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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 208 out of 8,010

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VAERS ID: 1694548 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthropathy, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Losartin Carvedilol Xeljanz Methotrexate Naproxen Tramidol
Current Illness: Kidney Stone 8/2021
Preexisting Conditions: Psoriatic Disease Hypertension
Allergies: Norvasc
Diagnostic Lab Data: medical exam
CDC Split Type:

Write-up: swelling in left arm, left upper body, throbbing joints


VAERS ID: 1694599 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Feeling abnormal, Feeling hot, Hyperhidrosis, Pallor, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Pt came to get his first Moderna covid shot 9.11.21. After receiving the shot, he sat near the registers for his 15 min observation time. 10 min after the shot, I heard a disturbance at the registers. The pt was very pale and complained of "not feeling right." He said he thought he may have had a seizure, he was not aware of his surroundings for a period of time and felt his eyes rolling in his head and was light-headed. I encouraged him to put his head between his knees; he was extremely sweaty and hot. We got him some ice water and a snack, and I told him he should stay sitting until he felt stronger. He denied having this kind of reaction with other vaccines or any time in his life. I also encouraged him to check with his PCP before getting the second dose of covid vaccine. His sister was able to drive him home when the time came. He left about 20-25 min after this event. I tried calling him three times throughout the day to check on him, but he never picked up and he did not have a voicemail set up. I tried calling again 9.13.21 but no response.


VAERS ID: 1694608 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-13
Onset:2021-09-11
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 RA / IM

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

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

Write-up: Patient tested positive for COVID on 9/11/2021


VAERS ID: 1694614 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Boniva Anastrozole Metoprolol Tartrate Succinate Eliquis Atrovastatin Lasix Vitamin D3 Oscal + D Miralax Cranberry with vitamin C Omega 3s
Current Illness: Follicular lymphoma. Not progressing
Preexisting Conditions:
Allergies: Musels
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Blood pressure,. On 9/11: 8:01 am 81/66 8:56 am 73/61 9:15am 104/78 9:50 am 111/73 10:12 m 87/73 10:20 am 80/66 2:56 pm 87/67 5:20 pm 110/3 9:00 pm 115/83


VAERS ID: 1694635 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-02-04
Onset:2021-09-11
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID-19 Sofia antigen test with a positive result.
CDC Split Type:

Write-up: Patient received the Pfizer COVID-19 vaccine on 1/14/21 and 2/4/21 so was fully vaccinated when they tested positive for COVID-19 on 9/11/21. The patient was admitted to the Med/Surg unit at Hospital with a diagnosis of COVID-19.


VAERS ID: 1694758 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-07
Onset:2021-09-11
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization due to COVID-19.


VAERS ID: 1694782 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Dyspnoea, Feeling of body temperature change, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: Waiting on Patient to bring in documentation when he returns to work on 14 Sep 2021.
CDC Split Type:

Write-up: Patient stated he received vaccine on Saturday 11 Sep 2021 at 1118. When he arrived home at 1630, he had no energy and was experiencing all over body aches and pain. He went to sleep and didn''t wake up until the next morning. Once he arrived at work the next day he had a severe headache, fever, chills, feeling hot and cold at the same time, loss of appetite and difficulty breathing. Patient left work at 0720 and went to clinic.


VAERS ID: 1694823 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-17
Onset:2021-09-11
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Anorectal varices, COVID-19, Computerised tomogram abdomen abnormal, Confusional state, Diarrhoea, Gastrointestinal disorder, Hepatic cirrhosis, Inflammation, Proctitis, SARS-CoV-2 test positive, Splenic lesion
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH of CLL/MDS (not currently on treatment), CAD s/p NSTEMI, asthma, hemorrhoids, hyperlipidemia, anxiety, GERD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to ED on on 9/11/21 after experiencing 3 days of abdominal pain, diarrhea, and confusion. Patient denied any respiratory symptoms and was not found to be hypoxic. A CT abdomen/pelvis showed inflammatory changes suggesting portal colopathy/rectal varices vs proctitis, signs of cirrhosis, and a hypodense lesion in the spleen. A COVID test was done in the ED on 9/11/21, and it came back positive. Patient is fully vaccinated for COVID (s/p 3 doses of Pfizer vaccine on 2/3/21, 2/24/21, and 8/17/21). Patient was admitted for further work-up and remdesivir was started because her MD believed the diarrhea was mainly due to COVID. Lovenox was also started as VTE prophylaxis. Patient is currently on day 2 of hospitalization and is still saturating well on room air.


VAERS ID: 1694827 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 - / IM

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

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

Write-up: Numbing and swelling at the site of injection.


VAERS ID: 1694842 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Migraine, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hives, 19 years old, Dec 2002, Influenza vaccine.
Other Medications: Ajovy, Ubrelvy, Topiramate, Fiorcet, Sumatriptan, Fexofenadine, Montelukast, Ferosul, Vitamin D2, Epi-pen
Current Illness: Migraines
Preexisting Conditions: Migraines
Allergies: Latex, feathers, peanuts, tree nuts, melons, avocados
Diagnostic Lab Data: Ajovy injection 225mg/1.5 mL in left thigh on 10 SEP 2021 @ 1445.
CDC Split Type:

Write-up: Migraine, swollen arm, pain at injection site, fatigue


VAERS ID: 1694857 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

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

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

Write-up: Large amount redness and itching in left upper arm, also headache that started 09/11/21. 09/13/21 redness improving, continues to have headache and itching. Has not taken any meds for side effects.


VAERS ID: 1694865 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu Shot
Other Medications: jardiance 25 mg Tylenol
Current Illness: no
Preexisting Conditions: type 2 diabetic alpha 1
Allergies: coconut ,penicillin, artificial sweetener latex
Diagnostic Lab Data: Went to ER was given Benadryl IV
CDC Split Type:

Write-up: Anaphylaxis reaction .


VAERS ID: 1694870 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Syringe issue, Underdose
SMQs:, Medication errors (broad)

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

Write-up: Syringe malfunctioned and patient did not receive full dose, however pharmacist stated over 1/2 dose was believed to be given at time of injection.


VAERS ID: 1694883 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-19
Onset:2021-09-11
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Delivery, Exposure during pregnancy, SARS-CoV-2 test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: G3P1, DELIVERED 39 WEEKS EGA, BABY DELIEVERED 6# 8 OZ . MOM ASYMPTOMATIC COVID+ 5/2021 (PER PT REPORT) AND 9/11/2021)


VAERS ID: 1694925 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-06
Onset:2021-09-11
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: Tested positive for COVID 9/11/21 after being fully vaccinated.


VAERS ID: 1694938 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: redness and swelling around the injection site on the 7th day after vaccination, lasted for 4 days
Other Medications: primolut-nor
Current Illness: no
Preexisting Conditions: no
Allergies: allergic reaction to insects (bees etc)
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever for 2 days, 38.7... 38.0 Celsius. pain in the muscle around the injection site.


VAERS ID: 1695007 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth, Lymphadenopathy, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira, Asacol, Nexium, Vitamin C, D
Current Illness: N/A
Preexisting Conditions: UC, asthma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large hive like, red, itchy, hot spot at vaccine site. Very sore arm as well. Slight swelling of lymph node in arm pit area of arm that was vaccinated.


VAERS ID: 1695012 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Malaise, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: A few minutes after the patient had received her vaccine, her mother came up to the counter and stated the patient was not feeling well. The patient was nauseous, pale, and dizzy. She was sitting in a chair. I put an ice pack on the patient''s neck and wrists. After 5 minutes or so, she started feeling better. I gave her some water. Within 15 minutes, she was feeling back to normal and the color had returned to her face. Her mother stated the patient has had this happen before at the doctor''s office due to anxiety around immunizations. Patient and her mother waited around 20 minutes before leaving. Patient was back to baseline before leaving the store.


VAERS ID: 1695234 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Vitamin C Vitamin D Zinc Beyaz Pristique
Current Illness: None
Preexisting Conditions: SVT
Allergies: CT Scan Dye Sudafed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart rate range from 178-200 all night. Ended up in ER. Referral to cardiologist.


VAERS ID: 1695245 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site reaction, Rash erythematous, Rash papular
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm-large red raised rash that started at injection site and went to armpit


VAERS ID: 1695253 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Disorientation, Hypoaesthesia, Myalgia, Paraesthesia, Swelling, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (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: Lisinipril, hydrochlorothyacide
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, disorientation, muscle aches in backs of calves, tingling in front of legs, below the knees, feet numb....swelling in arm at vaccination site, as well as under arm in armpit area.


VAERS ID: 1695461 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 - / SYR

Administered by: School       Purchased by: ?
Symptoms: Ear pain, Facial pain, Headache, Neuralgia, Pain, Pain in jaw
SMQs:, Peripheral neuropathy (narrow), Glaucoma (broad), Osteonecrosis (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Woke up with nerve/throbbing pain in right side of face including, ear, eye and back of head,jaw and inside of mouth. Has continued for 3 days now.


VAERS ID: 1695479 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Hyperhidrosis, Nausea, Pain, Pyrexia, Renal pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor 75mg daily
Current Illness: None
Preexisting Conditions: Anxiety depression
Allergies: Sulfa antibiotic
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe nausea, severe body aches (lower), severe kidney pain, weakness, chills, sweats, fatigue, low grade fever for 48 hours.


VAERS ID: 1695483 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Patient had received one dose of the Janssen COVID-19 vaccine. patient states that the injection site was sore, red, and hot to the touch after a few days after receiving the vaccine. patient''s husband called on 09/11/2021 stating that there was bruising and redness around the site of injection. initially, the use of ibuprofen and benadryl was suggested, but after further investigation, the patient stated that the condition looks like it was worsening and/or spreading. upon hearing this, it was suggested that the patient may want to consider going to urgent care just in case. called the patient 09/13/2021 as a follow-up. at urgent care, the provider stated that it may possibly be an allergic reaction or an infection. patient was prescribed bactrim, had been taking for 2 days and the patient reports feeling a bit better.


VAERS ID: 1695506 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-04
Onset:2021-09-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Just changed my hormone replacement from Bijuva to an estradiol and progesterone separate pills .
Current Illness: No
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: Have a dr appt on the 24th of September
CDC Split Type:

Write-up: After a week I have started to itch throughout my whole body. On my head neck back, chest arms, legs , feet. I feel like I have head lice . Seems to be getting worse. Sometimes feels like needles pricking me or something biting me. Changed my hormone pills at the same time so I?m not sure if it is this


VAERS ID: 1695511 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: chest tightness started 9/11, worse and 9/12 and worse on 9/13. Fatigue 9/11-9-13, achy muscles in legs 9/11-9/13.


VAERS ID: 1695520 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Exposure during pregnancy, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Rash or hives all over my belly, first pregnancy and due date 10/19/2021


VAERS ID: 1695521 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Dizziness, Ear inflammation, Feeling abnormal, Heart rate increased, Laboratory test, Migraine, Muscle twitching, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: none
Preexisting Conditions: no
Allergies: no food allergies were not aware of medication allergy at the time of vaccine
Diagnostic Lab Data: CT Scan conducted on Sept 13, 2021- normal test results ECT Test conducted on Sept 13, 2021 - normal test results Blood Test conducted on Sept 13, 2021- normal Ear exam conducted on Sept 13, 2021 indicated ear inflamation
CDC Split Type:

Write-up: -tingling/twitching of fingers and toes -dizzy -foggy thoughts/slow response time -rapid heartbeats -migraines -ear inflammation -ear ringing


VAERS ID: 1695730 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Echocardiogram, Electrocardiogram, Myocarditis, Troponin
SMQs:, Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Post Covid vaccination associated myopericarditis


VAERS ID: 1695737 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JNJ201A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dizziness, Heart rate irregular
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel 14 mg
Current Illness:
Preexisting Conditions: Lyme disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, heart irregular beating , chest pain , weakness


VAERS ID: 1695750 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C 1,000 mg, ibuprofen 500 mg
Current Illness: None
Preexisting Conditions: High blood pressure, obesity
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, swelling, tenderness & warmth at the injection site. Initially I couldn?t even see where I received the injection. However, approximately 12 hours later the injection site became very tender and a hard lump began forming. Over 72 hours later, the injection site is not improving. I also feel very fatigued and I have an upset stomach. Not nausea; more like acidy. It?s been over 72 hours since the injection and although I feel better than I did in the first 12 hours, I?m still not back to normal. It?s like an all over fatigue that isn?t related to physical exertion or lack of sleep. I just want to feel like I did before the vaccine.


VAERS ID: 1695781 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-01
Onset:2021-09-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood urine present
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (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: Amlopine Metformin Avorstatin Lantas Vitamin d Low dose aspirin
Current Illness:
Preexisting Conditions: Diabetic PTSD Hypertension Chronic pain
Allergies: N/a
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Back pain blood in urine


VAERS ID: 1695786 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Feeling cold, Headache, Limb discomfort, Mobility decreased, Pain, Palpitations, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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: Over the counter allergy medication Allegra-D
Current Illness: Seasonal allergies.
Preexisting Conditions: Seasonal allergies/asthma.
Allergies: none
Diagnostic Lab Data: Pulse ox 89%, HR 115, body temperature 102.5.
CDC Split Type:

Write-up: After receiving the vaccine my arm felt extremely heavy, swelling and hot. I was not able to elevate my arm above my shoulder level. I started developing chills, body aches and severe fatigue. Then, I started developing a severe headache, fever of 102.5, heart rate of 115, chest palpitations and shortness of breath. I started taking 650mg of Tylenol every 6hrs to control the fever, but it persisted for more than 24hrs. Albuterol Sulfate HFA inhalation 90mcg every 4-6hrs, 1-2 puffs, I drank about 5 liters of pedialyte in 48hrs and regular water to keep hydrated. I applied cold compressions to my left shoulder. I will continue to monitor these severe symptoms with the possibility to go to the hospital emergency room if they do not improve within the next 48hrs.


VAERS ID: 1695803 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan potassium, Ativan, apple cider vinegar gummies, multi vitamin gummies
Current Illness: Sinus head cold 2 weeks prior
Preexisting Conditions: High blood pressure, anxiety
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe pounding headache, fever, chills, body aches, arm pain, redness, elevated blood pressure.


VAERS ID: 1695806 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: mixed series: first dose was Moderna, 2nd dose was Pfizer (9/11/21) in 2-dose series. There was no immediate adverse reaction during 15 minutes observation period after vaccination.


VAERS ID: 1695810 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Covid-19 positive on 8/31/21
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Muscle weakness to bilateral upper extremities. Started the day after and has still persisted 4-5 days later with no changes.


VAERS ID: 1695814 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-07
Onset:2021-09-11
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood test Ultrasound 9-12-2021
CDC Split Type:

Write-up: Deep Vein Thrombus. Mid femoral vein to calf.


VAERS ID: 1695845 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FP8448 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Chest pain, lasted about 6 hours, went away on its own.


VAERS ID: 1696039 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Sarcoidosis
Allergies: Shellfish
Diagnostic Lab Data: Shingles PCR pending (9/14/21 collected)
CDC Split Type:

Write-up: Rash on anterior thighs (right $g left) that appeared consistent with shingles outbreak


VAERS ID: 1696047 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 RA / IM

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

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

Write-up: Patient''s arm is swollen and red from injection site and several inches around . It is becoming more painful and irritating each day since the vaccine was administered on 9/10.


VAERS ID: 1696061 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

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

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

Write-up: Patient stated that he was 12 years old. Mother completed form and falsified DOB to 5/10/2009. During later entry of vaccine into system, it was discovered that patient''s DOB is 5/10/2010. This nurse called the mother, who verified that patient''s DOB is 5/10/2010, states that she entered the year incorrectly on form. Advised mother to contact child''s pediatrician about child receiving vaccine, and advised that 2nd dose in series will need to be determined by pediatrician.


VAERS ID: 1696080 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, C-reactive protein increased, Cardiac imaging procedure abnormal, Chest discomfort, Chest pain, Cough, Discomfort, Dizziness, Dyspnoea, Ejection fraction decreased, Electrocardiogram PR segment depression, Electrocardiogram ST segment elevation, Hyperhidrosis, Liver function test normal, Magnetic resonance imaging heart, Myocarditis, Pain, Pericardial effusion, Pericardial fibrosis, Pericarditis, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Troponin increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xarelto from unprovoked DVT that was found on 8/25/21 (Initial Moderna vaccine dose #1 given on 8/13/21.)
Current Illness: Patient presented to the ED for a DVT that was found on 8/25/21. This was unprovoked. He has not had a completed hematology workup of DVT.
Preexisting Conditions: Dyslipidemia
Allergies: Sulfa antibiotics.
Diagnostic Lab Data: 9/13/21: EKG was obtained which shows diffuse ST segment elevation and PR depression, along with PR elevation and ST segment depression in AVR. CRP 12.5. ESR 32. Initial troponin 5.20, and trended down to 1.94. Pt negative for covid. LFTs normal. 9/14/21: cMRI obtained consistent with pericarditis with some myocardial involvement consistent with myopericarditis. Normal LV size, wall thickness and systolic function - LVEF 64%. No late gadolinium enhancement. Normal RV size and function. Normal atria. No significant valvular pathology. The pericardium is mildly thickened along the lateral cardiac border, with some tethering seen. There is a trivial pericardial effusion primarily along the lateral cardiac border. Pericardial late gadolinium enhancement along the lateral border noted.
CDC Split Type:

Write-up: *Following patient''s first Moderna vaccination (8/13/21), he developed pain and swelling in his left lower extremity which started on 8/21/21. A D-dimer was completed which was negative. An US was then obtained on 8/25/21 which showed a gastrocnemius thrombus extending into the popliteal vein. Pt was encouraged to present to the ED and was started on xarelto on 8/25/21. *Following patient''s second Moderna vaccination (9/10/21), he developed severe body aches, fevers, chest pain and SOB. Patient presented to the ED on 9/13/21 Pain worsened with lying flat. Leaning forward did not alleviate the pain. Pt notes that he initially thought he had bad reflux, then it felt like a cracking chest pressure. He has felt very uncomfortable lying flat with coughing and SOB. He also notes some bloating, diaphoresis, and lightheadedness. Patient was provided with ibuprofen 600mg PO TID along with colchicine 0.6mg 1 tab PO BID. On 9/14/21, he continued to have symptoms only with increased movement, otherwise his symptoms were improving. He continued to have diaphoresis. Plan is to continue colchicine x3 mos along with ibuprofen for the next 2 weeks, then taper down.


VAERS ID: 1696091 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 UN / IM

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

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

Write-up: PATIENT WAS GIVEN WRONG 2ND DOSE. MODERNA COVID19 WAS GIVEN AT FIRST VISIT.


VAERS ID: 1696114 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F/T6780 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injected limb mobility decreased, Myalgia, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: seborrheic dermatitis
Allergies: penicillin
Diagnostic Lab Data: Had vital signs taken. Within normal limits. 9/12/21
CDC Split Type:

Write-up: Muscle soreness throughout entire left arm. Inability to raise left arm above shoulder for 48hours. Additional symptoms included head ache and body aches.


VAERS ID: 1696116 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN_4_7: ADENOVIRUS TYPES 4 & 7, LIVE, ORAL (NO BRAND NAME) / TEVA PHARMACEUTICALS - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Ear discomfort, Extra dose administered, Headache, Nausea, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), 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: Topamax Linzess Diltiazem CD Maxalt prn
Current Illness: None
Preexisting Conditions: Migraine IBS-C SVT
Allergies: Zomig
Diagnostic Lab Data: Initial symptoms resolved after about 20 minutes. Contacted allergy/ immunology Monday am but at that point 48 hours later and too late to perform testing. Now trying to locate vaccine to perform skin testing. I am an infectious disease doctor and will need to clarify if I am truly allergic.
CDC Split Type:

Write-up: Throat tightening and ear pressure started about 5-10 minutes after injection and lasted for about 20 minutes. Concern for Type I hypersensitivity reaction. Ultimately in next 36 hours- rigors, n/v/d and headache. I did fine with the first 2 doses.


VAERS ID: 1696117 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Sleep disorder
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: Gabapentin 300 MG Cyclobenzaprine HCI 10 MG Acetaminophen-Codeine 300-60 MG Bystolic 20 MG Lisinopril-HCTZ 20-25 MG Ecotrin NSAID 81 MG Centrum Silver Multi-Vitamin
Current Illness: None
Preexisting Conditions: Neuropathy Hypertension Chronic Back Pain
Allergies: None Known
Diagnostic Lab Data: na
CDC Split Type:

Write-up: I experienced extremely excruciating pain constantly in my right foot;on the second day of taking the second dose of Moderna! I was unable to find any relief and was unable to sleep or do anything for 3 days and nights! The pain was unbearable and the gabapentin did not help any at all. On the forth day, the pain finally subsided.


VAERS ID: 1696122 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: shell fish and pollens
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urgent Care Doctor diagnosed rash that appeared after 2nd Pfizer vaccine as shingles.


VAERS ID: 1696143 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-06
Onset:2021-09-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Mensural bleeding out of cycle. It has been continuous for almost a week now.


VAERS ID: 1696217 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052EZ1A / 1 LA / SYR

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

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

Write-up: Red baseball circular size swelling in arm at injection site. Itching , hot to the touch.


VAERS ID: 1696225 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-09-11
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / UNK - / 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: positive covid 19 test


VAERS ID: 1696232 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Piercing Headache for 3 days, extreme body aches, chills and nausea


VAERS ID: 1696233 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-22
Onset:2021-09-11
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Gait disturbance, SARS-CoV-2 antibody test, SARS-CoV-2 test positive
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet,chewable Directions: 1 tablet oral daily (Active) atorvastatin (Lipitor) 40 mg Tablet Directions: 1 tablet oral daily at bedtime (Active) clopidogrel (Plavix) 75 mg Tablet Directions: 1 tablet oral daily (Active
Current Illness:
Preexisting Conditions: Diabetes, Dyslipidemia; TIA. Anxiety. . L Cataract / IOL Implant, R Cataract / IOL Implant; Left Knee surgery - arthroscopy. . Smoking Status Never Smoker.
Allergies: NKDA
Diagnostic Lab Data: SARS-CoV-2 Antigen (+) 9/11 SARS-CoV-2 PCR (+) 9/12 SARS-COV-2 IgM 0.09, IgG 0,.02 on 9/12 SARS-CoV-2 IgG2 QT-SPIKE 418.3
CDC Split Type:

Write-up: Admitted with "wobbly" gait and incidental finding of COVID + PCR and Antigen, was not treated.


VAERS ID: 1696250 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Headache, Injection site pain, Oropharyngeal pain, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

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

Write-up: Soreness/pain at the injection site, headache, drowsiness, slight sore throat (persisted over approximately 48 hour period, seem to be dissipating)


VAERS ID: 1696254 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-05
Onset:2021-09-11
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 9/12/21 SARS/COV-2, NAAT positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1696263 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-03
Onset:2021-09-11
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone increased, Chest pain, Dyspnoea, Electrocardiogram abnormal, Hypothyroidism, Laboratory test, Lymphadenopathy, Palpitations, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypothyroidism (narrow), Hyperthyroidism (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 125mcg Viibryd 10mg Multivitamin B12
Current Illness: None
Preexisting Conditions: Thyroidectomy 2013 Sjogrens syndrome
Allergies:
Diagnostic Lab Data: Blood labs
CDC Split Type:

Write-up: After 1st covid vaccine I have a swollen lymph node under my right arm. That is still there after getting my 2nd vaccine in my left arm as Dr recommend using opposite arm. One week after 2nd vaccine I started to get palpation. After two days of this I went to er because my heart rate was in the 160s just walking around the house. I also experienced shortness of breath and chest pains. Er dr gave fluids, did ekg that showed tachycardia. They also ran labs and it showed my tsh levels were really high at 32 making me hypo which has not happened in years. My last labs were done just in July and they were great with my tsh being 1.67. I take my medicine daily first thing in the morning with no food or drinks besides water for several hours. I regularly fast till lunch. Now all of a sudden my levels are off the charts and my dr said she is blown away and has no idea why this is happening. They have no clue if the vaccine causes this due to LACK OF STUDYING and you fools says it''s safe. So this is a issue and needs to be looked into further because my Dr''s have no clue why or what to do and that is very unsettling.


VAERS ID: 1696292 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cardiac flutter, Eye pain, Headache, Muscular weakness, Musculoskeletal stiffness, Peripheral swelling, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Tachyarrhythmia terms, nonspecific (narrow), Hearing impairment (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Gluten
Diagnostic Lab Data: I have not gone in yet. It is day 4
CDC Split Type:

Write-up: Aching in joints specifically the knees Stiffness in fingers and puffiness Headache behind the eyes Heart fluttering and weakness in legs Ringing in ears


VAERS ID: 1696307 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-11
Onset:2021-09-11
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 9/13/21 SARS/COV-2, NAAT, Positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1696310 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cervical radiculopathy, Condition aggravated, Fatigue, Fibromyalgia, Inflammation, Pain
SMQs:

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

Write-up: In the afternoon of 9/11 I noted a flare of my fibromyalgia coming on. I haven''t had one in so long I can''t remember the last one. All of my old standard pain sites that hurt with a flare were inflamed, including a nerve issue in my neck, and I was exhausted. The problem persists.


VAERS ID: 1696321 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Hyperhidrosis, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Fatigue staring 24 hours after vaccination and lasting 48 hours. Headache 72 hours after vaccination. Sweats and chills, cough, nausea and vomiting all 72 hours after vaccination.


VAERS ID: 1696341 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Condition aggravated, Dizziness, Electrocardiogram normal, Fear, Feeling abnormal, Gait disturbance, Hyperhidrosis, Loss of consciousness, Nausea, Respiratory rate increased
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin Humalog and Lantus, Verapamil, Lisinopril, VitaminD3, Synthroid, Alpha Lipoic Acid
Current Illness: Type 1 Insulin Dependent Diabetes Hashimoto''s Hypothyroidism Hypertension Sciatica
Preexisting Conditions: Type 1 Insulin dependent Diabetes Hashimoto''s Hypothyroidism Hypertension peripheral neuropathy in feet
Allergies: Sulfa and Iodine
Diagnostic Lab Data: EMT''s did the following. EKG normal BP 150/59 Blood sugar 150
CDC Split Type:

Write-up: Suddenly got weak and felt very faint, nausea and profuse sweating, rapid breathing . I crawled to phone called 911 and was barely able to get my words out then I passed out twice while lying on kitchen floor, holding on to the phone with dispatcher while waiting for EMT''s to arrive). I felt like I was dying. My blood sugar was 150, my BP was 150/59 and they checked me out thoroughly. Oxygen levels okay and EKG fine.. We discussed possible Anxiety attack but that did not make sense as i was going about my normal routine and was not upset about anything. I have passed out a couple times in my life but I''ve never felt like that or had anything like this happen to me before! It''s hard to know with all my other conditions exactly what happened but this event was nothing like anything I''ve experienced before. I am following up with my doctor and seeing if I need medication adjustments but I don''t think there is any definitive answer and I''m afraid to get the second dose of the vaccine now.


VAERS ID: 1696391 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Heart rate increased, Hyperhidrosis, Pyrexia, Swelling face, Vitreous floaters
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retinal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: couple hours after vaccine started getting a headache had a fever of 104.8, chills, sweating, rapid heartbeat, seeing flutters, left side of face swollen


VAERS ID: 1696459 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Pyrexia, Vaccination site erythema
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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:
Current Illness:
Preexisting Conditions: Folliculitis, hyperlipidemia, hypertension, palpitations, prediabetes and thrombocytosis.
Allergies: amlodipine, amoxicillin, atorvastatin, Bactrim, codeine, erythromycin, Darvocet-n 100, hycodan, pravastatin, tylox, ultram and vicodin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt states that the next morning after vaccine (9/11), she woke up with a slight fever of 101. Pt took Tylenol and the fever went away the same day. 9/13 pt states her Left arm was itchy and the vaccine site was red.


VAERS ID: 1696482 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram normal, Laboratory test normal, Magnetic resonance imaging head normal, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None
Preexisting Conditions: None
Allergies: Egg
Diagnostic Lab Data: MRA/MRI Brain - 09/11/2021 - normal exam Labs essentially normal.
CDC Split Type:

Write-up: The patient reports that she had a witnessed seizure event after having breakfast at a local restaurant. EMS was called and they administered Ativan for witnessed seizure activity. Patient was transported to the emergency department for further evaluation and treatment. Patient is seizure-free since her arrival to our emergency department. Coincidently the patient had her second Covid vaccination yesterday and there is concern that the seizure might be associated with her vaccination.


VAERS ID: 1696485 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-25
Onset:2021-09-11
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 - / -

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: Tested positive for covid


VAERS ID: 1696506 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Carditis, Chest X-ray, Chest discomfort, Chest pain, Chills, Computerised tomogram thorax, Discomfort, Exposure during pregnancy, Pain, Pyrexia, Scan, Urine analysis, Viral parotitis, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal (Nature Made) - 1xday CoQ10 (vitamin) - 1xday Levothyroxine - 1xday (dosage unknown)
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: Blood work Chest X-ray Chest CT Scan Urine Sample
CDC Split Type: vsafe

Write-up: I woke up with the typical side effects. I had fever, body aches, and chills. I just treated it with Tylenol to keep my fever down. Starting at about noon on the 11th, I started feeling tightness in my chest. It was uncomfortable, but not extremely painful. Throughout the day, those events started happening more frequently and became more uncomfortable. We spoke with my OB and she told us to go to the ER. We went to the ER at about 8:30pm. They ruled out that it was not a blood clot in my lungs. They noticed a spike in my white blood cells. They gave me an IV with antibiotics. They determined that a certain level in my labs was increasing at a concerning scale. It basically doubled or tripled in a matter of hours. The fever made the chest pains worse.I was dealing with fever, body aches, and increasing discomfort. I had chest pressure and pain. That lasted through the 11th. Finally on the 13th, it started to resolve. The fever started going down and the chest pain was going away. It started getting under control. The baby was fine through everything. I suffered through viral parotitis (inflammation of the heart). As of yesterday, my Petronian levels were still going down and they were in the 80s. I was discharged yesterday evening and my levels are still going down. I am due October 29th. I was 33 weeks pregnant.


VAERS ID: 1696522 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Headache, Intensive care, Pain, Paraesthesia, Troponin increased
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: At local ER: Troponin level 1.73 ng/ml EKG: ST elevations During hospitalization at Hospital from 9/11-9/14/21: Troponin on admission: 5.76 ng/ml Peak troponin level: 7.57 on 9/11/21 Troponin on discharge home on 9/14/21: 0.29 ng/ml EKG on admission on 9/11/21: Normal sinus rhythm Echocardiogram on admission on 9/11/21: 1 - Normal intracardiac anatomy. 2 - Normal chamber sizes, wall thickness, septal position and systolic function. 3 - Normal venous connections, coronary artery origins, and left aortic arch with normal branching. Repeat echocardiogram on 09/13/2021: Impression: 1 - Normal cardiac sizes, wall thickness, septal position and systolic function. 2 - Left ventricular biplane ejection fraction 56%, fractional shortening of 32%, global longitudinal strain of minus 20%, no pericardial effusion.
CDC Split Type:

Write-up: The patient was vaccinated with the second dose of the Pfizer COVID-19 vaccine on 9/7/21. He developed headache , abdominal pain, and general body aches on 9/10/21. On the morning of 9/11/21 he developed sudden onset mid sternal chest pain and left arm tingling. He was evaluated at a local ER and troponin was elevated at 1.73 and EKG showed ST elevations. He was transferred and admitted to Cardiac ICU on 9/11/21 for monitoring. On admission, repeat troponin level was 5.76. EKG and echocardiogram were normal on admission. Troponin peaked at 7.57 on 9/11/21 and then gradually declined. By discharge home on 9/14/21, troponin level was down to 0.29. No medications were administered during hospitalization. Close monitoring and serial troponin levels were performed. He remained hemodynamically stable and breathing room air during his hospitalization. Chest pain resolved 24 hrs after admission.


VAERS ID: 1696530 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID-19 VACC MDV #1 and #2
Other Medications: Leflunomide 20mg / day Gabapentin 600 mg/ day
Current Illness: n/s
Preexisting Conditions: Unidentified auto-immune disorder; erythromelalgia; migraine
Allergies: Latex; walnuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on stomach, chest, neck. Rash looked like slightly raised red speckles. Did NOT itch. Resolved in 36 hours.


VAERS ID: 1696538 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-02-26
Onset:2021-09-11
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9265 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Productive cough, Pyrexia, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HNT HLD, GERD
Allergies: Niacin, PCN
Diagnostic Lab Data: SARS CoV2 PCR COVID19 detected on9/11/21
CDC Split Type:

Write-up: He received Pfizer Covid Vaccines on 2/6/21 and 2/26/21. He was admitted on 9/11/21 due to abdominal pain, productive cough, and fever. On hospital day number 4, he is on room air with Saturation of 94%.


VAERS ID: 1696541 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fatigue, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (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: Taltz monthly injection Duloxetine 30 mg. twice a day
Current Illness:
Preexisting Conditions: psoriatic arthritis being treated with taltz orthostatic hypotention resulting in convulsive syncope and nerve pain being treated with duloxetine
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna Covid-19 Vaccine EUA Fatigue, Weakness, facial swelling


VAERS ID: 1696557 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Dyspnoea, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Paraesthesia, Pruritus, Pyrexia, Rash, SARS-CoV-2 test, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Immediately after my first vaccine on Friday, 8/20/21, I had burning that traveled down my arm and into my thumb and 1st finger.
Other Medications: 1000 mg Acetaminophen (taken one hour before vaccine) Zyrtec (taken morning of vaccine)
Current Illness: None that I am aware of.
Preexisting Conditions: No.
Allergies: None.
Diagnostic Lab Data: Chest x-ray 9/13/21 (negative) COVID test 9/14/21 (no result yet)
CDC Split Type:

Write-up: I took 1000 mg of Tylenol, one hour before my vaccination appointment time on 9/10/21. After this injection, I felt no pain - it was nothing like the first vaccine on 8/20/21. I continued to alternate 600 mg of ibuprofen and 1000 mg of Tylenol every 4 hours until I went to bed around 10:30pm. When I went to bed that night there was mild soreness, which I expected, but otherwise I felt fine. At 330 am on 9/11/21, my left arm woke me up throbbing. There was a lump under my arm, and I was hurting at the injection site. I also had a slight fever (100.6, axillary), so I took 1000 mg of Tylenol since it had been 6 hours without either. By mid-morning, there was more swelling under my L arm going towards my elbow, and by that afternoon it had started making its way across my chest. I could not actively move my arm away from my body, and when I would use my right hand to assist with movement, my chest / arm would throb. My resting heart rate was high (for me). I became lightheaded and nauseated every time I got up (my chest/arm would throb, and it became difficult to get a full breath when walking) (HR into the 130''s just walking to the bathroom). My fever continued (100.6 to 102, axillary), even with alternating Tylenol / Advil every 4 hours. By Saturday night, I stopped taking Advil because I started to notice that I felt worse after taking it, so I just took Tylenol every 6 hours. Surprisingly, I slept well through the night on Saturday (only waking up to help reposition my left arm). Sunday morning, there as more swelling than the day before, but I did not feel like I had a fever, so I only took 500 mg of Tylenol to help with the pain. I took a shower and within minutes of drying off, I began with the "pin / needles / itchy" feeling in both legs and my left (full) arm (please see reaction to 1st vaccine in "additional information"). This time was more intense than ever before, I was in tears. This event lasted about 40 minutes. As the day went on the pain continued to get worse, I started to notice more of a red area around the injection site. By that evening, my temperature was back to 101.2, axillary. The throbbing chest/arm pain was so intense at one point that I considered going to the emergency room, which I was really trying to avoid. I continued to elevate/ice and take Tylenol every 6 hours and ended up at the Urgent Care on 9/13/21. After that appointment, I was started on 2000 mg of Vitamin C (3x day), 50-100 mg Zinc (1x day), and 325 mg Aspirin (x 2 yesterday, then x 1 for 7-10 days). Today (9/14/21) if the first day since Friday that I do not feel like I am burning up from the inside out, although I am still taking Tylenol for the pain. My arm is still swollen, but it seems to be receding from my chest area. I am trying to more my arm more today to let the under arm "breath". I feel like I may be getting a rash in the fold of my swelling pocket under my arm. The redness around my injection site it still hard and very warm to the touch. It is beginning to itch today. My endurance is still low, but I can say I feel "weak" with walking up our stairs than just walking 20 feet to the bathroom today, which is a plus.


VAERS ID: 1696597 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-24
Onset:2021-09-11
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: hospitalization (non-ICU)


VAERS ID: 1696606 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Fatigue, Injection site pain, Lymphadenopathy, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: SATURDAY MORNING SORENESS TO INJECTION SITE, FATIGUE, AND BODY CHILLS SATURDAY NIGHT PATIENT PAIN TO LEFT UNDER ARM , TENDER TO TOUCH , ENLARGEMENT AND SWELLING TO LEFT AXILLIA LYMPH NODE.


VAERS ID: 1696679 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Right knee numbness and weakness. Feels unsteady on the leg with walking. No sx in other areas of the body. Physical exam reveals normal sensations all areas of the body other than the right knee. Normal deep tendon reflexes in lower and upper extremities. Symptoms are not ascending or progressive at this time, so is no obvious evidence of systemic neurological dysfunction. Patient was placed on steroids and given dexamethasone injection, will follow up in the next week to determine final outcomes.


VAERS ID: 1696693 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site swelling, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic, HCTZ
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, neosporan, Musinex, Shrimp
Diagnostic Lab Data: I am waiting to get a ultrasound to make sure there is no blockage
CDC Split Type:

Write-up: lump at the injections site and the lymphoid under my left arm got inflamed. It was very painful.


VAERS ID: 1696716 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash, Injection site swelling, Injection site warmth, Vaccination complication
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control Lowestrin (sp?)
Current Illness: none
Preexisting Conditions: Auto immune issues
Allergies: allergic to Benadrill and Tetnus
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid Arm. Large swollen rash at injection site. Appeared one day after the injection. Grew larger for the next four days. Hot to the touch, swollen and itchy.


VAERS ID: 1696830 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: No known
Current Illness: No known
Preexisting Conditions: GERD, Migraine with aura, PTSD, non-alcoholic fatty liver disease
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received 2nd Moderna COVID-19 Vaccine on Friday 9/10/21 and had no issues until she noted on Saturday evening (9/11/21) that her arm started to swell up in 2 areas and was quite red. On Sunday she noted that arm was about the same but thought the redness was spreading. She took some OTC allergy relief pills, acetaminophen, and ibuprofen. Pt reports today (Tuesday 9/14/21) the swelling has improved but there is still some redness and warmth to the area.


VAERS ID: 1696836 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-24
Onset:2021-09-11
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Mobility decreased, Pain
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: bottom half of my body, hips and below, became completely numb. All at once my hips, legs, feet, and toes did not respond to my muscles. They burned as if they were ''asleep''. I was sitting in a chair for 10 minutes eating lunch when this happened. I was able to use my arms and steady myself to walk to the couch, I tried sitting and laying down. I tried standing up with support but nothing seemed to lessen the pain and inability to move my lower body on its own. After 15 minutes my left leg felt normal and within a minute the rest of my lower body felt fine. Has not happened again.


VAERS ID: 1696853 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-27
Onset:2021-09-11
   Days after vaccination:107
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 9/13 SARS/COV-2, NAAT, positive
CDC Split Type:

Write-up: Breakthrough COVID


VAERS ID: 1696889 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Formication, Palpitations, Paraesthesia, Pruritus, Swollen tongue, Throat irritation, Tongue disorder
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Patient experienced a bumpy and swollen tongue, "raw" throat, arm tingle, cold sweats, "ant crawling itching", and heart palpitations


VAERS ID: 1696936 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Incoherent, Laboratory test normal, Pyrexia, Somnolence, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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: moderna- caused weakness for 3 days and covid like symptoms
Other Medications: furosemide 40 mg 1 daily, losartan 100 mg daily, potassium chloride 10 meq daily , 80 mg ASA daily, turmeric 500 mg/50 mg ginger 1 tab daily, Vitamin D 5000 iu daily, Iron 65 mg daily, 800 mg ibuprofen daily prn (does not take daily) Gluco
Current Illness: None other than some side effects caused by 1st covid vaccine
Preexisting Conditions: HTN, osteoarthritis
Allergies: PCN
Diagnostic Lab Data: 9/11- CXR and routine labs
CDC Split Type:

Write-up: Pt received her 2nd covid vaccine on 9/10/21 at 1700. She reports she had apt to donate plasma on 9/11 but center was not able to perform plasma donation due to fever of 102-103 F BP of 180/110. Pt took her BP meds, but her Bp did not respond and she remained febrile at home. She reports she fell asleep after this and was not able to wake up. After multiple family members tried to reach the employee, the fire department had to come to her home and break down the door to access her as she was not responsive. Once she was woken by fire department she was incoherent and had to be taken to the emergency dept for treatment. Temp was 101.8 and Bp remained in 180s/110s HR in 120s . She was given tylenol in the ER, labs were drawn and CXR performed. She is not sure how long she was in the ER, but she regained normal mentation, BP was in 140''s and tests negative so MD released her to home She reports that the physician in ER told the her that she probably had a reaction from the covid vaccine.


VAERS ID: 1696965 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-04
Onset:2021-09-11
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Laboratory test abnormal
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested positive 9/11/21


VAERS ID: 1696976 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-09-11
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Nephrolithiasis
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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: chronic kidney conditions
Preexisting Conditions: kidney stones
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: case admitted to hospital on 9/11 due to kidney stones


VAERS ID: 1697178 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Hypoaesthesia oral, Muscular weakness, Pain in extremity, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (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: Pfizer 02/2021, 1st shot fever, nausea, headache, sore arm, necrosis where the shot was given.
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache still on day four, ringing in ears, dizzy, extreme fatigue, tip of tongue numb, sore arm, and weak in same arm.


VAERS ID: 1697202 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Headache, Herpes zoster, Miliaria, Myalgia, Nausea, Pain, Pyrexia, Rash, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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: Lisinopril 20 MG 1 X daily, Citilopram 20 MG 1 X daily, Unithroid 137 MCG 1 X daily, Vitamin D 1.25 MG 1 X weekly
Current Illness:
Preexisting Conditions: Psoriatic arthritis (currently in remission), Hashimotos Thyroiditis, Mild Hypertension
Allergies: Ketorolac
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Developed shingles infection with first sign of rash appearing on Saturday, September 11, and shingles full rash by Tuesday, September 14. After Pfizer shot number 2 I did not experience any side effects. After this booster, I experienced all of the normal list side effects including nausea, vomiting, diarreah, headache, muscle aches and fever. This began at 1:30 AM Thursday morning, and it continued until I woke up Friday morning. Friday was a fairly normal day, and Saturday my headache began to come back. It was more of a shooting pain or zinging pain. The rash began to develop on Saturday. It appeared to maybe just be a heat rash, but by Sunday, it was obvious it was shingles. My primary care doctor was unavailable for an appointment, so I visited the Clinic listed above.


VAERS ID: 1697363 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-04
Onset:2021-09-11
   Days after vaccination:130
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Chest X-ray normal, Computerised tomogram normal, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: June?s Fe (birth control) - taken at the time of vaccination, but stopped taking 1 month prior to adverse event
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Bactrim Shellfish
Diagnostic Lab Data: CT scan, chest x-ray (09/11/2021); both normal.
CDC Split Type:

Write-up: Complete right side facial paralysis, came on extremely suddenly (minutes). ER visit (09/11/2021) diagnosed as Bell?s Palsy. Treatment consists of a 60mg dose of Prednisone once per day, and a 1g dose valACYclovir three times per day. treatment to last 1 week, and to be reevaluated at that time by PCP. First week of treatment is still ongoing. Full symptoms still ongoing.


VAERS ID: 1697762 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red raised itchy rash with blister on left forearm.


VAERS ID: 1697937 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation delayed
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: menstrual cycle was delayed by a week, and once it started experienced heavy bleeding and painful cramps (more then normal)


VAERS ID: 1700117 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-31
Onset:2021-09-11
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chills, Headache, Hypoxia, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, Aspirin 81 mg, Sinemet, Cholecalciferol, Cranberry capsule, famciclovir, gemfibrozil, glucosamine, losartan, metformin, pantoprazole, polyethylene glycol, pseudoephedrine, metamucil, sennosides, terazosin, trospium, atrovent
Current Illness:
Preexisting Conditions: BPH, HTN, GERD, HLD, OSA, Parkinsons, DM
Allergies: NKDA
Diagnostic Lab Data: 09/10/21: SARS-CoV-2 PCR positive
CDC Split Type:

Write-up: Presented to ED with weakness, was diagnosed with COVID-19 2 days prior to admission. Has had chills, headache. Was hypoxic on arrival and placed on O2. Oxygen titrated up to 10 L salter after admission


VAERS ID: 1700148 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

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

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

Write-up: Pounding heart beat overnight. Ok next day Severe headache forehead temple pressure still persistent after four days. No nausea or fever


VAERS ID: 1700175 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cluster headache, Condition aggravated, Extra dose administered, Headache, Magnetic resonance imaging normal, Pain
SMQs:, Guillain-Barre syndrome (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: Lisinopril, lipitor
Current Illness: None
Preexisting Conditions: Cluster headaches, psoriasis,reflux
Allergies: None
Diagnostic Lab Data: At the hospital after the first vaccine they did an MRI which was normal. This was done at hospital.
CDC Split Type:

Write-up: I have had 3 doses, each one produced the same issue. I am reporting this as people with cluster headaches will wind up in the ER if they have the problems I did and am also wondering if this might be a bad choice of type of vaccine for people with cluster headaches. 9 hours after the first dose I wound up in the ER and received 2 shots into my head, the pain was an ice pick like jabbing every 10 seconds and was completely debilitating. After this event I went to a headache specialist that was recommended to me, he diagnosed cluster headaches and prescribed sumatriptan nasal spray, which does seem to work but not nearly as well after each of my vaccines. 9 hours after the second vaccine the headache began and continued for 8 hours, I used 2 of the sumatriptan nasal doses. 16 hours after the third dose the headaches came on and were much harder to mitigate, I used 3 doses over 12 hours and I?d say after 13 hours it lessened . After each dose I experienced body aches along with the headache but I deemed this to be normal and wouldn?t bother reporting that. The aches were more severe every place that I have arthritis.


VAERS ID: 1700197 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 1 LA / SYR

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

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

Write-up: Large rash a week later at injection site. Spreading down arm. Taking antihistamine and cortisone cream


VAERS ID: 1700276 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Coordination abnormal, Gait inability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: not so high a fever after the first one
Other Medications: none
Current Illness: none (except I had a 103.1 fever after the first vaccine, which I already reported)
Preexisting Conditions: none
Allergies: Something in a Bicillin Shot, or maybe because the nurse said she pulled back blood, but I think she re-injected the same shot anyway., with the blood. I got a rash, tingling, epinephrine, and the site around the shot was read and warm for many weeks. Some kind of shot as a kid for ear aches. It twice made my arm get red, warm and swollen. Tylenol just makes me feel terrible, like when I long ago had hepatitis. But, I think I could take a few, again, if needed.
Diagnostic Lab Data: none PS I checked life threatening illness, below, but I am not a doctor. I don''t believe you can have a much higher fever than 104 for long. I did not have it for long, less than an hour. I am just doing the best I can with your form.
CDC Split Type:

Write-up: I am not complaining, but maybe my report might help someone else who gets a high fever. That is, if you can figure out what to offer people who get fevers. I could find no information on what to do. Only that the effects of Ibuprofen, Tylenol, etc. on the covid vaccine in preventing a fever were unknown. That implies that the effects on treating an actual fever are also unknown by you. I did not want to dampen the effect of the covid vaccine, so I let myself have a fever. It was 103.1 at 10 am. I did not feel too bad so I drove my son back from (privacy). At that time my fever was 104.1. I tried to get out of the car and stretch before driving back home, but I found to my surprise, I could not walk. I did not have the coordination to put one foot in front of the other. I managed, maybe, 20 steps out, but I am sure people thought I was inebriated. I went back to my car and rested awhile. My temperature came back down to the 103''s, and I drove back home. By the next morning I had no fever and felt pretty well. (Maybe if other people have fallen and died after a covid vaccine, you should check. Maybe it was because they had a high fever and couldn''t walk, not just a plain fall ?). I will still be happy to get the booster vaccine if I need it.


VAERS ID: 1700391 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary mass, Breast mass, Chills, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Vitamin D, Flonase, Flovent HFA
Current Illness: Asthma, Fibromyalgia, DJD, Low Vitamin D, Sleep Apnea
Preexisting Conditions: Asthma, Fibromyalgia
Allergies: Latex, PCN, Kiwi, IV Iron
Diagnostic Lab Data: 9/14/2021 saw doctor.
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Fever 100.1, chills, entire body aches, injection site extreme pain - took Tylenol regularly under arm/breast area lump felt - Dr is having me apply ice and watch to see if it decreases because it occurred on same arm that I received the injection. Wants to wait until after 2nd dose to see if it goes away


VAERS ID: 1700401 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 096C21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Extra dose administered, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Medication errors (narrow), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Pt. states that after receiving the Booster 3rd dose of Moderna 09/10/2021, started experiencing symptoms 09/11/2021 of Low Blood Pressure (88/58), feeling of low blood sugar, and weakness lasting 48hrs. No noted Primary visit. Symptoms have subsided.


VAERS ID: 1700406 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Military       Purchased by: ?
Symptoms: Cough, Pyrexia, Respiratory tract congestion
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: Severe headaches
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: My entire family has developed a cough and fever and congestion. 2 kids and spouse and I have similar symptoms


VAERS ID: 1700409 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multiple vitamin. Zinc, omega3, vitamin C vitamin D. All supplements no prescription
Current Illness:
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Consistent chest pain.


VAERS ID: 1700472 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-05
Onset:2021-09-11
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Adenovirus test, Asthenia, Bone disorder, Bordetella test negative, COVID-19, Chest X-ray abnormal, Chlamydia test negative, Chronic obstructive pulmonary disease, Chronic respiratory failure, Condition aggravated, Coronavirus test negative, Dyspnoea, Enterovirus test negative, Haematuria, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Lung opacity, Mycoplasma test negative, Osteopenia, Pleural effusion, Procalcitonin, Pulmonary calcification, Respiratory distress, Respiratory syncytial virus test negative, Respiratory viral panel, Rubulavirus test, SARS-CoV-2 test positive, Spinal osteoarthritis, Urine analysis abnormal, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (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), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (narrow), Hypersensitivity (broad), Arthritis (narrow), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler apixaban (ELIQUIS) 5 mg tablet (Expired) budesonide-formoterol (SYMBICORT) 80-4.5 mcg/actuation inhaler cholecalciferol, vitamin D3,
Current Illness:
Preexisting Conditions: Advanced COPD (CMS/HCC) Anemia Congestive heart failure (CMS/HCC) Chronic deep vein thrombosis (DVT) of left lower extremity (CMS/HCC) Chronic obstructive pulmonary disease (CMS/HCC) Depression with anxiety Depression Deep vein thrombosis (DVT) (CMS/HCC) Pulmonary emphysema (CMS/HCC) Generalized idiopathic epilepsy and epileptic syndromes, without status epilepticus, not intractable (CMS/HCC) Obstructive sleep apnea Seizure disorder (CMS/HCC) Sinus tachycardia Presence of artificial hip joint, left Fracture of humeral head, closed, right, with routine healing, subsequent encounter Sepsis secondary to UTI (CMS/HCC) Avascular necrosis of hip, right (CMS/HCC) Closed traumatic nondisplaced fracture of proximal end of left humerus with routine healing Hematuria Acute metabolic encephalopathy Confusion Ureteral calculus
Allergies: NKA
Diagnostic Lab Data: 09/11/21 2306 Respiratory virus detection panel Collected: 09/11/21 2124 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3302504541] Resulted: 09/12/21 1118 Order Status: Completed Updated: 09/12/21 1118 Narrative: XR CHEST 1 VW PORT IMPRESSION: There are no acute-appearing findings. END OF IMPRESSION: INDICATION: shortness of breath sob. TECHNIQUE: Frontal view of the chest was obtained. COMPARISON: X-ray of August 14, 2021 FINDINGS: Bilateral airspace opacities and a right pleural effusion have resolved. There are no consolidations, pulmonary edema or pleural effusions. The heart size is normal.The patient is rotated. Periaortic calcification is seen. There are overlying leads and wires. There are nonspecific coarse interstitial markings. Deformity of the left humerus is compatible with remote trauma. Osteopenia, spondylosis and degenerative skeletal change are noted.
CDC Split Type:

Write-up: ED to Hosp-Admission Current 9/11/2021 - present (4 days) l DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission COPD exacerbation (CMS/HCC) [J44.1] COVID-19 virus infection [U07.1] HPI Pt is an 71 y.o. female. with Past medical COPD, chronic respiratory failure on 3 L of oxygen, seizure, A. fib, not anticoagulation due to hematuria, came to emergency room due to generalized weakness and hypoxia. As per patient and daughter over the phone, patient had Covid positive family members visiting on Monday, today when daughter checked patient oxygen it was in low 80s, then patient was on 3 L, oxygen was increased to 4 L, was improvement to low 90s. Given patient significant history of COPD, she was brought to emergency room. Lab work in the emergency room unremarkable, no significant changes from previous values. Urine significant for hematuria, negative procalcitonin. Vital tests positive for COVID-19 Patient seen and examined bedside, in mild respiratory distress. Hospital Course Patient was admitted to med surgical floor with acute on chronic hypoxic respiratory failure secondary to COVID-19 infection. Her oxygen requirement at home is 3 L she was requiring up to 4 L with diffuse wheezing bilaterally. She was started on remdesivir as well as Decadron. Her oxygenation requirement came down to 3 L. She is back to her baseline and will be discharged home today. She has completed 5 doses of remdesivir Discharge instructions Patient strictly follow with her primary care provider in 1 week She will take 5 more days of dexamethasone 6 mg and then she can go back to her prednisone 10 mg daily


VAERS ID: 1700515 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-02
Onset:2021-09-11
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Atrial fibrillation, Bordetella test negative, COVID-19, Chest X-ray abnormal, Chest discomfort, Chest pain, Chills, Chlamydia test negative, Condition aggravated, Coronavirus test negative, Cough, Diarrhoea, Diarrhoea infectious, Dyspnoea, Electrocardiogram abnormal, Enterovirus infection, Enterovirus test positive, Fluid intake reduced, Headache, Human metapneumovirus test, Human rhinovirus test positive, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Mycoplasma test negative, Nasal congestion, Nausea, Palpitations, Pyrexia, Respiratory distress, Respiratory syncytial virus test negative, Rhinovirus infection, SARS-CoV-2 test positive, Sepsis, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: apixaban (ELIQUIS) 5 mg tablet benzonatate (TESSALON) 100 mg capsule dilTIAZem (CARDIZEM) 30 mg tablet dilTIAZem CD (CARDIZEM CD) 120 mg 24 hr capsule mometasone (ASMANEX TWISTHALER) 220 mcg/ actuation (60) inhaler omeprazole (PriLOSEC
Current Illness:
Preexisting Conditions: Essential hypertension CKD (chronic kidney disease) stage 2, GFR 60-89 ml/min Asthma Fibromyalgia Papanicolaou smear of cervix with high grade squamous intraepithelial lesion (HGSIL) Periodic limb movement disorder Raynaud''s disease Rosacea Morbid obesity with BMI of 40.0-44.9, adult (CMS/HCC)
Allergies: CiprofloxacinHives / Urticaria Iv Dye [Gadolinium-containing Contrast Media]Anaphylaxis VancomycinAnaphylaxis Celexa [Citalopram]Chest Pain / Tightness Keflex [Cephalexin]Hives / Urticaria Sulfa (Sulfonamide Antibiotics)Hives / Urticaria Gluten Percocet [Oxycodone-acetaminophen]Headaches
Diagnostic Lab Data: 09/11/21 0415 Respiratory virus detection panel Collected: 09/11/21 0220 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus PositiveAbnormal Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3302420619] Resulted: 09/11/21 0724 Order Status: Completed Updated: 09/11/21 0724 Narrative: XR CHEST 1 VW IMPRESSION: No acute radiographic abnormality. END OF IMPRESSION: INDICATION: Suspected sepsis Suspected sepsis. Female, 60 years COMPARISON: Chest radiograph from 5/14/2021. FINDINGS: Single frontal view of the chest shows clear lungs. The costophrenic angles are not blunted, therefore no large pleural effusion. The heart is of normal size. No pneumothorax. History of cervical fusion. Results Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3303100656] Resulted: 09/15/21 0951 Order Status: Completed Updated: 09/15/21 0951 Narrative: XR CHEST 1 VW PORT IMPRESSION: Left-sided airspace disease suggested. Positive: This nonspecific imaging pattern can be seen with COVID-19. Other considerations include but are not limited to other infectious etiologies or noninfectious etiologies. END OF IMPRESSION: Order Date: 9/15/2021 9:22 AM EDT INDICATION: COVID-19, continue having fever rule out pneumonia. Positive on 9/11/2021. TECHNIQUE: AP COMPARISON: 9/14/2021 FINDINGS: There is suggestion of patchy airspace disease in the left mid lung and left lung base. The heart and the mediastinum are normal. Bony structures are grossly intact. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3303036051] Resulted: 09/14/21 2011 Order Status: Completed Updated: 09/14/21 2011 Narrative: XR CHEST 1 VW PORT IMPRESSION: No active disease. END OF IMPRESSION: INDICATION: Chest pain. 60 years TECHNIQUE: AP chest COMPARISON: 9/11/2021 FINDINGS: The heart is normal in size. The lungs are free of acute infiltrates.
CDC Split Type:

Write-up: ED Discharged 9/11/2021 (9 hours) Hospital ED Patient presents with ? Fever ? Chest Pain ? Cough HPI is a 60-year-old female presents today for evaluation of respiratory distress in setting of chest pain, fever and cough. Patient states that symptom onset was abruptly tonight. She reports history of atrial flutter. She reports no that her heart was racing and she is unable to catch her breath. She is having substernal chest pressure at this time. Patient called EMS was brought to the emergency department. Initial EKG was concerning for possible ST elevations according to EMS, however this is likely secondary to her underlying flutter. Patient states that she has atrial flutter in the past and is currently on anticoagulants as well as Cardizem. She states that she is normally in a sinus rhythm and is very symptomatic when she does go into atrial flutter. She also reports nasal congestion, cough, fever and chills. The symptoms began several days ago. Patient reports that she is not using any supplemental oxygenation and EMS has not noted any hypoxia. Patient found to be tachycardic upon presentation which appears to be atrial flutter. Currently no known exacerbating or alleviating factors. ED Discharged 9/12/2021 - 9/14/2021 (2 days) Hospital ED COVID-19 Nausea and vomiting, patient is a 60 y.o. female presenting to the ED with chief complaint of nausea and vomiting. Patient states she has a history of A. fib is on Eliquis and diltiazem and was recently diagnosed with both COVID-19 as well as enterovirus. States she just was discharged from the hospital yesterday. Since returning home she has not been able to tolerate any fluids by mouth. Has tried drinking Pedialyte and water and has been vomiting everything up. Cannot keep down her home medications or Tylenol. She states that she has been coughing frequently and still having intermittent fevers. States that her breathing does not feel any worse than it did yesterday. Denies any chest pain or abdominal pain. No palpitations. Does endorse mid throbbing headache, gradual onset. No vision changes, speech difficulty or focal weakness. ED to Hosp-Admission Current 9/14/2021 - present (1 day) Hospital Atrial flutter (CMS/HCC) COVID-19 virus infection, Rhinovirus, Paroxysmal atrial fibrillation with rapid ventricular response (CMS/HCC) Diarrhea of presumed infectious origin


VAERS ID: 1700535 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-09
Onset:2021-09-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Body temperature increased, Computerised tomogram head, Dizziness, Dysstasia, Feeling cold, Nausea, Pain, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Carvedilol, Spironolactone, Welbutrin, Daily Multi-Vitamin
Current Illness: None
Preexisting Conditions: High blood pressure, tachycardia, hashimoto''s disease
Allergies: Erythromycin
Diagnostic Lab Data: ER sampled blood (unsure for what), performed a ct scan, and took a lung x-ray.
CDC Split Type:

Write-up: Received vaccine on a Thursday evening and had nausea within 15 minutes, lasting thru the night. On Friday afternoon I became extremely cold, by Friday night I had a temperature of 101 with extreme body aches. On Saturday morning I woke up fever free, but had a loud "whooshing" sound in my head. Low fever again Saturday night. I felt great on Sunday with the exception of what I now know to be pulsatile tinnitis. Monday started the same until that afternoon I instantly for no reason became extremely dizzy and was unable to stand or walk. After taking Meclizine I can now function, but the sound in my head is comparable to a jet engine.


VAERS ID: 1700560 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-19
Onset:2021-09-11
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Headache, Nasopharyngitis, Pain, 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: EE called for results that returned ?DETECTED? (tested on 9/14, resulted 9/15). EE stated cold-like symptoms, cough, HA, body aches began on 9/11. Symptoms persist, but improving. Informed EE that she has to isolate for at least 10 days from when symptoms started on 9/11-9/21.


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