus, Rash morbilliform, Skin lesion, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: no significant
Allergies: NKDA
Diagnostic Lab Data: no known labs or tests
CDC Split Type:

Write-up: hours after first vaccine administered patient reported hive like lesions on the abdomen with pruritus, continued to be present x several days, denied initial SOB, wheezing, diarrhea, fatigue; after several days on the 18th of Sept patient noted sudden increase in symptoms, spreading to abdomen, flanks then on the 20th had some mild SOB, was seen in the ER and likely given dexamethasone tabs, no response, evaluated by myself (Dermatologist), reaction c/w morbilliform drug eruption, treated with prednisone taper, topical steroids and atarax and avoidance of second pfizer vaccine recommended


VAERS ID: 1726471 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

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

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

Write-up: Red arm rash


VAERS ID: 1726519 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache, Laboratory test, Malaise, Neurological examination, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Vancomycin
Diagnostic Lab Data: Multiple labs, neurological exams, brain MRI scheduled.
CDC Split Type:

Write-up: Reactions started a couple days post vaccination. Fever (101.5), body aches, malaise, headache (10/10), chills, brain fog, paresthesia on both sides/back and left fingertips. All basically resolved by Thursday September 17th EXCEPT for paresthesia, brain fog, malaise and extreme fatigue. Was seen by ER on September 17th and follow up with Primary Care on September 20th. Infectious Disease phone consult on September 23rd who have referred me to Neurology.


VAERS ID: 1726725 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-02-01
Onset:2021-09-12
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 LA / IM

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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and hospitalized with COVID.


VAERS ID: 1726820 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-09-12
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Headache, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/25/21 2nd dose03/24/21 Diagnosed covid positive:09/14/21 Symptom onset:09/12/21 Exposure:Travel Symptoms:fever, cough,muscle aches,sore throat,chills,HA


VAERS ID: 1726824 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-11
Onset:2021-09-12
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/11/21 Diagnosed covid positive:09/13/21 Symptom onset:09/12/21 Exposure:home Symptoms:cough, runnynose


VAERS ID: 1726835 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-13
Onset:2021-09-12
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/13/21 Diagnosed covid positive:09/13/21 Symptom onset:09/10/21 Exposure: Symptoms:cough, fatigue,loss of smell/taste,sore throat, HA


VAERS ID: 1726837 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-13
Onset:2021-09-12
   Days after vaccination:242
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Fatigue, Headache, Myalgia, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/13/21 Diagnosed covid positive:09/13/21 Symptom onset:09/12/21 Exposure:community Symptoms:fever, fatigue,muscle aches,loss of smell/taste,chills, runny nose,HA


VAERS ID: 1726875 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-22
Onset:2021-09-12
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cold sweat, Coronavirus test positive, Cough, Influenza like illness, Pyrexia, Respiratory tract congestion
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), Hypoglycaemia (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: Prozac; Levora; Wellbutrin; Benadryl; melatonin
Current Illness: None
Preexisting Conditions: Seasonal and Cat allergies; Obesity; Depression; Anxiety
Allergies: Sulfa
Diagnostic Lab Data: 9/16/2021 Corona Test, Positive
CDC Split Type: vsafe

Write-up: Corona Breakthrough, 2-2 1/2 days fever 100.9, Loss of taste and smell, cold sweat, chest congestion, coughing. Flu-like symptoms. No treatment given.


VAERS ID: 1727047 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-12
Onset:2021-09-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Headache, Heavy menstrual bleeding, Migraine, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Corneal 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: 1st dose of Pfizer''s Covid 19 Vaccine triggered a migraine with aura lasting the entire day and night.
Other Medications: Progesterone
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Just before 12:30pm, after receiving my 2nd dose of Pfizer''s Covid Vaccine on 9/12, I got a burning sensation in my right eye for about 20 minutes and then a migraine hit. I took an Excedrin, which helped with the pain a little bit, but the throbbing lasted until the next day, Monday 9/13, finally going away around 11am. Monday night, 9/13, around 6pm, I started bleeding as if I started my menstrual cycle. At this point I was two months into taking Progesterone every single day and shouldn''t have been bleeding at all. Monday night into Tuesday morning''s flow was heavy but manageable. Tuesday afternoon between 6-7pm, my flow got even heavier. I bled through a size super tampon and pad within the hour. This carried into Wednesday, and I had to deal with such a heavy flow all day long. Wednesday night at 7:45pm I bled through through my pants only 30 minutes after inserting a fresh tampon and new pad. Thursday morning at 3:15am I woke up to blood soaked though my pants onto the bedsheet. This carried into Friday, gradually getting less heavy but still having to change my tampon and pad every hour. Saturday and Sunday were even less heavier, where I could go 2-3 hours between changes. The bleeding didn''t stop until Monday. The amount of blood that I couldn''t control was comparable to the postpartum bleeding I experienced with both of my children.


VAERS ID: 1727093 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: sertraline, iron, multi - vitamin, fiber
Current Illness: none
Preexisting Conditions: none
Allergies: eggs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: severe diarrhea for 12 hours


VAERS ID: 1727455 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-07-23
Onset:2021-09-12
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Breast cyst, Breast mass, Breast pain, Breast swelling, Breast tenderness, Lymphadenopathy, Mammogram abnormal, Ultrasound scan abnormal
SMQs:, Angioedema (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Lipodystrophy (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: Congestion and dry cough two weeks before vaccine.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MM MAMMOGRAM DBT-DIAGNOSTIC BL BREAST TOMO US BREAST BILATERAL LTD HISTORY: LEFT BREAST PALPABLE LUMP, BASELINE SCREENING THE RIGHT BREAST WHICH WAS CONVERTED TO DIAGNOSTIC EXAM GIVEN THE FINDINGS DESCRIBED BELOW. COMPARISON: NONE. THIS IS A BASELINE MAMMOGRAM. TECHNIQUE: BILATERAL CC AND MLO 2-D AND 3-D DIGITAL MAMMOGRAPHY. COMPUTER AIDED DETECTION WAS USED. TARGETED (LIMITED) ULTRASOUND OF BOTH RIGHT AND LEFT BREASTS. BREAST DENSITY: HETEROGENEOUSLY DENSE. FINDINGS: RIGHT MAMMOGRAM: ON THE MLO PROJECTION IN THE AXILLARY TAIL REGION/AXILLARY THERE IS A 16 MM NODULE WITH A LUCENT CENTER LIKELY DUE TO A LYMPH NODE WHICH WAS FURTHER EVALUATED WITH ULTRASOUND. NO ADDITIONAL FINDINGS ARE SEEN. RIGHT ULTRASOUND: REAL TIME SONOGRAPHIC EVALUATION THE RIGHT BREAST WAS PERFORMED FROM THE 10-12 O''CLOCK LOCATION IN THE AXILLA EXTENDING TO THE AXILLARY REGION. THERE IS A 17 X 7 X 9 MM NORMAL SIZE AND NORMAL-APPEARING AXILLARY TAIL LYMPH NODE WHICH CORRESPONDS THE MAMMOGRAPHIC FINDING. LEFT MAMMOGRAM: IN THE AREA OF PATIENT CONCERN, THERE IS DENSE HETEROGENEOUS BREAST TISSUE BUT A DISCRETE MASS IS NOT IDENTIFIED. THERE IS ALSO A NODULE WITH A LUCENT CENTER IN THE AXILLARY REGION WHICH I SUSPECT IS LIKELY DUE TO A LYMPH NODE AS WELL AS AN ENLARGED LEFT AXILLARY LYMPH NODE. FURTHER EVALUATION FOR ALL THESE FINDINGS WAS PERFORMED AND ULTRASOUND EXAM. LEFT ULTRASOUND: REAL-TIME SONOGRAPHIC EVALUATION OF THE LEFT BREAST WAS PERFORMED IN THE AREA OF PATIENT''S PALPABLE LUMP AS WELL AS AXILLARY TAIL AND AXILLARY REGION FROM 12-2 O''CLOCK. AT THE 12-1 O''CLOCK LOCATION, THERE IS A DEEP COMPLEX CYST SEEN MEASURING 11 X 7 X 8 MM WITH ADDITIONAL SIMPLE CYSTS SEEN MEASURING 3 AND 4 MM EACH. A 1:00, THERE IS A 10 X 49 MM LYMPH NODE WHICH CORRESPONDS TO THE LESION SEEN MAMMOGRAPHICALLY. EVALUATION THE AXILLA DEMONSTRATES AN ENLARGED LYMPH NODE MEASURING 27 X 9 X 12 MM CORRESPOND TO THE MAMMOGRAPHIC FINDING AS WELL. CONCLUSIONS: LEFT BREAST PALPABLE LUMP CORRESPONDS TO A SIMPLE CYST AS WELL AS A MORE DEEPER COMPLEX CYST FOR WHICH A SIXMONTH FOLLOW-UP MAMMOGRAM AND ULTRASOUND IS RECOMMENDED. ENLARGED LEFT AXILLARY LYMPH NODE WHICH IS SUSPECT IS LIKELY DUE TO RECENT COVID VACCINATION AND THEREFORE A FOLLOW-UP LEFT AXILLARY ULTRASOUND IN 2 MONTHS IS RECOMMENDED FOR RESOLUTION AND/OR STABILITY. RIGHT BREAST EVALUATION IS UNREMARKABLE. I PERSONALLY REVIEWED THE RESULTS AND RECOMMENDATIONS OF THIS EXAMINATION WITH THE PATIENT. RECOMMENDATIONS: SIX-MONTH FOLLOW-UP LEFT BREAST MAMMOGRAM AND ULTRASOUND FOR COMPLEX CYST. LEFT AXILLARY ULTRASOUND IN 2 MONTHS TO REASSESS THE ENLARGED LYMPH NODE SEEN TODAY LIKELY DUE TO RECENT VACCINATION. ANNUAL SCREENING 1 YEAR FOR THE RIGHT BREAST. BIRADS 3: PROBABLY BENIGN FINDINGS; SHORT INTERVAL FOLLOW-UP RECOMMENDED. RECALL INTERVAL: 6 MONTHS
CDC Split Type:

Write-up: Symptoms began 9/12/21 with a lump and swelling and tenderness / soreness about two inches above the nipple of my left breast (51 days after receiving Janssen / Johnson & Johnson vaccine). My menstrual cycle started on 9/10/21, two days before symptoms began. Menstrual cycle ended on 9/14/21. Four days later on 9/16/21, I visited the gynecologist. Left breast soreness had gone down slightly. Gynecologist examined both breasts and recommended a bilateral mammogram and ultrasound. The following day, 9/17/21 (exactly 8 weeks since receiving the Janssen vaccine), I had a 2-D and 3-D bilateral mammogram and targeted (limited) ultrasound. Radiologist found: "IN THE AREA OF PATIENT CONCERN, THERE IS DENSE HETEROGENEOUS BREAST TISSUE BUT A DISCRETE MASS IS NOT IDENTIFIED. THERE IS ALSO A NODULE WITH A LUCENT CENTER IN THE AXILLARY REGION WHICH I SUSPECT IS LIKELY DUE TO A LYMPH NODE AS WELL AS AN ENLARGED LEFT AXILLARY LYMPH NODE. FURTHER EVALUATION FOR ALL THESE FINDINGS WAS PERFORMED AND ULTRASOUND EXAM. LEFT ULTRASOUND: REAL-TIME SONOGRAPHIC EVALUATION OF THE LEFT BREAST WAS PERFORMED IN THE AREA OF PATIENT''S PALPABLE LUMP AS WELL AS AXILLARY TAIL AND AXILLARY REGION FROM 12-2 O''CLOCK. AT THE 12-1 O''CLOCK LOCATION, THERE IS A DEEP COMPLEX CYST SEEN MEASURING 11 X 7 X 8 MM WITH ADDITIONAL SIMPLE CYSTS SEEN MEASURING 3 AND 4 MM EACH. A 1:00, THERE IS A 10 X 49 MM LYMPH NODE WHICH CORRESPONDS TO THE LESION SEEN MAMMOGRAPHICALLY. EVALUATION THE AXILLA DEMONSTRATES AN ENLARGED LYMPH NODE MEASURING 27 X 9 X 12 MM CORRESPOND TO THE MAMMOGRAPHIC FINDING AS WELL. CONCLUSIONS: LEFT BREAST PALPABLE LUMP CORRESPONDS TO A SIMPLE CYST AS WELL AS A MORE DEEPER COMPLEX CYST FOR WHICH A SIX MONTH FOLLOW-UP MAMMOGRAM AND ULTRASOUND IS RECOMMENDED. ENLARGED LEFT AXILLARY LYMPH NODE WHICH IS SUSPECT IS LIKELY DUE TO RECENT COVID VACCINATION AND THEREFORE A FOLLOW-UP LEFT AXILLARY ULTRASOUND IN 2 MONTHS IS RECOMMENDED FOR RESOLUTION AND/OR STABILITY." As of today?s date, 9/23/21, lump and tenderness still remain, but not as sore as at onset on 9/12/21. Need to schedule: - FOLLOW-UP LEFT AXILLARY ULTRASOUND IN 2 MONTHS - FOLLOW-UP SIX MONTH FOLLOW-UP MAMMOGRAM AND ULTRASOUND IS RECOMMENDED.


VAERS ID: 1728807 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-09-12
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Malaise, 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted with COVID positive test and symptoms. Fully vaccinated March 2021


VAERS ID: 1729032 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Emotional distress, Urticaria, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Depression (excl suicide and self injury) (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: Before Vaccination-Tylenol
Current Illness:
Preexisting Conditions: Eczema
Allergies: ALeve, Anaprox, Aspirin, Motrin,latex gloves& black pepper etc
Diagnostic Lab Data:
CDC Split Type:

Write-up: SYMPTOMS: SEVERE HIVES $gright/left arm $gright/left leg $g right/left thigh $gbuttocks $gupper right side shoulder $g right/left side of the chest $gright top foot The above outbreak hives symptoms began September 12, 2021 and continue for about seven days. THe hives were treated by benedryl (pill) but unfortunately the symptoms continue progressing. Therefore, I had no choice but to seek medical attention on September 19, 2021 at a HCF. I was seen by ,PA-C and it was confirmed that my outbreak was due to the J&J COVID 19 vaccine. I am sharing my experience because these severe outbreak caused me to be very emotional and distressed. T


VAERS ID: 1729037 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Emotional distress, Urticaria, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Depression (excl suicide and self injury) (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: Before Vaccination-Tylenol
Current Illness:
Preexisting Conditions: Eczema
Allergies: ALeve, Anaprox, Aspirin, Motrin,latex gloves& black pepper etc
Diagnostic Lab Data:
CDC Split Type:

Write-up: SYMPTOMS: SEVERE HIVES $gright/left arm $gright/left leg $g right/left thigh $gbuttocks $gupper right side shoulder $g right/left side of the chest $gright top foot The above outbreak hives symptoms began September 12, 2021 and continue for about seven days. THe hives were treated by benedryl (pill) but unfortunately the symptoms continue progressing. Therefore, I had no choice but to seek medical attention on September 19, 2021. I was seen by PA-C and it was confirmed that my outbreak was due to the J&J COVID 19 vaccine. I am sharing my experience because these severe outbreak caused me to be very emotional and distressed.


VAERS ID: 1729082 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-01
Onset:2021-09-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cardiac flutter, Gait disturbance, Hypoaesthesia, Pain in extremity, Palpitations, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (broad), Tendinopathies and ligament disorders (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: Vit C, D3, Quercitin, Zinc
Current Illness: None
Preexisting Conditions: None
Allergies: N/A Unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After 10 days or so, "Covid-Arm, swelling, hot, and sore arm to touch. Arm ached. Heart fluttered, heart pounded. Right Leg went numb for several minutes. Right hip joint hurt so badly, I limped for 2 days. Happened over 24 hour period. Recovered as far as I know at the present moment.


VAERS ID: 1731302 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-09
Onset:2021-09-12
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

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

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

Write-up: Positive Covid results.


VAERS ID: 1731370 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Bedridden, Blood test normal, Full blood count normal, Headache, Illness, Mononucleosis heterophile test negative, Pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: The day after the vaccine I woke up with a terrible headache and body aches. I knew it was expected so I took motrin for the pain. This along with fever has lasted as of right now for twelve days. I have been in bed for eleven days total. I have been tested for covid, strep, mono, anemia, and a CBC was done. Everything came back normal or negative. This twelfth day the body aches are not as bad as they were. The headache is slightly still there, but not gone. The only correlation to where this headache, fever, and body aches are from is the vaccine. I understand feeling sick for a few days, but going on twelve seems to be too long.


VAERS ID: 1731449 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-21
Onset:2021-09-12
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise, Vaccine breakthrough infection
SMQs:

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

Write-up: Vaccine breakthrough, symptomatic. 9/12 Inpatient admit 9/17 to present,


VAERS ID: 1731571 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-07-01
Onset:2021-09-12
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / 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? 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 19


VAERS ID: 1731597 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / SYR

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

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

Write-up: Both hands and finger tips go numb


VAERS ID: 1731650 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-27
Onset:2021-09-12
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / 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: COVID 19


VAERS ID: 1731652 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Flushing, Hot flush, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) Hydochlorothiazide 25 mg 2) Vitamin D 5,000 IU 3) Losartan 50mg 4) One A Day Men?s +50 Multivitamin 5) Low Dose Asprin 81mg
Current Illness: None
Preexisting Conditions: Slight high blood pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: It started with an itchy scalp followed by sudden hair loss (I would say significant loss) I also was having hot flashes with a flushed face. The hair loss is my concern, I did see my dermatologist and primary care provider. Both were undetermined of what was causing the hair loss.


VAERS ID: 1731949 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-09-12
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

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

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

Write-up: Vaccinated patient hospitalized with COVID-19


VAERS ID: 1732139 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-01
Onset:2021-09-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Angina pectoris, Arthralgia, Chest discomfort, Dyspnoea, Headache, Neck pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart pain , chest tightness , headache , joint pain , neck pain , shortness of breath .


VAERS ID: 1732314 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-06
Onset:2021-09-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Cardiac flutter, Chest pain, Myocarditis, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Heart inflammation, fluttering, chest pain, palpitations


VAERS ID: 1732427 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-01
Onset:2021-09-12
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955/ EN6205 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Computerised tomogram, Dyspnoea, Electrocardiogram, Magnetic resonance imaging, Nausea, Night sweats, Oedema, Sleep disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Suboxone 8 mg. Wellbutrin 300 mg Oxcarbazepine 150 mg Duexis 800 mg Losartan 100mg Vitamin D3 5,000 IU
Current Illness: None
Preexisting Conditions: High BP Depression Cronic Back Pain
Allergies: None
Diagnostic Lab Data: CAT SCAN MRI EKG some others too
CDC Split Type:

Write-up: All the symptoms only started in the year of 2021 . Pitting Edema worsened over the months after shots. Night sweats started mid summer. Night time chills started around early August, or Mid August off and on . End of August I noticed extreme nausea, 24-7 , never easing up unless i took Dramamine, and it only helped for a very short time, then the nausea always returned quickly. First week of September, I started to have shortness of breath , really bad when I bent over, climbed the outside stairs, and especially when I''d lay down on either side for bedtime. I''ve always only slept on my side, so this really worried me. On the night of September 11th 2021, I had hard, lightning type, sharp, chest pains, on my left side that really hurt so much that I sat down on the bed, grabbed my phone to call 911


VAERS ID: 1732817 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-09-12
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Canalith repositioning procedure, Dizziness, Exercise tolerance decreased, Extra dose administered, Gait disturbance, Loss of personal independence in daily activities, Myalgia, Neck pain, Pain in extremity, Vertigo, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (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: An unusual bout of vertigo came on about 10 days after a previous dose of the Moderna COVID-19 vaccine (also at age 84; unsure w
Other Medications: 1) metoprolol 1xday 25 mg 2) calcium 1200 units/day 3) vitamin D3 2000 IU/day 4) magnesium 250 mg/day
Current Illness: None.
Preexisting Conditions: Osteoporosis.
Allergies: No known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: For the past two weeks, PT has had a problem that does not resolve. Received third Moderna dose (100 micrograms) on 8/26/21 in left arm. The only noticeable side effect was stronger arm pain than after the previous doses, and this went away after about 12 hours. About two weeks later, on 9/12/21, she awoke with extreme dizziness/vertigo, vomiting, and incapacitating muscle ache in left shoulder and left side of neck. This pain shifted after several days to all of neck. Around 9/15/21, she tried the Epley maneuver for the dizziness, but this made the dizziness worse. PT spoke to her doctor on the phone on 9/17/21. GP prescribed a prednisone regimen that will end on 9/27/21. She also went in to the doctor''s office on 9/20/21. Prednisone has resolved the pain problem. But the dizzy spells remain. Every night when getting up during the night and every morning when arising is dizzy and unstable enough to need help walking anywhere. The dizziness disappears by noon or early afternoon. After that, she feels just about normal and steady on legs, able to take a 30-minute walk. Yesterday, 9/23/21, she even ran a bit, optimistic that problems were over. On the contrary, the dizziness this morning, 9/24/21, was even worse than before. Prior to 9/12/21, Pt was a very active person who played tennis, swam, walked, and/or ran for several hours a day. The persistent dizziness over the past 2 weeks has forced her to change her lifestyle significantly. Questions include: 1) Could this be a delayed reaction to the Moderna 100-microgram 3rd dose?; 2) If so, what might be the best treatment for continued severe dizziness that has been most pronounced in the morning?; and 3) How long might such a reaction last? Thank you very much.


VAERS ID: 1732838 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-09-12
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Neuralgia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), 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: ACIPHEX 20mg tablet (once daily)
Current Illness:
Preexisting Conditions: acid reflux
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I noticed a rash on my lower-right side on 09/12/2021. By 09/14/2021, the rash spanned from my lower-right side to the middle of my back. I visited urgent care on 09/14/2021. I was diagnosed with Shingles and was prescribed Valtrex (1,000 MG x3 daily). I had an appointment with primary care on 09/22/2021 to address the nerve pain, and I was prescribed Neurontin (300 MG capsule).


VAERS ID: 1733871 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-09-12
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Arm start hurting today; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm start hurting today) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In June 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 12-Sep-2021, the patient experienced PAIN IN EXTREMITY (Arm start hurting today). At the time of the report, PAIN IN EXTREMITY (Arm start hurting today) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medication was provided by the reporter. Reporter did not allow further contact


VAERS ID: 1733878 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-07
Onset:2021-09-12
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 937902 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Inappropriate schedule of product administration, Malaise, Myalgia, Oropharyngeal pain, Pain, Pain in extremity, Vaccination site erythema, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Arthritis (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: ARTANE [ARTEMETHER]; ATENOLOL; GABAPENTIN; ROBAXIN; VISTARIL [HYDROXYZINE EMBONATE]; CELEXA [CELECOXIB]; VITAMIN C [ASCORBIC ACID]; MULTIVITAMIN [VITAMINS NOS]
Current Illness: Blood pressure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Burning and stinging sensation in her arm; Left arm pain, which is really bad and is spreading; At first the pain was only at the injection site, but now it''s travelling; Feeling sick overall; Her arm is red at the injection site; Arm started hurting/arm is hurting almost to her elbow/soreness is all the way to the elbow/muscle aches/muscle soreness; Her joints were hurting/soreness in the joints; Inappropriate schedule of vaccine administered (1st dose on 07-Aug-2021 and 2nd dose of the Moderna vaccine on 12-Sep-2021); She says that on Sunday evening, she started having muscle aches and pains/stinging sensation in her arm; She had a sore throat; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered (1st dose on 07-Aug-2021 and 2nd dose of the Moderna vaccine on 12-Sep-2021)), PAIN (She says that on Sunday evening, she started having muscle aches and pains/stinging sensation in her arm), OROPHARYNGEAL PAIN (She had a sore throat), MALAISE (Feeling sick overall) and BURNING SENSATION (Burning and stinging sensation in her arm) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020F21A and 937902) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure. Concomitant products included ATENOLOL for Blood pressure, ARTEMETHER (ARTANE [ARTEMETHER]), GABAPENTIN, METHOCARBAMOL (ROBAXIN), HYDROXYZINE EMBONATE (VISTARIL [HYDROXYZINE EMBONATE]), CELECOXIB (CELEXA [CELECOXIB]), VITAMIN C [ASCORBIC ACID] and MULTIVITAMIN [VITAMINS NOS] for an unknown indication. On 07-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 12-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 12-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered (1st dose on 07-Aug-2021 and 2nd dose of the Moderna vaccine on 12-Sep-2021)), PAIN (She says that on Sunday evening, she started having muscle aches and pains/stinging sensation in her arm), OROPHARYNGEAL PAIN (She had a sore throat), MYALGIA (Arm started hurting/arm is hurting almost to her elbow/soreness is all the way to the elbow/muscle aches/muscle soreness) and ARTHRALGIA (Her joints were hurting/soreness in the joints). On 14-Sep-2021, the patient experienced MALAISE (Feeling sick overall) and VACCINATION SITE ERYTHEMA (Her arm is red at the injection site). On an unknown date, the patient experienced BURNING SENSATION (Burning and stinging sensation in her arm), PAIN IN EXTREMITY (Left arm pain, which is really bad and is spreading) and VACCINATION SITE PAIN (At first the pain was only at the injection site, but now it''s travelling). The patient was treated with NAPROXEN SODIUM (ALEVE) at an unspecified dose and frequency and PARACETAMOL (TYLENOL) at an unspecified dose and frequency. On 12-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered (1st dose on 07-Aug-2021 and 2nd dose of the Moderna vaccine on 12-Sep-2021)) had resolved. On 18-Sep-2021, PAIN (She says that on Sunday evening, she started having muscle aches and pains/stinging sensation in her arm), PAIN IN EXTREMITY (Left arm pain, which is really bad and is spreading), MYALGIA (Arm started hurting/arm is hurting almost to her elbow/soreness is all the way to the elbow/muscle aches/muscle soreness), ARTHRALGIA (Her joints were hurting/soreness in the joints) and VACCINATION SITE PAIN (At first the pain was only at the injection site, but now it''s travelling) had resolved. At the time of the report, OROPHARYNGEAL PAIN (She had a sore throat), MALAISE (Feeling sick overall), BURNING SENSATION (Burning and stinging sensation in her arm) and VACCINATION SITE ERYTHEMA (Her arm is red at the injection site) outcome was unknown. Concomitant medication also included Clonipine. The received both shots on her left (non-dominant) arm. The patient mentioned that that the 2nd shot was worse than the 1st one. On 13-Sep-2021, the symptoms of the patient became worse. On 14-Sep-2021, her symptoms become better but she still had some muscle soreness as well as soreness in the joints. This case was linked to MOD-2021-320105 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 18-Sep-2021: Significant followup received contains event outcome were updated.


VAERS ID: 1734161 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-05
Onset:2021-09-12
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Maternal exposure during pregnancy, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMIN FOR WOMEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210913; Test Name: ; Test Result: Positive ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101197489

Write-up: Testing positive for covid-19; Testing positive for covid-19; Pregnant; This is a spontaneous report from a contactable consumer (Patient). This consumer reported information for both mother and fetus/baby. This is a maternal report. A 32-years-old pregnant female patient received second dose of bnt162b2 (BNT162B2, solution for injection; Lot Number: EP6955) dose 2 via intramuscular route of administration, administered in Arm Left on 26Mar2021 12:00 as dose 2, single and first dose of bnt162b2 (BNT162B2, solution for injection; Lot Number: EL3248) dose 1 via intramuscular route of administration, administered in Arm Left on 05Mar2021 13:00 as dose 1, single (At the age of 31-year) for covid-19 immunization. Medical history was not reported. Concomitant medication(s) included ascorbic acid, biotin, calcium carbonate, calcium pantothenate, chromium nicotinate, colecalciferol, cupric oxide, cyanocobalamin, ferrous fumarate, folic acid, magnesium hydroxide, manganese gluconate, nicotinamide, Phyto menadione, potassium iodide, pyridoxine hydrochloride, retinol, riboflavin, selenomethionine, sodium molybdate, thiamine hydrochloride, tocopheryl acetate, zinc gluconate (MULTIVITAMIN FOR WOMEN) taken for an unspecified indication, start and stop date were not reported. Patient was not diagnosed with COVID-19, prior vaccination. Patient has not been tested for COVID-19, post vaccination. On 12Sep2021 07:00 the patient experienced testing positive for covid-19 on sept 13, 2021, and pregnant. The mother reported she became pregnant while taking bnt162b2. The mother was 28 Weeks pregnant at the onset of the event. The mother was due to deliver. On 13Sep2021 the patient underwent lab tests and procedures which included sars-cov-2 test result was positive, Nasal Swab. The outcome of the event testing positive for covid-19 was recovering for and it was unknown for the rest.


VAERS ID: 1734163 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Loss of consciousness, Pallor, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), 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? 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 INC202101198149

Write-up: Passed out; Her lips were white; Slept all day and night; Fatigue; This is a spontaneous report from a contactable consumer (patient''s mother) A 15-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm, on 11Sep2021 at 14:00 (Lot Number: 301358A), at the age of 15 years old, as 2nd single dose for COVID-19 immunisation. Medical history was reported as none. There were no concomitant medications. There were no prior vaccinations within 4 weeks of the BNT162b2 vaccination. Past drug vaccinations included the 1st BNT162b2 single dose (Lot: FA6780) administered on 22Jul2021 at about 10 am, in the left arm. The patient''s mother stated that at 11am on 12Sep2021 her daughter woke up and came downstairs, then she saw stars and passed out. This lasted about a minute and then she came too, her lips were white when this happened. She was a lot better at the time of the reporting but after the passing out she slept all day and night. The reporter tried to wake her up to check on her but she kept sleeping. The patient also had fatigue on 12Sep2021 that at the time of the reporting was not all the way gone but the patient was better. The patient was treated with rest and liquids. The patient recovered from passing out and sleeping all day on 12Sep2021. The patient was recovering from fatigue. The outcome for pale lips was not specified. There was no need for a visit to Emergency Room, neither at the physician''s office. According to the reporter the events were considered non-serious. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1734647 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Hypoaesthesia, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (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: Metoprolol once daily Losartin once daily.
Current Illness:
Preexisting Conditions: High blood pressure.
Allergies: No known allergies.
Diagnostic Lab Data: No labs.
CDC Split Type:

Write-up: Tingling, numbness loss of strength in right hand, tiredness, pain in my joints, nerve twitches.


VAERS ID: 1735432 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-10
Onset:2021-09-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Antinuclear antibody negative, Arthralgia, Blood potassium decreased, Full blood count normal, Headache, Influenza virus test negative, Joint swelling, Myalgia, Nausea, Rheumatoid factor negative, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (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: Creator Bystolic Januvia
Current Illness:
Preexisting Conditions: Diabetes Hypertension
Allergies: Sulfa Lortab Minocycline Cipro Imitrex
Diagnostic Lab Data: Cbc normal x1. Potassium low x 1 Covid test negative x 2 Flu negative Rheumatoid factor negative Ana negative
CDC Split Type:

Write-up: Headache for weeks now Joint pain/swelling for weeks now Muscle aches for days Stomach upset for two weeks Nausea for last week


VAERS ID: 1735505 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: 9/12/21 6:00am vomiting began 7:30am diarrhea began 7:30am severe exhaustion began Slept through the night 9/11/21-9/12/21. Napped from 10:00am to 1:00pm. Then again napped 3:00pm to 6:00pm. 6:00pm headache began Slept again through the night. Severe fatigue and headache continued through 09/13/21


VAERS ID: 1735521 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-22
Onset:2021-09-12
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Brain stem haemorrhage, Computerised tomogram head abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

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

Write-up: Large pontine hemorrhage without hydrocephalus is considered incompatible with meaningful survival. Repeat CT of the head pending. There is no indication for neurosurgical intervention.


VAERS ID: 1735789 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-01
Onset:2021-09-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Change in sustained attention, Chest discomfort, Disorientation, Disturbance in attention, Dizziness, Dyspnoea, Feeling abnormal, Heart rate increased, Immediate post-injection reaction, Insomnia, Memory impairment, Menstrual disorder, Panic attack, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No prescriptions Vitamin C Omega 3 oil with vitamin D
Current Illness: None
Preexisting Conditions: Anxiety
Allergies: No allergies Sensitive to ephedrine in cold/flu medicine Lactose sensitive
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately after shot dizzy, rapid heartbeat, chest pressure, shortness of breath, followed by panic attack due to physical symptoms. Up until present: brain fog/unable to concentrate or focus, insomnia, occasional rapid pulse, shortness of breath, off and on dizziness, spatial awareness completely off, short term memory problems, freezing cold feet, strange menstrual period?.


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