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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 22 out of 1,889

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VAERS ID: 1235626 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)

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

Write-up: Dizziness, vertigo


VAERS ID: 1235633 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Injection site mass, Injection site pruritus, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone Vitamin D an C Multi Vitamin
Current Illness: Prior runny nose and cough
Preexisting Conditions: None known
Allergies: Cipro, erythromycin, quinolins latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1 hour, pins and needles and joint pain 3 hours itchy lump near injection site 5 hours multiple lumps on arm and torso 5 hours persistant cough


VAERS ID: 1235636 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-13
Onset:2021-04-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 - / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache
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: Repatha sureclik Aspirin 325mg Baclofen 10mgx3 Avostatin 10mg
Current Illness: None
Preexisting Conditions: Stroke 2010 and 2019
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache on night of shot and every day since Tiredness daily causing sleep of up.to 20 hours per day


VAERS ID: 1235637 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-16
Onset:2021-04-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027I20A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Headache, Injection site reaction, Pain, Pyrexia, Rash erythematous, Rash macular, Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair Ibuprofen Allergy Eyedrops
Current Illness: Seasonal allergies
Preexisting Conditions: Asthma
Allergies: Allergic to neosporin (triple anti-biotics) and many scented lotions/shampoos/detergents
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blotchy red rash that itches and feels warm to the touch developed an inch or so below the injection site that covers much of my upper arm. This first appeared on day 4 after the shot. I plan to take an anti-histamine to treat the reaction. I also experienced a slight fever, chills, body aches, and stomach pains lasting about 5-6 hours, starting about 18 hours after my shot. After that, I had a slight intermittent headache on days 2, 3, and 4 after the shot.


VAERS ID: 1235638 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (broad)

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

Write-up: patient received vaccine at held clinic shortly after complained of chest tightness that she has experienced in the past but more severe. reports hx of seasonal asthma but no rescue inhaler. monitored for 5 minutes with symptoms not improving attempted to call 911 patient refused because she did not want to be billed instead had husband drive general aprox 20 min drive. EMT on site also examined patient and recommended 911 call again patient refused


VAERS ID: 1235641 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-15
Onset:2021-04-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humira Methotrexate Fosamax Premarin Calcium Fish oil Folic acid Multi vitamin
Current Illness: None
Preexisting Conditions: RA
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: "Covid Arm" large area near injection site red, swollen, and warm to the touch. Same symptoms for my husband and his itches too.


VAERS ID: 1235643 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chest pain, Dizziness, Headache, Pruritus, Sneezing, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Allergy Shots
Other Medications: 40mG of CBD tincture
Current Illness: None
Preexisting Conditions: Asthma, allergies
Allergies: Shellfish, neosporin, latex, amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Times are based on amount of time having passed since vaccination - [ ] 5-10 mins - Itchiness randomly all over body on and off - [ ] 30-40 mins - throat itchiness, felt light headedness, took 2x Zyrtec - [ ] 1 hr - upper back aches - [ ] 2 hrs - left side and left side of chest/lung felt achey - [ ] 2-3 hrs - back and feet feel achey - [ ] 5 hrs - itchy throat returns - [ ] 6 hrs - sneezing - [ ] 7 hrs - headache


VAERS ID: 1235646 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site mass, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa Bandage and medical tape adhesives
Diagnostic Lab Data:
CDC Split Type:

Write-up: A lump at injection site roughly the same diameter as a baseball appeared the day after injection. Extremely tender. Red circular coloration about 2.5-3 inches in diameter.


VAERS ID: 1235660 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 LA / SYR

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

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

Write-up: COVID ARM - Swollen and hardness at injection site, itchy at injection site


VAERS ID: 1235662 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
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: Iron otc Progesterone
Current Illness: None
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: N/a at this time
CDC Split Type:

Write-up: Firm red area around the injection site Red area is warm to the touch and tender


VAERS ID: 1235726 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Mitral Valve Prolapse (mild)
Allergies: None that I''m aware of
Diagnostic Lab Data: Did not seek medical treatment
CDC Split Type:

Write-up: 7 days after the injection, large welt on my left arm surrounding the injection site (6cm high, 5cm wide)


VAERS ID: 1235732 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Discomfort, Headache, Injection site erythema, Injection site pain, Pain, Pyrexia, Sensitive skin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor 5mg Hydrochloride 50mg Potassium
Current Illness: None
Preexisting Conditions: Hypertension Elevated lipids
Allergies: Penicillin Streptomycin Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Injection site soreness and redness. Chills, body ache headache and fever. Ski Hurt to the touch. Very uncomfortable. Low grade Fever of 99.5 started around 5 am approx 13 hours after vaccination. 16 hours later at 8 am, it was 101.4, then 101.9, 102.1. I took Tylenol 2 tablets 500mg every 4 hours. By 3 pm it was 102.9. I took ibuprofen. 800mg 1 tablet. Fever went down to 101.4 and by 7 pm it was 98.6. By 11 pm it was 99.5 and climbing again. Took 2 Tylenol 500 mg each. 100.3 by midnight


VAERS ID: 1235918 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-18
Onset:2021-04-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Lip swelling
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: Hodroxychloriquin
Current Illness:
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fat lip


VAERS ID: 1236119 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Condition aggravated, Exposure during pregnancy, Fibrin D dimer increased, Full blood count, Immune thrombocytopenia, Platelet count decreased, SARS-CoV-2 test negative
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: Immune thrombocytopenia purpura, pregnancy
Preexisting Conditions: Immune thrombocytopenia purpura, pregnancy
Allergies: None
Diagnostic Lab Data: CBC 23 MAR (before vaccine): Platelets 119 CBC 20APR: Platelets 59 CBC 20APR: Platelets 56 DDimer 20APR: 732 (Normal range for third trimester of pregnancy) SARS CoV-2 Antigen: Neg PENDING: HIT antibodies (both ELISA and Functional), coags, cmp, repeat CBC, Urine Protein/Creatine ratio
CDC Split Type:

Write-up: 25 yo G2P0 @ 37+1 pregnant with longstanding immune thrombocytopenia purpura with a routine CBC showing PLTs of 56 down from 119 1 month ago. Had J&J vaccine on 4/9. - Lab repeated and confirmed - D/w MFM and Hematologist. In an abundance of caution, will get coags, CMP, and P/cr urine ratio to evaluate for HELLP. Will also get HIT antibodies to evaluate for possibility of Vaccine induced thrombocytopenia(VIT). - Will plan on treating with Dexamethasone 40mg Daily x 4 days to increase platelet count. D/w hematologist, and he will see the patient and run the test for HIT antibodies (PF-4) and initiate IVIG treatment, which would help treat the low platelets either from exacerbation of ITP or VIT. If these come back positive, will likely transfer patient to HN for admission and delivery to be followed by therapeutic anticoagulation with non-heparin based therapy, consistent with usual therapy for HIT.


VAERS ID: 1236315 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-17
Onset:2021-04-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Heavy menstrual bleeding, Muscle spasms
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad)

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

Write-up: Severe cramping and heavy menstrual bleeding headaches


VAERS ID: 1236316 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-16
Onset:2021-04-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Complete body rash, benadryl taken & symptoms gone within 12 hours


VAERS ID: 1236321 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-17
Onset:2021-04-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Pain
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: Rash around injection site, 33yo, fall 2020, pneumonia
Other Medications: IB Profen.
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness from the first night but 3 days later I noticed a large rash up my upper left arm around the injection sight. It is similar to a rash I got from a pneumonia vaccine last fall but I haven?t ever gotten a rash form a flu shot.


VAERS ID: 1236333 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Headache, Injection site erythema, Injection site pruritus, Nausea, Pain, Sleep disorder, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Escitalopram 5mg
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up at 5:30am on April 20 with headache, nausea and body aches. Pain at an 8 out of 10 scale. The injection site had a red circle around it, growing from 2 Inch diameter from the night before to about 4.5 inch diameter. Checked temperature around 4pm, at 101.8 degrees. Around 7pm that night, injection site began to itch slightly. Symptoms subsided with medicine but never fully vanished. Temperature fell to 100 degrees. Woke up 6:00 am April 21 to same headache and injection site itch. Body aches and nausea gone but have now been replaced with vertigo, scale 7 out of 10. Temperature at 101 degrees.


VAERS ID: 1236341 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1236556 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Flushing, Hypotension
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild


VAERS ID: 1236573 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cold sweat, Dizziness, Dysphagia, Fall, Syncope, Throat tightness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient was sitting for 15 minute observation when I heard a thump outside. Came out to patient face down on the floor. Immediately woke up when I called out, but was unaware he had fainted. Gave patient water and gatorade and continued to monitor for 40 minutes. Patient continued to feel clammy and lightheaded but eventually felt okay to go home.


VAERS ID: 1236593 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: estradioL 0.01 % (0.1 mg/gram) vaginal cream bupropion HCl (WELLBUTRIN ORAL) dextroamphetamine-amphetamine 20 mg tablet
Current Illness: Sinus heafache 3/17/21
Preexisting Conditions: Migraines ADHD-I Anxiety Scoliosis Secondary amenorrhea, hypothalamic Hypoestrogenism Please review your health issues and verify that the list is up to date. Call 911 if you have an emergency. Migraines Added 5/14/2002 Learn more Remove ADD (attention deficit disorder) without hyperactivity Added 2/13/2003 Learn more Remove Scoliosis Added 3/2/2006 Learn more Remove History of anorexia nervosa, 2005-2007, partial remission Added 5/19/2006 Learn more Remove History of endoscopic sinus surgery Added 7/3/2015 Learn more Remove Anxiety Added 9/9/2015 Learn more Remove Mood problem Added 9/9/2015 Learn more Remove Secondary amenorrhea, hypothalamic Added 10/23/2015 Learn more Remove Uses birth control Added 12/6/2018 Learn more Remove Disorder of sleep wake schedule
Allergies: Grass pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore throat all of 4/20/21 Extreme fatigue


VAERS ID: 1236653 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50mg
Current Illness: None
Preexisting Conditions: Major Depression (In Remission and Treated)
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Body aches and debilitating headache. Lasted approximately 12-24 hours. Took 1000mg Tylenol twice to manage symptoms around hour 8 and 14.


VAERS ID: 1236823 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-24
Onset:2021-04-20
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Condition aggravated, Pleural effusion, Pulmonary embolism, Pulmonary fibrosis
SMQs:, Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1. Azathioprine 100 mg daily. 2. Bystolic 5 mg daily. 3. Flovent 2 puffs BID. 4. Lasix 20 mg daily. 5. Ofev 150 mg BID. 6. Prednisone 10 mg daily. 7. Ramelteon 8 mg at bedtime. 8. Sildenafil 20 mg TID. 9. Tobramycin nebulizer 300 m
Current Illness: 1. Idiopathic pulmonary fibrosis, on chronic immunosuppressants and prednisone. 2. Pulmonary hypertension. 3. Depression and anxiety. 4. Hypertension. 5. pneumonia
Preexisting Conditions: see above
Allergies: 1. HEPARIN, WHICH HAS CAUSED HIT. 2. LUNESTA. 3. FLUTICASONE. 4. (inaudible) . 5. MONTELUKAST. 6. OXYCODONE 7. TRAMADOL. 8. ZOLPIDEM. HAVE ALL CAUSED RASH. 9. AMOXICILLIN CAUSES DIARRHEA. 10. CLINDAMYCIN HAS CAUSED NAUSEA.
Diagnostic Lab Data: CTA demonstrated a small acute left upper lobe PE with extensive pulmonary fibrotic changes, and a cavitary focus in the right apex seen from prior CT from March, but now containing a small amount of fluid
CDC Split Type:

Write-up: patient received vaccine 3/24/21, presented to the hospital with pulmonary embolism


VAERS ID: 1237039 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tizanadine, Gabapenten, Morphine, Zoloft, Promethazine, Verapamil, Linzess, Vitamin D3, Lactulose a
Current Illness: Pollen allergies
Preexisting Conditions: Spine
Allergies: IVP-Dye, Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dizziness, Extremely Sleepy Still continuing


VAERS ID: 1237299 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

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

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

Write-up: at 11pm the night of the vaccine I started to have a throbbing headache, chills, night sweats fever, and body aches. At about 2:30am I took ibuprofen and by 3:00am all the symptoms were gone.


VAERS ID: 1238494 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac, Chest pain, Electrocardiogram ST segment elevation, Electrocardiogram abnormal
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin D 50,000 units weekly triamterene/hctz atorvastatin diltiazem ER 180 mg omeprazole 20 mg aspirin 325 mg hydrochlorothiazide 25 mg levothyroxine 88 mcg
Current Illness: no known
Preexisting Conditions: afib hypertension
Allergies: no known
Diagnostic Lab Data: urgent cardiac catheterization.
CDC Split Type:

Write-up: Patient presented EKG consistent with anterior ST elevation MI with chest pains. Due to the presentation I feel she should undergo urgent cardiac catheterization.


VAERS ID: 1238784 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspar, fenofibrate, ferrous sulfate, liothyronine, losartan, norethindrone, omeprazole, paroxetine, albuterol, Pulmicort, singular, vitamin C
Current Illness: None
Preexisting Conditions: CAD s/p CABG, Asthma
Allergies: None
Diagnostic Lab Data: CTA chest
CDC Split Type:

Write-up: Pulmonary Embolus


VAERS ID: 1238852 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal mass, Pain
SMQs:

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

Write-up: patient stated that he noticed yesterday (4/20) that there is a lump that came up on his lower left abdomen , he felt it but didnt look at it. he drink some water and laid down . it starts going away . it was painful , on scale og 0-10 , he said the pain level was like 5.


VAERS ID: 1238921 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-05
Onset:2021-04-20
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

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

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

Write-up: Patient reports having severe upper thigh pain that started 4/20/2021. Patient stated that there have been no other symptoms at this time. Patient was advised to go to the emergency room immediately to get further evaluation. Patient verbalized agreement and stated that he would go to the nearest ER right away.


VAERS ID: 1239018 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eye discharge, Eye infection, Eye pain, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Eye infection - swollen eye, fluid, pain, swelling


VAERS ID: 1239221 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: renal abnormalities (kidney stones)
Preexisting Conditions: diabetes
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Janssen COVID vaccine on 4/6/2021. Patient states that approximately two weeks after receiving vaccine, location of injection started to swell and was hot to the touch. Patient reported adverse event to pharmacist on 4/21/2021 in which she stated that the "heat" in the injection site had improved but it was still swollen.


VAERS ID: 1239813 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-07
Onset:2021-04-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Oesophageal rupture, SARS-CoV-2 test positive
SMQs:, Gastrointestinal perforation (narrow), Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown, was told not on blood pressure medications. Only occasional heartburn medications
Current Illness: Unknown- Has had history of having food get stuck in esophagus per nurse at facility
Preexisting Conditions: unknown- told none
Allergies: unknown
Diagnostic Lab Data: Went to the hospital- Torn esophagus- having surgery at hospital
CDC Split Type:

Write-up: None at time of vaccine known. Reaction was 13 days later (potentially not related). Patient tested positive for COVID-19 later the evening of reaction.


VAERS ID: 1240184 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: injection site swelling and pain immediately after flu vaccine, flu like symptoms following vaccines
Other Medications: Timolol Maxide Pepcid Aspirin
Current Illness: none
Preexisting Conditions: glaucoma arthritis
Allergies: Morphine Demerol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Itching, swelling, at injection with rash appeared 8 days after 1 dose.


VAERS ID: 1240185 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

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

Write-up: due date: 6/16/21 symptoms:fever, extreme fatigue, aches, headache


VAERS ID: 1240226 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hypoaesthesia, Hypoaesthesia oral, Oral mucosal blistering, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Side effects - fever, chills, numb tongue, numb lips, numb fingers, blister under tongue - all gone within 24 hours.


VAERS ID: 1240262 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0162 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing other than ibuprofen when the side effects were at their worst
Current Illness: none
Preexisting Conditions: Very mild exercise-induced asthma
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Symptoms started with a light headache a few hours after the injection and slight arm pain at the site of the injection. Nothing serious until I fell asleep, which is when I developed a fever, uncontrollable chills, and aches all over my body, so much that I could not sleep until I took some ibuprofen. In the morning, the chills were gone, but a slight fever and body aches remained all day. They were gone by the next day.


VAERS ID: 1240268 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry throat, Eye swelling, Feeling hot, Pruritus, Tachycardia, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine, pepcid, prilosec, medrol, glipizide, invokana, losartan potassium, topamax, singulair, zofran, albueterol
Current Illness:
Preexisting Conditions: asthma, type 2 diabetes, chronic ITP,
Allergies: phenergan, sulfa, sumatryptan, promethazine, keflex, cephelasporins, polyethelyne glycol, watermelon, nutmeg, cherries, green bell pepper, fexofenadine, lyrica, nortryptaline, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: throat constriction, dryness, scratcy/itchy. facial itiching, head, arm, back itching, eye swelling, overheating, tachycardic. epinephrine administered, 911 called, ambulance taken across the street to ER for observation. steroids given. further benadryl taken at home. symptoms started 10-15 minutes post injection. I am allergic to PEG, my allergist put me on a pre dose of anthystamines & steroids to lessen or prevent reaction so overall reaction was fairly mild but epi was the only thing left to give as I had already had 400mg hydroxyzine, 40 mg pepcid x3, 28mg medrol x5 during the 24 hours prior to my vaccination.


VAERS ID: 1240493 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-01
Onset:2021-04-20
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / N/A RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax, Deep vein thrombosis, Pulmonary embolism, Subclavian vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena (IUD)
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: CT chest, US of R arm vasculature.
CDC Split Type:

Write-up: 6 weeks after administration of COVID-19 vaccine developed DVT in right subclavian vein which progressed to a subsegmental PE 2 days after confirmation by ultrasound despite being on Eliquis.


VAERS ID: 1241101 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

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

Write-up: Soreness of the injection site reoccurred after previously going away after initial injection. Same day itching started to occur, followed by swelling around the injection site (photo for reference if needed). This felt like an allergic reaction to me (I have had allergy shots in the past for preventative). Swelling and soreness have been off and on since. Started googling and seems to be a similar reaction as ?covid arm?


VAERS ID: 1241354 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Full body aches, night chills, sore throat, high fever. Chills only lasted over night. Broke 101 fever and body aches after the 12 hour mark of onset (36 hours after vaccine). Sore throat lingers after 48 hours.


VAERS ID: 1241577 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN8731 / 1 LA / IM

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

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Seizure-Mild


VAERS ID: 1241738 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Head discomfort, Headache
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: Ampicilin, Erythhromycin, Sulpha
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache and feeling of pressure on one side of the head.This has been happening 3 days in a row.


VAERS ID: 1241838 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu like symptoms
Other Medications: Xerelto
Current Illness: Suffering from the long term effects of COVID-19.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills and fever of 101.3 on and off for 36 hours. Body aches and sweating.


VAERS ID: 1241995 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-07
Onset:2021-04-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back injury, Condition aggravated, Contusion, Fall, Joint injury, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: HBP; diverticulitis
Preexisting Conditions: UNK
Allergies: Shellfish
Diagnostic Lab Data: Did not seek medical attention, originally thought dehydration was cause. Later, considered vaccine since last fainting occurred more than a decade ago!
CDC Split Type:

Write-up: April 20 2021: suffered a fainting/blackout episode where I collapsed onto my apartment building''s outside entry stair. I hit the deck causing contusions to my knees and upper back. I regained consciousness after _about 10 seconds, was helped up another flight of stairs by a friend and neighbor where I - again - blacked out falling to the hallway floor. I regained consciousness in another 10 seconds.


VAERS ID: 1242246 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-16
Onset:2021-04-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Joint swelling, Pain in extremity
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint swelling in hands three days after shot. Joint swelling and pain in big toe of right foot.


VAERS ID: 1242450 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-04-20
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase decreased, Basophil count normal, Blood albumin normal, Blood alkaline phosphatase increased, Blood bilirubin normal, Blood calcium normal, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Carbon dioxide normal, Chest X-ray abnormal, Chest discomfort, Chest pain, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Eosinophil count normal, Fibrin D dimer, Haematocrit normal, Haemoglobin decreased, Immature granulocyte percentage increased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count normal, Neutrophil percentage increased, Nucleated red cells, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width increased, Troponin I normal, White blood cell count normal
SMQs:, Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Myelodysplastic syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? albuterol (PROVENTIL) (2.5 MG/3ML) 0.083% nebulizer solution, Take 2.5 mg by nebulization 4 times daily., Disp: , Rfl: ? albuterol (PROVENTIL, VENTOLIN) 90 MCG/ACT inhaler, Inhale 1 Puff by mouth every
Current Illness:
Preexisting Conditions:
Allergies: Allergen Reactions ? Morphine Hallucinations and Headache ? Codeine Rash ? Lovenox Other/Unknown (See Comments) Abdominal wall hematoma
Diagnostic Lab Data: CTA Chest For Pulmonary Embolism w Contrast [245811813] Collected: 04/20/21 1327 Order Status: Completed Updated: 04/20/21 1348 Narrative: EXAMINATION: CTA Chest with Intravenous Contrast, Axial Imaging with Coronal and Sagittal 2-D imaging as well as 3-D MIP reconstructions. 80 mL Omnipaque 300 was administered intravenously. was administered intravenously for the post-contrast images. INDICATION: Elevated d-dimer 1330. History of pulmonary emboli. COMPARISON: PA and lateral chest x-ray 4/20/2021 and CT chest, abdomen and pelvis without contrast 7/6/2017. CTA CHEST FINDINGS: There is submaximal contrast opacification of the pulmonary arteries related to timing of imaging with regards to the phase of contrast, which may lower the sensitivity and specificity in evaluation of pulmonary emboli, especially in the distal subsegmental branches. Allowing for the limitations, no gross evidence of pulmonary emboli in the adequately opacified pulmonary arteries. Main pulmonary artery measures 3.2 cm in diameter. Aorta is age-appropriate without aneurysm. Direct origin of the left vertebral artery from the aortic arch proximal to the origin of the left subclavian artery, a normal variant. Mild atherosclerotic calcifications in the aortic arch and in the proximal left anterior descending coronary artery. Heart size is normal with no pericardial effusion. No pathologic adenopathy is seen in the chest. Nonspecific hypodense lesions in the included lower left lobe of thyroid measuring up to 1 cm, with the thyroid incompletely included on this exam. Minimal scarring in the lung apices. Minimal atelectasis or scarring in the anterior lingula or possibly artifact due to volume averaging with pericardial fat pad. No acute infiltrate, consolidation, pleural effusion or pneumothorax. No suspicious pulmonary nodule is visualized. Partially included upper abdominal organs are unremarkable. Stable chronic compression deformity approximately T5 and T8 vertebral bodies since chest x-ray of 9/30/2019, with suspected slight progression of compression fracture of T5 vertebral body since chest x-ray of 9/12/2018, with the compression deformity of T5 vertebral body new since CT chest exam of 7/6/2017. No acute osseous abnormality. IMPRESSION: 1. Limited evaluation for pulmonary emboli due to submaximal contrast opacification of the pulmonary arteries. Allowing for the limitations, no pulmonary emboli in the relatively adequately opacified central pulmonary arteries with limited evaluation of the distal subsegmental branches. 2. Nonspecific hypodense lesions in the partially included inferior left lobe of thyroid measuring up to 1 cm, which appear new since 2017. Suggest thyroid ultrasound exam for further evaluation. 3. Chronic compression deformities of T5 and T8 vertebral bodies, stable since at least 9/30/2019, with T5 compression fracture new since 7/6/2017. 4. Incidental direct origin of the left vertebral artery from the aortic arch, a developmental variant. Coronary artery calcifications. This CT exam was performed using one or more of the following dose reduction techniques: automated exposure control, adjustment of the mA and/or kV according to patient size, and/or use of iterative reconstruction technique. Radiation Dose: 607.8 mGy*cm total DLP Electronically signed by: Doctor 4/20/2021 1:47 PM CDT Workstation: 109-01249NK APTT [245811811] Collected: 04/20/21 1231 Order Status: Completed Specimen: Blood Updated: 04/20/21 1312 APTT 27.5 25.4 - 38.4 SEC Protime (Prothrombin Time) [245811810] Collected: 04/20/21 1231 Order Status: Completed Specimen: Blood Updated: 04/20/21 1312 PROTIME 11.3 10.3 - 12.6 SEC INR 0.9 0.9 - 1.1 Comment: Recommended therapeutic ranges or oral anticoagulant is and INR of 2.0 to 3.0. An INR of 2.5 to 3.5 is recommended to prevent recurrent MI. Protime (Prothrombin Time) [245811798] Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1312 PROTIME 11.2 10.3 - 12.6 SEC INR 0.9 0.9 - 1.1 Comment: Recommended therapeutic ranges or oral anticoagulant is and INR of 2.0 to 3.0. An INR of 2.5 to 3.5 is recommended to prevent recurrent MI. Brain Natriuretic Peptide (BNP) [245811799] Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1301 B-Type Natriuretic Peptide 22 0 - 100 PG/ML D-dimer, quantitative [245811805] (Abnormal) Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1259 D-Dimer 1,330High Panic 0 - 400 NG/ML FEU Comprehensive metabolic panel [245811797] (Abnormal) Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1246 Glucose 108High 65 - 100 MG/DL Blood Urea Nitrogen 16 7 - 18 MG/DL Creatinine 0.9 0.5 - 1.0 MG/DL Sodium 141 136 - 145 MMOL/L Potassium 4.0 3.5 - 5.1 MMOL/L Chloride 107 98 - 107 MMOL/L Co2 25 21 - 32 MMOL/L Calcium 8.9 8.5 - 10.1 MG/DL Protein Total 7.4 6.4 - 8.2 G/DL Albumin 3.5 3.4 - 5.0 G/DL A/G Ratio 0.9 0.8 - 2.0 Alkaline Phosphatase 131High 46 - 116 U/L Alt (SGPT) 24 14 - 59 U/L AST(SGOT) 14Low 15 - 37 U/L Bilirubin, Total 0.3 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 66Low $g90 ML/MIN/1.73sq.m Troponin Series [245811800] Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1246 Troponin I 0.00 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. XR Chest 2 View [245811802] Collected: 04/20/21 1229 Order Status: Completed Updated: 04/20/21 1246 Narrative: EXAMINATION: AP and lateral radiograph(s) of the chest CLINICAL HISTORY: 67 years Female,Shortness of breath COMPARISON: There is no prior similar study available for correlation. FINDINGS: The cardiomediastinal size and contour are normal. There is mild to moderate atherosclerotic disease The lungs are clear with no pneumothorax, pleural effusion or focal airspace consolidation. There is 20% compression deformity of a single mid thoracic vertebral body of uncertain age. IMPRESSION: No acute cardiopulmonary process Mild to moderate atherosclerotic disease 20% compression deformity of a single mid thoracic vertebral body of uncertain age Electronically signed by: Doctor 4/20/2021 12:45 PM CDT Workstation: 109-0082SB8 CBC w Auto Diff [245811796] (Abnormal) Collected: 04/20/21 1218 Order Status: Completed Specimen: Blood Updated: 04/20/21 1228 White Blood Cell Count 9.3 4.3 - 10.5 THOUS/uL Red Blood Cell Count 4.27 3.93 - 5.07 MIL/uL Hemoglobin 11.9 11.8 - 14.8 GM/DL Hematocrit 38.2 35.6 - 45.0 % Mean Corpuscular Volume 89.5 83.5 - 95.9 FL Mean Corpuscular Hemoglobin 27.9 27.4 - 32.0 PG Mean Corpuscular Hemoglobin Conc 31.2Low 31.5 - 34.7 G/DL Rdwcv 17.0High 11.8 - 14.2 % Rdwsd 55.8High 37.2 - 47.8 FL Platelet Count 213 167 - 402 THOUS/uL Mean Platelet Volume 9.2 8.8 - 12.0 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 71.0High 34.0 - 67.9 % Lymphs 18.4Low 20.4 - 48.6 % Monocytes 7.2 5.0 - 11.5 % Eos 1.8 1.0 - 5.4 % Basos 0.5 0.2 - 1.3 % Neutrophils Absolute Count 6.6 2.1 - 6.6 THOUS/uL Lymphocytes Absolute Count 1.7 1.2 - 3.9 THOUS/uL Monocytes Absolute Count 0.7 0.3 - 0.8 THOUS/uL Eosinophils Absolute Count 0.2 0.1 - 0.4 THOUS/uL Basophils Absolute Count 0.1 0.0 - 0.1 THOUS/uL Imm Gran 1.1High 0.1 - 0.7 % Abs Imm Gran 0.10 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 4/20/21 ER HPI: 67 y.o. female who presents with complaint of shortness of breath since yesterday night when she went to bed and describes it as heaviness associated with lower chest pain both back and front. Patient says shortness of breath is worse with lying down and with activity. Patient also complained of cough that is nonproductive. No fever or chills, no nausea vomiting and no abdominal pain. Patient has been off her Coumadin is since for 04/09/2021 for back injection for back pain. Patient said the the shortness of breath is similar to the last time she had blood clot.


VAERS ID: 1242735 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Electronic cigarette user, Eye pain, Fibrin D dimer, Full blood count, International normalised ratio increased, Magnetic resonance imaging head abnormal, Metabolic function test, Migraine, Platelet count decreased, Scan with contrast, Thrombocytopenia, Venogram abnormal, Vision blurred, Vomiting, White matter lesion
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC: Multiviatmin tablet by mouth daily, fish oil capsule by mouth daily, creatine poweder - frequency unknown Precription: None
Current Illness: None reported.
Preexisting Conditions: None reported
Allergies: NO known drug allergies
Diagnostic Lab Data: 4/21/2021 @ 1659 Platelets 66 D-Dimer Qunantatative $g 12,800 INR 1.2 CT of head without contrast: 1. Fairly abnormal CT of the head with patchy areas of abnormal attenuation throughout the white matter, which may represent edema. 2. Dense-appearing superior sagittal sinus, potentially representing venous thrombosis. 3. Recommend a contrast-enhanced MRI of the brain, as well as an MRV of the brain. 4. The findings were called at 6:15 PM MRI Brain with and without Contrast: 1. The findings are most consistent with venous thrombosis with involvement of the right jugular, right transverse sinus and superior sagittal sinus. 2. There is patchy edematous change within the subcortical white matter areas bilaterally and symmetrically. No CVA. 3. The findings are called at 8:15 PM. MRI Angiogram Heat without Contrast: 1. The findings are most consistent with venous thrombosis with involvement of the right jugular, right transverse sinus and superior sagittal sinus. 2. There is patchy edematous change within the subcortical white matter areas bilaterally and symmetrically. No CVA. 3. The findings are called at 8:15 PM.
CDC Split Type:

Write-up: ED NOTE is as follows...from 4/21/21 @ 21:47 a 28 y.o. male who to the emergency room with reports of a headache for the last 48 hours. He reports this as being one of the worst headaches he has ever had. He was seen at urgent care and given Toradol, Zofran and Benadryl and still rates his pain an 8 out of 10. He does feel pressure behind his eyes. And reports vomiting in the parking lot at urgent care. He denies abdominal pain back pain, neck pain, shortness of breath, chest pain, numbness or tingling or any other worsening concerns. Reports that he did receive a recent Johnson & Johnson vaccination. Patient states he does vape. He occasionally drinks alcohol he denies any illicit drugs. Patient denies any head trauma. Diagnosis management comments: This is a 28-year-old male arrives to the emergency room with reported migraine headache for the last 48 hours. He did report that he was go to urgent care in which he received a migraine cocktail of Zofran, Benadryl and Toradol. Patient reported that his headache was not resolved so urgent care sent him on for further evaluation. Patient upon arrival had a negative neurological exam however he did report that he had pressure behind his eyes. Was unable to see any papilledema on funduscopic exam. Check patient''s pressures bilaterally and they were 21 and 18. Patient did report to me that this was the worst headache of his life. I did administer IV fluids here as well as Tylenol and morphine. Patient did report some improvement. Patient did report in his past medical history had a recent Johnson & Johnson vaccination. A CBC and CMP was obtained. Did have thrombocytopenia with a count of 66. Since my exam was PERRL with normal extraocular movements. He had no eye redness or eye pain. Of low concerns for any iritis or uveitis. Patient''s patient CT of his head did show a abnormal CT that had a dense appearing superior sagittal sinus that was representing a venous thrombosis. Radiologist did recommend a MRI MRV. An MRI and MRV was ordered. Patient MRI MRv did show findings are consistent with a venous thrombosis involving the right jugular right transverse sinus and superior sagittal sinus there is also a patchy edematous change within the subcortical white matter areas bilaterally and symmetrically. There was no CVA. With patient''s reported migraine headache. Reported blurred vision, low platelets, recent vaccination I do believe patient has vaccine induced thrombotic thrombocytopenia. With this finding I did converse with my overseeing physician Calls were made out to neurology and then a call out did prefer to have patient started on IVIG at 1 g/kg daily for 2 days and blood thinner Xarelto 15 mg p.o. twice daily. These orders were initiated. Internal med services was consulted and with conversations of family, internal med services out possible transfer that an interventionalists could be available if patient needed it. Report was given at 2100 upon my end of shift.


VAERS ID: 1243062 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Migraine
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: Valsartan low dose asprin
Current Illness: none
Preexisting Conditions: hypertension
Allergies: na
Diagnostic Lab Data: na
CDC Split Type:

Write-up: I''m on day 3 of a blistering migraine headache. Usually over-the-counter remedies are not working.


VAERS ID: 1243443 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206AZ1A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: none reported as illness she had a baby in January of 2021
Preexisting Conditions: none reported
Allergies: none reported
Diagnostic Lab Data: none reported
CDC Split Type:

Write-up: She has developed a cellulitis to the left arm near the elbow. site is very swollen and painful and warm to touch. She is also developing some pain, warmth and swelling near the right elbow. she has been started on doxycycline. She saw her PCP and was informed that they have seen this in another individual after receipt of the J and J vaccine.


VAERS ID: 1244004 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-02
Onset:2021-04-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Computerised tomogram abnormal, Pulmonary embolism, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: CT scan on 4/20 - Acute, mostly right lower lobe segmental occlusive PE and with slight amount of right lower lobar artery nonocclusive PE as well. There is mild pulmonary arterial hypertensive changes and evidence of mild right heart distention. There is no central pulmonary embolus. D-dimer - 4/17 - 2.77, 4/18 - 6.58, 4/19 - 4.58, 4/20 - $g35.2, 4/21 - $g35.20
CDC Split Type:

Write-up: Patient received the COVID 19 vaccine on 4/2, he developed symptoms of COVID on 4/10, he tested positive for COVID on 4/13. He was admitted to the hospital on 4/17 for acute respiratory failure. On 4/20, he was diagnosed with a pulmonary embolus.


VAERS ID: 1245040 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dizziness, Fatigue, Headache
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular 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: Bupropion SR 150 mg, 2x daily Depo Sq Provera Inj., once every 3 months
Current Illness: None
Preexisting Conditions: None
Allergies: Dairy allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain, dizziness, light headedness, severe exhaustion/fatigue, headache


VAERS ID: 1245253 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-14
Onset:2021-04-20
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ear discomfort, Hypoacusis, Tinnitus
SMQs:, Hearing impairment (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, Melatonin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet. Plan to visit a doctor soon.
CDC Split Type:

Write-up: Partial hearing loss, tinnitus. Both ears feel "muffled" and "stuffy" and are ringing loudly. First, the left ear started feeling that way, and then the next day, the right ear started feeling it and the left ear got worse.


VAERS ID: 1245256 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-18
Onset:2021-04-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: 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: Tri-Lo-Estarylla
Current Illness: None, but had COVID 4 months prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 4/18 received COVID vaccine 4/20 developed rash 4/22 was seen in office - full body rash, hives on face


VAERS ID: 1245334 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-20
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210440339

Write-up: A LITTLE BIT OF ACHES AND PAIN; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 20-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 20-APR-2021, the patient experienced a little bit of aches and pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of a little bit of aches and pain was not reported. This report was non-serious.


VAERS ID: 1245966 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Atorvastatin, Paroxetine, Buproprion
Current Illness: None
Preexisting Conditions: Occasional sinus headaches.
Allergies: Demerol causes nausea; allergies to perfumes, dust, mold
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Whole body muscle aches and pains, chills, fever between 100- 101. These symptoms began within about 14 hours after the shot and lasted for about 15 hours. Then just tired for several hours


VAERS ID: 1246095 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: protonix 40 mg per day multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day following the injection, I experienced chills, lack of appetite, fever (101.4), and fatigue. That evening I sweated profusely during sleep. Two days after the injection, I had continued fatigue, lack of appetite, and unusual sweating with little to no activity. Third day, continued fatigue but no unusual sweating. Appetite is returning slowly


VAERS ID: 1246163 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Hypoaesthesia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol , Vitamin D, Multi vitamin, Motrin, Xolair Injection monthly
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: IV CONTRAST, EDTA (preservative)
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Numbness radiating down left arm, numbness moving up neck and left side of ear and scalp. Multiple Hives on arms , chest, and back.


VAERS ID: 1246216 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Severe, Systemic: Vomiting-Severe


VAERS ID: 1246267 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-04-20
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection 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: Athletic asthma
Allergies: Amoxicillin & penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fist size rash occurred on the arm where the injection took place.


VAERS ID: 1246294 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: ?Covid arm? large painful welt around the injection site


VAERS ID: 1246305 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Headache
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: Enbrel
Current Illness: NA
Preexisting Conditions: Rheumatoid Arthritis
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Severe headache continuing several days after vaccine.


VAERS ID: 1246350 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Fever, headache which lasted about 24 hours. Extreme tiredness which lasted 48 hours. Advil taken.


VAERS ID: 1246380 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Troponin increased, Vascular occlusion
SMQs:, Myocardial infarction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol 325 mg prn
Current Illness: none
Preexisting Conditions: varicose veins, bowel obstruction, abdominal hernia, cataract, arthritis, UTI
Allergies: Keflex, naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: right radial occlusion, elevated troponin


VAERS ID: 1246395 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
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: Armour Thyroid, Vit D3/K2, fish oil, low dose naltrexone
Current Illness: none
Preexisting Conditions: hashimotos
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache began 4/20 until present, feels like a tight band around my head.


VAERS ID: 1246421 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram normal, Deep vein thrombosis, Platelet factor 4, Venogram normal
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HISTORY OF GESTATIONAL DIABETES
Allergies: NONE
Diagnostic Lab Data: PLATELET FACTOR 4 ANTIBODY TEST NEGATIVE. NO THROMBOCYTOPENIA. CT AND MRV BRAIN NEGATIVE FOR CEREBRAL VEIN THROMBOSIS.
CDC Split Type:

Write-up: LEFT BRACHIAL VEIN DVT.


VAERS ID: 1246584 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0207L20A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain, Pyrexia, Rash, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: First shot I have a rash which my doctor diagnosed as COVID arm. It was itchy and raised, it presented 7 days after my first shot. Second shot, by 10p I had a fever of 101, chills, body ache, nauseous and headache. The next day I got COVID arm on the left arm again and a different rash presented itself on my right arm. I had a fever for over 24 hours with the other symptoms listed. It?s 4/23, my fever has gone away. The only symptoms I?m still having are the rashes


VAERS ID: 1246654 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-05
Onset:2021-04-20
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fluoxetine (40 mg capsule) Take 1 capsule by mouth once a day as directed insulin glargine Inject 20 unit subcutaneously as directed as directed losartan (25 mg tablet) Take 1 tablet by mouth once a day megestrol (400 mg/1
Current Illness: ESRD on hemodialysis three times weekly Hospitalization for pulmonary edema 3/11/21
Preexisting Conditions: ESRD on hemodialysis three times weekly DM Type 2 Dementia/Schizophrenia CAD, HTN
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: admitted to University of South Alabama Medical Center on 4/20/21 with bilateral Pulmonary embolus


VAERS ID: 1246754 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysgeusia, Lip swelling, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: Possible seasonal, never diagnosed
Diagnostic Lab Data: No testing administered yet
CDC Split Type:

Write-up: Hives, swelling in lips, face, metallic taste in mouth. Continuing even after ER visit at 4 am Wednesday morning and taking meds to control reaction


VAERS ID: 1247077 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 8029819 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Olmesartan Medoxomil tablets 5mg (Blood pressure)
Current Illness: None
Preexisting Conditions: High blood pressure Regular migraines (at least 1 per month lasting 2-3 days)
Allergies: None
Diagnostic Lab Data: Physical examination at Urgent Care on 4/20/2021
CDC Split Type:

Write-up: I developed a rash a week after the dose. Went to urgent care and diagnosed allergic reaction. Gave me Prednisone 20mg tablet 3 tablets by mouth daily for 3 days and reacting correctly


VAERS ID: 1247654 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-02
Onset:2021-04-20
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Angiogram abnormal, Arthralgia, Chest pain, Pulmonary embolism, Ultrasound Doppler, Ultrasound scan normal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CTA chest showed a segmental right lower lobe pulmonary embolism. Venous duplex of the lower extremities was negative for DVT.
CDC Split Type:

Write-up: Patient got the J&J Covid vaccine on 4/2/2021, presented to the ER on 4/20/2021 with complaint of left chest and shoulder pain. This has been progressively getting worse over the past 3 days. She denies any overt shortness of breath or cough and her vital signs are stable.


VAERS ID: 1248089 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Gait disturbance, Lethargy, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Back pain, severe leg pain (muscle pain) , patient wobbles when he walks. Lethargy.


VAERS ID: 1248125 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-20
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anal incontinence, Paraesthesia, Sensitive skin, Urinary incontinence
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious diarrhoea (broad)

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

Write-up: My full list of symptoms were: Pins and needle feeling as well as hypersensitivity all over my skin that originated in my lower legs but traveled up my body to include my entire legs, hips, and arms. It was more severe on the left side of my body which is the side I received the vaccine. I did not notice it on my head, face, and upper torso. I had full muscle control but I did have problems with my bladder and bowels. I''m not sure if I could not control them or did not feel them because the sensitivity was high in my hip area but I could not control them fully. No treatment was administered except to wait and see. Three days later and I am improving but not fully recovered yet.


VAERS ID: 1248396 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, C-reactive protein, Chills, Full blood count, Metabolic function test, Pain, Pyrexia, Red blood cell sedimentation rate increased, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: N/A
Preexisting Conditions: OBESITY.
Allergies: NKDA
Diagnostic Lab Data: RT KNEE X-RAY, CBC, CMP, SED RATE, CRP ORDERED ON 04/22/2021.
CDC Split Type:

Write-up: (pt visited the clinic on 04/22/2021) Pt received J&J injection on left arm in the morning @ Store pharmacy 04/10/2021. Pt got chill, fever, body aches on the first day. However, 3 days ago, pt started to notice RT knee pain. Pt never had a knee pain like this before. Pt cannot pick up leg and it really hurts around the knee. Pt does not remember any trauma or injury to RT knee recently or from the past. Pt has been taking tylenol but not so helpful. Naproxen 500mg BID rx''ed. Will f/u in 2wks.


VAERS ID: 1249508 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:2021-04-20
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Headache, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: On the previous day of report, patient took sleeping pills.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442648

Write-up: SHORT OF BREATH; TIREDNESS; DIZZINESS; NAUSEA; HEADACHE; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included on the previous day of report, patient took sleeping pills. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-APR-2021, the subject experienced dizziness. On 20-APR-2021, the subject experienced nausea. On 20-APR-2021, the subject experienced headache. On 21-APR-2021, the subject experienced short of breath. On 21-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from nausea, headache, and dizziness, and had not recovered from tiredness, and short of breath. This report was non-serious.


VAERS ID: 1249667 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-23
Onset:2021-04-20
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Dyspnoea, Facial paralysis, Rash
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No medical history reported.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: anaphylactic shock; difficulty breathing; faced was paralyzed; rash on arms and chest; This spontaneous case was reported by a pharmacist (subsequently medically confirmed) and describes the occurrence of ANAPHYLACTIC REACTION (anaphylactic shock), DYSPNOEA (difficulty breathing) and FACIAL PARALYSIS (faced was paralyzed) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 001C21A and 008B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (No medical history reported.). On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Apr-2021, the patient experienced ANAPHYLACTIC REACTION (anaphylactic shock) (seriousness criterion life threatening), DYSPNOEA (difficulty breathing) (seriousness criterion medically significant), FACIAL PARALYSIS (faced was paralyzed) (seriousness criterion medically significant) and RASH (rash on arms and chest). At the time of the report, ANAPHYLACTIC REACTION (anaphylactic shock), DYSPNOEA (difficulty breathing), FACIAL PARALYSIS (faced was paralyzed) and RASH (rash on arms and chest) outcome was unknown. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment medication included epinephrine injection. Company comment: based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded. This case was linked to MODERNATX, INC.-MOD-2021-081859 (E2B Linked Report).; Sender''s Comments: based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded. MODERNATX, INC.-MOD-2021-081859:Crossed linked


VAERS ID: 1255977 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Electrocardiogram, Full blood count, Hypoaesthesia, International normalised ratio, Metabolic function test, Pain, Pain in extremity, Peripheral swelling, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On 4-22-2021 the following tests were conducted. They were CBC, CMP, PT INR, EKG, and US leg duplex venous left. I was prescribed Xarelto afterwards.
CDC Split Type:

Write-up: On 4-20-2021 I felt a deep pain in my lower left leg that increased until I went to the hospital on 4-22-2021. The pain is a deep throbbing pain that has caused swelling to where I cannot feel most of my left foot. I went to the hospital around 3 p.m. and they found I have Deep vein thrombosis of distal end of left lower extremity.


VAERS ID: 1257378 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: I was born with SVT and had an ablation performed as a child.
Allergies: none
Diagnostic Lab Data: They drew blood work i''m not sure of the results.
CDC Split Type:

Write-up: I had normal covid vaccine sideffects throughout the night. Then around 8am my heart rate shot up in the 110 -120 bpm range. This remained at a high rate for several hours. In addition to this i was having severe heart palpitations. I ended up needing to go to urgent care where they gave me an iv of saline and beta blockers to slow my heart.


VAERS ID: 1257393 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-15
Onset:2021-04-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Atrial septal defect, Blood test normal, Cerebrovascular accident, Computerised tomogram head, Computerised tomogram thorax, Echocardiogram, Magnetic resonance imaging head abnormal, Scan with contrast abnormal, Thrombosis, Ultrasound Doppler
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tysabri Dalfampridine Bupoprion Gabapentin Baclofen Vitamin D Multivitamin Calcium Phentermine Quetiapine
Current Illness: None
Preexisting Conditions: Multiple Sclerosis
Allergies: Sulfa, levaquin, vitamin E, beeswax/propolis, fragrance mix II
Diagnostic Lab Data: Between 4-20 and 4-25 I underwent numerous blood tests, CT scans of brain and chest, CT-A scan, two MRI w/wo contrast, multiple blood tests, echocardiogram, transesophageal echocardiogram, Doppler ultrasound deep veins bilateral lower extremities. All lab results came back within normal ranges. MRI showed 4 strokes. TEE included Injection of agitated saline documented a small right to left interatrial shunt. Probable small PFO present. The cardiologist said that approximately 20% of the general population has a small PFO. I probably had it all my life. It is so small that it did not show on the regular echocardiogram - only on the TEE. Final diagnosis is ?cryptogenic stroke?. They have no idea why my blood is clotting.
CDC Split Type:

Write-up: 5 days after I had the second dose of the Pfizer Covid vaccine, I had blood clots that caused several strokes. I have normal cholesterol, normal blood pressure, normal A1C and other diabetes measures, and my blood was tested for multiple things to identify what caused the clotting. Every single test came back within normal limits. The ONLY thing that changed was that vaccine. And it was 5 days after the second dose. The doctors cannot figure out why I had a stroke.


VAERS ID: 1257423 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Influenza like illness, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Flu-like symptoms for 24-36 hours. Chills, exhaustion, muscle aches, fuzzy head. Also sore arm persisted for 5 days


VAERS ID: 1257624 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-04-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Epistaxis, Oropharyngeal discomfort
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)

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

Write-up: Dizziness, severe nose/throat bleed


VAERS ID: 1257929 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-31
Onset:2021-04-20
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Full blood count, Immunoglobulin therapy, Laboratory test, Lumbar puncture, Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirizine
Current Illness: none
Preexisting Conditions: none
Allergies: Compazine Sulfa drugs
Diagnostic Lab Data: CBC, Chem, Lumbar Puncture
CDC Split Type:

Write-up: Patient treated with IVIG infusion daily x 5 days Symptoms reduced but not resolved


VAERS ID: 1258284 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pain, Sleep disorder, X-ray normal
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: pt had her J & J vaccine at medical center- on april 8th ... on the 20th , she developed arm pain, in the same arm, lower than where the shot went in. she also said it "burned" when she got the shot. she has had extreme pain, hasn''t slept in 6 nights. went to ER on 21st, and did telemedicine with NP on 24th. xray was negative.


VAERS ID: 1260578 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood glucose decreased, Blood urine present, Contusion, Dizziness, Feeling abnormal, Haematochezia, Headache, Heavy menstrual bleeding, Hypertension, Menstrual disorder, Platelet count normal, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal haemorrhage (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax 25mg x2 daily
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I have severe, random, and unprovoked bruising covering both legs. I have abdominal pain that has persistent since being vaccinated. I?m dizzy. I?m bleeding in my urine, stool, and vaginally. Period came early (unrelated to previous vaginal bleeding) and is not clotting. Just significant amounts of red blood, soaking through one ultra absorbency tampon an hour. I have a headache. Went to the ER and my platelets were (345) and my blood sugar low. My bp was 145/90 which is high for me, from the bleeding. They said I have a ?higher chance of being bitten by a shark? than having a side effect. They diagnosed me with a single contusion and sent me home. Have been feeling worse since leaving the hospital.


VAERS ID: 1260996 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

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

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

Write-up: Woke up with lower back pain, thought it would go away in a couple of days but still have it Period came 5 days early, the morning after the vaccine (trying to conceive so am monitoring).. has had a heavier flow than normal. I also am on day 6 and it hasn?t gotten lighter with still bright red blood which doesn?t usually happen


VAERS ID: 1261342 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-20
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Burning sensation, Fatigue, Headache, Polymerase chain reaction
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Leukemia (History of leukemia with low platelet count .Has treatment for leukemia.)
Preexisting Conditions: Medical History/Concurrent Conditions: Platelet count low; Comments: No known drug allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210101; Test Name: PCR; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210442569

Write-up: BURNING SENSATION ON LEG; SEVERE ABDOMINAL PAIN; HEADACHE; FATIGUE AND TIRED; This spontaneous report received from a parent concerned a 55 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included low platelet count, and concurrent conditions included leukemia, and other pre-existing medical conditions included no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch no was not reported and has been requested. No concomitant medications were reported. On 01-JAN-2021, Laboratory data included: PCR (NR: not provided) NEGATIVE. On 20-APR-2021, the subject experienced burning sensation on leg. On 20-APR-2021, the subject experienced severe abdominal pain. On 20-APR-2021, the subject experienced headache. On 20-APR-2021, the subject experienced fatigue and tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from burning sensation on leg, severe abdominal pain, headache, and fatigue and tired. This report was non-serious.


VAERS ID: 1261347 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-20
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210443282

Write-up: FLU-LIKE SYMPTOMS; WHOLE BODY ACHES; CHILLS; HEADACHE; FEVERISH; This spontaneous report received from a patient concerned a 20 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-APR-2021, the subject experienced flu-like symptoms. On 20-APR-2021, the subject experienced whole body aches. On 20-APR-2021, the subject experienced chills. On 20-APR-2021, the subject experienced headache. On 20-APR-2021, the subject experienced feverish. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from flu-like symptoms, whole body aches, headache, feverish, and chills. This report was non-serious.


VAERS ID: 1261449 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-20
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Gait disturbance, Hypoaesthesia, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448523

Write-up: SEVERE BACK PAIN; SEVERE MUSCLE PAIN IN LEGS; TINGLING OF LEGS; NUMBNESS IN LEGS; DIFFICULTY IN WALKING/LIMPING; This spontaneous report received from a pharmacist concerned a 50 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and expiry: 21-Jun-2021) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-APR-2021, the subject experienced severe back pain. On 20-APR-2021, the subject experienced severe muscle pain in legs. On 20-APR-2021, the subject experienced tingling of legs. On 20-APR-2021, the subject experienced numbness in legs. On 20-APR-2021, the subject experienced difficulty in walking/limping. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe back pain, severe muscle pain in legs, tingling of legs, difficulty in walking/limping, and numbness in legs. This report was non-serious.


VAERS ID: 1261520 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-23
Onset:2021-04-20
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dysautonomia; Neurocardiogenic syncope; Orthostatic hypotension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Feels dizzy while walking; Can not get up; Bad chills in night and Teeth chattering; Passed out for couple of hours; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out for couple of hours) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Dysautonomia, Neurocardiogenic syncope and Orthostatic hypotension. On 23-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 20-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (Passed out for couple of hours) (seriousness criterion medically significant) and CHILLS (Bad chills in night and Teeth chattering). On 21-Apr-2021, the patient experienced DIZZINESS (Feels dizzy while walking) and ASTHENIA (Can not get up). At the time of the report, LOSS OF CONSCIOUSNESS (Passed out for couple of hours) and DIZZINESS (Feels dizzy while walking) had not resolved and ASTHENIA (Can not get up) and CHILLS (Bad chills in night and Teeth chattering) outcome was unknown. There was no treatment information provided. Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, her concurrent medical conditions of Dysautonomia, Neurocardiogenic syncope and Orthostatic hypotension are cofounders.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded. However, her concurrent medical conditions of Dysautonomia, Neurocardiogenic syncope and Orthostatic hypotension are cofounders.


VAERS ID: 1261527 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cough, Generalised tonic-clonic seizure, Migraine, Myalgia, Nausea, Pruritus, Vaccination site pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPAKOTE; TEGRETOL; TRAZODONE; POTASSIUM GLUCONATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Seizures
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: two grand mal seizures; migraine; under skull feels like it itches; persistent cough; body aches; chills; pain at vaccination site; extreme n/v; extreme n/v; This spontaneous case was reported by a consumer and describes the occurrence of GENERALISED TONIC-CLONIC SEIZURE (two grand mal seizures) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Seizures. Concomitant products included VALPROATE SEMISODIUM (DEPAKOTE), CARBAMAZEPINE (TEGRETOL), TRAZODONE and POTASSIUM GLUCONATE for an unknown indication. On 20-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, the patient experienced GENERALISED TONIC-CLONIC SEIZURE (two grand mal seizures) (seriousness criterion medically significant), MIGRAINE (migraine), PRURITUS (under skull feels like it itches), COUGH (persistent cough), MYALGIA (body aches), CHILLS (chills), VACCINATION SITE PAIN (pain at vaccination site), NAUSEA (extreme n/v) and VOMITING (extreme n/v). On 20-Apr-2021, VACCINATION SITE PAIN (pain at vaccination site) had resolved. At the time of the report, GENERALISED TONIC-CLONIC SEIZURE (two grand mal seizures), MIGRAINE (migraine), PRURITUS (under skull feels like it itches), COUGH (persistent cough), MYALGIA (body aches), CHILLS (chills), NAUSEA (extreme n/v) and VOMITING (extreme n/v) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication: Norco 10mg, Zofran 8mg, Tylenol, Motrin. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Patient''s hx of seizures and conmeds of Depakote, tegretol, trazadone, and potassium gluconate are confounding factors that may play a possible contributory role to the event PT seizures. .; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Patient''s hx of seizures and conmeds of Depakote, tegretol, trazadone, and potassium gluconate are confounding factors that may play a possible contributory role to the event PT seizures. .


VAERS ID: 1262108 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-03
Onset:2021-04-20
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

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

Write-up: Around 4/20/2021 developed itching along left jawline. Progressed to rash and bumps along left jawline/chin and rash and bumps above left temple near left eye (this area was sensitive). Itching continued and worsened. 4/23/2021 had telehealth visit - suspected shingles and was started on Valtrex 1,000mg three times daily. By 4/25/2021, rash had mostly resolved along left jaw/chin and above temple near left eye ..still some slight itching (but improved). By 4/26/2021, rash, bumps and itching nearly completely resolved.


VAERS ID: 1262156 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-19
Onset:2021-04-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Eructation, Flatulence
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10mg of Prozak, 100mg of Magnesium Glycinate, 2500 IU of Vitamin D3.
Current Illness:
Preexisting Conditions: Hemochromatosis and Factor 7 Deficiency.
Allergies: Keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Esophagus/stomach (center of chest) tightness/pain/pressure accompanied by some burping gas, but mostly painful. Lasted about 8 hours.


VAERS ID: 1262175 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Other       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: NONE REPORTED
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Allergies: NKA
Diagnostic Lab Data: NA
CDC Split Type: TX29

Write-up: 1ST DOSE MODERNA 2ND DOSE PFIZER


VAERS ID: 1262566 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-17
Onset:2021-04-20
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Limb discomfort, Mass, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (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: levothyroxine 75mcg
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: My husband is a nurse and kept an eye on it. My sister has a PhD in Nursing and she is keeping a watch on my symptoms as well. I have not gone to a facility for treatment.
CDC Split Type:

Write-up: Blood clot in my left forearm. I first noticed it on 4/20 around 7pm. There was a bump (the size of a dime) and small bruise. Overnight the bump got a bit smaller and the bruise expanded. Over the next several days the bump kept diminishing. The bruise remained about the same size and kept getting darker. It?s been one week now and the bump is very tiny (size of a small pea), and the bruise is incredibly dark, but showing more of a healing process color.


VAERS ID: 1262581 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Thrombophlebitis superficial, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: multi-vitamin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: ultrasound
CDC Split Type:

Write-up: Developed superficial leg clot on leg leg from ankle to grion


VAERS ID: 1263361 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Apallic syndrome, CSF lymphocyte count increased, Gait disturbance, Headache, Language disorder, Lumbar puncture abnormal, Magnetic resonance imaging head abnormal, Pleocytosis, Viral test, White matter lesion
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Malignant lymphomas (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buproprion, Vraylar, Dextroamphetamine-amphetamine, Disulfarim, Lithium, Naltrexone, Topiramate, Liraglutide, olpidem, Mirtazapine, Minocycline, Levothyroxine.
Current Illness: See below.
Preexisting Conditions: Reported histories of hypothyroidism, Small-fiber polyneuropathy treated with IVIg infusions, Depression, Anxiety Disorder, ADHD, Celiac Disease, questionable history of Lyme Disease, and PANDAS.
Allergies: Gluten, Sulfamethazine.
Diagnostic Lab Data: MRI brain as noted above, concerning for autoimmune process such as acute disseminated encephalomyelitis, or less likely a toxic leukoencephalopathy (4/24/2021). Lumbar puncture with lymphocytic pleocytosis (63 lymphocytes/microliter, 88% lymphocytes) (4/24/2021). CSF viral infectious disease panel (Biofire Meningoencephalitis Panel) (4/24/2021).
CDC Split Type:

Write-up: Approximately 10-11 days after receiving the vaccine, the patinet began to complain of severe headaches. Around day 11-12, she was noted by family to have deterioration in ambulatory function and language skills, prompting a visit to a local ED. By day 13 she had lapsed into a vegetative state in which she could only yawn, moan and occasionally open eyes. MRI brain demonstrated significant, confluent T2 intensities in the subcortical white matter of the bilateral cerebral hemispheres.


VAERS ID: 1263890 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-04-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoacusis, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: I had a call with a primary care NP. She has referred me to an ENT. I am currently waiting for that appointment.
CDC Split Type:

Write-up: Tinnitus in both ears, worse in the left ear. The condition began as a periodic whooshing sound in one ear that lasted for a day or two, after which it became a constant ringing in both ears. I have not had tinnitus previously. Prior to the condition, I was not exposed to any loud sounds. I work from home at a desk in a quiet room and have done so for years.


VAERS ID: 1264695 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Nausea, Pain in extremity, Paraesthesia, Photophobia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMINS [VITAMINS NOS]
Current Illness: Egg allergy; Food allergy (dairy); Shellfish allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Food allergy (different food when she was a child); Hysterectomy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Numbness of face and lip; Face tingling; Felt sensitive to light; Nauseous; Really bad headache, left side of face; Arm soreness; This spontaneous case was reported by a consumer and describes the occurrence of HYPOAESTHESIA (Numbness of face and lip) and PARAESTHESIA (Face tingling) in a 39-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Hysterectomy. Concurrent medical conditions included Shellfish allergy, Egg allergy, Food allergy (dairy) and Food allergy (different food when she was a child). Concomitant products included MULTIVITAMINS [VITAMINS NOS] for an unknown indication. On 20-Apr-2021 at 12:00 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Apr-2021, the patient experienced PAIN IN EXTREMITY (Arm soreness). On 20-Apr-2021 at 12:00 PM, the patient experienced HEADACHE (Really bad headache, left side of face). On 21-Apr-2021, the patient experienced HYPOAESTHESIA (Numbness of face and lip) (seriousness criterion medically significant), PARAESTHESIA (Face tingling) (seriousness criterion medically significant), PHOTOPHOBIA (Felt sensitive to light) and NAUSEA (Nauseous). At the time of the report, HYPOAESTHESIA (Numbness of face and lip), PARAESTHESIA (Face tingling), PAIN IN EXTREMITY (Arm soreness), PHOTOPHOBIA (Felt sensitive to light), HEADACHE (Really bad headache, left side of face) and NAUSEA (Nauseous) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment medication included ibuprofen. Based on the information provided which includes a temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship with the product use cannot be excluded. Headache and nausea are consistent with the known safety profile of the product.; Sender''s Comments: Based on the information provided which includes a temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship with the product use cannot be excluded. Headache and nausea are consistent with the known safety profile of the product.


VAERS ID: 1265617 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dermatitis, Rash, Sensitive skin, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine, bupropion, busiprone, Vyvanse, trinessa
Current Illness:
Preexisting Conditions: Depression, PTSD, anxiety
Allergies: Penicillin, amoxicilin, sulfa, hydroxyzine
Diagnostic Lab Data: No medical tests performed. Doctor advised to seek treatment at urgent care facility.
CDC Split Type:

Write-up: Rash formed on the back side of my right thigh probably 4-6 hours after receiving vaccine. Rash has intensified over time. One week after receiving the first dose, the area of the rash increased in size, turned darker in color, and the skin became more inflamed and sensitive.


VAERS ID: 1265645 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-20
Onset:2021-04-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal distension, Dysmenorrhoea, Fatigue, Heavy menstrual bleeding, Impaired work ability, Menstruation irregular, Mood swings, Sleep disorder
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: I ended up starting my period April 20, 2020 (same day I got the vaccine) and it was the heaviest cycle I''ve had in years. I went through several tampons in a day for about a week til my period abruptly stopped on April 26, 2020. It started about 2 hours after the vaccination. I usually don''t cramp but I was having problems sleeping because of how bad it got. I was also more bloated than my usual cycles. I dealt with extreme fatigue, I slept a lot that week and I did the bare minimum that week at work (which is unusual for me). I also don''t usually have mood swings but I felt like my hormones were a bit intense to the point I kept snapping at people even though I like to think of myself as level-headed.


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