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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 214 out of 4,799

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VAERS ID: 1388524 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-03-02
Onset:2021-06-02
   Days after vaccination:92
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
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: SARS-CV-2 RAPID JUNE 2, 2021
CDC Split Type:

Write-up: TESTED POSITIVE WHEN FULLY VACCINATED


VAERS ID: 1388541 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-06-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control
Current Illness:
Preexisting Conditions: obesity
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: stroke


VAERS ID: 1388559 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bell''s palsy 6 days after vaccine, mild to moderate, unresolved at this time


VAERS ID: 1388833 (history)  
Form: Version 2.0  
Age: 100.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: medication Error- Patient received first dose on 5/6/21 of Pfizer Covid-19 vaccine. On 6/2/21 he was given the Janssen Covid vaccine, instead of the second dose Pfizer. No Adverse event occurred.


VAERS ID: 1388896 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-18
Onset:2021-06-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest discomfort
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: TYPE 2 DIABETES HX OF OPEN HEART SURGERY
Preexisting Conditions: TYPE 2 DIABETES HX OF OPEN HEART SURGERY
Allergies: NKDA
Diagnostic Lab Data: Wife reported; Heart cath was done and doctor reported no significant findings on any tests.
CDC Split Type:

Write-up: Reported by wife; Husband (client) had chest pressure two weeks after Covid-19 Vaccine around June 2nd and has not experienced that pressure before, wife says. Wife explained it was so severe the husband was taken via ambulance to hospital.


VAERS ID: 1389031 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-14
Onset:2021-06-02
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (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: Occasionally ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound done on my left leg.
CDC Split Type:

Write-up: I developed a blood clot. I went to an urgent care and was directed to the emergency room.


VAERS ID: 1389143 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-20
Onset:2021-06-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO186 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dysmenorrhoea, Fatigue, Gastroenteritis viral, Menstrual discomfort, Menstrual disorder, Nausea, Thrombosis
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None this is my first attempt to alert anyone of my experience and symptoms
CDC Split Type:

Write-up: I am a woman who has PCOS. My cycle is extremely inconsistent and never last more than a day maybe once every year or 2. Two weeks after my 2nd dose of the Covid vaccine I started my menstral cycle , experiencing cramps, discomfort, pressure in my uterus, blood clots daily, and so far it?s been for 8 days. I am not alarmed yet because I understand this might be natural but I am documenting this because it is out of the ordinary in my unique case. I also experienced what seemed like a stomach flu for about 2 days On the 6th and 7th of June. Experiencing diarrhea, nausea, no fever, but heavy fatigue. I no longer feel sick but my period is still active.


VAERS ID: 1389779 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Pain, Pyrexia, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL, CLONAZEPAM, TRAMADOL, VITAMINS
Current Illness: N/A
Preexisting Conditions: VIRAL INDUCED AIRWAY HYPERACTIVITY.
Allergies: SHRIMP, DOXYCYCLINE, TRANSDERM PATCH
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT STATES SHE WOKE UP IN THE MIDDLE OF THE NIGHT WITH A FEVER OF 101.5, BODY ACHES, AND FLU LIKE SYMPTOMS. TRIED TREATING FEVER WITH TYLENOL FOR PAIN AND FEVER. FELT RESTLESS FOR 2 DAYS.


VAERS ID: 1390382 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Hypersensitivity, Pain, Sleep disorder
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headaches aches fatigue since shot, headaches more severe at night, can?t sleep Severe allergic reaction with trip to ER following excederin 6/5 Headaches continue trying Tylenol and imitrex


VAERS ID: 1390682 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A OR 048 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Chills, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210606552

Write-up: ABDOMINAL CRAMPING; EXTREME CHILLS; SHOULDER PAIN IN BOTH SHOULDERS; REALLY BAD HEADACHE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-JUN-2021, the subject experienced abdominal cramping. On 02-JUN-2021, the subject experienced extreme chills. On 02-JUN-2021, the subject experienced shoulder pain in both shoulders. On 02-JUN-2021, the subject experienced really bad headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from abdominal cramping, and had not recovered from extreme chills, really bad headache, and shoulder pain in both shoulders. This report was non-serious.


VAERS ID: 1390689 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Diarrhoea, Fatigue, Hyperhidrosis, Myalgia, Pain in extremity, Peripheral swelling, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: POTASSIUM; BREO ELLIPTA; ALBUTEROL [SALBUTAMOL]; IPRATROPIUM BROMIDE; FUROSEMIDE; SPIRONOLACTONE
Current Illness: Borderline diabetes (not taking anything yet,but A1c is 5.6.); Congestive heart failure (patient takes oxygen); Pulmonary failure (patient takes oxygen); Smoker (1-2 cigarettes per day)
Preexisting Conditions: Comments: Ipratropium bromide inhaler,Breo inhaler,Albuterol inhaler. 2 clamps on liver. Sulfate drugs, Zithromax, ambien allergy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210611859

Write-up: STOMACH BLOATING; LEG SWELLING; LEGS HURT; MUSCLE ACHES; FATIGUED; DIARRHEA; VOMITTING; SWEATING; This spontaneous report received from a patient concerned a 51 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included borderline diabetic, congestive heart failure, lung failure, and smoker, and other pre-existing medical conditions included ipratropium bromide inhaler,breo inhaler,albuterol inhaler. 2 clamps on liver. sulfate drugs, zithromax, ambien allergy. The patient experienced drug allergy when treated with zolpidem tartrate, sulfacetamide sodium/sulfadiazine/sulfadimidine/sulfamerazine, and azithromycin. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. Concomitant medications included furosemide for congestive heart failure, potassium for congestive heart failure, spironolactone for congestive heart failure, fluticasone furoate/vilanterol trifenatate for lung failure, ipratropium bromide for lung failure, and salbutamol for lung failure. On 02-JUN-2021, the subject experienced diarrhea. On 02-JUN-2021, the subject experienced vomitting. On 02-JUN-2021, the subject experienced sweating. On 02-JUN-2021, the subject experienced muscle aches. On 02-JUN-2021, the subject experienced fatigued. On 05-JUN-2021, the subject experienced stomach bloating. On 05-JUN-2021, the subject experienced leg swelling. On 05-JUN-2021, the subject experienced legs hurt. The action taken with covid-19 vaccine was not applicable. The patient recovered from diarrhea, vomitting, and sweating, was recovering from muscle aches, and fatigued, and had not recovered from leg swelling, stomach bloating, and legs hurt. This report was non-serious.


VAERS ID: 1390704 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210616484

Write-up: INAPPROPRIATE AGE AT VACCINE ADMINISTRATION; OFF-LABEL USE; This spontaneous report received from a physician concerned a 15 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A and expiry: 23-JUN-2021) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-JUN-2021, the subject experienced inappropriate age at vaccine administration. On 02-JUN-2021, the subject experienced off-label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the inappropriate age at vaccine administration and off-label use was not reported. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required per standard procedure as the case is assessed as non-serious.


VAERS ID: 1391460 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), 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: Naproxen
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was given the 2nd dose of the Moderna vaccine on day 21 vs day 28. She did not have symptoms except sore arm.


VAERS ID: 1391466 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea, Pallor, Vomiting
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? 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 reports feeling light headed with mild nausea, after 1st pfizer vaccine dose. Similar occurrences with previous injection according to dad. Skin mildly pale, spit up a small amount, denies any recent injury, denies pain, dad denies loss of consciousness, skin warm & dry on discharge. BP 112/67 HR 94 O2 sat 100%. Left ambulating with her dad.


VAERS ID: 1391611 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Computerised tomogram, Computerised tomogram normal, Epistaxis, Immune thrombocytopenia, Immunoglobulin therapy, Oral blood blister, Oral disorder, Platelet count decreased, Platelet transfusion, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: None
Allergies: Shrimp
Diagnostic Lab Data: Blood test on 6/2/2021 platelets 4000 Blood test on 6/3/2021 platelets 12000 Blood test on 6/4/2021 platelets 8000 Blood test on 6/5/2021 platelets 34000 Blood test on 6/6/2021 platelets 51000 Blood test on 6/8/2021 Platelets 4000 CT Scan 6/9/2021 normal Blood test 6/8/2021 platelets 4000 Blood test 6/9/2021 platelets
CDC Split Type:

Write-up: 2 weeks after 2nd injection 6/2/2021 I presented in the ED with a red rash on my legs and blood lesions in my mouth with nose bleed. I was admitted to hospital with ITP blood platelet count 4000. After 3 infusions of platelets with no improvement they did a steroid and IVIG. My platelets went up to 51000. After 5 days in hospital they sent me home. Two days later on 6/8/2021 I started having the mouth blood blisters lesions again went back to ED where I was admitted again. They gave iv steroids in ED. On 6/9/2021 gave 65mgs of oral steroids and did a IVIG treatment platelets went up to 26000. On 6/10/2021 continued 65mgs of oral steroids another treatment of IVIG and platelets are at 36000. Not what I or the doctors were expecting we were expecting a higher number. So now 6/11/2021 still in hospital with no answers.


VAERS ID: 1391705 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Diplopia, IIIrd nerve paralysis, Magnetic resonance imaging head normal
SMQs:, Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine Levothyroxine Pantoprazole
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: MRI scan head and neck - no evidence of restricted diffusion.. Chest X-ray - no acute abnormality seen.
CDC Split Type:

Write-up: Double vision upon awakening on June 2. Went to ER for MRI to rule out stroke. Diagnosed with cranial nerve 3 palsy by ophthalmologist, Still having double vision, wearing a patch on right eye.


VAERS ID: 1391989 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-06-02
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / -

Administered by: Other       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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic lung disease, diabetes, cardiovascular disease, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient hospitalized after testing positive for COVID-19. Patient is fully vaccinated.


VAERS ID: 1392015 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood creatinine increased, Blood culture negative, Computerised tomogram thorax abnormal, Drug screen negative, Dyspnoea, Fatigue, Headache, Intensive care, Lung infiltration, Myalgia, Pneumonitis, Pulmonary mass, Respiratory viral panel, SARS-CoV-2 test negative, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: insulin, metoprolol, torsemide, ibuprofen, Plavix, Prilosec, APAP, Neurontin, Cymbalta
Current Illness: HTN, COPD, ASA, CHF, GRD, HLD, DM
Preexisting Conditions: HTN, COPD, ASA, CHF, GRD, HLD, DM
Allergies: seasonal
Diagnostic Lab Data: Resp. panel, BC, Urine tx all neg CT nodular infiltrates both lungs Creat . was 3.9 on admission. 33 on D/C WBC wnl went up to 18.8 on D/C (because of steroids) CLD was 12.3 of admin. came down to 4.4 Rep panel neg. Rapid Covid neg I strongly suspect she received an IV injection inadvertently, causing a picture of pneumonitis.
CDC Split Type:

Write-up: 6/2/21 HA, MYALGIA, ARTHRALIAS, FATIGUE, SOB 6/4/21 Admitted via ED to ICU. Doxy Cefepime 6/4/21 O2 6L. Dexamethasone Improved 6/9/21 D/C from ICU 6/10/21 D/C home. Dexamethasone. No O2


VAERS ID: 1392139 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disturbance in attention, Dyspnoea, Fatigue, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, shortness of breath, nausea, fatigue, aches, and temporary loss of mental acuity


VAERS ID: 1392517 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 123456 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: tingly hurting arm for 10 days after vaccine


VAERS ID: 1392519 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-18
Onset:2021-06-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 100mcg QD Indurel 120mg QD Advair 115/21 2 puffs BID Mobic 15mg QD Vitamin B12 1000mcg QD Albuterol 90mcg 1-2 puffs q4hrs PRN OTC Tylenol PRN
Current Illness: None
Preexisting Conditions: Migraines Glaucoma Pulmonary artery HTN Ovarian Ca s/p hysterectomy and oophorectomy + chemo 2014 Arthritis Hypothyroidism
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient contracted COVID-19 approximately 2 weeks after receiving 1st dose of the Pfizer vaccine. Pt was hospitalized for 2 days for oxygen requirement and oral intolerance. She recovered and was discharged home


VAERS ID: 1392622 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 3002332 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Limb discomfort, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 11th June - telephone appointment who advised me to take paracetamol for the pain and monitor symptoms. If there?s no improvement by 14th June then I have to attend appointment for tests to be carried out.
CDC Split Type:

Write-up: On day 2 after vaccination. Pain and heaviness in left arm, which lasted 3 days gradually wearing off. Headache which went away with paracetamol. Extreme exhaustion, which has continued since the injection. On day 6 after vaccination pain started in left arm at the site on injection. It became swollen, red and hot about 2 inches diameter around the injection site and also feels itchy. Extreme exhaustion persists too. On day 10 after vaccination also developing achiness in muscles especially around neck, back and shoulders. All the symptoms that started on day 6 are also ongoing.


VAERS ID: 1392647 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Pain, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Nausea, vomiting, palpitations- body and headaches


VAERS ID: 1392706 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-18
Onset:2021-06-02
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anal incontinence, Angiogram peripheral abnormal, Asthenia, Back pain, Computerised tomogram abdomen, Computerised tomogram pelvis abnormal, Diplegia, Iliac artery embolism, Iliac artery occlusion, Peripheral arterial occlusive disease, Peripheral artery occlusion, Peripheral artery stenosis, Peripheral artery thrombosis, Poor peripheral circulation, Urinary incontinence
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: glipizide, lisinopril, centrum silver and fish oil
Current Illness: no
Preexisting Conditions: diabetes type II
Allergies: aspirin and ibuprofen
Diagnostic Lab Data: CT angio abdomen and pelvis: RIGHT RUNOFF: 1)There is abrupt vessel cut off suggestive of acute thrombotic occlusion of the proximal common femoral artery with propagation into the superficial femoral artery and the popliteal artery. On the delayed imaging, small amount of contrast is seen within the severely stenotic popliteal artery and very small amount of contrast is seen in the peroneal artery extending to the ankle suggesting proximal stenosis and extremely slow flow. LEFT IMPRESSION: 2)Abrupt cut off suggestive of acute thrombotic or embolic occlusion identified at the origin of the LEFT common iliac arteries with propagation throughout the LEFT lower extremity down to the popliteal artery. 3)On the delayed phase imaging, tiny wisp of contrast within the severely stenotic popliteal artery identified suggestive of very slow flow. The peroneal artery is also faintly patent on the delayed phase imaging with flow contrast extending to mid calf level.
CDC Split Type:

Write-up: Patient had acute onset of low back pain 1.5 weeks prior to presentation on 6/3/2021. This pain and weakness progressed to complete bilateral lower extremity paralysis with loss of bowel and bladder function on 6/09/2021. Patient was seen emergently and found to have critical, bilateral lower extremity ischemia. imaging showed RIGHT RUNOFF: 1)There is abrupt vessel cut off suggestive of acute thrombotic occlusion of the proximal common femoral artery with propagation into the superficial femoral artery and the popliteal artery. On the delayed imaging, small amount of contrast is seen within the severely stenotic popliteal artery and very small amount of contrast is seen in the peroneal artery extending to the ankle suggesting proximal stenosis and extremely slow flow. LEFT IMPRESSION: 2)Abrupt cut off suggestive of acute thrombotic or embolic occlusion identified at the origin of the LEFT common iliac arteries with propagation throughout the LEFT lower extremity down to the popliteal artery. 3)On the delayed phase imaging, tiny wisp of contrast within the severely stenotic popliteal artery identified suggestive of very slow flow. The peroneal artery is also faintly patent on the delayed phase imaging with flow contrast extending to mid calf level. Due to severity of the ischemic limb, patient was offered bilateral above the knee amputations. He declined and will discharge to hospice on 6/12/2021. He is going to die.


VAERS ID: 1392832 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertaline 50mg
Current Illness: none
Preexisting Conditions: Immunodeficiency, PCOS, Allergies,
Allergies: Peppermint; Eggs;
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting for multiple days- fine for a week and then vomiting again several times. Sore arm and sweating and chills with vomiting.


VAERS ID: 1392902 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTERED INCORRECTLY STORED VACCINE; REQUIRES RE-VACCINATION


VAERS ID: 1392935 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tyelenol Given at 8:30 pm 6/2/2021
Current Illness: none
Preexisting Conditions: none
Allergies: mild stomach upset with sulfa
Diagnostic Lab Data: All tests were performed 6/5/2021. EKG, Chest xray, labs, Lung sounds are normal. No imaging was performed on the heart. Only labs drawn were CBC and lytes.
CDC Split Type:

Write-up: chest pain occured 4.5 hrs post second dose vaccine. next day, he felt fine, but fatigued. On the second day, chest pain occurs again upon inspiration and expiration, no shortness of breath. Only upon deep breathing, not shallow. On third day, pain is still an issue, he gets taken to urgent care. All test are normal (chest xray, EKG, lab, cbc, chem) lung sounds are normal. Chest pain continues for 3 more days. He rests and takes ibuprofen as directed. Is never is respiratory distress.


VAERS ID: 1392973 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dry mouth, Dry throat, Fatigue, Headache, Nausea, Pain, Pruritus, Sluggishness, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ozempic, Synjardy, Amlodipine, Losartan, Pantoprazole, Tresiba, Metformin,
Current Illness:
Preexisting Conditions: Type 2 Diabetes
Allergies: sulfamethoxazole
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient called the pharmacy (6/5/21) to talk about his Moderna Covid vaccinations. He stated he felt drained and sluggish. He had his 1st dose on 5/5/21 and his 2nd dose on 6/2/21. In general he has had the following: Headache, dry mouth, body aches, nausea, and fatigue. I asked him how he felt the day he called on 6/5/21 (3 days post his second dose). He stated that he still had a headache and was fatigued (he only felt like lying down). Patient is an employee here and wanted to know what he should do about returning to work. I referred him to store manager. I gave her his number and she was going to call him. He had spoken to managers before 6/5/21. I explained that these side effects are possible with vaccines and that some patients respond with more side effects than others or have a stronger response. However, I am filing a VAERS because the patient mentioned that he had the following after his 2nd dose. He stated that about an hour after his vaccine on 6/2/21, he had hives and itching on his arms and neck and dry throat. He stated that he has used Benadryl and hydrocortisone to treat these symptoms. I asked him did he have any reaction after his 1st dose on 5/5/21. He stated that he had itching in his throat after the 1st one, but he thought it was just a dry throat and did not know if it was coming from the vaccine. As far as I know, 6/5/21 was the first day that the he had let anyone at the pharmacy know about any side effects. I told him to let his primary care doctor know this information that we discussed. I also recommended that he could take Tylenol if he wanted to do so. Patient used a Doctor on Demand service through employee and provider prescribed aspirin 325 mg tablet once daily.


VAERS ID: 1392995 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Nausea, Throat irritation, Vomiting
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Nausea, followed with vomiting. @3.25 - Began to have itching in her throat. Benadryl 50 mg was administered


VAERS ID: 1394060 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-27
Onset:2021-06-02
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 - / OT

Administered by: Unknown       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; MULTIVITAMINS [VITAMINS NOS]
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Anaphylactic reaction to vaccine; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ANAPHYLACTIC REACTION (Anaphylactic reaction to vaccine) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 050C21A and 016C21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) for Antihistamine therapy, MULTIVITAMINS [VITAMINS NOS] for Vitamin supplementation. On 27-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Jun-2021, the patient experienced ANAPHYLACTIC REACTION (Anaphylactic reaction to vaccine) (seriousness criterion medically significant). The patient was treated with ALBUTEROL [SALBUTAMOL] on 02-Jun-2021 for Anaphylaxis, at an unspecified dose and frequency. On 02-Jun-2021, ANAPHYLACTIC REACTION (Anaphylactic reaction to vaccine) had resolved. On 02 Jun 2021, after the vaccination patient began to experience shortness of breath at 12:30 pm and patient''s airways started to constrict at around 9:00 pm. Therefore patient went to the hospital. Action taken with mRNA-1273 in response to the events was not applicable. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.


VAERS ID: 1394145 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-06-02
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Balance disorder, Blood pressure measurement, Dizziness, Hypertension, Illness, Malaise, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Blood pressure; Result Unstructured Data: Test Result:High
CDC Split Type: USPFIZER INC2021667827

Write-up: Dizzy; her head was spinning and she felt like she was going to fall on the floor; She could barely stand, she could hardly walk, her head just spinning out of control and she just felt like everything was spinning around her and she could hardly keep her balance.; She was vomiting, the whole afternoon/ she vomited again like nonstop this point her head was like, she didn''t even know where she was.; She got so ill; she was still not feeling well; She was so worried about herself; blood pressure was little bit of high; This is a spontaneous report from a contactable consumer (patient). A 53-years-old female patient received bnt162b2 (BNT162B2 PFIZER-BIONTECH COVID-19 VACCINE Batch/Lot Number: unknown, Expiry Date: Unknown) via an unspecified route of administration, in right arm on an unknown date in May2021 as 2nd dose, single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (COMIRNATY, Solution for injection) on an unknown date for covid-19 immunization. Patient stated, on 02Jun2021, she was calling be-cause she got the 2 shots of Covid-19 virus last Monday was the second, two weeks end of two week after second shot and Wednesday, this was last Wednesday, she did not know if that was still a side effect that was lingering from the Covid shot because she got so ill. She ended up to the emergency room. She was vomiting, the whole afternoon, Wednesday afternoon. She became dizzy, her head was spinning, and she felt like she was going to fall on the floor. She had to hold on to keep her balance. So, she was not sure if after 2 weeks here was lingering the effects from the vaccine. She went to the emergency room and she was told by the doctor she had a condition called vertigo, so she was not so sure how come they came about but the side effects were so short and so dangerous for her and she considering herself young enough. She just turned 53, May 27 and she never experienced any-thing like that. It was just unlike unset of something of that kicked her out of nowhere. She was up for run when she woke up the morning, had her breakfast, her shower and started working and then after 3 O'' clock in the afternoon, she felt like she was having this in her forehead and also like she need to vomit. So, she went into the restroom and she started vomiting and she felt better, and she decided after work this was after 6 O'' clock, she finished her work and she decided to go out to the laundry to get her clothes done because she was feeling better. She was in laundry taking care of her clothes and she felt dizzy again and she started vomiting again on laundry mat and then it was like an unset of whatever it was that come over her. She could barely stand, she could hardly walk, her head just spinning out of control and she just felt like everything was spinning around her and she could hardly keep her balance. She had to hold on to her shopping card, get her clothes of the laundry and get home. She couldn''t even put her clothes up. She has to just pass the cart and lay down on bed and she stayed on bed for while then she felt like she needed to get to the restroom, but she tried to get up and she couldn''t control herself. Her balance was off like totally off. She had to hold on to be alive for a while to get in the rest room. When she got there, she used the bathroom, and she came back towards and she laid down and she decided that she was going to take Advil and get some sleep. She tried some pills of Advil (Further clarification unknown hence not captured in tab) and she was still not feeling well. Next thing again may be half an hour, so she felt like she need to vomit again. She had to trying to get herself to the bathroom support all over the floor because she could not control herself and she got when she got managed to go the bathroom and she vomited again like nonstop this point her head was like, she didn''t even know where she was. She was so worried about herself and she live alone. She got managed to get some clothes on and called ambulance and the guy they checked her out and they said well that, her blood pressure was little bit of high, nothing wrong with her. Her blood pressure was little bit high and if she needed to go to emergency room, she said yes because she was still not back to her old stuff. She was still dizzy, she was, feel like really most of fall on the floor what she was mostly concerned about. So, when she went there, they gave her a drip and they gave her something for the vomiting and gave her something for dizziness and the next morning the doctor checked her out and told her that she could come home and she need to follow up with her primary care, but she did not know, she never felt anything like this in her life. When confirmed vaccine as Covid-19 vaccine of Pfizer, patient stated, ''Yes, because that was the one which she got. She got the 2 shots. Age of the onset of adverse event was consumer stated, Just recently after the second shot Wednesday, last week Wednesday. She didn''t know the number of vaccine because she has to go to clinic to take that vaccine. She went on Friday the day when they give the shot. she would not have that information. All events onset date was 02Jun2021. On 02Jun2021The patient underwent lab tests and procedures which included blood pressure measurement: high. Patient stated, Not only this that has taken in the hospital (Further not clarified hence not captured in tab) when she went to the emergency room. (no further clarification provided hence not checked as yes). Treatment for the adverse event, got dripped, IV drip. She got something for the vomiting when she was at hospital and she got something for the dizziness. The outcome of all events was unknown. Information on Lot/Batch number has been requested.


VAERS ID: 1394169 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Heart rate increased, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Noticed occasional increased/irregular heart rate, shortness of breath, discomfort in chest beginning around June 2. Symptoms have continued occur multiple times a day since then. Taking NSAIDs (naproxen, aspirin) has helped, but symptoms do continue to come back.


VAERS ID: 1394320 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

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

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

Write-up: 2nd dose was administered on 6-2-21. It was supposed to be given 6-12-21


VAERS ID: 1394562 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-05-24
Onset:2021-06-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Loss of personal independence in daily activities
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: 1 week later c/o intermittent burning pain in chest when eating or taking a deep breath. Sometimes feels like heart is being squeezed. No fever, no chills. Does not feel like heart is beating funny. Has not stopped him from normal activities like working out or playing baseball.


VAERS ID: 1394598 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Illness, Immediate post-injection reaction, Menstrual disorder, Nasopharyngitis, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Imediately after the injection i had itching in my left hand for 2 hours. I was very sick for the net week which i expected with chills a fever and cold symptoms. The thing im concerened about is that i have started menstrauting. I havent menstrauted in 6 months due to an IUD. Now its been almost two week and my shoulder is still hurting.


VAERS ID: 1394662 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Looked over and saw patient slumped backwards in chair. He was unresponsive and mom had to catch him before his head hit the ground. I did not want to wait to determine if patient was breathing or not and gave him epinephrine in case he could have been allergic. I was concerned because he did not express any nervousness or history with fainting after vaccinations.


VAERS ID: 1394678 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Feeling cold, Immediate post-injection reaction, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamin, nexium 20 MG, and Claritin
Current Illness: No
Preexisting Conditions: No
Allergies: None known
Diagnostic Lab Data: None having done on 6/15/21 at cardiologist.
CDC Split Type:

Write-up: Upon immediate injection. I started to shudder, tremble and was freezing cold and my BP spiked to 177/104 at highest. Took a full 12 hours to normalize BP. HR was totally normal. But BP was still in 160?s after 2 hours.


VAERS ID: 1394765 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

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

Write-up: Fever up tp 102? sweats and body aches headache and loss of appetite lasted 11 days after vaccination


VAERS ID: 1394866 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: PHARMACY LEFT PFIZER VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE DOSES OUT FROM THE VIALS,RENDERING THEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1394905 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-07
Onset:2021-06-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Constipation, Dehydration, Disturbance in attention, Dysmenorrhoea, Dysphemia, Headache, Malaise, Mental fatigue, Nausea, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Occassionally: Alprazolam
Current Illness: none
Preexisting Conditions: Diverticulosis
Allergies: sulfa drugs, rodents and cats
Diagnostic Lab Data:
CDC Split Type:

Write-up: Second Vaccine Location: Pharmacy. On 6/2/21 (day after 2nd dose) I vomited repeatedly throughout the day, a total of 4 times between 9am and 5pm and was unable to keep any water or Tylenol down at all. I had a strong headache the entire day, which also brought with mental fatigue and overwhelm - I couldn''t even manage to watch tv I was so ill, it was hard to concentrate, think or even focus my eyes. Around 5pm, feeling severely dehydrated and realizing the urgent cares would be closing soon I scheduled a telehealth dr. appt. with assistance. (I couldn''t sit up or focus long before being overcome with nausea, and it was very hard to think.)The telehealth dr. prescribed me anti nausea medicine - Ondansetron, orally disintegrating tablet, 4mg. Told me to attempt drinking 1tsp water every 10 min. after having the medicine. After taking this medicine and also a dissolving form of tylenol you could put on your tongue, and waiting another hour I was able to begin taking sips of water and sit up. I was able to drink more water over the next few hours and finally some cold plain cereal. I thought I was finally in the clear, however I was surprised that I continued to feel nauseous the next two days and continued to need to take the medicine prescribed (from 6/2 - 6/4). My stomach was so upset from nausea and also I had cramps from beginning my menstrual cycle, but I continued to have stomach aches for the following two days (6/2-6/5). I wondered if it was a side effect from the vaccine or the anti nausea medicine. I also experienced constipation 6/2-6/12, (up to the day of writing this) something I never have an issue with. While I could say it might be related to the medicine, I don''t understand why it would continue so long. It has improved somewhat gradually. What was most surprising to me after all of this is I then began to experience having a stutter when speaking, approximately once a day every day since returning to work through June 8th. (6/4 - 6/8). While this might seem minor, I have not ever experienced this in my life, so four times in four days is markedly unusual.


VAERS ID: 1394916 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-06-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro, plaquenil, iud
Current Illness: no
Preexisting Conditions: asthma, arthritis
Allergies: guinea pigs, grass seed
Diagnostic Lab Data: rheumatologist ran labs to determine if it was the plaquenil (ruled out)
CDC Split Type:

Write-up: hives and rash


VAERS ID: 1394942 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-30
Onset:2021-06-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding, Muscle spasms, Sleep disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad)

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

Write-up: Really bad cramping, like period but worse and through the lower back. Only a few days of spotting intermittently since - no full period but still pain. Enough to wake up in the middle of the night several nights


VAERS ID: 1394944 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Balance disorder, Fatigue, Feeling cold, Myalgia, Pain in extremity, Photophobia, Secretion discharge, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2006 - age 62.5 years - Dtap shot (information not known) similar strong reaction to shot as to Modeerna
Other Medications: Antivert, Lovastatin, Cilostazol, Albuterol Solfate, Estradiol
Current Illness: None
Preexisting Conditions: Allergies, asthma, peripheral artery disease, mitral valve prolapse, fibromyalgia
Allergies: Naproxen, Trental, Zocor, flu shots, NSAIDS, paper tape bandag
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Symptoms began 12-13 hours after shot was given. 2-4 a.m., strong chill with whole body shaking and knife-like sharp pains in legs 5- 7 days heavy nasal mucus discharge painful muscles and joints; fatigue, unstable balance, sensitivity to light lasted 3-4 days 3rd day sore upper left arm with rash from injection site to elbow lasted 3-4 days Symptoms generally cleared up by June 16. Treatment: bed rest, fluids and 1000 mg Tylenol every 6 hrs over 4 days


VAERS ID: 1394959 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Conjunctivitis, Herpes simplex, Hypersensitivity, Lymphadenopathy, Pain, Pain of skin, Paraesthesia, Paraesthesia oral
SMQs:, Severe cutaneous adverse reactions (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Conjunctival disorders (narrow), Ocular infections (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: Otc allergy citrizine
Current Illness: Hashimoto''s
Preexisting Conditions: Seasonal allergies,
Allergies: Codeine aspirin, nuts, pollens, dust
Diagnostic Lab Data:
CDC Split Type:

Write-up: Eye virus prob herpes. Multiple lesions around left eye. Conjunctivitis. Initially diagnosed as allergic issue. Then after Dr visit, localized pain, swollen lymph nodes, for herpes sores around orbital lobe, headaches, multiple tingling Locations around mouth and scalp.


VAERS ID: 1395252 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Palpitations, Pyrexia
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), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, heart racing, trouble breathing.


VAERS ID: 1395444 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-24
Onset:2021-06-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood test, Computerised tomogram, Renal disorder
SMQs:, Retroperitoneal fibrosis (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: Pravastatin, Norvasc 10mg, Janumet 100/1000
Current Illness:
Preexisting Conditions: High blood pressure and Type 2 diabetes
Allergies: Aspirin, citrazine, phenobarbital
Diagnostic Lab Data: CT scan 6/2/21, 6/4/21, 6/5/21 Blood tests daily from 6/2/21 to 6/5/21
CDC Split Type:

Write-up: On 6/2/21 I got a severe pain starting in my left side and wrapped around my back. Went to ER. Was told I had pooled blood around my left kidney. The doctors still haven''t figured out why.


VAERS ID: 1395737 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-06-02
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Borrelia test negative, C-reactive protein increased, COVID-19, Chest pain, Chills, Cytomegalovirus test negative, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Enterovirus test negative, Epstein-Barr virus test negative, Fatigue, Full blood count normal, Injection site pain, Metabolic function test normal, Myalgia, Parvovirus B19 test negative, Red blood cell sedimentation rate increased, Respiratory viral panel, SARS-CoV-2 antibody test positive, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Autism Epistaxis Ehlers Danlos hypermobility Von Willebrands disease type 1
Allergies: Sulfa
Diagnostic Lab Data: Troponin (6/4) 56, (6/6) 1097, 6/8 (98) EKG (6/4,5,6) wnl ECHOcardiogram (6/5), (6/7) wnl CBCd, CMP (6/4) wnl ESR (6/4) 30 CRP (6/4) 98, (6/6) 34 mg/L ID work up (6/7): 1. Respiratory viral panel negative 2. COVID Ab positive 3. Enterovirus, adenovirus, parvovirus B19 Qual PCR blood neg 4. Quant PCR EBV, CMV blood PCR neg 5. Lyme serologies neg
CDC Split Type:

Write-up: Got second dose of vaccine 6/2. Same day had chills, myalgia, fatigue and soreness at injection site. 6/3 developed substernal chest pain and dyspnea. Admitted to hospital for suspected myocarditis given elevated troponin and mildly elevated inflammatory markers 6/4. No treatments given. Symptoms resolved and troponins improved prior to discharge 6/8. He remains well today 6/14.


VAERS ID: 1396416 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-06-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pain, Headache, Lethargy, Neck pain, Pain, Pain in jaw, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Osteonecrosis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Sore and lethargic first 48 hours after initial shot. A severe headache began the evening of June 2. I woke up and vomited due to head pain later that evening/early morning.. Slight Fever at 99.5, sore and Lethargic for about 48 hours. The headache has continued since it began, including pain and soreness around neck, jaw, back of head and eyes. I spoke with a clinician prior to my second Pfizer shot on June 7th, and they said to treat the symptoms. For pain relief, I''ve tried acetaminophen (no help) and aspirin (helpful). The headache has persisted and continues to this day (June 14th. This is unusual, as I rarely have headaches, probably averaging less than one a year, and for no more than an hour or two.


VAERS ID: 1396417 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-0580-15 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Dizziness, Fatigue, Feeling abnormal, Headache, Impaired work ability, Nausea, Neck pain, Pyrexia, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Massive headache for 8 days. I believe it was encephalitis. Dizziness, fatigue, nausea, terrible neck pain, pain allover skull. Completely out of it. Disoriented, Fever, rash, missed work. Now I have a purple spot on my inside of left leg, found this morning 6/14/21 7:30 am.


VAERS ID: 1396540 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-13
Onset:2021-06-02
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan-hctz 100-25
Current Illness: None
Preexisting Conditions: None
Allergies: Celiac Disease
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rash in groin area, legs, chest and neck


VAERS ID: 1396633 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-06
Onset:2021-06-02
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 RA / IM

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

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

Write-up: Patient came into the pharmacy on 6/2/21 to get his 2nd dose of Pfizer vaccine. One of our technicians noticed he had vaccination cards for all 3 COVID-19 vaccines in his wallet (Moderna, Janssen, and Pfizer). We refused service on 6/2/21 due to patient showing multiple COVID-19 vaccinations and admitting that he had received all except his 2nd dose of Pfizer. He stated he needed them for travel since he traveled to various countries for work. It is not advised to receive all doses of the COVID 19 vaccines, so myself as the pharmacist on duty at the time, refused to give him the 2nd dose of Pfizer. We had already given him the 1st dose of Pfizer as he had written on the consent form he had not received any previous COVID 19 vaccines and when verbally asked on 5/6/21, he stated he hadn''t either. Upon checking system on 6/2/21, it showed he was going to various clinics and pharmacies to get the different vaccines.


VAERS ID: 1396655 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2020-12-20
Onset:2021-06-02
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Coagulation test, Computerised tomogram abnormal, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: advair celexa adderall singulair
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: clotting factor lab work/ct scan /venous and arterial ultrasound xarelto po
CDC Split Type:

Write-up: large blood clot in right leg/groin, xarelto po, consult hematologist and vascular surgeon, still waiting for treatment to resolve blood clot


VAERS ID: 1396742 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Intermenstrual bleeding, Menstruation irregular
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility 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: Aloe
Current Illness: None
Preexisting Conditions:
Allergies: seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: She recieved the COVID19 vaccines that day and later in the day she started menses 3 weeks early, accompanied by continued abdominal/pelvic cramping and spotting which has continued


VAERS ID: 1396822 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bilateral pulmonary embolisms, patient admitted to ICU.


VAERS ID: 1397015 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Dyspnoea, Fatigue, Injection site pain, Migraine, Myocarditis, Neuralgia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50mg spironolactone once a day; 20mg Adderall XR once a day; 10mg loratadine once a day; 7mg naltrexone hcl once a day; 500mg valacyclovir twice a day; 0.1mg aripiprazole once a day; depo-provera shot once every 3 months
Current Illness: None
Preexisting Conditions: chronic fatigue syndrome, ehlers-danlos syndrome hypermobility type, acne, ADD
Allergies: Dust, pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Myocarditis-Severe fatigue and chest pain amd shortness of breath for 7 days beginning 3 hours after injection and occurred after any small physical exertion like taking out the trash or walking 2 blocks (lingering moderate fatigue and some chest soreness still remains today ), migraine for 3 days beginning 2 days after injection, left upper arm pain (sore) for 3 days beginning 12 hours after injection, sporadic mild running nerve pain for 7 days beginning 2 min after injection (no pain during injection itself), cold chills for 3 days beginning 24 hours after injection.


VAERS ID: 1397027 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir 400 MG 1 Time Per Day Armour Thyroid 120 MG Capsule (1 Per Day) Climara .1 Mg/Day (1 Estrogen Patch Weekly) Dilauded 2 Mg (5 Tablets Per Day) Lisinopril, 10 MG Tablet 1 Per Day Promethazine (Phenegren) 12.5 MG Tablet as Needed To
Current Illness: Recovering from back surgery.
Preexisting Conditions: Fibromyalgia, arthritis
Allergies: All Antihistamines Antibiotics - For Surgery Vancomycin Works Very Well Antibiotics - Most (Ciprofloxacin 500 MG is OK) Augmentan Clindamycin HCL Keflex Levaquin Anti-Depressants Beta & Channel Blockers Beta dine Celebrex Chlordiazepoxide-Clidinium Cap Codeine Cortisones Decongestants Epinephrine Hydrocodone / Contrast Dye Oxycodone Penicillin Prilosec Prvicid Reglan Salsalate Steroid Inhalers i.e. Provental Versed Vioxx Zelnorm
Diagnostic Lab Data:
CDC Split Type:

Write-up: Recovering from surgery, doing well after shot, back pain became signifantly worse (back to right after surgery). Assume reaction caused swelling in the tissues of my back.


VAERS ID: 1397719 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-06-02
   Days after vaccination:53
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance test, Blood test, Blood thyroid stimulating hormone, Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood test (5.970 TSH level) on 06/14/2021, failed basic balance test on 06/10/2021
CDC Split Type:

Write-up: Vertigo aggravated by looking at screens, sudden onset vertigo


VAERS ID: 1399022 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / -

Administered by: Senior Living       Purchased by: ?
Symptoms: No adverse event
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: No adverse affects and no side effects since vaccine given..


VAERS ID: 1399137 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-06-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Autoimmune disorder, Nephropathy, Protein urine, Weight increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Chronic kidney disease (broad), Proteinuria (narrow), Immune-mediated/autoimmune disorders (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: No
Current Illness: none
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pinkish rash on face, neck, chest, arms and hands. Lasted 3 days after first vaccine, after second dose - autoimmune kidney disease. Started feeling protein in urine, gained 30 lbs water weight


VAERS ID: 1399214 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Asthenia, Chest pain, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad)

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

Write-up: Dizziness, light headed, heart pain, chest pain low energy


VAERS ID: 1399290 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder, Vaginal haemorrhage
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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Disrupted menstrual cycle: Expected June 4th, started spotted on June 1st (possibly a side effect of first dose received May 4). June 1st and morning of 2nd: spotting. - June 2nd - bleeding stopped altogether immediately after 2nd dose received. - June 6th - bleeding started back up 4 days later. - June 7-8 -- extremely heavy bleeding (unusual). - June 9 -- light - June 10 -- nothing (also unusual as my periods usually taper off and last at least 7-8 days) - June 11 -- back up again with a light day (strange). - June 12 -- official end but post-period I did not have the usual ovulation discharge . This was a highly unusual and erratic cycle, that was inconsistent with my typically predictable periods.


VAERS ID: 1399406 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-18
Onset:2021-06-02
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Exposure during pregnancy, Herpes virus test, Herpes zoster, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: When I got the first vaccine I was in my 36th week of pregnancy. I started to get a tingling sensation 06/3/2021 on my right pelvic area and extended up to my back. I developed a rash on 06/05/2021 and it felt like a burning sensation if I touched it. I went to the Urgent Care two days later because the rash was spreading. They took a swap and it was positive for Shingles. I had the Chicken Pox as a child and I had the Chicken Pox vaccine as well. I was given Acyclovir5Xdaily for 7 days. The rash dried up and it is starting to get better. Due Date: 06/28/2021 Pregnancy: First


VAERS ID: 1400256 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 2 LA / IM

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

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

Write-up: the first dose was given on 05/14/2021 and the second dose on 06/02/2021


VAERS ID: 1400366 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Flushing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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. left after observation period of 15 minutes. Pt. returned back to vaccine clinic a few minutes later and stated his face felt a little flushed and his ears felt warm. Vitals taken and BP 177/97. Pt states he takes medication for high BP. Pt. waited additional 15 minutes and stated he felt okay to go home. Pt dc'' d home with precautions given.


VAERS ID: 1401658 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Delaware  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Influenza like illness, Injection site bruising, Sensory disturbance, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes; Rash
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210612247

Write-up: SHE FELT LIKE GOT HIT BY A TRUCK; FLU LIKE SYMPTOMS; URTICARIA (RASH ALL OVER BODY EXCEPT NECK AND FACE AND SCALP); INJECTION SITE BRUISING; This spontaneous report received from a consumer concerned an 84 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, and stress induced rash, and other pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A expiry: 23-JUN-2021) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-JUN-2021, the subject experienced injection site bruising. On 03-JUN-2021, the subject experienced she felt like got hit by a truck. On 03-JUN-2021, the subject experienced flu like symptoms. On 03-JUN-2021, the subject experienced urticaria (rash all over body except neck and face and scalp). The action taken with covid-19 vaccine was not applicable. The patient was recovering from urticaria (rash all over body except neck and face and scalp), and injection site bruising, and the outcome of flu like symptoms and she felt like got hit by a truck was not reported. This report was non-serious.


VAERS ID: 1401690 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Seasonal allergy
Preexisting Conditions: Comments: patient had no drug abuse or illicit drug usage. Patient was pretty health and does not take any medication
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Heart rate; Result Unstructured Data: intermittent rapid heart beat; Comments: Typically patient have a low heart rate of about 60 beats
CDC Split Type: USJNJFOC20210627740

Write-up: INTERMITTENT RAPID HEARTBEAT AND NOTICE MORE HEART BEATS WHILE SITTING; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergies, non-alcoholic, and non-smoker, and other pre-existing medical conditions included patient had no drug abuse or illicit drug usage. Patient was pretty health and does not take any medication. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-JUN-2021, the subject experienced intermittent rapid heartbeat and notice more heart beats while sitting. Laboratory data included: Heart rate (NR: not provided) intermittent rapid heart beat. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from intermittent rapid heartbeat and notice more heart beats while sitting. This report was non-serious.


VAERS ID: 1402007 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: SARS-CoV-2 ELISA test; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210626695

Write-up: SUSPECTED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report received from a health care professional concerned a 69-year-old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included no information on medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On 02-JUN-2021, the patient had a negative antibody test (coded as suspected immunological vaccine failure). Laboratory data included: SARS-CoV-2 ELISA test (NR: not provided) as negative. The test was an IgG Elisa-Spike. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of suspected immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210626695 -Covid-19 vaccine ad26.cov2.s- suspected immunological vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1402043 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-31
Onset:2021-06-02
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: adapalene (DIFFERIN) 0.1 % gel amLODIPine (NORVASC) 10 mg tablet azithromycin (ZITHROMAX) 500 mg tablet clindamycin (CLEOCIN T) 1 % lotion fluocinolone and shower cap 0.01 % oil JUNEL FE 1/20, 28, 1 mg-20 mcg (21)/75 mg (7) per tablet lisin
Current Illness: None
Preexisting Conditions: Circulatory Renovascular hypertension Secondary hypertension Genitourinary Stage 2 chronic kidney disease Musculoskeletal Strain of thoracic paraspinal muscles excluding T1 and T2 levels, initial encounter Hematologic Anemia Immune Psoriasis Immunosuppression (CMS/HCC) Other Status post kidney transplant Tremor Proteinuria Moderate major depression, single episode (CMS/HCC) Generalized anxiety disorder
Allergies: Ibuprofen PenicillinsRash
Diagnostic Lab Data: POCT COVID-19 PCR
CDC Split Type:

Write-up: Cough Fever Sore throat headaches myalgias Postnasal drip


VAERS ID: 1402156 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-14
Onset:2021-06-02
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Depressed mood, Headache, Injection site reaction, Mental disorder, Micturition disorder, Pain, Pyrexia, Unevaluable event
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Depression (excl suicide and self injury) (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: She got her vaccine, she went crazy that night, she lost her mind. Her fever was so high that she thought that she would not wa
Other Medications: Lipitor, multivitamin, hair/skin/nail vitamin.
Current Illness: None.
Preexisting Conditions: High cholesterol.
Allergies: Latex, eggs, whole milk, strawberries, kiwi''s and some shellfish and nuts.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: She got her vaccine, she went crazy again that night, she lost her mind. Her fever was so high (not measured and home by herself), that she thought that she would not wake up. At one point she felt like she was in the bed, and she could see her own body and she could see herself sweating and that something else entered her body. She did not know what she was doing. Days after she was very stressed out. Two days later the fever went away and she was okay. Then on 6/2/21 she started urinating for a long time, and never used to happen to her and frequent. She became worried and she noticed that she was getting headaches that she had not gotten before. She has a throbbing feeling in her arm like something wants to burst out of her arm, and the feeling is on the inside not the outside. She claims that her arm is magnetic now, she was doing something and her phone stuck to her arm, and so she tried a knife, fork, and a spoon and everything sticks to the vaccine site, but not the other arm. She also put a light bulb up to her and it shocked her so she didn''t see if it would light up like she had seen on social media. She said she never saw a hole from the vaccine, never saw where the shot went just the reaction from it, but sometimes feels a little throbbing and pain in that area. She had a telemed appointment with her doctor this morning and she demonstrated the fact that the utensils were magnetic to her skin and she told her to call us and report the event. She is nervous about the throbbing pain and the sticking of the magnetic problem, and wanting to travel and wanting to know if this was going to be a problem, and will her life be the same again. She is now very depressed about the whole situation.


VAERS ID: 1402207 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-06
Onset:2021-06-02
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alcohol withdrawal syndrome, COVID-19, Hospitalisation, Hypertensive urgency, SARS-CoV-2 test positive
SMQs:, Psychosis and psychotic disorders (broad), Hypertension (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 650 mg 8 hr tablet ARIPiprazole (ABILIFY) 10 mg tablet ARIPiprazole (ABILIFY) 5 mg tablet aspirin 81 mg chewable tablet atorvastatin (LIPITOR) 80 mg tablet chlorthalidone (HYGROTON) 25 mg tablet docosahexanoic acid/e
Current Illness:
Preexisting Conditions: Hospital Coronary artery disease Bipolar disorder Depression Dyslipidemia Hypertension H/O heart artery stent COPD, mild Tobacco abuse Alcohol abuse Obstructive sleep apnea hypopnea, moderate Hyponatremia History of MI (myocardial infarction) Closed fracture of nasal bone Transaminitis Non-Hospital Benign essential hypertension Caries Condyloma acuminatum Insomnia Myopia Cigarette nicotine dependence without complication Obesity Chest pain Caffeine dependence Erectile dysfunction, unspecified erectile dysfunction type Daytime hypersomnia Lesion of left external ear Exposure to COVID-19 virus Nodule of anterior chest wall Hypertensive urgency Anterior mediastinal tumor
Allergies: Paroxetine HclMental Status Change
Diagnostic Lab Data:
CDC Split Type:

Write-up: was admitted for hypertensive urgency & alcohol withdrawal management. In regards to COVID, he was asymptomatic, did not require supplemental oxygen and did not require treatment. Precautions were kept in place throughout his stay and he was instructed to do a 10-day quarantine from the date of his positive test which was 6/2.


VAERS ID: 1402839 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

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

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

Write-up: Neck Stiffness


VAERS ID: 1402969 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Injection site swelling, Migraine, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID-19 Moderna 1 vaccine, age 19, 4/27/21, vomiting, migraines, fever, chills, eye sight affected, dizziness
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Projectile vomiting High fever Migraine Chills Severely swollen limb on side of injection Dizziness


VAERS ID: 1403268 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: tingling in Left hip (random times)


VAERS ID: 1403375 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash maculo-papular
SMQs:, 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: Chronic ankle pain, injury
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Full body macular papular rash that began within 24 hours s/p dose #2 and lasted for ~ 7 days. Not reported to be pruritic, no urticaria.


VAERS ID: 1403469 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: migraines, arthritis
Allergies: none
Diagnostic Lab Data: ER visit on 6/2/2021 labwork and ultrasound
CDC Split Type:

Write-up: Pt developed a blood clot.


VAERS ID: 1403698 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH #EW0185 / 1 AR / IM

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

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

Write-up: mom noted start of urticarial rash within a couple of hours of administration, rash pesists 10+ days


VAERS ID: 1403740 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-01
Onset:2021-06-02
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Postmenopausal haemorrhage
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: General multivitamin QD
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA or other allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Post menopausal bleeding. 2+ years post menopausal without bleeding.


VAERS ID: 1404013 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Clumsiness, Disturbance in attention, Dizziness, Feeling abnormal, Headache, Sinus pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: HPV, age 12, dizziness/passing out
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headaches and pain in sinuses Dizziness persisting "Brain fog" trouble concentrating/memory clumsiness, balance problems possible vertigo


VAERS ID: 1404019 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness, Eye irritation, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Corneal disorders (broad), Hearing impairment (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: Estradial .0375 patch, Progesterone 200 mg (10 days a month from the 15th thru the 25th of the month), Tagamet 200 mg as needed for GERD, Metoprolol tartrate 25 mg as needed for heart palpitations
Current Illness: None
Preexisting Conditions: Diagnosed with Cochlear Hydrops at age 38 in left ear
Allergies: Decadron, Protonix, Soma, Ibuprofen
Diagnostic Lab Data: Hearing tests conducted two days after the start of the hearing loss. Symptom of hearing loss started June 2nd. First hearing test conducted on June 4th. That hearing test showed a 30 decibel hearing loss.
CDC Split Type:

Write-up: About 12 hours after receiving my 2nd shot I had a normal immune response, low grade fever around 100 degrees, achy, burning eyes. By the next morning I felt better. That evening around 6 pm I couldn''t hear. I went to bed around 9pm and when I woke up the morning of June 3rd I could not hear normal speech. I called my ENT and went into his office on June 4th at 2pm. A hearing test was conducted and I had a 30 decibel hearing loss in my right ear. My ENT started steriod injections behind my ear drum. I went back in on June 7, 11 and the 14th for additional steriod injections. Currently, my hearing is better but still compromised. I am going in for a hearing test on Friday June 18th.


VAERS ID: 1404020 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Muscle spasms, Pain, Paralysis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: I was unable to breathe. Airway closed up and was unable to take deep breaths. I went to urgent care and the refused to see me as I the triage nurse said had a fever of 102degrees Fahrenheit. I had severe bodily cramps and paralysis. I sti
Current Illness: None
Preexisting Conditions: No
Allergies: Aleve
Diagnostic Lab Data: Temp and oxygen taken
CDC Split Type:

Write-up: Difficulty breathing. Paralysis body aches and cramping. Fever. I was unable to breathe. Airway closed up and was unable to take deep breaths. I went to urgent care and the refused to see me as I the triage nurse said had a fever of 102 degrees Fahrenheit. I had severe bodily cramps and paralysis. I still have difficulty breathing and it''s the 16th. The first dose also presented me w/ the inability to breathe however went away after about 7 days. This second dose seems to have given me ongoing lung issues.


VAERS ID: 1404264 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-05
Onset:2021-06-02
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA R16M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013A211A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hyperaesthesia, Injection site pain, Photosensitivity reaction, Sunburn
SMQs:, Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: COPD diagnosis 8 years ago. Have had treatment for skin cancers (both benign and malignant) during the past 25 years.
Allergies: mild allergy to milk and eggs
Diagnostic Lab Data: None - I do not have a primary care provider and next available appointment with a primary care physician (online) is over 30 days away.
CDC Split Type:

Write-up: After first injection on 02/05/2021, the only event was a 24 hour soreness at injection site. No adverse effects after second injection on 3/5/2021. During the first few days of June 2021, I noticed that my skin became hyper-sensitive to sunlight and it was like I got sunburned in as little as 30 minutes to sun exposure. I''m a red-haired person (grey now) and have always sunburned easily but prior to the vaccine I could tolerate 3-4 hour sun exposure with little or no effect. Now I''m a noticeable redness to my skin after exposure of 30 minutes or less and my skin (face mostly) feels sunburned. This skin sensitivity has not abated since I became aware of it.


VAERS ID: 1404279 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-29
Onset:2021-06-02
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Herpes zoster, Laboratory test, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: turmeric, CQ10
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa
Diagnostic Lab Data: Postive shlinges test
CDC Split Type:

Write-up: fWithin the first 24 hours I had a low grade fever, headache, and chills. About 35 days later I noticed serve pain in my leg and a skin rash which was diagnosed as shlinges.


VAERS ID: 1404786 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-31
Onset:2021-06-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eyelid disorder, Hordeolum, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Swelling and drooping of right eyelid. Painful to touch. Turned into a stye after several days. Believe it could be a reaction to a dermal filler.


VAERS ID: 1404792 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Postmenopausal haemorrhage
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: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got my period after not having it for over 2 years. It was very heavy and lasted almost two weeks.


VAERS ID: 1404805 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-05-28
Onset:2021-06-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022821A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax, Electrocardiogram, Laboratory test, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Labs, CTA Chest, EKG
CDC Split Type:

Write-up: Pericarditis


VAERS ID: 1404808 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-29
Onset:2021-06-02
   Days after vaccination:65
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ? / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Levothyroxine
Current Illness: None
Preexisting Conditions: Slight Hypothyroidism
Allergies: None
Diagnostic Lab Data: Emergency room visit June 2nd, 2021 for Bell''s Palsy
CDC Split Type:

Write-up: 2 weeks after the shot I had a scary night where I had severe chest pain. I sat up for a few hours hoping I wasn''t having a heart attack and taking water and tums. I have never had chest pain before or since. I was very concerned and wondered if it was the vaccine. I didn''t have anything unusual to eat or drink. I was happy when it finally resolved that same night. I also experienced Bell''s Palsy 2 months after the vaccine. (~June 1st) I have never experienced Bell''s Palsy. I am not sure if either of these events were related to the vaccine, but I have no intention of getting a yearly covid or flu vaccine now that I have Bell''s Palsy. It is terrible, and I''m not taking ANY chance of getting this again even if that means I get the flu and covid yearly. I placed my trust in science, and not I am not sure I made the right choice. Although I hope my facial movement and ability to use my lips and face come back, I realize that some never recover.


VAERS ID: 1405291 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-08
Onset:2021-06-02
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chest pain, Dizziness, Dysstasia, Headache, Hypoaesthesia, Loss of consciousness, Nausea, Paraesthesia, Pyrexia, Vaccination site pain
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? 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: BUSPAR; LAMOTRIGINE
Current Illness: Anxiety
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Body temperature; Test Result: Borderline ; Result Unstructured Data: Fever-99 degrees Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Temperature was 99 degrees Fahrenheit; Almost passed out; Whole right side of my body went numb; Left leg tingly/Whole right side of my body tingly; Dizzy; Hard to stand; Chest pain; Arm pain at the injection site; Nausea; Slight Headache; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Almost passed out) in a 33-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Anxiety. Concomitant products included BUSPIRONE HYDROCHLORIDE (BUSPAR) and LAMOTRIGINE for Anxiety. On 08-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 02-Jun-2021, the patient experienced LOSS OF CONSCIOUSNESS (Almost passed out) (seriousness criterion medically significant), HYPOAESTHESIA (Whole right side of my body went numb), PARAESTHESIA (Left leg tingly/Whole right side of my body tingly), DIZZINESS (Dizzy), DYSSTASIA (Hard to stand), CHEST PAIN (Chest pain), VACCINATION SITE PAIN (Arm pain at the injection site), NAUSEA (Nausea) and HEADACHE (Slight Headache). On 03-Jun-2021, the patient experienced PYREXIA (Temperature was 99 degrees Fahrenheit). At the time of the report, LOSS OF CONSCIOUSNESS (Almost passed out), HYPOAESTHESIA (Whole right side of my body went numb), PARAESTHESIA (Left leg tingly/Whole right side of my body tingly), DIZZINESS (Dizzy), DYSSTASIA (Hard to stand), CHEST PAIN (Chest pain), VACCINATION SITE PAIN (Arm pain at the injection site), NAUSEA (Nausea), HEADACHE (Slight Headache) and PYREXIA (Temperature was 99 degrees Fahrenheit) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 03-Jun-2021, Body temperature: 99 (Borderline) Fever-99 degrees Fahrenheit. Patient reported that she had not taken anything for her symptoms. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1405841 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dizziness, Hypersensitivity, Hypoacusis, Near death experience, Pulmonary function test
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy (shot made my allergies like ten times worse)
Allergies:
Diagnostic Lab Data: Test Name: test in my lung; Result Unstructured Data: Test Result:everything is fine
CDC Split Type: USPFIZER INC2021643055

Write-up: I have severe allergies now because from the shot I almost died; shot made my allergies like ten times worse; I have severe allergies now because from the shot I almost died; shot made my allergies like ten times worse; I can''t hear you my allergies are horrible today; Light-headed; Cough; This is a spontaneous report from a contactable consumer (patient). A 53-year-old female patient received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration at 1 O''clock on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included allergies from an unknown date. The patient reported I''m on five different pills, I don''t have them right now I didn''t take up from the pharmacy yet. The patient stated, "I had to go to emergency room last night and I had a reaction to the vaccine and I have severe allergies now because from the shot I almost died. I can''t hear you my allergies are horrible today. I started now with a cough, I have severe allergies and this all I had to go to hospital. I''m still like light-headed and I''m coughing too much and I never done it until I got the COVID shot. The events started couple of days after the injection. The patient further stated, "I have severe allergies and they thought I have a blood clot in my lung and I still have nothing wrong with that, my lungs and heart are fine. It''s this shot the shot made my allergies like ten times worse. Now I''m in like on five different pills now." The patient reported no treatment received for the events, only thing they did is they done a test in my lung and everything is fine, my heart is fine so I''m doing pretty good. The event Cough started on 02Jun2021; other events started on unspecified date. The patient was hospitalized for the severe allergies now because from the shot she almost died. The outcome of event Cough and Light-headed was not recovered, outcome of other events was unknown. Information on the lot/batch number has been requested.


VAERS ID: 1405850 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-23
Onset:2021-06-02
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021648926

Write-up: running a fever yesterday; This is a spontaneous report from a contactable consumer (reporting on herself). A 64-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number and Expiration date was not reported), via an unspecified route of administration on 23May2021 as 2nd dose, single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Previously patient took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 02May2021 for COVID-19 immunization. It was reported that a patient received first dose of Pfizer''s COVID vaccine on 02May2021 and the second dose on 23May2021. She was running a fever yesterday (on 02Jun2021) and it is gone today (on 03Jun2021). Asking does she need to quarantine because she was out of town and does she need to test for COVID if she had the fever yesterday (on 02Jun2021). Patient asking if the vaccine was good for 6 months. What are the 6 months top line analysis results of the Pfizer-BioNTech COVID-19 Vaccine. The outcome of the event was recovered on 03Jun2021. Information about lot/batch number has been requested.


VAERS ID: 1405877 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Chest discomfort, Decreased appetite, Dizziness, Fatigue, Headache, Malaise, Musculoskeletal discomfort, Nausea, Paraesthesia, Paranasal sinus discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Sulfonamide allergy (Verbatim: Sulfa-Drugs)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021659638

Write-up: Pins and needle sensations that moved to the rest of body; Sinus pressure; Tingling that started in the feet; Loss of appetite; Headache; Nausea; Dizziness; Fatigue; Pressure in back and abdomen; Pressure in back and abdomen; Chest tightness; Malaise; This is a spontaneous report from a contactable consumer (patient) reported that: A 29-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0185; formulation: solution for injection; Expiration date: unknown), via unspecified route of administration in left arm on 01Jun2021 at 15:00 (at the age of 29-years-old) as second dose, single dose for COVID immunisation in Health Clinic/Administration facility. The patient medical history included Sulfa-Drugs with allergies. The concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. Patient known allergies included Sulfa-Drug. Device timestamp was reported as 05Jun2021. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not received other medications within two weeks of vaccination. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8736; formulation: solution for injection; Expiration date: unknown), via unspecified route of administration in left arm on 11May2021 at 14:00 (at the age of 29-years-old) as first dose, single dose for COVID immunisation. On 02Jun2021 at 11:00, the patient experienced Pins and needle sensations that moved to the rest of body including feet, legs, pelvis, buttocks, back, abdomen, chest, arms, neck, cheeks, back and front of head as well as occasional sensation in right eye, Sinus pressure, Tingling that started in the feet, Loss of appetite, Headache, Nausea, Dizziness, Fatigue, Pressure in back and abdomen, Pressure in back and abdomen, Chest tightness, Malaise. The adverse events resulted in doctor or other healthcare professional office/clinic visit. The adverse events resulted in Emergency room/department or urgent care. The patient did not received treatment for the events. The outcome of the event was not recovered.


VAERS ID: 1405961 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-06-02
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021672022

Write-up: rashes; hives; itching; headache; swollen lymph nodes; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 15Apr2021 as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 for COVID-19 immunization. On 02Jun2021, patient experienced rashes, hives, itching, headache and swollen lymph nodes. The outcome of events was unknown. Information about batch/Lot number has been requested.


VAERS ID: 1406190 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-17
Onset:2021-06-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure abnormal, Blood pressure measurement, Costochondritis, Mass, Musculoskeletal chest pain, Musculoskeletal stiffness, Pain, Product dose omission issue
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (broad), Arthritis (broad), Medication errors (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: Medical History/Concurrent Conditions: Anxiety; Aortic aneurysm (Diagnosed about 3 years ago.); Cancer (Father had prostate cancer that went into his throat.); Depression; Heart block (Diagnosed about 3 years ago.)
Allergies:
Diagnostic Lab Data: Test Name: blood pressure; Result Unstructured Data: Test Result:abnormal
CDC Split Type: USPFIZER INC2021702883

Write-up: has problems with his blood pressure; didn''t get the second shot; His lower back tightens up sometimes.; a growth at the base of his rib cage; causing pain; Soreness in his ribcage; costochondritis; This is a spontaneous report from a contactable consumer or other non hcp. A 67-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EN6198), via an unspecified route of administration in the right arm on 17May2021 at 15:30 (at the age 67-year-old) as 1st dose, single dose for COVID-19 immunisation. Medical history included atrioventricular block, diagnosed about 3 years ago; aortic aneurysm, diagnosed about 3 years ago; anxiety and depression. The patient''s family history included father had prostate cancer that went into his throat. Historical vaccine included flu vaccine about 4 years ago and experienced has not had anything except a sore arm after vaccines. One time the patient had weakness in his left arm for months. The pharmacist said it was because of how they administered it. The patient''s concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient stated he was called about the COVID 19 vaccine. He had his first vaccine on 17May2021, and second shot was supposed to be on 07Jun2021. He went to his doctor "tomorrow" at 20:40 regarding a growth at the base of his rib cage. He called and spoke to someone at Pfizer earlier "today", 14Jun2021 and forgot to tell the agent that he was taking Tylenol and Advil. He completely forgot. He does not have a report number from the call "this morning". When probed the information from the COVID 19 vaccine card, he reports it was hard to read the pharmacist''s handwriting but the date for the first vaccine was 17May2021, he remembered it was a Monday and he was supposed to have his second vaccine 3 weeks from 17May2021. He reported he did not have the growth on his rib cage prior to the COVID 19 vaccine. He had soreness in-between his ribs and went to the doctor. The doctor said he had costochondritis, two weeks after the vaccine and felt all along that area in his ribs. This was 3 weeks and 3 days after he had the first COVID 19 vaccine. He woke up and felt big lump right underneath where his ribcage ends, the size of his hand, and it was causing pain. That Wednesday the patient was fine and then Thursday it was there. He does not know if the lump was pressing on nerves or whatever. His doctor told him to take Tylenol. The patient''s physician assistant said it was a sub-Q lump of fat, it was very pronounced. The caller sees his doctor "tomorrow". When he first got up in the morning for the first 5 or 10 minutes, he has pain that nearly brings him to tears and the Advil and the Tylenol was not curing that. He has been fortunate that the pain disappears after about 10 minutes. He has been taking Tylenol at 1000mg twice a day, once in the morning and once in the evening. He stopped taking the Advil because he has problems with his blood pressure. His doctor does not want him to take Advil. He was not reported any new events. He was taking the Tylenol also taking a muscle relaxer, Skelaxin. He takes Skelaxin for his lower back. His lower back tightens up sometimes. He was not blaming that on the vaccine because he had this problem in the past. The Patient was very questionable to get the COVID 19 vaccine, but his doctor said he does not want the caller to be the last person who ends up in a grave. So, he decided to get the COVID 19 vaccine. The Tylenol was Acetaminophen at 500mg (Lot# OKE2997, Expiry Sep2022). He bought it from the supermarket "PRIVACY". Advil at 200mg, Lot# X84375, Expiry Jul2021. He would take 2 tablets in the morning and 2 tablets at bedtime so he could sleep. He has one tablet left but he was not taking this anymore. He will ask the doctor tomorrow at this appointment if he was going to order an ultrasound. He was not in pain at the time of the first call to Pfizer. The events resulted in visit to physician''s office. The outcome of event "a growth at the base of his rib cage" was not resolved; pain was resolved and rest all other was unknown.


VAERS ID: 1406855 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-25
Onset:2021-06-02
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, SARS-CoV-2 test negative, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyprex, Elavil, Neurontin, Tadalafil, Celebrex
Current Illness:
Preexisting Conditions: Scerosing Mesenteritis, Mitral Valve Prolapse, Schizoaffective Disorder
Allergies: Gluten/dairy (but not a true allergy)
Diagnostic Lab Data: Yesterday I was retested for COVID and it came back negative.
CDC Split Type:

Write-up: My breathing has chronically been a little wheezy with some coughing.


VAERS ID: 1407709 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-15
Onset:2021-06-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171, / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia, Temperature intolerance
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: note reported
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: ibuprofen
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient developed Unilateral (Left)numbness and tingle 3 weeks post 2nd vaccination. Symptoms have not improved. Patient says his left side is very sensitive to hot and cold now. Its his entire left side from left side of face to his foot. Describes it like a line down center of body. No prior episodes of anything like this in teh past. Says it was sudden onset . went to bed fine and woke up with it.


VAERS ID: 1407781 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Glossodynia, Lip pain, Pruritus, Psychomotor hyperactivity, Upper respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None (had been taking Vitamin C, D3, Zinc) in the days prior. Some homeopathic drops for allergies, but none on that day.
Current Illness: Was having an issue with sternal wires (open heart surgery, 1/4/2018. Found out there is nickel in the titanium wires. Had a procedure to remove some of them on 6/6/2021
Preexisting Conditions:
Allergies: Corn starch, many antibiotics, Warfarin, Metoprolol, Eliquis, smoke, nickel, coconut oil, dimethicone (in lotions), mineral oil, wool. I had seen an allergist (May 20, 2021) and was tested for the 2 things most likely to cause a reaction (Polysorbate - in the Johnson and Johnson and PEG - in the Moderna). Negative reaction to bot
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Congestion in throat, stinging tongue and lip, general itching, hyperactivity


VAERS ID: 1407922 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: There was a mix up with expired vaccine and recently reconstituted vaccine. The patient may have received a vaccine that was outside the recommended syringe storage time of 6 hours. After consultation with Pfizer, the CDC and our vaccine experts it was determined that microbial contamination was primary concern and revaccination was not necessary. We made daily attempts to reach out to patient and notify but they do not answer phone or return calls. We are going to discuss at next dose. Unknown if patient had any increase incidence of fever or site reaction.


VAERS ID: 1408002 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-24
Onset:2021-06-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Pain in extremity, 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), Tendinopathies and ligament disorders (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: Daily multi-vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: No known
Diagnostic Lab Data: 06/07/2021: Ultrasound performed in the ER. Diagnosis was Deep Vein Thrombosis (DVT) of distal vein of right lower extremity.
CDC Split Type:

Write-up: Pain in the back of patient''s right calf started after a flight on 6/2/2021. We ended up in the ER on 6/7/2021. There he was diagnosed per ultrasound with DVT or having a blood clot in a vein in his right calf. He was prescribed Eliquis and counseled to follow up with his physician at home. Patient met with our family physician on 6/9/2021, the day we arrived home to follow-up. After receiving the medical records Dr. advised us to file this report. We understand that blood clots can happen on flights, but Dr. felt that this event was such an anomally for patient that it merited further reporting. Patient is a completely healthy 16 year old male who is an extremely active athlete who participates in basketball, track, cross-country and other physical activities daily. For him to develop a blood clot after a 4 hour flight is an exceptional, unexpected event. Dr. long term plan is to keep patient on Eliquis for 6 months, then take him off of the medicine and then run more blood tests after 2 weeks to fully investigate the incident.


VAERS ID: 1408253 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO 186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chest X-ray, Chest pain, Chest scan, Chills, Dyspnoea, Fatigue, Immediate post-injection reaction, Lymph node pain, Myalgia, Pyrexia, Scan with contrast, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sleeve resection of right lung 2019 due to carcinoid tumor.
Allergies: None
Diagnostic Lab Data: X-ray and CT scan with contrast Note: he had taken one Flexeril on June 7, 2021 for back and chest pain prior to seeking medical attention at Hospital.
CDC Split Type:

Write-up: Patient experienced fatigue and muscle aches immediately following the vaccination. His symptoms became progressively worse as time passed and by the next day he was experiencing chills, fever, tachycardia, shortness of breath, and excruciating chest and upper back pain. He described the pain in his chest as "stabbing" and also had a small and painful protrusion from his chest wall that was determined to be a lymph node.


VAERS ID: 1409649 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Cold sweat, Dysphagia, Mydriasis, Pallor, Presyncope
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021641495

Write-up: anaphylactic reaction; about to black out/lost consciousness; cold sweats; had a hard time /trouble swallowing; turning pale; his pupils were dilated; This is a spontaneous report from a contactable Pharmacist via Medical Information. This Pharmacist reported for two patients, this is the first of two reports regards to a male patient. A 34-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via intramuscular, administered in left arm on 02Jun2021 between 10:00 and 11:00 am, maybe around 10:30ish (Batch/Lot Number: EW0178; Expiration Date: Aug2021, NDC number: 59267100002) as 1ST DOSE 0.3ML, SINGLE for covid-19 immunisation at pharmacy. The patient medical history and concomitant medications were not reported. No prior vaccinations (within 4 weeks). No additional vaccines administered on same date of the Pfizer suspect. A pharmacist from pharmacy had 2 patients who received the vaccine and both had a reaction after the dose, within one hour after receiving the dose, and EMS was called. The pharmacist confirmed the first patient had the reaction within 1 hour of receiving the dose. She clarified this person was having cold sweats, about to black out, had a hard time and trouble swallowing and was turning pale, his pupils were dilated. Pharmacist explained they make them sit there for 15 minutes after receiving the vaccine so this reaction happened maybe 3 minutes after he got the shot. The EMS came and he was brought to the hospital. The patient did come back afterwards and he said the doctor didn''t know 100 percent what happened, but it might been a slight allergic reaction, not to the point where he lost consciousness, but they did release him. She clarified they checked his vitals and everything and released him. When pharmacist was probed for the event, the pharmacist thought it was an anaphylactic reaction. The events require a visit to Emergency Room, patient was brought by EMS. Not had a visit to Physician Office. Unknown if patient received treatment, the pharmacist wasn''t be told that much information. The outcome of events was unknown. Causality: In this case, pharmacist did not think so. She thinks maybe it was anxiety but she wouldn''t know.; Sender''s Comments: Based on plausible temporal relationship, a possible causal association between the events and the suspect drug BNT162B2 cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-2021646208 same reporter, product, different patient and similar events.


VAERS ID: 1409664 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / OT

Administered by: Pharmacy       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? 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: USPFIZER INC2021646208

Write-up: anaphylactic reaction; This is a spontaneous report from a contactable pharmacist. This Pharmacist reported for two patients. This is the second of two reports regards to a female patient. A 29-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) intramuscular, administered in Deltoid Left on 02Jun2021 (Batch/Lot Number: EW0178; Expiration Date: Aug2021) at the age of 29-year-old, as 1st dose, single for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications was reported as taking other medication (unspecified). The patient experienced anaphylactic reaction on 02Jun2021. They took her to the hospital. It was reported the vaccine shot was between 11:30 and 12:00 in the morning. The patient experienced anaphylactic reaction literally like may be within 5 minutes after taking the shot. So its again 11:30 or 12:00. The outcome of event was unknown. Information on Lot/Batch number is available; Further information has been requested.; Sender''s Comments: Based on the plausible temporal relationship and known drug safety profile, a possible causal relationship between the event Anaphylactic reaction and suspect drug BNT162B2 cannot be excluded.,Linked Report(s) : US-PFIZER INC-2021641495 same reporter, product, different patient and similar events.


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