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

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



Case Details (Reverse Sorted by Onset Date)

This is page 218 out of 8,010

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VAERS ID: 1700696 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-09-10
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Exposure to SARS-CoV-2, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol 2.5mg/3mL nebulized q6hr aspirin 81mg PO qday atorvastatin 80mg PO qday ferrous sulfate 325 mg PO bid fosamax 70mg PO qweek nitrostat 0.4mg sublingual PRN potassium chloride 99mg qday prednisone 20mg 1/2 tab PO bid prilosec 40mg
Current Illness: COPD right lung nodule left thyroid nodule
Preexisting Conditions:
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has a history of COPD and had a COVID exposure at home. She has had increasing shortness of breath and a fever.


VAERS ID: 1700704 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear pain, Headache, Neck pain
SMQs:, 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: vit d3, vit b12
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: started getting bad headaches as she speaks she feels throbbing pains, when walking she has to walk slowly and if she does to much she gets pain in the base of her neck then pains goes to the right side of her head and ear


VAERS ID: 1700722 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Headache, Malocclusion, Mastication disorder, Oral mucosal exfoliation, Pain, Pain in jaw, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol 25 mg singulair 10 mg multi-vitamin
Current Illness:
Preexisting Conditions: sleep apnea irregular heartbeat
Allergies: morphine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The next day, fever 102,5, severe body aches including headache, severe fatigue, shortness of breath, chest pain. Took tylenol for body aches, and one asprin because of chest pain. Most symptoms subsided by the next day. Fatigue continued for 2 more days. On Sunday, 9/12/21 awoke with TMJ symptoms on the right side, which I have NEVER had before. Inside of my mouth also began peeling. The TMJ continues to be a problem. Teeth do not close together properly. Chewing is extemely difficult.


VAERS ID: 1700741 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Fatigue, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Malaise, Neck pain
SMQs:, Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Pulmonary Hypertension, Pulmonary Fibrosis , Left Diastolic Disfunction, COPD
Allergies: Sulfa, Penicillin, Rocephin IM Injection
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Large area of Redness approximately 8 inches in size, similar to a cellulitis, Area of injection is hot, very swollen, Headache x5 days so far , severe neck and back pain fatigue malaise Using Tylenol and Advil OTC pain medication


VAERS ID: 1700742 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Echocardiogram, Myocarditis
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Started having chest pain the day of the 2nd dose. Went to the Emergency Room 9/13/2021. Released with a diagnosis of Myocarditis. Has appointment with Cardiologist Monday 9/20/2021.


VAERS ID: 1700750 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-11
Onset:2021-09-10
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 5318 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 6955 / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Malaise, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Coronary artery disease, advanced dementia
Preexisting Conditions:
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: sxs onset 9/10 including fever, SOB, cough. admitted to hospital for 9/10 thru 9/11 for COVID symptoms.


VAERS ID: 1700780 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: About one hour after patient received her J&J vaccine, the left side of her tongue started getting numb. She called the pharmacy today (5 days later) and stated she still has the numbness. She also stated that sometimes the numbness radiates to her cheek, and it appears during stress.


VAERS ID: 1700825 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-28
Onset:2021-09-10
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Blood urine present, Computerised tomogram normal, Malaise, Pelvic pain, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: Epiploic Appendagitis
Allergies: None
Diagnostic Lab Data: Cat Scan performed on 09/10/21 and blood was also drawn and a urine sample was taken. Cat scan came back normal with no signs of infection anywhere and no kidney stones. My urine was very bloody.
CDC Split Type:

Write-up: 2 weeks after I received the shot, I suddenly felt very ill and experienced severe pelvic pain and urinated blood on 09/10/21. The pain was so severe, I was rushed into the emergency room and treated. Upon investigation and various tests performed (such as a cat scan), the doctor assumed it was kidney stones, HOWEVER, there were no kidney stones present. The diagnosis was unknown and the doctor was uncertain what caused such pain and blood in my urine.


VAERS ID: 1700831 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Feeling hot, Nodule, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient reported redness that got worse over several days. Eventually the size of a saucer. Arm was swollen and sore and hot to the touch and had a knot in it


VAERS ID: 1700834 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram, Laboratory test, Palpitations, Urine analysis
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2012 Anthrax booster - I went to pull up my sleeve and I woke up on a gurney. I was covered in sweat. Age: 29
Other Medications: Apple Cider Vinegar Allergy Spray - Flonase
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG - 09/10/2021 Labs - 09/10/2021 Urine sample - 09/10/2021 Everything looked normal.
CDC Split Type: vsafe

Write-up: So Friday I started with chest pain it was nipple line directly on my sternum. It was like a constant pressure. Friday as well as the pressure my heart was beating hard but not fast. I went to the ER they did EKG, labs and urine work. They came back and said I didn''t have any infections and that I looked good. They said they didn''t see any signs of a heart attack. They discharged me and Saturday its been the same thing. Sunday I didn''t wake up with it. As I would do active things around the house I could feel it. It would just creep up on me and every day since then its been kind of like harder to show up but not as severe as it was previously. Monday I woke up and went to work. Its pretty much the same thing all week. I wake up and feel good but then little things will happen and it will come up. If I get upset or nervous it will come back. I feel like my heart beating really forcefully when that''s not normal for me. Kind of like I was recovering from a hard work. Like it was beating hard but not fast. Monday I did go to my primary doctor and he pretty much just said he was unsure of what to do with it and gave me light duty at work. He then put in a referral for me to see a cardiologist.


VAERS ID: 1700848 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Headache, Lymph node pain, Lymphadenopathy, Malaise, Nausea, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (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: Pfizer COVID vaccine
Other Medications: Sulfasalazine, Lopressor, Premarin, Allegra-D 12 hour, Omeprazole, Tylenol, Probiotic, Metamucil
Current Illness: Seasonal Allergies.
Preexisting Conditions: Psoriatic Arthritis, HTN
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen and painful left axillary and left supraclavicular lymph nodes along with headache, malaise, body/muscle aches and nausea. Seen by the NP on an already scheduled doctor visit.


VAERS ID: 1700897 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Monoplegia
SMQs:, Peripheral neuropathy (broad), 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), Sexual dysfunction (broad)

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

Write-up: Patient reports arm being numb and paralyzed


VAERS ID: 1700899 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Influenza like illness, Injection site pain, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient experienced flu like symptoms within 24 hours of vaccine. Chills, fever of up to 101 , severe injection site pain, headache, body aches, fatigue. Also had swelling below injection site that wrapped around arm. Symptoms subsided by 48 hours.


VAERS ID: 1700900 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: flu like symptoms. headache, chills, mild fever less than 101, severe injection site pain that lasted 5 days. body aches and fatigue.


VAERS ID: 1700945 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-06
Onset:2021-09-10
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Appendicitis, Computerised tomogram abdomen abnormal
SMQs:, Retroperitoneal fibrosis (broad)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Keppra XR, Seasonique, Vitamin D, Vitamin B 12, Magnesium, Elderberry sambuccus,
Current Illness: None
Preexisting Conditions: Seizure disorder, morbid obesity
Allergies: Penicillin
Diagnostic Lab Data: CT done in ER 9/10 confirming acute appendicitis
CDC Split Type:

Write-up: Developed acute appendicitis approx. 5 weeks after vaccine


VAERS ID: 1701296 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-16
Onset:2021-09-10
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Headache, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium supplements, Zetia 10mg, Glyburide 5mg, Linzess 145mcg, Metformin 500mg, Metoprolol 50mg, Omeprazole 20mg, Crestor 10mg
Current Illness: unknown
Preexisting Conditions: Diabetes, CAD, gastritis, hypertension, metastatic breast cancer
Allergies: none
Diagnostic Lab Data: COVID-19 PCR+ 09/10/2021
CDC Split Type:

Write-up: hospitalized for COVID-19 infection, tested positive on09/10/2021; Signs and symptoms: SOB, headache, body aches cough


VAERS ID: 1701531 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Cardiac discomfort, Chest discomfort, Exposure during pregnancy, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: prenatal vitamin prenatal DHA supplement iron supplement magnesium supplement coral calcium supplement Synthroid 88mg daily
Current Illness: none
Preexisting Conditions: Hashimoto''s disease Gluten intolerance (inflammatory)
Allergies: sulfa drugs
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I am 31 weeks pregnant with my second child, a boy, due November 6. At 10:00 PM on Sep 10, 13 hours after the vaccine was administered, I began noticing an episodic pinching feeling in my heart. It was unsettling and difficult to sleep. I counted 16 occurrences. The next day, Sep 11, the episodic ''pinching'' had stopped but I felt a mild pressure in my chest for most of the day. I eventually called my friend who is a cardiologist and she asked several questions and had me lean forward, which did work to resolve the pressure. The fetus was kicking and moving normally, and I had no other signs or symptoms of distress or illness. She said it could be a case of Pericarditis, and I considered going to L&D to be checked out, however by 8:00 PM, the pressure sensation had disappeared. I have been fine ever since.


VAERS ID: 1701725 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Pallor, Panic attack
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: NONE DISCLOSED
Current Illness: NONE DISCLOSED
Preexisting Conditions: NONE DISCLOSED
Allergies: NONE DISCLOSED
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PATIENT REPORTED FEELING LIKE HE COULDN''T CATCH HIS BREATH AND CHEST TIGHTNESS ABOUT 10 MINUTES AFTER VACCINATION. HE DIDN''T APPEAR TO BE IN RESPIRATORY DISTRESS BUT LOOKED A LITTLE PALE. WE CALLED 911, PARAMEDICS CAME AND UPON CHECKING HIM OUT THEY SAID THE PATIENT APPEARED TO HAVE HAD A PANIC ATTACK. HE DIDN''T LEAVE WITH THE PARAMEDICS SINCE HE STARTED FEELING BETTER AND OPTED TO GO HOME TO REST AND RECOVER.


VAERS ID: 1701738 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain
SMQs:

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

Write-up: I have been getting shooting pains in my ovaries randomly since getting the shot. I should not start my period till the 25-27. The pain is not as consistent as normal cramps and was shorter but has been very intense a few times. In total I have experience roughly 7 shooting pain incidence in my lower abdominal area most noticeable on the left side and always when I am in a standing position.


VAERS ID: 1701928 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pramipixole Lamictal Tramadol Wellbutrin Levothyroxine Rosuvastatin Amlodipine Besylate
Current Illness: None
Preexisting Conditions: UCTD
Allergies: Avocados Honey Some shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Next morning after shot my Chest or lungs felt very impacted. Hurts to breath in. Similar feeling to when you have bronchitis. Been feeling this for 5 days


VAERS ID: 1703382 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Intermenstrual bleeding, Limb discomfort, Pain in extremity, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Aside from heavy/ sore arm low grade fever and change in appetite, I experienced post menstruated bleeding around the 10th of September until currently. I am also on birth control, this bleeding has been daily and enough to change a panty liner with every time I use the rest room.


VAERS ID: 1703948 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-05-28
Onset:2021-09-10
   Days after vaccination:105
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036C21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Incomplete course of vaccination
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: CKD AKA CHF PAD Dementia Neurogenic bladder HTN
Allergies: chlorhexedine contrast dye fentanyl keflex morphine PCN vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had 1st moderna shot in 5/2021 - no second shot received. Now admitted to hospital with COVID 9/10/2021


VAERS ID: 1704002 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-09-10
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen/diphenhydramine, alendronate, ascorbic acid, benzonatate, Symbicort, calcium carbonate, cetirizine, cholecalciferol, dexamethasone, famotidine, fluticasone, multivitamin, rivaroxaban
Current Illness:
Preexisting Conditions: Asthma, osteoporosis, allergic rhinitis
Allergies: Ceftin (Diarrhea), sulfa antibiotics (Hives)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital for hypoxia due to COVID-19 pneumonia on 9/14/21.


VAERS ID: 1704197 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Extra dose administered, Fatigue, Headache, Oedema peripheral, Oral herpes, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Oropharyngeal infections (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, Hydrochlorothiazide, Metaphorim, Tylenol, Advil
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Pt. states that after receiving the 3rd Booster dose of Moderna 09/10/2021, started experiencing symptoms that evening of body aches, extreme fatigue, severe headache, low appetite, and swelling under the left arm. 09/12/2021 presented with 2 new Cold sores. Symptoms have subsided besides the 2 cold sores. No noted Primary visit.


VAERS ID: 1704217 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-09-10
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Atelectasis, COVID-19, Chest discomfort, Dyspnoea, Inappropriate schedule of product administration, Lung disorder, Lung opacity, Productive cough, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, CAD, pre diabetes, overweight, hyperlipidemia,
Allergies: penicillins
Diagnostic Lab Data: COVID test 9/10/2021
CDC Split Type:

Write-up: First dose 2/12/2021 84-year-old male seen in office 9/7/2021 for clearance for upcomming knee surgery. presents to the emergency department complaining of shortness of breath yesterday morning. He began having congestion and cough with sputum production approximately 1 week ago with increasing dyspnea and chest pressure. CTA of the chest completed which demonstrated ground-glass opacities was a continuation most pronounced in the left lower lobe likely due atelectasis or air trapping tested positive for COVID-19. Tested positive for COVID-19 three weeks ago but was vaccinated with the second dose in April of 2021.


VAERS ID: 1704219 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: BLOOD WORK, OTHER IMZ IN PAST
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: PFIZER COVID IMZ
CDC Split Type:

Write-up: PT HAD HISTORY OF "PASSING OUT/SYNCOPE" WHEN RECEIVING IMMUNIZATIONS AND BLOOD WORK. AFTER THE COVID IMZ, PT SAT DOWN NEXT TO HER HUSBAND AND SOON BECAME LIMP AND FELL DOWN TO THE FLOOR. PT WAS ALTERED FOR ABOUT 15 MINUTES, AND HER BLOOD PRESSURE/BLOOD GLUCOSE WAS WNL. 911 WAS CALLED, AND PT WAS TAKEN ON STRETCHER TO BE ASSESSED @ AMBULANCE. PT WAS COHERENT AT THAT TIME, AND SAID SHE DID NOT WANT TO GO TO THE HOSPITAL.


VAERS ID: 1704240 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, Palpitations, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Medications at time of vaccination: ? acetaminophen (TYLENOL) 500 MG tablet Take 1 tablet by mouth every 6 (six) hours as needed for Pain. ? albuterol sulfate (PROVENTIL HFA;VENTOLIN HFA) 90 mcg/actuation HFA inhaler Inhale 1-2 Inhalations
Current Illness:
Preexisting Conditions: PMH significant for HTN, DM, Depression during pregnancy, CKD, microalbuminuric diabetic nephropathy, Hypertriglyceridemia, HLD, Anemia, Obesity and an intramural leioyoma of the uterus.
Allergies: Pt w/ a hx of allergy to Lantus (Rash) and Diltiazem (Puritis w/out rash).
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hx of seeing her endocrine specialist before vaccination, blood sugar at 1400 was 250, was advised to take insulin dose, but she didn''t because she couldn''t eat a meal at that time. Also hx of anxiety with injections/vaccines. 38mins post vaccination pt c/o dizziness, nausea, and HA. Vitals: 17:38 BP 160/83, HR73, RR 18, SpO2 99% -- $g @17:45 165/94, 80, 18, 99% -- $g @17:55 155/86, 76, 18, 98 -- $g @18:05 153/86, 73, 18, 99% -- $g @18:20 153/86, 75, 18, 98%. @17:45 pt c/o palpitations sensation, dizziness, nausea, HA, and tingling in hands. Pt given water. @17:55 pt noted that dizziness has improved @1825: Escorted off unit via w/c to car. Husband driving. Advised to check sugar at home, take her BP meds and insulin if needed. If worsens to call emergency services or urgent care


VAERS ID: 1704318 (history)  
Form: Version 2.0  
Age: 1.17  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: None stated.


VAERS ID: 1704320 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-02
Onset:2021-09-10
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / SYR

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

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

Write-up: Positive COVID test


VAERS ID: 1704329 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / SYR

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

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

Write-up: At 6pm covid like symptoms hit like a brick wall, exhausted, heated chills , headache, injection site pain heat and swelling. Today is 6 days post injection and I still have extreme exhaustion and migaines


VAERS ID: 1704339 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-02
Onset:2021-09-10
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 - / -

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

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

Write-up: Positive COVID Test


VAERS ID: 1704344 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-20
Onset:2021-09-10
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Gait inability, Oxygen saturation decreased, SARS-CoV-2 test positive, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Alzheimers, BPH, dementia, depression, hypertension, hyperlipidemia, Parkinsons, stroke
Allergies: morphine
Diagnostic Lab Data: COVID symptomatic test + 9/10/2021
CDC Split Type:

Write-up: First dose 12/30/2020 not able to read the lot number, no call back from the health department. 83-year-old man Patient received 2 doses of the COVID-19 vaccine is specifically Pfizer. Patient is nonverbal, cannot walk. He was brought to the hospital secondary to COVID-19 infection. Specifically he was found with low oxygen saturation at the nursing home persistently for which they decided to bring into the hospital for further evaluation and treatment


VAERS ID: 1704400 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-07
Onset:2021-09-10
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/10/21 2nd dose02/07/21 Diagnosed covid positive:09/10/2021 Symptom onset:09/10/21 Exposure:Home Symptoms:Asymptomatic


VAERS ID: 1704528 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05AE21A / 2 RA / 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: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patients 2nd Moderna dose was given on day 22 instead of day 28.


VAERS ID: 1704547 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Headache, Rash
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Pcn, mycelog, kenelog, sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on entire body, nonstop headache and I mean it''s always there! Hip pain


VAERS ID: 1704556 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling cold, Hypoaesthesia, Paraesthesia, Tenderness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No other illnesses
Preexisting Conditions: None.
Allergies: No allergic reactions.
Diagnostic Lab Data: Just saw physician on 9/16/21 and he has ordered an EMG and a referral to Neurology.
CDC Split Type:

Write-up: 5:45 am on 9/10/21 L arm was cold and numb and tingly and painful to squeeze hand. That lasted for approx 24hrs. The adverse cold feeling went away the next day. He is still having numbness and tingling in his hands that is random and increases with functional use of his hand.


VAERS ID: 1704565 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: My balance is off. Did Epley Maneuver thinking Lightheadedness might be caused by misplaced ear crystals. Also some tingling on the tip of left fingers Today is Thursday 16 Sep 2021


VAERS ID: 1704566 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Condition aggravated, Confusional state, Decreased appetite, Dyspnoea, Fatigue, Insomnia, Mental fatigue, Nausea, Nervousness, Peripheral coldness, Tachycardia, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium, vitamin C
Current Illness: tachycardia, anxiety, stress, fear of needles.
Preexisting Conditions: Long covid lingering symptoms such as anxiety, tachycardia, stress shortness of breath and fatigue.
Allergies: gluten sensitivity to carbs
Diagnostic Lab Data: As of now I have not gone in person because I have no stamina, nor strength nor the will to go out because I am concerned of not being able to breathe if I travel away from home
CDC Split Type:

Write-up: On Friday September 10, at 7:00 pm, I began having symptoms of anxiety which triggered shortness of breath , heaviness in chest. I been feeling nauseous, confused, body tremors, difficulty falling asleep, tachycardia, nervousness cold feet and hands, mental exhaustion, loss of appetite that have not subsided until this day.


VAERS ID: 1704576 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-02
Onset:2021-09-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031M20A / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Medication errors (narrow), 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: 300 mg of Wellbutrin descovy Fiber supplement Multivitamin
Current Illness: None
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: A week after the Booster shot, I awoke at 12:30am to go to the bathroom. When I went to the bathroom I passed out while urinating. I have never passed out or fainted before.


VAERS ID: 1704616 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Erythema, Fatigue, Headache, Injection site pain, Malaise, Myalgia, Nausea, Pain in extremity, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (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), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg, rosuvastatin 10mg, hydrocodone 10-325
Current Illness:
Preexisting Conditions: Cervical disc disease, high blood pressure, sciatic nerve
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site pain,tiredness,headache,muscle pain,chills,joint pain,swelling,redness,nausea,feeling unwell,arm pain


VAERS ID: 1704672 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-03-08
Onset:2021-09-10
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient diagnosed and hospitalized with COVID-19.


VAERS ID: 1704680 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-26
Onset:2021-09-10
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 UN / IM

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

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

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


VAERS ID: 1704710 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Pain in extremity, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate, Gabapin, Levothyroxine, multi vit, Tizanidine, Topiramate, Valacyclovir, vit d,
Current Illness: no
Preexisting Conditions: MS
Allergies: lactose and tolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: next morning she had severe muscle pain in her calf thighs and legs, joint pains in her knees, got very bad rash all over body


VAERS ID: 1705005 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Agitation, Dizziness, Fatigue, Feeling cold, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, fatigue, prolonged fatigue after. Agitation. Headache. Muscle ache. Feeling like blood was running cold, feeling faint. Lasting 4+ days. Fatigue is still continuing, a week later.


VAERS ID: 1705019 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Dyspnoea, Fatigue, Flushing, Tachycardia, Tinnitus
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel 125 mg daily Zoloft 100 mg daily
Current Illness: Upper respiratory infection. Covid negative on rapid test on 09/09/21. Was told could still get vaccine that was scheduled on 09/10/21 due to no fever and negative covid test.
Preexisting Conditions: Arrhythmia
Allergies: Penicillin Doxycycline Capzasin Indoor/outdoor allergies
Diagnostic Lab Data: None to date. Have made appointment with my cardiologist for 10/07/21.
CDC Split Type:

Write-up: Flushing and tachycardia, feeling lightheaded, shortness of breath feeling, have had some dizziness and extreme tiredness, feelings of impending doom, increased anxiety, ringing in ears.


VAERS ID: 1705241 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot
Other Medications: Zyrtec
Current Illness: Diverticulitis
Preexisting Conditions:
Allergies: Penicillin, keflex, flu shot
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covered in hives from head to toe, immediate and persistent injection site soreness, extreme joint pain, fever


VAERS ID: 1705928 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

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

Write-up: patient denied having previous vaccine however it was discovered when reporting 09/10/2021 vaccine that the patient had received a previous janssen vaccine on 03/19/2021 at another facility


VAERS ID: 1705931 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site erythema, Injection site swelling, Joint stiffness, Vitreous floaters
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Retinal disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: States left arm and hand were numb and getting better 1 day after vaccine given. States also had stiffness behind both knees and floaters in his eyes (both of which have went away 1 day later).


VAERS ID: 1705937 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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-Medium, Systemic: Nausea-Mild, Additional Details: Fainted, but came to within approx 1 min. Had upset stomach afterward. Remained in the pharmacy for approx 30 minutes after. Was able to walk out of pharmacy. Called pt next day and pt stated she was ok, her stomach was still a litle upset


VAERS ID: 1705939 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Incorrect route of product administration, Injection site pain, Joint range of motion decreased, Paraesthesia, Shoulder injury related to vaccine administration
SMQs:, Peripheral neuropathy (broad), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Sexual dysfunction (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient suspects vaccine was given too high and thinks its shoulder injury related to vaccine administration. She has a doctor''s appointment on Wed 9/15 for evaluation. Limited range of motion. Some finger numbness/tingling running down her arm and into her armpit/left breast area.


VAERS ID: 1705970 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Visual Changes/Disturbances-Medium


VAERS ID: 1705972 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bacterial infection, Erythema, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Fever-Medium, Additional Details: developed redness around site that spread to under armpit and breast. urgent care said bacterial infection and put on 10 days antibiotic


VAERS ID: 1706441 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 OT / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1706442 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 OT / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1706445 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (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: Flushed / Sweating-Medium, Systemic: Seizure-Mild, Additional Details: I did not witness the event but girlfriend started yelling for help saying that patient was seizing and when I got to him he was alert and sweating.


VAERS ID: 1706446 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Write-up: Site: Bruising at Injection Site-Mild, Additional Details: pt came to pharmacy on 09/12/2021 after receiving pfizer vaccine on 09/10/2021 -- very large bruise on arm starting upper arm extending to elbow. pt stated that bruise was spreading. very dark and edges defined with dark areas. advised to seek immediate treatment but was reluctant because no pain. stated on eliquis. said would contact her doctor monday. said normal her pharmacy told her not to worry about it


VAERS ID: 1706475 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Limb discomfort, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Latex allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921241

Write-up: FEELING HEAVY ON THE RIGHT ARM; PINS AND NEEDLES TYPE OF PAIN ON THE RIGHT ARM THAT RADIATING TO SHOULDER AND BACK; BURNING PAIN ON THE RIGHT ARM; This spontaneous report received from a patient concerned a 37 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: latex allergy. The patient experienced drug allergy when treated with erythromycin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202AZ1A expiry: UNKNOWN) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced burning pain on the right arm. On 11-SEP-2021, the patient experienced feeling heavy on the right arm. On 11-SEP-2021, the patient experienced pins and needles type of pain on the right arm that radiating to shoulder and back. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from burning pain on the right arm, feeling heavy on the right arm, and pins and needles type of pain on the right arm that radiating to shoulder and back. This report was non-serious.


VAERS ID: 1706476 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Discoloured vomit, Headache, Nausea, Pain, Panic attack, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLUVOXAMINE; ASPRIN; LORATADINE; SAM-E
Current Illness: Panic attacks; Seasonal allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Stroke (2 years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921264

Write-up: VOMITING (BLACK IN COLOR); PANIC ATTACK; BODY ACHES; HEADACHE; NAUSEA; FEVER; This spontaneous report received from a patient concerned a 21 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: stroke and concurrent conditions included: seasonal allergies, and panic attacks. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 10-SEP-2021 10:00 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, ademetionine, fluvoxamine, and loratadine. On 10-SEP-2021, the patient experienced panic attack. On 10-SEP-2021, the patient experienced body aches. On 10-SEP-2021, the patient experienced headache. On 10-SEP-2021, the patient experienced nausea. On 10-SEP-2021, the patient experienced fever. On 11-SEP-2021, the patient experienced vomiting (black in color). The action taken with covid-19 vaccine was not applicable. The patient had not recovered from vomiting (black in color), headache, body aches, nausea, and fever, and the outcome of panic attack was not reported. This report was non-serious.


VAERS ID: 1706477 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921277

Write-up: FEELING HOT; FEVER; This spontaneous report received from a parent concerned a 32 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 (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-SEP-2021, the patient experienced feeling hot. On 10-SEP-2021, the patient experienced fever. The action taken with covid-19 vaccine was not applicable. The outcome of the fever and feeling hot was not reported. This report was non-serious.


VAERS ID: 1706478 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: West Virginia  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac flutter, Fatigue, Malaise, Pain, Pain assessment
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN; MYFORTIC; JARDIANCE; WELLBUTRIN; PIOGLITAZONE; SYNTHROID; PROGRAF; EZETIMIBE; VITAMIN D [ERGOCALCIFEROL]; ASPRIN; METOPROLOL; NORVASC; CALCIUM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clot blood; Liver transplant
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Pain scale; Result Unstructured Data: pain over 10/10
CDC Split Type: USJNJFOC20210921278

Write-up: HEART FLUTTERING; PAIN EVERYWHERE/ACHY FROM HEAD TO TOES; DID NOT FEEL GOOD; EXTREMELY TIRED; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight was 260 pounds, and height was 64 inches. The patient''s past medical history included: liver transplant and blood clot. The patient experienced cellulitis when treated with levofloxacin (Lovenox), and oxycodone hydrochloride/paracetamol (Percocet). The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, 1 total, administered to left arm on 09-SEP-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, amlodipine besilate, bupropion hydrochloride, empagliflozin, ergocalciferol, ezetimibe, levothyroxine sodium, losartan, metoprolol, mycophenolate sodium, pioglitazone, calcium and tacrolimus. On 10-SEP-2021, the patient felt extremely tired and did not feel good. The patient went to bed around 9 pm and on 11-SEP-2021, she woke up at 4 am and felt like somebody beat her and she had pain everywhere, also her hair hurt. The patient was achy from head to toes, and her pain was over 10/10 on the pain scale. The patient took 2 Tylenols and felt no relief. On the same day, the patient felt like her heart was fluttering a couple of times. Laboratory data included: Pain scale (NR: not provided) pain over 10/10. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain everywhere/achy from head to toes, and heart fluttering, and the outcome of extremely tired and did not feel good was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 20210921278-COVID-19 VACCINE AD26.COV2.S- heart fluttering. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1706483 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site hypoaesthesia, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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:
Current Illness: Asthma
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921406

Write-up: NAUSEA; INTERMITTENT TINGLING IN LEFT LEG; INJECTION LEFT ARM NUMBNESS WHICH MADE FEEL LIKE DEAD WEIGHT AND AFFECTED WHOLE HAND; This spontaneous report received from a patient concerned a 46 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: asthma, 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: UNKNOWN) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced injection left arm numbness which made feel like dead weight and affected whole hand. On 11-SEP-2021, the patient experienced nausea. On 11-SEP-2021, the patient experienced intermittent tingling in left leg. The action taken with covid-19 vaccine was not applicable. The patient recovered from nausea on 11-SEP-2021, had not recovered from intermittent tingling in left leg and injection left arm numbness which made feel like dead weight and affected whole hand. This report was non-serious.


VAERS ID: 1706489 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Chills, Dizziness, Dyspnoea, Fatigue, Headache, Illness, Night sweats, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Body temperature; Result Unstructured Data: F, 101.7 (Unit unspecified)
CDC Split Type: USJNJFOC20210921568

Write-up: SHORTNESS OF BREATH UPON ACTIVITY; UNABLE TO GO TO WORK CALLED OUT SICK; DIZZY ACTIVITY INTOLERANCE; WEAK; FATIGUE; SEVERE NIGHT SWEATS; BODY ACHE; SEVERE FEVER (101.7); SEVERE HEADACHE, WEAK PERSISTENT HEADACHE; RASH ON BOTH ARMS AND LEGS; CHILLS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. 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: 202A21A expiry: UNKNOWN) dose was not reported, administered on 10-SEP-2021 12:20 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced body ache. On 10-SEP-2021, the patient experienced rash on both arms and legs. On 10-SEP-2021, the patient experienced chills. On 10-SEP-2021, the patient experienced severe fever (101.7). On 10-SEP-2021, the patient experienced severe headache, weak persistent headache. Laboratory data included: Body temperature (NR: not provided). Treatment medications included: paracetamol. On 11-SEP-2021, the patient experienced severe night sweats. On 11-SEP-2021, the patient experienced fatigue. On 12-SEP-2021, the patient experienced shortness of breath upon activity. On 12-SEP-2021, the patient experienced unable to go to work called out sick. On 12-SEP-2021, the patient experienced dizzy activity intolerance. On 12-SEP-2021, the patient experienced weak. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe fever (101.7), rash on both arms and legs, chills, severe night sweats, unable to go to work called out sick, dizzy activity intolerance, weak, and shortness of breath upon activity, and the outcome of severe headache, weak persistent headache, body ache and fatigue was not reported. This report was non-serious.


VAERS ID: 1706497 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Heavy menstrual bleeding, Pain
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921821

Write-up: INTENSE MENSTRUATION WITH BLOOD CLOTS; A LOT OF HEADACHES; BODY ACHES; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-SEP-2021, the patient experienced body aches. On 10-SEP-2021, the patient experienced a lot of headaches. On 11-SEP-2021, the patient experienced intense menstruation with blood clots. The action taken with covid-19 vaccine was not applicable. The outcome of the a lot of headaches, body aches and intense menstruation with blood clots was not reported. This report was non-serious.


VAERS ID: 1706503 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Colitis ulcerative, Colonoscopy, Dizziness, Full blood count, Metabolic function test, Rectal examination
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal ulceration (narrow), Ischaemic colitis (broad), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SULFASALAZINE
Current Illness: Alcohol use (May be 6 beer in a year.); Non-smoker; Penicillin allergy (when patient was a child but patient has had it since then and patient has been okay.); Pollen allergy; Ulcerative colitis (had been under control)
Preexisting Conditions: Medical History/Concurrent Conditions: Colonoscopy; Comments: The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 2019; Test Name: Colonoscopy; Result Unstructured Data: Not reported; Test Date: 20210911; Test Name: Comprehensive metabolic panel; Result Unstructured Data: Not reported; Test Date: 20210911; Test Name: Rectal examination; Result Unstructured Data: Rectal bleeding and colitis flare up; Test Date: 20210911; Test Name: Complete blood count; Result Unstructured Data: Not reported
CDC Split Type: USJNJFOC20210922028

Write-up: LIGHT HEADED; COLITIS FLARE; This spontaneous report received from a patient via a company representative concerned a 57 year old male. Initial information was processed with the additional information received on 12-SEP-2021. The patient''s height, and weight were not reported. As past history, patient had a colonoscopy in 2020 (a year and half ago). The patient''s concurrent conditions included: ulcerative colitis that had been under control, reaction to penicillin, allergy to tree pollen, alcohol user (may be 6 beers in a year), and non smoker, and other pre-existing medical conditions included: The patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: 21-SEP-2021) dose was not reported, 1 total, administered to right arm on 10-SEP-2021 16:45 for prophylactic vaccination. Concomitant medications included sulfasalazine for ulcerative colitis. On 10-SEP-2021, patient felt washed out for 8-10 hours. On 11-SEP-2021, after 14 to 15 hours of received the vaccine the patient had rectal mucus and an hour later the blood started but had no diarrhea and the patient had blood in stool. Patient stated that It was the fastest time that had happened to patient from going mucus to bleeding. Patient was also light-headed and On 11- SEP-2021, patient went to the emergency room around 15:00. The patient started with blood work. On 11-SEP-2021, patient waited till 01:30 (at night) at hospital but doctor was busy. Patient had sips of water to kept hydrated. Patient was waited during the patient started getting colon pain on the left side and the right side groin area that come and go. The patient was diagnosed with colitis flare up (and possibly due to the vaccination). Patient still had lower groin pain (lower colon) and not higher up the mid-stomach area (patient knew that, patient would in trouble). The patient had reluctant to get the vaccine but decided to got it. Treatment medications (12- SEP-2021) included: prednisone. Laboratory data (11-SEP-2021) included: Complete blood count (NR: not provided) Not reported, Comprehensive metabolic panel (NR: not provided) Not reported, and Rectal examination (NR: not provided) Rectal bleeding and colitis flare up. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from light headed, and colitis flare, and had not recovered from lower groin pain/pain on the right side groin area that come and go. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0-20210922028-COVID-19 Vaccine AD26.COV2.S-Colitis Flare. This event(s) is considered not related. The event(s) 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(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE


VAERS ID: 1706530 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, 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: USJNJFOC20210924052

Write-up: ADMINISTERED PUNCTURED VACCINE LEFT AT ROOM TEMPERATURE FOR 5.5 HOURS; PUNCTURED VACCINE STORED AT ROOM TEMPERATURE FOR 5.5 HOURS; This spontaneous report received from a pharmacist concerned a 38 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 (suspension for injection, intramuscular, batch number: 041A21A expiry: 19-SEP-2021) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced administered punctured vaccine left at room temperature for 5.5 hours. On 10-SEP-2021, the patient experienced punctured vaccine stored at room temperature for 5.5 hours. The action taken with covid-19 vaccine was not applicable. The outcome of the administered punctured vaccine left at room temperature for 5.5 hours and punctured vaccine stored at room temperature for 5.5 hours was not reported. This report was non-serious.


VAERS ID: 1706532 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Burning sensation, Feeling hot, Loss of consciousness, Paraesthesia, Urine analysis, Vomiting
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), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no medical history, no known allergies and no drug abuse or illicit drug usage. The patient was not pregnant at the time of report.
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Urinalysis; Result Unstructured Data: Normal; Test Date: 20210910; Test Name: Blood test; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210924068

Write-up: BLACKOUT/ FAINTING/ DIZZINESS; SEVERE ABDOMINAL PAIN/ ABDOMINAL CRAMPING; HANDS FELT "SUPER HOT"; FEELING OF BURNING; VOMITING; TINGLING SENSATION DOWN THE ARM; This spontaneous report received from a patient concerned a 30 year old white, non-Hispanic or Latino female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non-alcohol user, and non-smoker, and other pre-existing medical conditions included: The patient had no medical history, no known allergies and no drug abuse or illicit drug usage. The patient was not pregnant at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, and batch number: 202A21A expiry: unknown) dose was not reported, 01 total, administered on 10-SEP-2021 to the right arm for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced fainting and blackout which lasted for 2 seconds that was accompanied with dizziness and her hands felt super-hot, and there was a feeling of burning and tingling sensation down the arm, she vomited 12 times within an hour. The patient also experienced severe abdominal pain. The patient stated that it was the worst abdominal pain she had, and this made her go to the emergency room (ER). On same day at the ER the patient was given diphenhydramine hydrochloride(Benadryl) via Intravenous route, soon after that her symptoms were resolved. The doctor stated that either the patient had food poisoning or an allergic reaction. During the ER visit, she had blood test and urinalysis which all came out normal. After the ER visit, the patient went to her doctor/primary care physicians (PCP), and her doctor stated that it was unlikely that what happened to her was due to an allergic reaction to the vaccine because it did not happen quickly. Her doctor/PCP stated that some people get really sick whenever they get the vaccine (like normal flu symptoms). She was not prescribed anything. On 11-SEP-2021, the patient experienced abdominal cramping, it was very light and was resolved.. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from blackout/ fainting/ dizziness on 10-SEP-2021, and severe abdominal pain/ abdominal cramping, hands felt "super hot", feeling of burning, vomiting, and tingling sensation down the arm on 11-SEP-2021. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210924068-COVID-19 VACCINE AD26.COV2.S - blackout/ fainting/ dizziness, severe abdominal pain/ abdominal cramping, hands felt "super hot", feeling of burning. These events are considered unassessable. The events have a compatible/suggestive temporal relationship, are unlabeled, and have unknown scientific plausibility. There is no information on any other factors potentially associated with the events. 20210924068-COVID-19 VACCINE AD26.COV2.S -vomiting and tingling sensation down the arm. These events are labeled per RSI and are therefore considered potentially related.


VAERS ID: 1706546 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Laboratory test, Oedema, Weight, Weight increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Lab test; Result Unstructured Data: numbers are good; Test Date: 20210910; Test Name: Weight; Result Unstructured Data: 9 kg, about 18 pound Every day she gets on the scale and she sees 2.2kg more
CDC Split Type: USJNJFOC20210924773

Write-up: GAINED 9KG (ABOUT 18 POUNDS. EVERY DAY SHE GETS ON THE SCALE AND SHE SEES 2.2 KG MORE NON STOP. IT INCREASES EVERY DAY); WHOLE BODY SWOLLEN; This spontaneous report received from a patient concerned a 37 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, batch number: Unk) dose was not reported, administered on 09-SEP-2021 12:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On SEP-2021, Laboratory data included: Lab test (NR: not provided) numbers are good. On 10-SEP-2021, the patient experienced gained 9kg (about 18 pounds. every day she gets on the scale and she sees 2.2 kg more non stop. it increases every day). On 10-SEP-2021, the patient experienced whole body swollen. Laboratory data included: Weight (NR: not provided) 9 kg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from gained 9kg (about 18 pounds. every day she gets on the scale and she sees 2.2 kg more non stop. it increases every day), and whole body swollen. This report was non-serious.


VAERS ID: 1706908 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Mouth swelling, Rash, Rash pruritic, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (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:

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Additional Details: Patient called back to the pharmacy approximately 2 hours after receiving vaccine stating that she had broken out with an itchy rash on her face and neck


VAERS ID: 1706919 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD4884 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Dyspnoea, Fatigue, Flushing, Headache, Hyperhidrosis, Hypertension, Hyperventilation, Hypoaesthesia, Lethargy, Pain, Paraesthesia, Seizure, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Medium, Systemic: Hypertension-Severe, Systemic: Hyperventilation-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Seizure-Medium, Systemic: Shakiness-Severe, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Pt fainted and sezied for 10 seconds, this was 3 minutes after vaccine. After 2 minutes this repeated again. Pt was okay after talking to her, given her cold water, orange juice, and juice drink x2. Took her 30 mins to recover


VAERS ID: 1706920 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium


VAERS ID: 1706922 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC8134 / 3 LA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1706924 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 RA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1706925 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 LA / SYR

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

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Fever-Mild, Systemic: Swelling and tenderness noted to left posterior cervical lymph nodes-Medium, Systemic: Lymph Node Swelling-Medium


VAERS ID: 1707618 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Seizure-Medium


VAERS ID: 1707622 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1707623 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 2 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-


VAERS ID: 1707628 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: Pt pass out out. Was sitting down for about 8 minutes after vaccine and got up to walk and passed out. HR went to 44, bp 90/60 and 02 sat was 93. Later recovered within 30 minutes.


VAERS ID: 1707630 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient fainted and regained consciousness. EMS was called


VAERS ID: 1707632 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Confusional state, Dizziness, Eye movement disorder, Injection site pain, Loss of consciousness, Neck pain, Pain, Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Joint Pain-Severe, Systemic: Seizure-Medium, Additional Details: patient took tylenol every 4 hours afterwards. was completely fine after first shot and this shot she passed out twice and eyes rolled back, severe neck pain and unresponsive. following up with cardiac for EKG and further testing.


VAERS ID: 1707993 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003251A / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site pain, Injection site swelling, Product administered at inappropriate site
SMQs:, Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Medium, Additional Details: Patient complains of redness/ swelling at injection site that radiates down arm. She went to another CVS and was told shot could have been administered too low. I counseled patient that the dose was administered in the correct shot and this was a normal reaction. Counseled to ice and take ibuprofen. Patien will contact md if pain persists


VAERS ID: 1708049 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Decreased appetite, Dehydration, Feeling abnormal, Headache, Muscle spasms, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glipizide, Metformin, Losartan, Atorvastatin, Sertraline, Gabapentin.
Current Illness: None.
Preexisting Conditions: Diabetic; Partial Thyroid Removal due to nodule.
Allergies: Demerol; Pineapple; Seafood/Shellfish.
Diagnostic Lab Data: There was no infection, no virus. Blood work came back normal. Only showed signs of dehydration.
CDC Split Type:

Write-up: I started to break out in a rash about 2 hours after the shot. By morning, it covered a large portion of behind my arm, back of legs, and knees. I also had a racing pulse of over 110, severe headache, leg and foot cramping, loss of appetite, fever, a foggy feeling where I could not speak properly or keep my thoughts in line.


VAERS ID: 1708218 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hallucination, auditory, Hallucination, visual
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: Visual and auditory hallucinations


VAERS ID: 1708258 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anion gap abnormal, Diarrhoea, Differential white blood cell count, Dyskinesia, Dysstasia, Electrocardiogram, Full blood count, Gait disturbance, Heart rate increased, Hypoaesthesia, Metabolic acidosis, Metabolic function test, Tachycardia, Thyroid function test, Troponin, Urine analysis
SMQs:, Lactic acidosis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Anion Gap metabolic acidosis CBC with Diff -9/12/21 BMP-9/12/21 Troponin-9/12/21 Thyroid function-9/12/21 EKG-9/12/21 Urinalysis-9/12/21
CDC Split Type:

Write-up: 1 day after vaccination, heart rate increased to 152 bpm, both arms went numb, and contracted thereafter, numbness became generalized throughout the body with muscle jerks in extremities. Unable to stand and walk without assistance with tachycardia. Went to ED 3 days post-vaccine regained the ability to walk without assistance and no further muscle numbness or jerks, tachycardia subsided. The onset of persistent diarrhea 3 days post-vaccine.


VAERS ID: 1708314 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-06
Onset:2021-09-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cellulitis
SMQs:

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

Write-up: Cellulitis - bilateral lower extremities


VAERS ID: 1708401 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Fatigue, Injection site warmth, Myalgia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt. states that after receiving the 3rd Booster dose of Moderna 09/09/2021, started experiencing symptoms 09/10/2021 of fatigue, muscle pain, and itchiness. Injection site hot to the touch. No noted Primary visit. Still experiencing symptoms.


VAERS ID: 1708465 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site urticaria, Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify 2 mg daily flexeril 10 mg at bedtime as needed levothyroxine 25 mg daily propranolol 10 mg 1 tab twice daily fluoridex 1.1 dente paste ventolin inhaler 1 -4 puff q 4 prn migrelief coQ10 magnesium oxid-mg aa chelate
Current Illness: migraine
Preexisting Conditions: hx melanoma IBS reactive airway disease vitamin d deficiency hypothyroidism migraine lumbar radiculopathy iron deficiency anemia
Allergies: ketorolac, metoclopramide
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 10 minutes after injection patient reported feeling nauseated, itchy all over, and was found to have redness and hives near injection site. Patient was seen by doctor on call who recommended administration of epi 0.3 mg. Patient began to improve. EMS was called per protocol for patient to be transported and monitored.


VAERS ID: 1708484 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-21
Onset:2021-09-10
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Condition aggravated, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: metastatic endometrial CA
Preexisting Conditions: endometrial CA s/p hysterectomy, HTN, HLD, anemia, radiation pneumonitis/fibrosis with chronic resp failure
Allergies: paclitaxel
Diagnostic Lab Data: initial covid + 9.10, confirmed on PCR 9.16.2021
CDC Split Type:

Write-up: breakthrough covid + with acute on chronic resp failure


VAERS ID: 1708498 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-03
Onset:2021-09-10
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/11/2021 PCR COVID test positive at Clinic.
CDC Split Type:

Write-up: Patient is fully vaccinated as on 1/26/2021 with Pfizer and contracted COVID, tested positive on 9/10/2021.


VAERS ID: 1708559 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

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

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

Write-up: Headaches and unexplained rash in right armpit.


VAERS ID: 1708569 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-09-10
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 UN / UN
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKN
Current Illness: UNKN
Preexisting Conditions: UNKN
Allergies: NONE KNOWN
Diagnostic Lab Data: SARS-COV-2 PCR - PERFORMED 9/10/2021
CDC Split Type:

Write-up: 9/10/2021 - COVID POSITIVE AND HOSPITALIZED WITH SOB & COUGH, DIAGNOSED WITH SEVERE COVID PNEUMONIA


VAERS ID: 1708581 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Heart rate increased, Myalgia, Nausea, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Significant injection site swelling and muscle soreness after flu vaccines containing thimerosal have had several because they''r
Other Medications: Dietary fiber supplement
Current Illness: None
Preexisting Conditions: None
Allergies: Eucalyptus oil; Actifed; Thimerosal sensitivity (in contact solution and as vaccine adjuvant)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (99F 1hr after dose of Extra Strength Tylenol), chills, muscle aches, headache, congestion, nausea, fatigue, elevated heart rate. Typical resting heart rate 50-55 bpm, resting heart rate during event 100-120 bpm. Most symptoms lasted ~2 days. Headache and fatigue lasted 3 days.


VAERS ID: 1708619 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyskinesia, Fall
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (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: dizziness with fist vaccine
Other Medications: Lyrica, Inderal, Wellbutrin, Klonopin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness, arms and legs wouldn''t stop moving and started falling all over the place


VAERS ID: 1708620 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 1 LA / IM

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

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

Write-up: PATIENT WAS ONLY 16 AT AGE OF VACCINATION


VAERS ID: 1708681 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Extreme fatigue persisting 7 days post vaccination. Arm in which vaccination was administered is still sore. The arm was initially "swollen" but that has gone down and patient denies redness or heath in that arm.


VAERS ID: 1708718 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / UNK - / IM
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: allopurinol atorvastatin metroprolol vitamin D Child''s aspiring
Current Illness: Diagnosed Chronic Lymphomic Leukemia - not being treated
Preexisting Conditions: See Lymphoma above - diagnosed as MZL since 2016 Implanted Pacemaker
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I was contacted to invite me to have a 3rd Pfizer COVID shot and the annual flu shot. I am designated as immunocompromised due to MZL treatment and CLL diagnosis. I received the vaccines in my right shoulder (different sites). Friday morning I developed a rash on my right bicep extending from the shoulder to my elbow. The area became red, slightly swollen, itchy, and warm to the touch. (No fever). It was uncomfortable over the weekend but eased off by Monday evening. Because the injections were in the same arm, I can?t discern if one or the other of the vaccines caused the effect or if it was a combination. Perhaps I should have had the shots in opposite arms. The flu shot was described to me as the ?strong? version. I am reporting this because the directions are to notify the care provider of adverse reaction.


VAERS ID: 1708754 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-21
Onset:2021-09-10
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 - / IM

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

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

Write-up: Tested posiitve for COVID 19


VAERS ID: 1708874 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Feeling abnormal, Headache, Hypertension, Muscle twitching, Muscular weakness, Myalgia, Neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol succinate, pravastatin, Topamax, Gabapentin, Smartypants Adult mineral, Smartypants Organic Women?s vitamin
Current Illness: Fibromyalgia, long COVID
Preexisting Conditions: Fibromyalgia, long Covid
Allergies: Imitrex, codeine, hydrocodone, Reglan, bentyl, Toradol, tramadol, levofloxacin, steroids
Diagnostic Lab Data: Flow therapy all week (recording blood pressures)
CDC Split Type:

Write-up: All severe- Muscle weakness (starting in legs), muscle and joint pain, headaches, brain fog, blood pressure (hypertension), nerve pain and twitches


VAERS ID: 1708934 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Muscle tightness, Tension headache
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: DTaP 4-weeks after delivery of baby
Other Medications:
Current Illness: none
Preexisting Conditions: hypothyroid, thyroiditis
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site pain (for 2 days following vaccine) muscle tension in neck and knot in uppers back/shoulders, tension headache (for 3 days following vaccination) - husband massaging knots, got a chiropractic adjustment. Neck is still tight on/off a week after vaccination


VAERS ID: 1708972 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood test, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Hypoaesthesia, Pain, Pyrexia, Sinus tachycardia, Tremor, Urine analysis
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: VSD and LongQT syndrome
Allergies: N/A
Diagnostic Lab Data: EKG (9/10, 9/11, 9/14, 9/15, 9/16) Blood Tests (9/11, 9/15, 9/16) Echocardiogram (9/16) Urine Tests (9/11, 9/15, 9/16)
CDC Split Type:

Write-up: Sinus Tachycardia, Shortness of Breath, Anxiety, Chest Pain, Tremors, Numbness, Fever, General Pain


VAERS ID: 1709023 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Hypersomnia, Hypoaesthesia, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), Sexual dysfunction (broad)

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

Write-up: 1. LEFT ARM NUMB FROM THE SHOULDER TO FINGER TIPS STARTING 9/10/2021 AND STILL CONTINUES. 2. NAUSEA FROM 9/10/2021 UNTIL 9/14/2021. 3. DIARREA FROM 9/11/201 AND STILL CONTINUES. 4. EXTREME TIREDNESS FROM 9/10/2021. SLEPT OVER 20 HOURS EACH DAY FOR 3 DAYS. STILL EXTREMELY TIRED. 5. VERTIGO STARTED 9/17/2021 WHEN I GOT UP IN THE MORNING AND STILL CONTINUES.


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