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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 219 out of 8,010

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VAERS ID: 1709062 (history)  
Form: Version 2.0  
Age: 61.0  
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 EW0217 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, D; Progesterone, Estradiol
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Dairy--milk & cheese
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving the shot I had to be observed for 30 mins and 15mins into the observation I began to cough my throat felt as if there was something in in and tightness in my chest along with difficulty breathing. I did not note the length of time but a Doctor was called to listen to my lungs and I was offered some water. I continued to experience increased shortness of breath and after using my Nebulizer and Inhaler with no result went to Urgent Care on 9/15/21


VAERS ID: 1709117 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-13
Onset:2021-09-10
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bedridden, Injection site pain, Malaise, Migraine
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid Medication; multivitamin.
Current Illness: None.
Preexisting Conditions: Hashimoto''s.
Allergies: None.
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: I get migraines often and I have medication I usually take when I feel one coming. This one I took when I felt it coming On 09/10/2021 in morning but it did nothing so I can usually take a 2nd pill within a couple hours but I called my Dr. to make sure. It still didn''t do anything so at that point I started thinking I was actually sick instead of it being a migraine because with my migraines I usually get nausea and so it''s hard to know. Usually they''ll last a day at the most sometimes two days but I was in bed for 3 days and I called my doctor again and she said within 24 hours I could take another dose. I did start feeling better but it did not touch the migraine. I did have sore arm after the vaccination as well.


VAERS ID: 1709202 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Mexico  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Headache, Impaired work ability, Muscle spasms, Muscle twitching, Oropharyngeal pain, Pain, Pain in extremity, Tenderness
SMQs:, Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: influenza vaccination 2017 age 39 had terrible pain in Right arm for 9 months, settled into the elbow joint and nothing helped f
Other Medications: tylenol ibuprofen and multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: pineapple
Diagnostic Lab Data: none
CDC Split Type:

Write-up: deep tender pain that extended down the arm for four days, diarrhea for three days and The next day post vaccine I began to have muscle spasms-twitching and in r arm and in various body locations, such as R rib muscles and bilateral buttocks, lower back muscles and r arm bicep and Forearm intermittently for up to 5 days and also had moderate to severe cramping intermittent of leg muscles R /L buttocks hamstrings and calves, charlie-horse like at times, and overall body aches these symptoms lasted for 5 days. The mild sore throat and moderate headache for two days. *** Missed several days of work.


VAERS ID: 1709213 (history)  
Form: Version 2.0  
Age: 30.0  
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 FF2587 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTERED EARLIER THAN THE RECOMMENDED 21 DAY INTERVAL. DOSE ONE OF PFIZER/BIONTECH (LOT #EW0187) WAS ADMINISTERED TO PATIENT ON 08/27/2021 (LEFT ARM, DELTOID, IM). PATIENT HAD NO ADVERSE REACTION. VAERS REPORT SUBMITTED TO RECORD EARLY VACCINATION.


VAERS ID: 1709216 (history)  
Form: Version 2.0  
Age: 20.0  
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 FF2587 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTERED EARLIER THAN THE RECOMMENDED 21 DAY INTERVAL. DOSE ONE OF PFIZER/BIONTECH (LOT #EW0187) WAS ADMINISTERED TO PATIENT ON 08/27/2021 (LEFT ARM, DELTOID, IM). PATIENT HAD NO ADVERSE REACTION. VAERS REPORT SUBMITTED TO RECORD EARLY VACCINATION.


VAERS ID: 1709217 (history)  
Form: Version 2.0  
Age: 25.0  
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 FF2587 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTERED EARLIER THAN THE RECOMMENDED 21 DAY INTERVAL. DOSE ONE OF PFIZER/BIONTECH (LOT #EW0187) WAS ADMINISTERED TO PATIENT ON 08/27/2021 (LEFT ARM, DELTOID, IM). PATIENT HAD NO ADVERSE REACTION. VAERS REPORT SUBMITTED TO RECORD EARLY VACCINATION.


VAERS ID: 1709219 (history)  
Form: Version 2.0  
Age: 19.0  
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 FF2587 / 2 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTERED EARLIER THAN THE RECOMMENDED 21 DAY INTERVAL. DOSE ONE OF PFIZER/BIONTECH (LOT #EW0187) WAS ADMINISTERED TO PATIENT ON 08/27/2021 (LEFT ARM, DELTOID, IM). PATIENT HAD NO ADVERSE REACTION. VAERS REPORT SUBMITTED TO RECORD EARLY VACCINATION.


VAERS ID: 1709230 (history)  
Form: Version 2.0  
Age: 47.0  
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 FC318U / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Hypoaesthesia, Pain, Pain in extremity, Paraesthesia, Sleep disorder, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine 2012
Other Medications: No medications was taken at the time of the vaccination
Current Illness: None
Preexisting Conditions: None
Allergies: Almonds
Diagnostic Lab Data: I have a schedule doctor appointment on 9/20/2021
CDC Split Type:

Write-up: After 30 minutes of administration of injection my symptoms were headache, light headness, sore arm and throat felt very scratchy and felt like my throat was closing up. The symptoms lasted for two days. 5 days after injection I woke up with shooting pain, numbness, tingling from waist down down to my toes. I continue to have these symptoms that I cannot rest even at night. Lastly, I have had occurrences of scratchy throat as I have to clear my throat as if my throat is closing up.


VAERS ID: 1709461 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
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 3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Breast swelling, Chest discomfort, Dyspnoea, Gait disturbance, Pruritus, Swelling, Vaginal haemorrhage, X-ray
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zinc, Vitamin D and C
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs
Diagnostic Lab Data: 9/13 xrays
CDC Split Type:

Write-up: Day 1 shortness of breath, as soon as the vaccine went on my chest was tight. I had to use inhaler to breath. Day 3 body swollen and hip joint painful to the point that I could not walk. X-rays show no injuries or break. Day 7 body still swollen after 13 years of no vaginal bleeding as I had ablation surgery, I am spotting, breast swollen, skin itches due to being stretched due to swelling.


VAERS ID: 1709640 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anger, Anxiety, Dizziness, Ear discomfort, Headache, Heavy menstrual bleeding, Vertigo
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Hostility/aggression (narrow), Vestibular disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Vertigo, inner ear pressure, nausea, constant dizziness even when laying down, pressure headaches that I?ve never experienced before, severe anxiety paired with unprovoked rage which is exceptionally abnormal for me, unusually heavy period with at least double my normal amount of clotting


VAERS ID: 1709670 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-20
Onset:2021-09-10
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Cough, Nasal congestion, Respiratory tract congestion, Rhinorrhoea, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Runny nose/stuffy nose, congestion, intermitten cough, itchy throat.


VAERS ID: 1709864 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Nevada  
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 - / 2 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, No adverse event
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: Patient came in for second dose of Moderna. Registration checked him on the system, which showed he only had one dose of Moderna (WebIZ: 5377664). Second dose was given and after his observation period, on the way out, he told registration that it was his fourth dose of the vaccine and showed them a picture of his Pfizer card. No adverse events were noted during time of observation. WebIZ was searched using his birthday and he had both Pfizer vaccinations under the name (WebIZ: 3791774). Both IDs on WebIZ have same birthday and address on file, just different first name.


VAERS ID: 1710210 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-05-01
Onset:2021-09-10
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angina pectoris, Blood test, Cardiac disorder, Electrocardiogram, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mild, but huge fever
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Allergic to finned fish
Diagnostic Lab Data: So many now. 9/12 heart pain 9/13 elevated Troponin 147 and EKG ECG--review with cardiologist 9/14 blood draw and elevated Troponin 112 9/14 blood draw and elevated Troponin 112 9/16 blood draw and elevated Troponin 62 9/16 at 11 pm pain again.
CDC Split Type:

Write-up: My son has myopericarditis. With troponin levels of 147, this indicates heart muscle damage. My son is a runner, hiker, skiing athelete. This is so out of the blue.


VAERS ID: 1710595 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Dyspnoea exertional, Hypersensitivity, Immediate post-injection reaction, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None. RT-PCR test was negative on the day before the vaccine
Preexisting Conditions: Rhinosinusitis. Allergic bronchitis after every cold.
Allergies: Severe allergy to egg white and nuts.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest tightness and breathlessness immediately after the vaccine was administered. The pharmacist said to take Aspirin or Ibuprofen. Later developed fever (102F) and severe pain in right arm, which resolved after 3 days. However, breathlessness after even slight walking continues as of 8th day. Also developed dry cough on 4th day, needing nebulization. This is typical allergic reaction for the patient after exposure to allergens. RT-PCR test was negative on the day before the vaccine. Had completed both doses of MODERNA in another Country as of 7/2/21, but took Moderna because the school required a approved vaccine. Called Health Services and informed about the symptoms.


VAERS ID: 1710819 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Hepatic enzyme increased
SMQs:, Liver related investigations, signs and symptoms (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: Comments: The patient did not have any medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Blood test; Result Unstructured Data: Elevated liver enzymes (did not tell the exact number)
CDC Split Type: USJNJFOC20210932786

Write-up: ELEVATED LIVER ENZYMES; This spontaneous report received from a patient concerned a 73 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient did not have any medical history. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805025, expiry: UNKNOWN) dose was not reported, administered on 12-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced elevated liver enzymes. Laboratory data included: Blood test (NR: not provided) Elevated liver enzymes (did not tell the exact number). The action taken with covid-19 vaccine was not applicable. The outcome of elevated liver enzymes was not reported. This report was non-serious.


VAERS ID: 1711195 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Dysphagia, Fatigue, Feeling abnormal, Feeling cold, Malaise, Nasal congestion, Nausea, Parosmia, Swollen tongue, Taste disorder, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMINS [VITAMINS NOS]; FISH OIL; VITAMIN D NOS; ESTROVEN; ZYPAN
Current Illness: Raynaud''s disease; Vasovagal symptoms
Preexisting Conditions: Medical History/Concurrent Conditions: Gastrointestinal discomfort
Allergies:
Diagnostic Lab Data: Test Name: Blood Pressure; Result Unstructured Data: High blood pressure 151/138
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Smell is off; Nostrils feel of; Felt disconnected to her body and mind; Taste is off; She is very cold; Blood pressure increased; Wasn''t feeling good or well; Left arm became really sore; Feel vey tired; Nausea; Difficulty swallowing; Tongue was swelling; This spontaneous case was reported by a consumer and describes the occurrence of DYSPHAGIA (Difficulty swallowing) and SWOLLEN TONGUE (Tongue was swelling) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Gastrointestinal discomfort. Concurrent medical conditions included Vasovagal symptoms and Raynaud''s disease. Concomitant products included MULTIVITAMINS [VITAMINS NOS], FISH OIL, VITAMIN D NOS, ESTROVEN and AMMONIUM CHLORIDE, BETAINE HYDROCHLORIDE, PANCREAS EXTRACT, PANCREATIN, PEPSIN, SPLEEN, STEARIC ACID (ZYPAN) for an unknown indication. On 10-Sep-2021 at 10:30 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021 at 6:30 PM, the patient experienced DYSPHAGIA (Difficulty swallowing) (seriousness criterion medically significant) and SWOLLEN TONGUE (Tongue was swelling) (seriousness criterion medically significant). On an unknown date, the patient experienced PAROSMIA (Smell is off), NASAL CONGESTION (Nostrils feel of), FEELING ABNORMAL (Felt disconnected to her body and mind), TASTE DISORDER (Taste is off), FEELING COLD (She is very cold), BLOOD PRESSURE INCREASED (Blood pressure increased), MALAISE (Wasn''t feeling good or well), VACCINATION SITE PAIN (Left arm became really sore), FATIGUE (Feel vey tired) and NAUSEA (Nausea). The patient was treated with FAMOTIDINE (PEPCID [FAMOTIDINE]) for Adverse event, at an unspecified dose and frequency and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency. At the time of the report, DYSPHAGIA (Difficulty swallowing), PAROSMIA (Smell is off), NASAL CONGESTION (Nostrils feel of), FEELING ABNORMAL (Felt disconnected to her body and mind), TASTE DISORDER (Taste is off), FEELING COLD (She is very cold), BLOOD PRESSURE INCREASED (Blood pressure increased), MALAISE (Wasn''t feeling good or well), VACCINATION SITE PAIN (Left arm became really sore), FATIGUE (Feel vey tired) and NAUSEA (Nausea) outcome was unknown and SWOLLEN TONGUE (Tongue was swelling) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: 151/138 (High) High blood pressure 151/138. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient has stated that she called to hospital and assessed and they thought she is having vagovagal and patient notified her doctor. The patient was in emergency room for 4 hours. Laboratory investigations performed on 10 Sep 2021 included EKG (Electrocardiography) and vital signs whose results were not provided. Treatment for the event included steroids. Company comment: This case concerns a 47-year-old female patient with no relevant medical history, who experienced the unexpected serious events of dysphagia and swollen tongue; unexpected non-serious events of parosmia, nasal congestion, feeling abnormal, taste disorder, feeling cold, blood pressure increased, malaise; expected non-serious events of vaccination site pain, fatigue and nausea. The events occurred on the same day after the first dose of mRNA1273. The rechallenge is not applicable since the second dose is not due at the time of report. The reporter did not provide the causality assessment. The benefit-risk relationship of mRNA1273 in not affected by this report. Event seriousness assessed as per Regulatory Authority reporting. Most recent FOLLOW-UP information incorporated above includes: On 13-Sep-2021: Additional information received as live follow up included patient demographics, relevant history details, concomitant medication details, adverse event details, laboratory investigation details and treatment medication details. The case was upgraded to serious.; Sender''s Comments: This case concerns a 47-year-old female patient with no relevant medical history, who experienced the unexpected serious events of dysphagia and swollen tongue; unexpected non-serious events of parosmia, nasal congestion, feeling abnormal, taste disorder, feeling cold, blood pressure increased, malaise; expected non-serious events of vaccination site pain, fatigue and nausea. The events occurred on the same day after the first dose of mRNA1273. The rechallenge is not applicable since the second dose is not due at the time of report. The reporter did not provide the causality assessment. The benefit-risk relationship of mRNA1273 in not affected by this report. Event seriousness assessed as per Regulatory Authority reporting.


VAERS ID: 1711987 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, SARS-CoV-2 test, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Absence of menstruation (Prior to intrauterine device (IUD), oral contraceptives without menstruation x 25 years); COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19: Yes); Intra-uterine contraceptive device (Have an IUD and haven''t had a menstruation cycle in 3 years.); Irritable bowel syndrome (Ibs); Oral contraceptive (Prior to intrauterine device (IUD), oral contraceptives without menstruation x 25 years)
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Binax; Test Result: Negative ; Comments: Nasal swab
CDC Split Type: USPFIZER INC202101190430

Write-up: Vaginal spotting/bleeding; Abdominal cramping; This is a spontaneous report from a contactable other healthcare professional, the patient. A 44-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0175) via an unspecified route of administration in the right arm on 08Sep2021 at 15:00 (at the age of 44-years-old) as a single dose for COVID-19 immunisation. Medical history included irritable bowel syndrome (IBS), the patient have an intrauterine device (IUD) and did not have a menstruation cycle in three years, prior to IUD, the patient had oral contraceptives without menstruation for 25 years, and COVID-19 on an unknown date. Prior to the vaccination, the patient was diagnosed with COVID-19. Concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient previously received amoxicillin (MANUFACTURER UNKNOWN) and azithromycin (ZPAK); both from unknown dates for unknown indications and experienced allergy to antibiotic. On 10Sep2021 at 09:00, (also reported as three days after vaccination), the patient experienced abdominal cramping and had vaginal spotting/bleeding. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Since the vaccination, the patient had been tested for COVID-19. On 09Sep2021, the patient underwent a binax test (COVID test) via nasal swab and the result was negative. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events vaginal spotting/bleeding and abdominal cramping were recovering at the time of this report.


VAERS ID: 1712022 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Axillary pain, Feeling abnormal, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (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:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192459

Write-up: Swelling under the armpit on the left side where the injection was taken on the upper part of the arm; Under arm felt really weird like irritated; Under arm felt really weird like irritated and painful from movement; This is a spontaneous report from a contactable other healthcare professional, the patient. A 30-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 10Sep2021 at 14:00 (at the age of 30-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history and no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID-19 vaccine. The patient did not receive concomitant medications. On 10Sep2021 at 23:00, the night of the vaccination, the patient''s under arm felt really weird like irritated and painful from movement. On 11Sep2021, the patient experienced swelling under the armpit on the left side where the injection was taken on the upper part of the arm. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events underarm felt really weird like irritated and painful from movement and swelling under the armpit was unknown at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1712025 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Migraine, Somnolence, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MELOXICAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Intervertebral disc disorder (Bad disk in back)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192539

Write-up: This is a spontaneous report from a contactable consumer, the patient. A 48-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration in the left arm on 09Sep2021 at 14:30 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. Medical history included bad disk in back. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included meloxicam (MANUFACTURER UNKNOWN) for an unspecified indication from an unknown date and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3181) via an unspecified route of administration in the left arm on 16Aug2021 at 10:00 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. On 10Sep2021 at 07:00, the patient had swelling in left armpit. The patient woke up with a migraine and vomiting. On 11Sep2021, whole next day, the patient felt exhausted and slept. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events swelling in left armpit, migraine, vomiting, exhausted and slept the whole next day were resolving at the time of this report.


VAERS ID: 1712055 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Limb discomfort, Musculoskeletal discomfort, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fibromyalgia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101197252

Write-up: feel it now on her neck; Saturday, she had pain in her arm, shoulder, and on her back by her bra strap; back near her bra strap; same pain plus some in her shoulder blade area; discomfort in her arm; This is a spontaneous report from a contactable Other-Health Care Professional. A 39-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration, administered in Arm Left on 10Sep2021 at 18:00 (Lot Number: FF2588) (at the age 39-years-old) as dose 2, single for Covid-19 immunization. Medical history included ongoing fibromyalgia (diagnosed 9 years ago now). Concomitant medication included unspecified medication. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) via an unspecified route of administration, administered in Arm Left 20Aug2021 (Lot Number: FC3180) (at the age 39-years-old) as dose 1, single for covid-19 immunization and experienced Discomfort.There were no relevant tests. On 10Sep2021, the patient experienced discomfort in her arm, on 11Sep2021, the patient experienced Back pain, Shoulder blade pain and Pain in arm and on 12Sep2021, the patient experienced Neck discomfort. It was reported that patient had the usual arm discomfort Immediately after vaccination . By Saturday 11Sep2021, she had pain in her arm, shoulder, and on her back by her bra strap. By the night, she had all the same pain plus some in her shoulder blade area. The pain has increased to the point of unbearable now. She tried to make a doctor''s appointment, but the doctor''s office told her to call Pfizer. She didn''t have a prescribing doctor. The pain started radiating to the other areas on Saturday 11Sep 2021. The initial discomfort started right after she got the vaccine at 6pm. She pretty much immediately experienced discomfort. She did have discomfort after the first vaccine. She has taken Tylenol arthritis because she has Fibromyalgia, and she typically has pain in this arm. If she were to go to the doctor, she wanted to know if this vaccine can exacerbate fibromyalgia or is it the placement of where she got the injection or how it was administered that is causing the pain she was experiencing. She got the vaccine both times in her left arm. The pain is on the left side. She has had Fibromyalgia. She was diagnosed 9 years ago now. No doctor has agreed to see her. There was no prior vaccinations within 4 weeks. The event did not result in emergency room or physician Office visit. On 13Sep2021 morning, at 5am, she took 2 Tylenol arthritis, and 2 more at 9am to control the pain. Therapeutic measures were taken as result for all events. The patient had not yet recovered from pain in arm and outcome of all other events were unknown. Follow-up activities are completed. No further information is expected.


VAERS ID: 1712057 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Leukemia (Receiving chemo for leukemia)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101197606

Write-up: All over body rash on forearms, elbows, progressed to back, thighs, abdomen, waist; Welts; Pustules; Itchy; This is a spontaneous report from a contactable nurse. A 71-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2588) via intramuscular route of administration in the left arm on 08Sep2021 at 16:00 (at the age of 71-years-old) as a single dose for COVID-19 immunisation. Medical history included leukemia (the patient receiving chemotherapy for leukemia). It was unknown whether the patient had any known allergies. Prior to vaccination, it was unknown whether the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included oral chemotherapy (unspecified) for leukemia from an unknown date and unknown if ongoing. On 10Sep2021, the patient experienced all over body rash, on forearms, elbows, progressed to back, thighs, abdomen, waist. It was reported that, it started as a fine rash and progressed to welts, pustules and was itchy. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measure was taken as a result of the events which included treatment with diphenhydramine hydrochloride (BENADRYL). Since the vaccination, it was unknown whether the patient had been tested for COVID-19. The clinical outcome of the events all over body rash, on forearms, elbows, progressed to back, thighs, abdomen, waist and it was started as a fine rash and progressed to welts, pustules and itchy was resolving at the time of this report.


VAERS ID: 1712067 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dysgeusia, Erythema, Feeling hot, Nausea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198041

Write-up: Aches; Metallic taste in mouth; Ears red and hot; Ears red and hot; Nausea; Chills; This is a spontaneous report from a contactable consumer, the patient. A 56-year-old male patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3181) via an unspecified route of administration in the left arm on 09Sep2021 at 19:30 (at the age of 56-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive concomitant medication. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the left arm on 18Aug2021 at 19:30 (at the age of 56-years-old) as a single dose for COVID-19 immunisation. The patient previously received codeine (MANUFACTURER UNKNOWN) for an unknown indication on an unknown date and experienced allergy. On 10Sep2021 at 15:30, the patient experienced aches, metallic taste in mouth, ears red and hot, nausea and chills. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events aches, metallic taste in mouth, ears red and hot, nausea and chills was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1712132 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Mass
SMQs:, 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: USPFIZER INC202101212195

Write-up: she experienced a lump just above her collar bone on the same side she received the injection; Caller states she originally thought it could be swollen lymph nodes; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration on 08Sep2021 as DOSE 2, SINGLE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 10Sep2021, the patient experienced she experienced a lump just above her collar bone on the same side she received the injection, caller states she originally thought it could be swollen lymph nodes. Caller states the lump has remained about the same since Friday. Caller states she saw her primary care doctor, but the doctor did not know what it was and "had never seen this before." Caller states she went to the hospital today and the providers at the hospital also told her they had never seen this before. Caller states she originally thought it could be swollen lymph nodes. The outcomes of events were not recovered. The Lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1712726 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site urticaria, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (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: Unknown reaction, pertussis vaccination - received during infancy
Other Medications: venlafaxine 225 mg
Current Illness: None
Preexisting Conditions: Anxiety Depression
Allergies: Pertussis vaccination
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Within an hour of vaccination, a hard red spot appeared at and a little lower from the injection site. It was about 3" and oblong in shape. 6 days after, a rash appeared in random spots: forearm, back of neck/upper shoulder, leg. Day 7 hives appeared where the red hard spot hard been.


VAERS ID: 1713236 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Disorientation, Disturbance in attention, Feeling abnormal, Hypoaesthesia, Nausea, Presyncope, Visual impairment
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (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? No
Previous Vaccinations:
Other Medications: Vitamin D (2000), daily mens multivitamin
Current Illness:
Preexisting Conditions: Venous angioma and post-concussion syndrome
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Disorientation, mental fog, inability to focus, mood swings, numb arm, vision impairment (straight lines became wavy and when he moved his head it took time for his vision to catch up with where he was looking), nausea, loss of some motor function, and nearly blacked out.


VAERS ID: 1713375 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-28
Onset:2021-09-10
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Exposure to SARS-CoV-2, Nasal congestion, Sinus congestion, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin; calcium; fish oil; Preservision; Lisinopril; Atorvastain
Current Illness: none
Preexisting Conditions: hypertension; hyperlipidemia;
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient presents with URI symptoms for 1 week. Symptoms include cough, sinus congestion, nasal congestion. 2 daughters-tested positive yesterday (1 lives with her; both were vaccinated).


VAERS ID: 1713428 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-02
Onset:2021-09-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pruritus, Injection site rash
SMQs:, 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: Multivitamin, vitamin D
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash and itching on right arm approximately 2 inches below injection site. Started 8 days after vaccine and lasted 4 days. No treatment needed. Rash self-resolved


VAERS ID: 1713484 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

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

Write-up: Third dose, persistent headache since day of injection and blurred vision.


VAERS ID: 1713486 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-01-20
Onset:2021-09-10
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J2OA / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L2OA / 2 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Contusion, Pain in extremity, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: Ellume Covid test positive 09/12/2021.
CDC Split Type:

Write-up: Severe arm pain and bruising at time of vaccine. Contracted COVID 9/10/2021. Covid symptoms moderate, requiring chest X-rays and prescription of antibodies. Infusion center unable to accommodate.


VAERS ID: 1713493 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-29
Onset:2021-09-10
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0182 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0187 / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia, Fatigue, Headache, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific dysfunction (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: heartburn issues and is admitted to hospital for heartburn issues
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: admitted 9/10/2021 with heartburn issues as well as headache, fatigue and sore throat


VAERS ID: 1713632 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour thyroid, vitamins d, b, biotin, potassium and magnesium
Current Illness: Covid in July
Preexisting Conditions: Lupus
Allergies: Eggs, percocet
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Large, swollen spot in left deltoid for 5 days , Swelling in all my joints. Feet and hands, wrist and knees. Now my pulse is running between 101 and 138 at rest, severe migraine from possibly high pulse


VAERS ID: 1713834 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / SYR

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

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

Write-up: One day after my initial COVID 19 Pfizer shot, I started to get a red rash on my entire chest.


VAERS ID: 1713835 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-01
Onset:2021-09-10
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Mycobacterium tuberculosis complex test positive, Tuberculosis
SMQs:, Infective pneumonia (narrow), Opportunistic infections (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: Wellbutrin, Adderal, Trazadone, MVI and supplements
Current Illness: Muscle aches pains prior and started on prednisone
Preexisting Conditions: Depression
Allergies: EES, Celebrex, lyrica (started prednisone at time of vaccination)
Diagnostic Lab Data: TB Gold + but CXR neg. asymptotic for TB
CDC Split Type:

Write-up: Positive TB test after. In 3/2021- I was negative per TB Gold test and after vaccine, tested positive for first time in my life.


VAERS ID: 1713902 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Cough, Dyspnoea, Electrocardiogram, Fibrin D dimer, Pain, SARS-CoV-2 test, Troponin, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: shortness of breaht
Other Medications: MULTIVITAMIN THAMINE CALCIUM
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: SHRIMP, KIWI PCN CAT DANDER
Diagnostic Lab Data: ER performed ekg, d-dimmer, troponin and possibly other cardiac blood work, x-ray and ekg urgent care performed: covid test, xray and ekg
CDC Split Type:

Write-up: After receiving dose #2 of the Moderna vaccine i began to have complaints of chest tightness and increase shortness of breath with extreme body ache along with dry cough. Through the night my symptoms got worst . I took Tylenol to address the body aches and attempted to calm down as is relates to sob and chest tightness. i made 3 attempts to see an urgent care doctor once on Friday then on Saturday then again on Sunday. On Sunday I was finally able to see someone who ask me to report to ER for R/O PE. body aches. I reported my complaints to my PCP and my RA doctor


VAERS ID: 1714021 (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: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Chills, Headache, Hypoaesthesia, Influenza like illness, Muscle spasms, Pain, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: I felt the injection and a burning sensation as it went into my arm. I felt it down my arm to my fingertips and back up my arm into my shoulder. The burning stopped after it reached my shoulder. Headache began around 9:25 the same evening. 30 minutes later chills began. By 11:30 at night I had uncontrollable shakes and a fever of 102 degrees that lasted throughout the night. Leg cramps and loss of feeling in toes around 3:00am. By 9:00am symptoms subsided and felt like a mild flu. Body aches and mild temperature of 99degrees lasted until 6:00pm.


VAERS ID: 1714140 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-13
Onset:2021-09-10
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Atelectasis, Blood gases, Body temperature increased, Bronchial secretion retention, COVID-19, Chest X-ray abnormal, Chest pain, Electrocardiogram, Empyema, Full blood count abnormal, Haemoglobin decreased, Haemothorax, Influenza virus test negative, Iron deficiency anaemia, Lung consolidation, Lung opacity, Metabolic function test, Occult blood negative, Pleural effusion, Pleural thickening, Pneumonia, SARS-CoV-2 test positive, Troponin
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Pulmonary hypertension (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol PRN, aspirin, docusate PRN, levetiracetam, memantine ER, miralax, nystatin cream, triamcinolone cream, vitamin D3
Current Illness:
Preexisting Conditions: Seizure disorder, history of BPH with obstruction, history of cystoscopy, history of UTI, hypertension, schizophrenia, COPD, ex-smoker, nursing resident, previously vaccinated for COVID-19.
Allergies: none
Diagnostic Lab Data: 9/10/21 chest xray: Area of opacification left lower hemithorax described above likely mixture of consolidation with pleural effusion. Findings likely reflect underlying pneumonia. Underlying malignancy not excluded on the basis of this exam. Clinical correlation and follow-up recommended. 9/10/21 CTA chest: No acute pulmonary thromboembolic disease is identified. Associated consolidation adjacent to the effusion at the left lung base, favored predominantly if not entirely round atelectasis. Mild bilateral ground-glass pulmonary opacities could represent COVID-19 pneumonia. 9/13/21 chest xray: Continued opacification left lower lung suggesting pneumonia.
CDC Split Type:

Write-up: a long-term nursing home resident, who has been fully vaccinated against COVID-19 about 7 months ago, comes to emergency room complaining of sudden onset of temp substernal chest pain with no associated shortness of breath, cough, fever. His workup in the ER showed a normal CMP. His CBC was within normal limits excepting a hemoglobin of 8.8 with a baseline being around 11.2. Patient denies any epistaxis, hemoptysis, hematemesis, melena, hematochezia, hematuria, and his stool for occult blood was indeed negative; however, his COVID-19 screen came back as positive. Chest x-ray was raising possibility of infection or malignancy, so a CT angio of the chest was done which shows no PE, but shows bilateral ground-glass opacity, especially in the upper lobes consistent with COVID-19. There is some bilateral mucus plugging as well and some small complex left loculated pleural fluid, empyema versus sequelae of old hemothorax. An ABG was ordered and then the hospitalist service was called for admission. Please note, the pulmonologist is also being called for further workup. At this point of time, it appears prudent to have the patient admitted as an observation to our COVID-19 unit. I am starting the patient on some vitamin D, vitamin C, and Mucinex. We will await his ABG results to see if he would benefit for any Decadron or not. Please note, the patient''s temperature was 100.1 when he came in. His influenza swab was negative. Because of possibility of empyema, I might start him on Zosyn at this point of time and have Pulmonary see him in the morning with a possible consult to IR to see if his loculated pleural effusion even needs to be drained or treated empirically.small left complex loculated effusion with pleural thickening , empyema vs sequela of hemothorax was suggested on CT scan report 09/10/21. He had positive COVID 19 on admission 09/10/21 ( apparently fully vaccinated 7 months ago) . He was started on zosyn, I discharged him on augmentin . Patient was initially on room air , and then 2 L NC , but back to room air. I started decadron and Remdesivir when he was using oxygen , but now doing well on RA. Both cardiology and pulmonary medicine were consulted by admitting physician. Patient was evaluated by pulmonary medicine in course of hospitalization with plan for outpatient follow up . Patient does not want any surgical procedures for left pleural effusion at this time , but ok for follow up appointment with pulmonary medicine. I corresponded with case management who arranged a referral to facility with Dr. EKG and trop on admission did not show acute changes suggestive of ACS . Cardiology recommended medical management , patient was started on Carvedilol , Amlodipine . He also has iron deficiency anemia and started on Ferous sulphate 325 mg BID upon discharge.


VAERS ID: 1714163 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 LA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 LA / SC

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

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

Write-up: vaccinated with expired vaccine by 10 days. No adverse reaction


VAERS ID: 1714183 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM

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

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

Write-up: vaccinated with expired vaccine by 10 days. No adverse reaction noted.


VAERS ID: 1714203 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-13
Onset:2021-09-10
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6200 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6206 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Diarrhoea, Fatigue, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: cough, loss of taste and smell, congestion, diarrhea and fatigue


VAERS ID: 1714222 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

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

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

Write-up: Vaccinated with expired vaccine by 10 days. No adverse reaction noted.


VAERS ID: 1714228 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Menstrual cycle changes. Started earlier than anticipated. Menstruation is darker and more stringy than usual. Instead of typical 7 day length, it has still continued for over 10.


VAERS ID: 1714239 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

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

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

Write-up: Vaccinated with expired vaccine by 10 days. No adverse reaction noted.


VAERS ID: 1714250 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

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

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

Write-up: vaccinated with expired vaccine by 10 days. No adverse reaction


VAERS ID: 1714292 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-12
Onset:2021-09-10
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Computerised tomogram head, Feeling abnormal, Headache, Nausea, Seizure
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (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? Yes
Hospitalized? No
Previous Vaccinations: Same symptoms and ER visit reported to VAERS on May 14,2021.
Other Medications: probiotics
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Head CT scan
CDC Split Type:

Write-up: Nausea, chest pressure, headache/fuzzy brain, convulsions at 9am at home at 11am in family doctor''s office. Nurse and doctor called 911, taken to ER by ambulance.


VAERS ID: 1714416 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN0177 / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Condition aggravated, Dyspnoea, Dyspnoea exertional, Heart rate increased, Mass, Tenderness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (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: History of breathing problems
Allergies: Nickel allergy, dairy, flu vaccine
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Beginning within a week I noticed increased heart rate, shortness of breath when walking. I cannot catch my breathe or take deep breathes. I am wheezing and cannot breathe well. I have a mass on my collar bone that developed within a few days after the shot. This mass is painful to touch and has been there for a total of going on 12 days.


VAERS ID: 1714627 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-05
Onset:2021-09-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site rash
SMQs:, Hypersensitivity (narrow)

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

Write-up: red rash about 3 inches by 6 inches on arm where the vaccine was given; red rash about 3 inches by 6 inches on arm where the vaccine was given; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE RASH (red rash about 3 inches by 6 inches on arm where the vaccine was given) and VACCINATION SITE ERYTHEMA (red rash about 3 inches by 6 inches on arm where the vaccine was given) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 05-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced VACCINATION SITE RASH (red rash about 3 inches by 6 inches on arm where the vaccine was given) and VACCINATION SITE ERYTHEMA (red rash about 3 inches by 6 inches on arm where the vaccine was given). At the time of the report, VACCINATION SITE RASH (red rash about 3 inches by 6 inches on arm where the vaccine was given) and VACCINATION SITE ERYTHEMA (red rash about 3 inches by 6 inches on arm where the vaccine was given) outcome was unknown.


VAERS ID: 1714675 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Difficult to breathing; Chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Difficult to breathing), CHILLS (Chills) and HEADACHE (Headache) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014F21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced DYSPNOEA (Difficult to breathing), CHILLS (Chills) and HEADACHE (Headache). At the time of the report, DYSPNOEA (Difficult to breathing), CHILLS (Chills) and HEADACHE (Headache) outcome was unknown. No concomitant medication reported. No treatment information was provided


VAERS ID: 1714684 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / OT

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

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

Write-up: Redness at injection site; Pain at injection site; This spontaneous case was reported by a consumer and describes the occurrence of INJECTION SITE ERYTHEMA (Redness at injection site) and INJECTION SITE PAIN (Pain at injection site) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced INJECTION SITE ERYTHEMA (Redness at injection site) and INJECTION SITE PAIN (Pain at injection site). At the time of the report, INJECTION SITE ERYTHEMA (Redness at injection site) and INJECTION SITE PAIN (Pain at injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant product reported by reporter. No treatment medication reported by reporter.


VAERS ID: 1714690 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-05
Onset:2021-09-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: First dose on 5 Aug 2021, second dose on 10 Sept 2021; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose on 5 Aug 2021, second dose on 10 Sept 2021) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Chemotherapy (Every two weeks) since an unknown date. On 05-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose on 5 Aug 2021, second dose on 10 Sept 2021). On 10-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (First dose on 5 Aug 2021, second dose on 10 Sept 2021) had resolved. No Concomitant medication was reported. No treatment medications were reported. This case was linked to MOD-2021-318336 (Patient Link).


VAERS ID: 1714884 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 3 - / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR 42EM3 / UNK UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Back pain, Chest X-ray, Dizziness, Dyspnoea, Laboratory test, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/14/2021 ED visit with labs and CXR
CDC Split Type:

Write-up: Reported nausea on 2nd day post vaccine. Worked 3 twelve hour shifts in the days following vaccination. Began to get worse. On wednesday last week she was weak, dizzy, nausea, back pain, shortness of breath. All seem to be worsening. Was seen in ED with negative labs and CXR. Rested at home the next several days. Still having sx as of today. Advised to seek out COVID testing to rule this out and contact her PCP..


VAERS ID: 1715030 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-02
Onset:2021-09-10
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / UNK - / -

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

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

Write-up: Covid positive work related


VAERS ID: 1715052 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fenofibrate, metformin, Montelukast, metoprolol, Wellbutrin, omeprazole, aterax, Excedrin, Botox for headaches, lidocaine injections for headaches, vitamin b12, melatonin
Current Illness:
Preexisting Conditions: PCOS, migraines, GERD, depression, allergies, OSA
Allergies: Topamax , ceftriaxone, tape
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: At about 1030 am I began to have red spots on my neck, by 5-530 pm I had red raised rash all over face and neck, and my throat was itchy, took Benadryl all symptoms resolved about 2 hours after Benadryl


VAERS ID: 1715086 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-26
Onset:2021-09-10
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

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

Write-up: Covid positive unknown link


VAERS ID: 1715105 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-07
Onset:2021-09-10
   Days after vaccination:126
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / UNK - / -

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

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

Write-up: Covid 19 positive with symptom onset 9/10/21


VAERS ID: 1715106 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-22
Onset:2021-09-10
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8737 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anosmia, COVID-19, Fatigue, Hypersensitivity, Nasal congestion, Pain in extremity, SARS-CoV-2 test positive
SMQs:, Angioedema (broad), Taste and smell disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Covid Test
CDC Split Type: vsafe

Write-up: The day after the vaccine I felt tired and my arm was sore. September 10, 2021 I got tested for covid. The results came back the next day and were positive. I felt like I had allergies and my nose was congested. September 12th 2021 I lost my smell, and I haven''t gotten that back yet but everything else is fine.


VAERS ID: 1715142 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-09-10
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04/09/2021 / UNK - / -

Administered by: Unknown       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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid positive contact unknown


VAERS ID: 1715165 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-09-10
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

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

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

Write-up: Covid positive community


VAERS ID: 1715182 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-16
Onset:2021-09-10
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium carbonate 1200 mg daily Clobetasol 0.05% cream topically BID PRN (rash) Cyanocobalamin 1000 mcg daily Estriol powder vaginally MWF Lactobacillus acidophilus 1 capsule daily Meloxicam 15 mg daily Metformin 1000 mg ER daily Rabeprazol
Current Illness: Frontal lobe dysfunction. Anger outbursts, problems with attention, concentration, easy agitation
Preexisting Conditions: Arthralgia Arthritis Chronic SI joint pain Colon polyps Carpal tunnel syndrome Dementia Depression Diverticulitis Fibrocystic breast disease Generalized Anxiety Disorder Genital Herpes GERD Hammertoe Hyperlipidemia IBS Lichen sclerosus Myofascial pain syndrome Osteopenia Stress headaches Type 2 Diabetes
Allergies: Celecoxib - itching Ibuprofen - not specified
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted to hospital with COVID-19 symptoms on 9/10/2021 after receiving vaccination second dose in February. Patient ultimately discharged from hospital on 9/16/2021, never needing to be intubated during stay.


VAERS ID: 1715194 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-25
Onset:2021-09-10
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: Covid positive household member


VAERS ID: 1715251 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Chills, Diarrhoea, Dizziness, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test positive, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin
Current Illness: Diabetic
Preexisting Conditions: Diabetic
Allergies: None
Diagnostic Lab Data: Tested positive for COVID on 9/15/2021
CDC Split Type:

Write-up: Swelling and pain in the area. That evening had body chills fever, headache, fatigue , diarrhea and dizziness days following


VAERS ID: 1715278 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Exposure during pregnancy, Fatigue, Headache, Night sweats, Vaccination site bruising, Vaccination site erythema, Vaccination site irritation, Vaccination site swelling, Vaccination site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (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 Vitamins
Current Illness: Pregnancy
Preexisting Conditions: None noted
Allergies: NKDA
Diagnostic Lab Data: None noted
CDC Split Type:

Write-up: 11.4 weeks pregnant at the time of the vaccination. Around 8 pm on 09/09/2021, after getting out of the shower I noticed a red circle around the vaccination site, it was hot to touch and raise slightly. I proceeded to go to bed. Around 01:47 am, I woke up with the worst headache, chills, and night sweats. The following morning, I tried to get up to go to work and felt very dizzy to the point I almost fell down so I laid back down. I set a new alarm and tried to get out of bed about an hour later. At that time, I was unable to pick my body up. I dealt with night sweats, chills, headache, dizziness, generalized weakness and extreme fatigue until about 5:00 pm. The fatigue and weakness lasted until 09/11/2021 around 11:00 am. The spot on my arm continued to grow and become very irritated over the next several days. It got to the size of a softball and then turned until a bruise.


VAERS ID: 1715331 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Back pain, Blood pressure increased, Chest pain, Computerised tomogram normal, Ear discomfort, Fatigue, Feeling cold, Gait disturbance, Headache, Hot flush, Hypoaesthesia, Inflammation, Limb discomfort, Mobility decreased, Myalgia, Nausea, Pain, Pain in extremity, Paraesthesia, Sensitive skin
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (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: Junel Fe Vit D Vit C
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa Amoxicillin
Diagnostic Lab Data: Cat Scan09/12/21
CDC Split Type:

Write-up: Received Vax 9.10.21 at 4:30pm. Immediately I felt pain/heaviness in my arm. Slight nauseous Within an hour, the forehead started tingling and gradually moved across the entire face and into the neck. Started flushing with water and started walking and moving my face and lips constantly. a cooling sensation began on both sides of my kidney area- from middle of back down to hips. shortly after my ears started plugging. Had a video dr visit around 7:00pm- was told as long as its on both sides of body, that she thought it was an inflammatory response to the vaccine. Told me to take ibuprofen and tylenol at the same time, then alternate them through the weekend, to eat a healthy meal and drink lots of water. face tingling subsided later that evening. Had extreme hot and cold flashes along with extreme body aches in joints and muscles. Eating and drinking were no problem. Saturday late afternoon to late evening was the worst for body aches. Very difficult to move or do anything. My left arm was extremely sore to the point that I couldn''t touch or move it. Sunday morning I woke up and my entire left arm was tingling. Extremely tired and body aches were pretty high. Hot and cold flashes were slightly better. Around 3:00 in the afternoon, the whole left side of my face started going numb. Took my blood pressure which was 170s-/high 80/low 90. After 30-45 minutes, I decided to get checked out at ED as the tingling was severe only on my left arm and left face. A Cat scan confirmed no sign of stroke. Tingling lasted until Monday late morning and afternoon. Monday-Deep chest/back pain only on the left side. Extreme exhaustion and body aches. Hard to do much of anything. Tuesday aches were mostly gone along - had some mild hot and cold flashes, extremely fatigued, and slight headache all day. No relief from ibuprofen or nurtec. Wednesday tried walking with patient- Very difficult, extreme hot flashes and very exhausted. Mild headache persisted all of wednesday. Thursday- pain in both hips, low energy, arm still feels heavy, but pain is gone to touch and can move without pain.all other symptoms gone. Friday- woke up feeling normal again


VAERS ID: 1715393 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: questran, neurontin, norco, phenergan,aldactone., zofran
Current Illness: none
Preexisting Conditions: IBS gastropereisi
Allergies: iodine, peanut oil
Diagnostic Lab Data: iv fluid and hospitalizatiion.
CDC Split Type:

Write-up: Employee has Nausea , vomiting headache daily. Symptom were exacerbated after vaccine was given leading to Hospitalization and IV hydration.


VAERS ID: 1715456 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3182 / 1 LA / IM

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

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

Write-up: Three days of muscular pain at injection site


VAERS ID: 1715524 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-23
Onset:2021-09-10
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: Covid positive household member


VAERS ID: 1715532 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-19
Onset:2021-09-10
   Days after vaccination:144
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / UNK - / -

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

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

Write-up: Covid positive unknown contact


VAERS ID: 1715542 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-22
Onset:2021-09-10
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: Covid positive household member


VAERS ID: 1715549 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-24
Onset:2021-09-10
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2
SMQs:, COVID-19 (narrow)

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

Write-up: Covid positive household member


VAERS ID: 1715614 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro 10MG
Current Illness: none
Preexisting Conditions: none
Allergies: avocado/watermelon/latex - oral reaction including itchy throat and mouth
Diagnostic Lab Data:
CDC Split Type:

Write-up: immediately started menstrual cycle on 9/8 which was 13 days early. Got the same reaction after first shot. on 9/10 I developed a rash that looks like hives- itchy red rash on under arms and torso. Still have the rash after 10 days


VAERS ID: 1715694 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-18
Onset:2021-09-10
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Cough, Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl
Current Illness:
Preexisting Conditions: Has Himont Thyroiditis
Allergies: Soy; Peg
Diagnostic Lab Data: COVID-19 test
CDC Split Type: vsafe

Write-up: I have been congestive, headache, sore throat, fatigue, and a cough at night. No fever. Went to a clinic, they did a COVID-19 test. It came back negative.


VAERS ID: 1715738 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Computerised tomogram normal, Facial paralysis, Hypoaesthesia, Muscular weakness, Nystagmus, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Vestibular disorders (broad), Ocular motility disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Had CT on 9/14/2021 normal except for slight asymmetric prominence of left ventricles. CPK elevated at 217. Art pH 7.55, blood gasses: pCOr 24, pO2 120, total CO2 art 22.
CDC Split Type:

Write-up: Patient reports left sided facial and arm numbness within 15 minutes of receiving the vaccine. He continues to have left sided facial numbness 10 days post vaccine. He had bilateral thigh weakness and bilateral feet numbness and tingling after the vaccine. He went to the Emergency Department on 9/14/2021 because of these complaints. His exam on 9/20 shows slight left sided facial droop and slight nystagmus when looking right, otherwise normal.


VAERS ID: 1715775 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: Aphronia
Current Illness:
Preexisting Conditions: High Blood Pressure; Pre-Diabetic
Allergies:
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: I had lightheaded, dizzy, blurred vision, and fainting. I went to urgent care.


VAERS ID: 1715802 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F 3184 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: GSK Shingles vaccine-small shingles outbreak within 48 hours. Did not receive the 2nd shingles vaccine as a result. 65 years ol
Other Medications: Pulmacort and multi-vitamin
Current Illness: none
Preexisting Conditions: Reactive Airway Disease
Allergies: Ceclor, Codeine, other narcotics
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm muscle at injection site for about 3 days


VAERS ID: 1715842 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Chills, Fall, Fatigue, Feeling abnormal, Hot flush, Hyperhidrosis, Myalgia, Neck pain, Pain in extremity, Pyrexia, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Left arm soreness following the injection lasting a week. 4 hours after injection, Pt experienced fever, chills, and sweats lasting most of that first night. 100.4 degree F temperature for several hours during that night. Day 1 - Pt had severe whole body muscle aches, neck soreness and ringing in left ear. Pt experienced severe balance issues, including a fall from standing height without injury. The balance issues lasted 4 days, and the ringing in ears lasted for 1 day. Day 10 - Pt described having hot flashes that lasted from a few seconds to several seconds in duration this continues today, this has been happening since Day 6. In addition, Pt feels mildly fatigued, with episodes of "spacyness" that continue today.


VAERS ID: 1716327 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness:
Preexisting Conditions: Bells palsy year ago mild asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbing in hands feet and face. Didnt feel my tongue


VAERS ID: 1716345 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-09-10
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Atelectasis, COVID-19, Cardiomegaly, Chest X-ray abnormal, Cough, Diarrhoea, Haemodialysis, Hypoxia, Lung opacity, Oxygen saturation decreased, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute renal failure (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet atorvastatin (LIPITOR) 40 MG tablet bosutinib (BOSULIF) 100 MG TABS insulin glargine (LANTUS SOLOSTAR) 100 UNIT/ML pen-injector insulin lispro (HUMALOG KWIKPEN U-200) 200 UNIT/ML pen isosorbide mononitr
Current Illness: cough
Preexisting Conditions: Circulatory Essential hypertension Digestive Morbid obesity (HCC) Lower GI bleeding Alternating constipation and diarrhea GERD (gastroesophageal reflux disease) Pancreatic cyst Infectious/Inflammatory Mycotic toenails COVID-19 Hematologic CML (chronic myeloid leukemia) (HCC) Anemia, unspecified type Nervous Chronic midline low back pain without sciatica Genitourinary ESRD (end stage renal disease) (HCC) Endocrine/Metabolic Type 2 diabetes mellitus without complication, with long-term current use of insulin (HCC) Hyperlipidemia Other Depression At risk for falling Cognitive impairment Bilateral leg edema History of CVA (cerebrovascular accident) Fistula History of recurrent UTIs Compression fracture of C7 vertebra (HCC) Renal osteodystrophy
Allergies: CodeineRash KeflexAngioedema LisinoprilCough Zoloft [Selective Serotonin Reuptake Inhibitors] PollenSneezing
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time DR CHEST SINGLE VIEW [340216812] Resulted: 09/10/21 0847 Order Status: Completed Updated: 09/10/21 0849 Narrative: EXAMINATION: Single View Chest EXAM DATE: 9/10/2021 8:38 AM TECHNIQUE: Single view chest INDICATION: cough, covid COMPARISON: November 30, 2019. ENCOUNTER: Not applicable _________________________ FINDINGS: Lung volumes are low. Cardiac silhouette is moderately enlarged. Calcified atelectatic plaque is noted at the aortic arch. There is moderate central pulmonary vascular prominence with diffuse bilateral interstitial prominence. No sizable pleural effusion or pneumothorax. _________________________ Impression: Moderate cardiomegaly with central pulmonary vascular prominence. Diffuse bilateral interstitial opacity may relate to edema and/or atypical infectious process.
CDC Split Type:

Write-up: Patient is a 68F who presents with vomiting, diarrhea, cough, generalized weakness since about 5-6 days PTA. She has a history of ESRD on HD, HTN, CML, hyperlipidemia. She continued to feel considerably weak, so was tested for COVID on 09/08, which was positive. She continued to have cough without production of sputum. She did receive COVID vaccine (Moderna) in March and April. On admission she was hypoxic to 84%, and required 2 L via NC. CXR showed moderate cardiomegaly with central pulmonary vascular prominence and diffuse bilateral interstitial opacities. She was started on decadron 6 mg daily. Nephrology consulted and she underwent HD. She remains stable on 2lpm NC. She denies further diarrhea and no fever.PT recommends home. She was discharged in stable condition on 9/14/21. She is to follow up with COVID at home program on discharge Pt S+E on 9/14. Alert, NAD, Stable for discharge. In agreement with verbal instructions to follow up with her outpatient physicians


VAERS ID: 1716390 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-01
Onset:2021-09-10
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Hypersensitivity, Seasonal allergy
SMQs:, Angioedema (broad), Conjunctival disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Exacerbated seasonal environmental allergies.


VAERS ID: 1717367 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-09-10
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder, Oligomenorrhoea
SMQs:, Fertility disorders (broad)

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

Write-up: Period came almost two weeks early, lasted for 1.5 weeks. Usual period is at the same time each month and only 4 days.


VAERS ID: 1717691 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to antibiotic; Bee sting hypersensitivity; Contrast media allergy; Drug allergy; Fish allergy; Food allergy; Shellfish allergy; Soy allergy; Sulfonamide allergy (Allergic to sulfa drugs)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Previously sick with Covid)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: but tender at spot where vaccine was injected; Rash 6 days after injection; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (but tender at spot where vaccine was injected) and RASH (Rash 6 days after injection) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 014C21A) for COVID-19 vaccination. The patient''s past medical history included COVID-19 (Previously sick with Covid). Concurrent medical conditions included Sulfonamide allergy (Allergic to sulfa drugs), Allergy to antibiotic, Drug allergy, Drug allergy, Contrast media allergy, Soy allergy, Food allergy, Fish allergy, Shellfish allergy and Bee sting hypersensitivity. On 03-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced RASH (Rash 6 days after injection). On an unknown date, the patient experienced VACCINATION SITE PAIN (but tender at spot where vaccine was injected). At the time of the report, VACCINATION SITE PAIN (but tender at spot where vaccine was injected) outcome was unknown and RASH (Rash 6 days after injection) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported. Large red rash, measures 3 inches by 6 inches on left arm was reported.


VAERS ID: 1717845 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal rigidity, Fatigue, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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)

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: USJNJFOC20210934103

Write-up: STOMACH SPASM; NAUSEA; FEVER; TIREDNESS; MUSCLE ACHE; This spontaneous report received from a patient via a company representative 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 (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 10-SEP-2021, the patient experienced fever. On 10-SEP-2021, the patient experienced tiredness. On 10-SEP-2021, the patient experienced muscle ache. On 12-SEP-2021, the patient experienced stomach spasm. On 12-SEP-2021, the patient experienced nausea. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from nausea, and stomach spasm, and the outcome of fever, tiredness and muscle ache was not reported. This report was non-serious.


VAERS ID: 1717857 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 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: USJNJFOC20210935028

Write-up: INCORRECT PRODUCT STORAGE; OUT OF SPECIFICATION PRODUCT USE; This spontaneous report received from a pharmacist concerned multiple patients. 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: 203A21A, and expiry: 21-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 incorrect product storage. On 10-SEP-2021, the patient experienced out of specification product use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the incorrect product storage and out of specification product use was not reported. This report was non-serious.


VAERS ID: 1717989 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: nurse gave some injections from a vial that was pierced the day before (19 hours after first punctured); This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (nurse gave some injections from a vial that was pierced the day before (19 hours after first punctured)) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (nurse gave some injections from a vial that was pierced the day before (19 hours after first punctured)). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (nurse gave some injections from a vial that was pierced the day before (19 hours after first punctured)) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided. No treatment information was provided by the reporter. 02-Sep-2021, The vial was initially stored in the refrigerator 09-Sep-2021, The vial was first punctured at 13.30 hs and then was left in the refrigerator. 10-Sep-2021, This morning a nurse came in and administer the vaccine to 3 patients from this vial. the vial was not undergo any temperature excursions and total amount of time the vial was exposed to room temperature range was 8? to 25?C equal to 46? to 77?F: 7 times was out of the fridge just to withdraw doses and never sat at room temperature. Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Follow-up include dose number added.


VAERS ID: 1718011 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Received a dose from a vial first punctured more than 12 hours ago; The vial was opened yesterday (09Sep2021) and then was left in the refrigerator; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received a dose from a vial first punctured more than 12 hours ago) and PRODUCT STORAGE ERROR (The vial was opened yesterday (09Sep2021) and then was left in the refrigerator) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 046C21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received a dose from a vial first punctured more than 12 hours ago) and PRODUCT STORAGE ERROR (The vial was opened yesterday (09Sep2021) and then was left in the refrigerator). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received a dose from a vial first punctured more than 12 hours ago) and PRODUCT STORAGE ERROR (The vial was opened yesterday (09Sep2021) and then was left in the refrigerator) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication were reported. No treatment medication were reported.


VAERS ID: 1718014 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-12
Onset:2021-09-10
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21-2A / 1 - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT

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

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

Write-up: Received Moderna as first dose and Pfizer as second dose; This spontaneous case was reported by a pharmacist and describes the occurrence of INTERCHANGE OF VACCINE PRODUCTS (Received Moderna as first dose and Pfizer as second dose) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042B21-2A) for COVID-19 vaccination. Co-suspect product included non-company product TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) for COVID-19 vaccination. No Medical History information was reported. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient started TOZINAMERAN (PFIZER BIONTECH COVID-19 VACCINE) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced INTERCHANGE OF VACCINE PRODUCTS (Received Moderna as first dose and Pfizer as second dose). On 10-Sep-2021, INTERCHANGE OF VACCINE PRODUCTS (Received Moderna as first dose and Pfizer as second dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitants medications were reported. No treatments medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: follow up received and contain no new information


VAERS ID: 1718027 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vomiting
SMQs:, Acute pancreatitis (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: She has been vomiting; This spontaneous case was reported by a consumer and describes the occurrence of VOMITING (She has been vomiting) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 08-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced VOMITING (She has been vomiting). At the time of the report, VOMITING (She has been vomiting) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment medications were reported. Reporter did not allow further contact


VAERS ID: 1718034 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F214 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Muscle spasms, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Breaking out in sweats; Muscles cramping up in legs/Muscles cramping up in stomach; Chills; Vomiting real bad/Vomiting a lot; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (Breaking out in sweats), MUSCLE SPASMS (Muscles cramping up in legs/Muscles cramping up in stomach), CHILLS (Chills) and VOMITING (Vomiting real bad/Vomiting a lot) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002F214) for COVID-19 vaccination. Co-suspect product included non-company product ELECTROLYTES NOS for Dehydration. No Medical History information was reported. On 09-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient started ELECTROLYTES NOS (unknown route) at an unspecified dose. On 10-Sep-2021 at 4:30 AM, the patient experienced HYPERHIDROSIS (Breaking out in sweats), MUSCLE SPASMS (Muscles cramping up in legs/Muscles cramping up in stomach), CHILLS (Chills) and VOMITING (Vomiting real bad/Vomiting a lot). The patient was treated with VITAMIN D NOS at an unspecified dose and frequency and VITAMIN C [ASCORBIC ACID] at an unspecified dose and frequency. At the time of the report, HYPERHIDROSIS (Breaking out in sweats), MUSCLE SPASMS (Muscles cramping up in legs/Muscles cramping up in stomach), CHILLS (Chills) and VOMITING (Vomiting real bad/Vomiting a lot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient is on no concomitant medication reported by reporter.


VAERS ID: 1718047 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Neck pain, Vaccination site pain
SMQs:, Arthritis (broad)

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

Write-up: Pain on his neck; Chills; Headache; Pain on his shoulder at the same arm of injection site; This spontaneous case was reported by a consumer and describes the occurrence of NECK PAIN (Pain on his neck), CHILLS (Chills), HEADACHE (Headache) and VACCINATION SITE PAIN (Pain on his shoulder at the same arm of injection site) in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. Concomitant products included ATORVASTATIN CALCIUM (LIPITOR), LOSARTAN and PANTOPRAZOLE for an unknown indication. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced NECK PAIN (Pain on his neck), CHILLS (Chills), HEADACHE (Headache) and VACCINATION SITE PAIN (Pain on his shoulder at the same arm of injection site). At the time of the report, NECK PAIN (Pain on his neck), CHILLS (Chills), HEADACHE (Headache) and VACCINATION SITE PAIN (Pain on his shoulder at the same arm of injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication was provided by the reporter. No treatment information was provided.


VAERS ID: 1718049 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: Patient today who received their first Covid vaccine dose today however the vial had been in the refrigerator for 31 days/it was 1 day past beyond use date; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient today who received their first Covid vaccine dose today however the vial had been in the refrigerator for 31 days/it was 1 day past beyond use date) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient today who received their first Covid vaccine dose today however the vial had been in the refrigerator for 31 days/it was 1 day past beyond use date). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Patient today who received their first Covid vaccine dose today however the vial had been in the refrigerator for 31 days/it was 1 day past beyond use date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided. Treatment information was not provided. Reporter did not allow further contact


VAERS ID: 1718050 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 - / OT

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

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

Write-up: Dose administered 20 hours after punctured; Dose administered to 16 year old; This spontaneous case was reported by a physician and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose administered 20 hours after punctured) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to 16 year old) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021 at 11:00 AM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose administered 20 hours after punctured) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to 16 year old). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Dose administered 20 hours after punctured) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (Dose administered to 16 year old) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided. It was reported that vial was initially punctured on 09-Sep-2021 at 3 P.M . It was stored at room temperature post puncture for about 20 hours. The vial did not undergo any temperature excursions. Treatment information was not provided.


VAERS ID: 1718072 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-11
Onset:2021-09-10
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Body temperature; Result Unstructured Data: Fever of 102.2 degrees Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Body aches; Fever of 102.2 (degrees Fahrenheit); This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Body aches) and PYREXIA (Fever of 102.2 (degrees Fahrenheit)) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 062E21A and 038A21A) for COVID-19 vaccination. No Medical History information was reported. On 11-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced MYALGIA (Body aches) and PYREXIA (Fever of 102.2 (degrees Fahrenheit)). The patient was treated with PARACETAMOL (TYLENOL) for Adverse event, at a dose of 1 UNK. At the time of the report, MYALGIA (Body aches) was resolving and PYREXIA (Fever of 102.2 (degrees Fahrenheit)) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Sep-2021, Body temperature: 102.2 (High) Fever of 102.2 degrees Fahrenheit. No concomitant medications were provided by the reporter.


VAERS ID: 1718073 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: received my 3rd Moderna vaccine yesterday and my armpit is tender; This spontaneous case was reported by a consumer and describes the occurrence of AXILLARY PAIN (received my 3rd Moderna vaccine yesterday and my armpit is tender) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced AXILLARY PAIN (received my 3rd Moderna vaccine yesterday and my armpit is tender). At the time of the report, AXILLARY PAIN (received my 3rd Moderna vaccine yesterday and my armpit is tender) outcome was unknown. No treatment medications were provided. No concomitant medications were provided. Patient received 3rd Moderna vaccine yesterday, which resulted in tender armpit and enquiring whether that was normal? or not and denied to be followed by safety Reporter did not allow further contact


VAERS ID: 1718078 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-12
Onset:2021-09-10
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: administration of a vaccine from a vial that was punctured more than 12hours ago; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administration of a vaccine from a vial that was punctured more than 12hours ago) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. The patient''s past medical history included COVID-19. On 12-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (administration of a vaccine from a vial that was punctured more than 12hours ago). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (administration of a vaccine from a vial that was punctured more than 12hours ago) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications was reported. The vial was first punctured on 03-Sep-2021, and put back in the fridge after the initial puncture. The vaccine was administered on 10-Sep-2021. The patient was observed for 25 minutes and did not experience any adverse events. Treatment medications was not provided.


VAERS ID: 1718086 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant medication reported No Treatment medication reported.


VAERS ID: 1718088 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 2 LA / OT

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

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

Write-up: pain in arm; chills; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in arm) and CHILLS (chills) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 078C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced PAIN IN EXTREMITY (pain in arm) and CHILLS (chills). At the time of the report, PAIN IN EXTREMITY (pain in arm) and CHILLS (chills) had not resolved. Concomitant medications were not provided. Treatment medications were not provided. This case was linked to MOD-2021-315977 (Patient Link).


VAERS ID: 1718092 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received 3rd dose of the Moderna COVID 19 vaccine that was beyond use date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication reported. No treatment information was provided.


VAERS ID: 1718098 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: Received a 2nd dose of the Moderna COVID 19 vaccine that was beyond use date.; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received a 2nd dose of the Moderna COVID 19 vaccine that was beyond use date.) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received a 2nd dose of the Moderna COVID 19 vaccine that was beyond use date.). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received a 2nd dose of the Moderna COVID 19 vaccine that was beyond use date.) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication were provided. No treatment medication were provided.


VAERS ID: 1718104 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product 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: USMODERNATX, INC.MOD20213

Write-up: Received a 1st dose of the Moderna COVID 19 vaccine that was beyond use date; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received a 1st dose of the Moderna COVID 19 vaccine that was beyond use date) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received a 1st dose of the Moderna COVID 19 vaccine that was beyond use date). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received a 1st dose of the Moderna COVID 19 vaccine that was beyond use date) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1718122 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-09-10
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 05ZE21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: left sore arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (left sore arm) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 05ZE21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced VACCINATION SITE PAIN (left sore arm). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) for Adverse event, at a dose of 2 dosage form. At the time of the report, VACCINATION SITE PAIN (left sore arm) outcome was unknown. The concomitant medications information was not reported. The patient had no known allergies.


VAERS ID: 1718128 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-16
Onset:2021-09-10
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA #013L20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: soreness in the injection site.; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (soreness in the injection site.) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 059E21O, #013L20A and #021M20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced VACCINATION SITE PAIN (soreness in the injection site.). At the time of the report, VACCINATION SITE PAIN (soreness in the injection site.) outcome was unknown. No Concomitant use were reported. No Treatment were reported Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Non-Significant F/U Case.


VAERS ID: 1718131 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-20
Onset:2021-09-10
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Maternal exposure during pregnancy, Product preparation error
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (narrow)

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

Write-up: Patient is currently pregnant with an unknown due date; Mixed Moderna + Pfizer vaccine; This spontaneous prospective pregnancy case was reported by a pharmacist and describes the occurrence of MATERNAL EXPOSURE DURING PREGNANCY (Patient is currently pregnant with an unknown due date) and PRODUCT PREPARATION ERROR (Mixed Moderna + Pfizer vaccine) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) for COVID-19 vaccination. Co-suspect product included non-company product BNT162B2 for COVID-19 vaccination. No Medical History information was reported. On 20-Aug-2021, the patient started BNT162B2 (unknown route) 1 dosage form. On 10-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, BNT162B2 (unknown route) dosage was changed to at an unspecified dose. Last menstrual period and estimated date of delivery were not provided. On 10-Sep-2021, the patient experienced PRODUCT PREPARATION ERROR (Mixed Moderna + Pfizer vaccine). On an unknown date, the patient experienced MATERNAL EXPOSURE DURING PREGNANCY (Patient is currently pregnant with an unknown due date). On 10-Sep-2021, PRODUCT PREPARATION ERROR (Mixed Moderna + Pfizer vaccine) had resolved. At the time of the report, MATERNAL EXPOSURE DURING PREGNANCY (Patient is currently pregnant with an unknown due date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant and treatment drugs were reported. The pharmacist reported that the patient is currently pregnant with an unknown due date, possibly in November 2021. This case concerns a 25 year old pregnant female, who experienced Maternal exposure during pregnancy and Product Preparation error on the day of receiving vaccine. The rechallenge is not applicable since this is the firt time patient received Moderna vaccine. The benefit-risk relationship of Moderna vaccine is not affected by this report.; Sender''s Comments: This case concerns a 25 year old pregnant female, who experienced Maternal exposure during pregnancy and Product Preparation error on the day of receiving vaccine. The rechallenge is not applicable since this is the firt time patient received Moderna vaccine. The benefit-risk relationship of Moderna vaccine is not affected by this report.


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