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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 22 out of 5,069

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VAERS ID: 1478363 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dysphonia, Feeling abnormal, Hypoaesthesia, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: Nuts-anaphylaxis, Sulfa drugs-hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began feeling tingling in her arm, felt left side of face go numb. Stated she just didn''t feel right. Then stated her throat was starting to close up and became hoarse. EPI was administered x 1 at clinic and patient transported to ED where she was observed and discharged on Prednisone.


VAERS ID: 1478399 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

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

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: "Pt c/o of facial and tongue numbness 5 minutes after receiving his vaccine. Denies any hx of allergies or taking any medication. Negative for hives or tongue/throat swelling. Denies difficulty swallowing or breathing. Water, juice, and Graham crackers given. Vital sign stable BP 115/87, HR 71, RR16, SPO2 100%. Symptoms resolved 45 min later. ER precaution advised. Pt d/ced in stable condition. "


VAERS ID: 1478425 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Patient and guardian confirmed DOB and stated his age as 18 years old. Patient did not present his ID. We will implement a strategy of showing a birth certificate if photo ID is not readily available.


VAERS ID: 1478466 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Injection site erythema, Myalgia, Palpitations, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Swollen arm, Redness at injection site Heart palpitations Fatigue Muscle soreness Loss of appetite Headache Chills


VAERS ID: 1478476 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2020-12-19
Onset:2021-07-14
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

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

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

Write-up: Fully vaccinated and tested positive for Covid-19


VAERS ID: 1478483 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL7533 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Lymphadenopathy, 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: OCP
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type: N/A

Write-up: fatigue, fever, chills, body aches, left axillary lymphadenopathy


VAERS ID: 1478491 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Feeling abnormal, Injection site erythema, Injection site warmth
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine, Levothyroxine, Glycopyrrolate, gabapentin, tizanidine, doxepin, Simvastatin, Lisinopril, Naproxen, Duloxetine
Current Illness: Hypothyroidism, hyperlipidemia, hypertension, fibromyalgia
Preexisting Conditions:
Allergies: Morphine and Codeine
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient came in to office on 07/14/2021. Patient came up to vaccine table and presented her Covid vaccine card to care person. Patient?s vaccine card was given to care person. Once care person saw patient''s Covid vaccine card we saw the card had the first and second dose of the Moderna covid vaccine was documented on the card from facility; the card was stamped twice from said facility. Patient was asked by care person if she had in fact received both covid vaccnine doses. Patient stated the vaccine stamps for both doses were done on the same day. Patent stated she had her first vaccine shot back in march and was not able to get second shot due to forgetting that the she had to go back. Pateint asked if she had to start all over with getting the vaccine administered. I and care person informed patient that if she had ?only one shot she did not have to start over, we can administer second shot today?. I asked patient ?if she was sure that she was administered only one shot from previous facility even though her card stated she was given both doses.? Patient stated she only received one shot, so we stated we could administered the second shot. After second shot was administered, patient?s original vaccine card was returned. We then also gave patient a new card showing that we administered her second dose of the Covid Vaccine Moderna. Patient was then informed to wait the 15 minutes in room to be monitored. After all shots were given for the clinic was completed. I then started entering information into system. I looked up patient and saw that two doses of the covid vaccine was already inputted into system showing patient had received both covid vaccine shot previously before coming into clinic today. I noticed system entry for both shots were from the same facility patient had on her original vaccine card. I told care person we discuss it and decided that our plan was to wait for coordinator to come back to office to discuss further action. COVID coordinator I called patient to confirm story, the patient expressed the same details as noted above. I requested for the patient to e-mail me a copy of her original card for documentation and the patient said she was on her way out she would stop by the office. When the patient got here, she showed me her card and all dates and lot numbers on card matched what was in system. I expressed to patient that if this were incorrect documentation by the facility, we would need to call them and have them fix it so that we may document her second vaccine. As I was giving the phone number to the patient, she begins to tell me that she does have a bad memory and she may have received the second dose already. I asked patient how she was feeling and requested to see the injection site. I did not see anything out of the ordinary, a little redness and warmth at the site. Patient stated that she was feeling bad on 07/15/2021 the day after vaccine administration, took some Tylenol and rested the rest of the day. Feels much better today. I expressed to patient that if ANYTHING changes, she needs to go straight to the ER and to call me after she was taken care of. Patient understood.


VAERS ID: 1478524 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-07-14
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0153 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough, Decreased appetite, Dyspnoea, Fatigue, Hyperglycaemia, Malaise, Metabolic acidosis, Pain, Pneumonia, Pyrexia, Renal impairment, SARS-CoV-2 test positive, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: carvedilol, levothyroxine, insulin lispro, lisinopril, isosorb
Current Illness:
Preexisting Conditions: Type 2 diabetes, chronic kidney disease, hypertension
Allergies: No known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: First dose of Pfizer COVID-19 vaccine on 3/22/2021, followed by the 2nd dose on 4/12/2021. 7/14/21: Patient arrived to ER with COVID symptoms after testing positive on 7/7/2021. Per ER records, the patient received the positive result on 7/10/21 and went to see his PCP who prescribed the patient a Zpack and cough medicine. The patient finished the Zpack but was still having body aches, shortness of breath, fever, loss of appetite, and fatigue. 7.15.21: in the ED patient found to have hyperglycemia, anion gap metabolic acidosis, worsening kidney function, and multifocal pneumonia. Diagnosed with acute hypoxic respiratory failure due to COVID-19 pneumonia, sepsis secondary to COVID pneumonia. started on remdesivir


VAERS ID: 1478527 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Pruritus, Rash, Skin burning sensation, Swollen tongue, Tunnel vision
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Retinal 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received first Pfizer covid vaccine and subsequently developed large rash within 15 minutes of receipt of the vaccine. Due to prior reactions to vaccines, the patient was taken to the emergency department. Patient reported tunnel vision, burning feeling on skin with itching, numb lips, tongue and hands. Patient had rash across neck, chest, arms, and back as well as tongue swelling. Patient had taken benadryl 50mg prior to immunization and an additional 50mg of benadryl upon feeling reaction.


VAERS ID: 1478575 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-09
Onset:2021-07-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen abnormal, Deep vein thrombosis, Full blood count, Metabolic function test, Nausea, Pelvic venous thrombosis, SARS-CoV-2 test, Ultrasound Doppler abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: UTI, Urinary Retention,
Preexisting Conditions: Hypertension, Dementia, Heart disease, Renal disease and GI disease
Allergies: None reported
Diagnostic Lab Data: Abd. CT , Venous Doppler, CBC, BMP, and SARSCoV2 RNA test
CDC Split Type:

Write-up: Patient presented to ED for abdominal pain, nausea and vomiting. during CT of the abdomen and pelvis a finding suspicious for DVT in the left external iliac vein and left common femoral vein. External venous doppler was done to confirm DVT. impression : Acute DVT throughout the left lower extremity extending from the left lower calf to the left common femoral vein. Patient has been admitted to Medical floor for care


VAERS ID: 1478579 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA FA6780 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Paroxetine Simvastatin Lisinopril
Current Illness: N/A
Preexisting Conditions: Depression, HTN, Dyslipidemia
Allergies: NKDA
Diagnostic Lab Data: ER Evaluation and treatment
CDC Split Type:

Write-up: Fever of 103.9 1 day after, coming down after ER treatment


VAERS ID: 1478581 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-11
Onset:2021-07-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Pt called on 7/16/2021 stated that they received the vaccination on 7/11/21 in their left arm. On Wednesday 7/14/21 they started having a tingling in their right hand. Upon calling their Dr they where instructed to call the pharmacy were the received the vaccine.


VAERS ID: 1478602 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Fatigue, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: CHEST PAIN, SORE THROAT, FATIGUE, SEVERE CHEST PAIN


VAERS ID: 1478628 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-01
Onset:2021-07-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site induration, Irritability, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Hard lump in left arm near injection site. Swollen lymph node. Slight fever. Irritability. Tiredness


VAERS ID: 1478659 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Nervousness, Respiration abnormal
SMQs:, Acute central respiratory depression (broad), Respiratory failure (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: MVI
Current Illness:
Preexisting Conditions: none
Allergies: vanco
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received dose 1 of the Pfizer COVID vaccine (lot EW0191) at approximately 1715. At 1730, Paramedic noted patient yawning and fidgeting with her mask. Paramedic approached patient who reported heavy breathing and anxiety. PHN approached to assess and noted no diaphoresis, work of breathing, or use of accessory muscles. Patient moved to zero-gravity chair, monitored by Paramedic and PHN, and was laid supine. Vital signs: O2 98%, pulse 96, respirations 18. At 1735, vital signs: blood pressure 130/76, pulse 76. PHN offered patient Benadryl but patient declined. Patient reported she has an anaphylactic allergy to Vancomycin, she takes a multivitamin, and she does not have any medical conditions. Patient reported she had eaten at 11am but only drank approximately 8oz of fluids. PHN provided water and patient drank it. At 1740, temperature 97.9 degrees F. At 1747, PHN noted a decrease in heavy breathing. Vital signs: blood pressure 124/82, pulse 76, O2 99%, respirations 16. Patient reported feeling "shaky," PHN noted no visible or palpable tremors. Patient provided and drank juice. Patient reported decreased anxiety and that symptoms had resolved. PHN encouraged patient to follow up with provider and when to contact 911. At 1757, vital signs: blood pressure 120/78, respirations 16, pulse 74, O2 97%. Patient stood up slowly, monitored by PHN and Paramedic, and reported no symptoms. Patient left walking with steady gait at 1800.


VAERS ID: 1478674 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-21
Onset:2021-07-14
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Pain in extremity, Panic attack, Tension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron supplement, magnesium supplement, vitamin C & B complex, vitamin D
Current Illness: None
Preexisting Conditions: Anemia
Allergies: Penicillin, Amoxocillin, etc; Erythromycin(?), Terbinafine
Diagnostic Lab Data: None were done because the reaction wasn''t harmful.
CDC Split Type:

Write-up: I had a minor reaction to the injection at the time of both doses. Less than 5 minutes after receiving the shot, I experienced the physical effects of a panic attack despite my relatively calm attitude about the vaccine: I felt very tense, my heartbeat sped up, and I was slightly short of breath. As well as I can recall, I''ve never had a panic attack before in my life. The reaction lasted a few minutes longer the first time than the second time, with both durations in the 10-15 minute range. Neither caused any problems, and I did not have any noticeable subsequent effects beyond arm soreness. However, almost 2 months later, this past Wednesday night, I opted to kiss someone for the first time with both of our mouths open. Not instantly, but again, less than 5 minutes after the kiss, I had the physical sensation of a panic attack. I had not been nervous at all about the kiss or the person, and I was not expecting any form of discomfort to follow. But the effect felt exactly the same as the reaction I''d had to the Moderna vaccine, and it lasted roughly the same amount of time.


VAERS ID: 1479060 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-10
Onset:2021-07-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 005CC21A / 1 - / IM

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

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

Write-up: Rash on arm, round circle at the site of the immunization (covid arm)


VAERS ID: 1479073 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-28
Onset:2021-07-14
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 7/15/21 - Covid Test (Rapid) 7/15/21
CDC Split Type:

Write-up: Covid positive after vaccination.


VAERS ID: 1479085 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-03-25
Onset:2021-07-14
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / SYR

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

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

Write-up: patient developed mild symptoms on 7/14/21 and tested positive for covid on 7/15/21


VAERS ID: 1479265 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-14
Onset:2021-07-14
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test normal, Chest X-ray normal, Chest discomfort, Chest pain, Decreased eye contact, Echocardiogram, Electrocardiogram normal, Insomnia, Loss of personal independence in daily activities, Moaning, Pericarditis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: arthritis medication
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG, chest x-ray, heart ultrasound and blood work all came back normal.
CDC Split Type:

Write-up: My husband woke up from chest pain around 2:30 am on 7/14/2021. He wasn''t able to sleep and struggled to function the next day. He describes the pain as feeling like his muscles are pushing against his rib cage. He was most comfortable when he would sit upright. Laying down made it worse. He also felt pain in his upper back. I have never seen him in so much pain. He was moaning and had difficulty sustaining eye contact with me. The second night on 7/15/2021 he again barely slept due to the pain. He was able to briefly fall asleep sitting up. On 7/16/2021 I took him to his doctor where we saw a physicians assistant. She advised we go to the ER since he was having chest pain. At medical center Doctor suspected pericarditis after hearing my husband''s symptoms. The doctor said it usually occurs after and infection and my husband has not been treated no has had any infection in many years. All of the test they ran came back clear showing no heart issues. My husband was given narco while in the ER for the pain, but it did not help.


VAERS ID: 1479613 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site erythema, Injection site urticaria, Mass, Pain, Pain in extremity, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The following day I had a round, itchy, painful, red lump. It is hot to the touch. Very painful if arm rubs against something. But today, 3 days later, it seems to be spreading. At least 5 inches uneven n 5 inches across but going to back of arm. It feels like a big lump that''s very hot to touch. There are also white marks in red area like hives?


VAERS ID: 1479622 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chills, Gait disturbance, Influenza like illness, Injection site pain, Muscle tightness, Pain
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: Suboxone Film (Buprenorphine/Naloxone)
Current Illness: N/A
Preexisting Conditions: Opioid Dependence
Allergies: Pollen (Seasonal Allergies)
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started feeling flu-like symptoms around 14 hours after the second vaccine. Each symptom occurred at the same time at 03:37 AM on July 14, 2021. The symptoms included achiness, cold shivering, slightly elevated temperature (100.8 ?F), and almost complete muscular tension in arms and legs. It made it difficult to walk. I took a mixture of Tylenol (acetaminophen) and Advil available in one tablet. I took 2x of these, drank plenty of fluids, and went to bed around 05:15 AM on Wednesday, July 14, 2021. I had a heating blanket along with a microwave bean bag to keep myself warm. I woke up at 1:45 PM with most side effects subsiding, besides vaccine injection site still remaining sore.


VAERS ID: 1479636 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Sudden and brief severe headaches right side of head since vaccine - started approx 18 hours after vaccine administration and continues every 10-15 minutes.


VAERS ID: 1481258 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Migraine with aura
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210730541

Write-up: SINUS PRESSURE; CHEST TIGHTNESS; CAN''T CATCH BREATH; This spontaneous report received from a patient concerned a 21 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included migraine with aura. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 07-AUG-2021) dose was not reported, administered on 13-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the subject experienced sinus pressure. On 14-JUL-2021, the subject experienced chest tightness. On 14-JUL-2021, the subject experienced can''t catch breath. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sinus pressure, chest tightness, and can''t catch breath. This report was non-serious.


VAERS ID: 1481279 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Military       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210731394

Write-up: HEADACHE; This spontaneous report received from a patient concerned a 50 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 13-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.


VAERS ID: 1481281 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210714; Test Name: Body temperature; Result Unstructured Data: 100.2 F
CDC Split Type: USJNJFOC20210731450

Write-up: FEVER OF 100.2F; This spontaneous report received from a consumer concerned a 21 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin was not reported, batch number: unknown) dose was not reported, administered on 13-JUL-2021 15:00 for prophylactic vaccination. The batch number was not reported. The Company was unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 14-JUL-2021, the subject experienced fever of 100.2f. Laboratory data included: Body temperature (NR: not provided) 100.2 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever of 100.2f was not reported. This report was non-serious.


VAERS ID: 1481308 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210733678

Write-up: MUSCLE TIGHTNESS IN LEG; HEADACHE; FEVER; NAUSEA; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 14-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the subject experienced headache. On 14-JUL-2021, the subject experienced fever. On 14-JUL-2021, the subject experienced nausea. On 15-JUL-2021, the subject experienced muscle tightness in leg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle tightness in leg, and the outcome of headache, fever and nausea was not reported. This report was non-serious.


VAERS ID: 1481314 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema
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: Site: Redness at Injection Site-Medium


VAERS ID: 1481331 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CVS 10048 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose increased, Condition aggravated
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: Ozempic Altenol Crestor Wellbutrin Multi-vitamin Vitamin D Zyrtec Vitamin C
Current Illness: Long haul Covid Tinnitus Migraines
Preexisting Conditions: Diabetes Type II (MODY) High blood pressure High cholesterol GERD
Allergies: Sulfa drugs Lipitor Zocor buyduren Wheat Bees
Diagnostic Lab Data: Self monitoring
CDC Split Type:

Write-up: High blood sugar (250-350 range) going on 3 days now. This also occurred after getting Covid but otherwise has been well controlled for years. Will probably need to seek medical assistance if it continues more than a couple of more days or gets much higher.


VAERS ID: 1481333 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-07-14
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81mg daily, candesartan-hctz 16-12.5mg daily, D3-2000u daily, folic acid 0.5mg daily, Metformin 1000mg BID, Crestor 20mg daily, CoQ10 2 tab daily, Amlodipine 10mg daily, Metoprolol 25mg BID, Klor-con 20mEq BIW
Current Illness:
Preexisting Conditions: Hypertension, Diabetes type II
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient vaccinated with 2 doses Pfizer vaccine (3/2021 and 4/2021) and hospitalized with acute respiratory failure with hypoxia due to covid pneumonia in July 2021


VAERS ID: 1481340 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0161 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women?s multi vitamin, magnesium supp, biotin and collagen supp, occasional vitamin d
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, chills, sweats, headache, neck ache , weakness, nausea


VAERS ID: 1481387 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-09
Onset:2021-07-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood pressure pill
Current Illness: Two months ago influenza a
Preexisting Conditions: Asmtha
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain like when I had covid


VAERS ID: 1481423 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Muscle spasms, Nausea, Night sweats, Panic attack, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma and iron deficiency anemia
Allergies: Iodine, red dye, latex, shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash across chest and neck (about three minutes after the shot, went away an hour later), fever 103.5 by 3pm that day, nausea and vomiting by 8pm, panic attacks and night sweats throughout the night and the following day. Fever wouldn?t break with Tylenol for two days. Cramping in left calf to present day.


VAERS ID: 1481456 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM

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

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

Write-up: Patient reported swelling and redness at injection site. She said it was hot to the touch and was very itchy.


VAERS ID: 1481471 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

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

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

Write-up: Patient and caregiver deliberately misled staff with regard to age of patient.


VAERS ID: 1481532 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Right after receiving a shot I asked the patient to have a seat for 15 min, about a min later patient fainted, syncope, on the chair for about half a min. While I was calling 911 he became conscious and refused ambulance. While already being conscious pt started to sweat. I was told after that he didn''t eat since the day before. A person who accompanied him gave him orange juice and chocolate. In about 10-15 min pt returned to normal. Another 15 min and he left.


VAERS ID: 1481600 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C2A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Fall, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had a syncopal event a few minutes after receiving his COVID-19 Moderna vaccine. He was seated in a chair for a 15 minute observation period. He fell off the chair onto his side. He regained consciousness within about 10 seconds of falling off the chair. He was placed in a supine position with legs elevated. He was given water. He denied any pain associated with fall. Denied any symptoms of itching, swelling, cardiac, or GI complaints. He was alert and oriented x4 with color and temperature within normal limits. After 10 minutes lying down, he was assisted into a chair for further observation. He denied any further symptoms and was discharged after an additional 15 minute observation. He was advised to seek emergent care if he experienced any worsening symptoms.


VAERS ID: 1481624 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-01
Onset:2021-07-14
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pyrexia, Respiratory symptom, SARS-CoV-2 test positive, Upper respiratory tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 7/15/21 covid-19 positive
CDC Split Type:

Write-up: Onset of URI symptoms with fever, after traveling. Return flight 7/13/21. Symptom onset 7/14/21


VAERS ID: 1481684 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Electrocardiogram, Heart rate increased, Hypoaesthesia, Metabolic function test, Paraesthesia, Poor peripheral circulation, Pregnancy test negative, Sinus tachycardia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel Fe
Current Illness:
Preexisting Conditions:
Allergies: Hydrocodone
Diagnostic Lab Data: EKG, sinus tachycardia BMP, good Pregnancy test, negative
CDC Split Type:

Write-up: Hand Numbness and tingly. Wednesday Small symptoms kept going on. Blood flow to hands deteriorated. Couldn?t move feet, Feet became dusky. This all happened Thursday after symptoms became worse. Blood pressure elevated 175/100. Usually 110/70. Heart rate 170s generally 65-70. I was at work as a nurse and I about coded. Was taken to er.


VAERS ID: 1483750 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Eye pain, Eye swelling, Headache, Macular fibrosis, Myalgia, Neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Retinal disorders (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: covid 19 moderma 1st shot
Other Medications: levothyroxine, escitalopram, cimetidine, ezetism, chantix
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Muscle aches, severe headache around eyes, dizziness, balance loss, right side of face nerve pain including eyeball. Day 5 most symptoms have receded except the eye is now swollen and filling with film that has be removed.


VAERS ID: 1483777 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Fall, Head injury, Laboratory test, Skin laceration, Syncope, Wound haemorrhage
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Pt was vaccinated without issue. Pt advised to sit for 15 mins. After being in observation area for 5 mins, pt stood up and immediately fainted and fell to the floor hitting head on floor. Pt had some bleeding from small laceration on head. 9:50am VS BP 130/80, P 60. Rescue called and was brought to ED for evaluation since he hit his head.


VAERS ID: 1483798 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis
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: Zoloft, Strattera
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Appendicitis. Appeared on Saturday 7.17 after 1st dose was administered on 7.14. surgery to remove appendix on 7.18.21.


VAERS ID: 1483822 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-12
Onset:2021-07-14
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, Chronic kidney disease, Condition aggravated, SARS-CoV-2 test negative, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), 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), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, chlorthalidone, insulin, levothyroxine, losartan
Current Illness:
Preexisting Conditions: DM2, HTN, ASCVD, CKD
Allergies: none
Diagnostic Lab Data: SARS COVID2 7/14/21 13:41 - Detected, repeated at 19:46 Non Detected
CDC Split Type:

Write-up: Pt admitted for AKI on CKD COVID 19 swab positive as as screening test in the ED, repeat COVID test was negative on the same day (7/14/21) Hospitalized at Hospital


VAERS ID: 1483861 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

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

Write-up: Dizziness, Lightheaded, Brain fog


VAERS ID: 1483973 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Headache, Injection site pain, Malaise, Myalgia, Pain in extremity, Pharyngeal swelling, Swelling face
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenole, gabapentin, sensibal, alpram, mypole, trileptal
Current Illness:
Preexisting Conditions: Fybromyalgia, post herpetic neuralgia, trigeminal neuralgia
Allergies: Metal (thick needle)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swelling of my face and throat, dizziness, injection site pain, arm pain, headache, tiredness, muscle pain, feeling unwell, shortness of breath a little bit


VAERS ID: 1484018 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-05-01
Onset:2021-07-14
   Days after vaccination:74
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Malaise, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: Rapid test for Covid positive on 7/16/2021
CDC Split Type:

Write-up: Client was vaccinated with Moderna vaccines on April 1 and May 1* 2021. Client developed Covid symptoms and tested positive on 7/16/2021. Symptoms of Covid are mild. (fever x 1 day, runny nose, slight cough.) Reported to VAERS because client was fully vaccinated and developed Covid. *Client was not sure of exact dates of vaccines and states that they may be off by a day or two, but definitely a month between vaccines.


VAERS ID: 1484020 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-05
Onset:2021-07-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pain, Pain in extremity, Radiculopathy
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: denies
Current Illness: denies
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data: referral of out patient care and strict ER precautions
CDC Split Type:

Write-up: on 7/14 left deltoid pain with radiation and intermittent radiculopathy to LUE and Left hip. No trauma, no illness, no edema, no nv changes, increased with movement.


VAERS ID: 1484033 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-07-14
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Chest X-ray, Electrocardiogram
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Mild hypertension
Allergies: Cigarette smoke
Diagnostic Lab Data: All in hard copy form from Emergency Room done on 7/16. Includes EKG, Chest Xray,and many blood tests. I could send copies.
CDC Split Type:

Write-up: Extreme spike in blood pressure 230 systolic. First blood pressure reading since receiving vaccine. I was sent to Emergency Room. They found none of the usual suspects that cause this spike. Vaccination was my only new experience in many months. Never had near this high of a reading. Is there a connection?


VAERS ID: 1484035 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Fatigue, Glossodynia, Joint stiffness, Joint swelling, Migraine, Nausea, Oropharyngeal pain, Pharyngeal swelling, Swollen tongue, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: Edema in lower left leg migraines and anemia
Preexisting Conditions: Lower left leg edema migranes and anemia
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slightly swollen painful tongueand throat with the feeling of tightening in the throat, migraines got worse, vomiting, Nausea, extreme fatigue, swollen painful and tight shouldershoulderl


VAERS ID: 1484042 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Ear pain, Feeling hot, Flushing, Gingival blister, Glossodynia, Herpes zoster, Lip pain, Oral mucosal blistering, Paraesthesia oral, Sensitive skin, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: triamterene Hctz 75/50 Enalapril 5mg Metformin 500mg Simvastatin 20mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: sensation as injection was moving thru body-down left arm and across shoulder blade- till in evening -up neck, flushing of face-left side of tongue tingling, general heat from body, alternate with chills, lymph node behind left ear very sensitive, 2nd day sore developed in front of left ear and on top of left side of tongue and under tongue, still first day symptoms, 3rd day sores continue half way to lip in a line, still all other symptoms- 4th day- line of sores is to mouth and on chin of only left side mouth has numerous small blisters- gums, cheek, still other symptoms. 5th day worse on sores - diagnosed with Shingles


VAERS ID: 1484051 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood pressure orthostatic, Ear discomfort, Electrocardiogram abnormal, Hyperhidrosis, Menstruation normal, Mental status changes, Presyncope, Sinus bradycardia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: Emergency Room - Positive orthostatic and menstruation. 2Liters of fluid and discharged.
CDC Split Type:

Write-up: 5 minutes after vaccination monitoring client had blurred vision, diaphoretic X@ altered pressure in ear, and alter mental status. Had eaten lunch- chick-fila and had no medical HX Vitals taken twice P48, BP 100/50, R16 O2 96% EKG sinus bradia, Near Syncopal P53, BP 88/51, R 20, O2 98%


VAERS ID: 1484054 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure decreased, Condition aggravated, Dizziness, Headache, Nausea, Nervousness, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Client reported nausea, tingling in her left hand, and slight dizziness at 6:45ish. Vitals obtained at 6:53PM PM were as follows: BP 120/78, HR 71, O2 96%. The client reported a history of nausea when she is nervous. Client was provided an emesis bag. Vitals obtained at 6:58PM were as follows: BP 120/68, HR 65, and O2 98%. The client reported a history of hypotension. The client stated she has to be sure to stay adequately hydrated or she notices a decrease in her blood pressure. Current medications include Avapena. The client denied any s/s of anaphylaxis. At 6:55PM the client reported a headache. The client did eat today. At 7:02PM RN provided the client a cotton ball with peppermint oil on it to smell.. The client stated her headache was very light at 7:05PM. The client left at 07:10PM.


VAERS ID: 1484060 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-13
Onset:2021-07-14
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: on July 14th, patient had a massive ischemic stroke; no risk factors. Patient did have COVID infection February 2021


VAERS ID: 1484277 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chills, 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: Amlodipine, Atorvastatin, Bumetanide, Calcium Carbonate/Vitamin D, Coreg CR, Famotidine, Hydroxychloroquine, Losartan, Mycophenolate, Potassium Chloride. Prednisone, Tacrolimus, Vitamin D3
Current Illness:
Preexisting Conditions: Systemic lupus erythematosus
Allergies: Colchicine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, chills, headache, body aches, fatigue


VAERS ID: 1484435 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Chills, Decreased appetite, Dizziness, Fatigue, Feeling abnormal, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: approx 8 hours after vaccine started having nausea, vomiting, chills, fever, muscle aches. Since vaccine having constant fatigue, dizziness, brain fog, muscle and joint pain primarily in both knees, stomach pain and lack of appetite


VAERS ID: 1484508 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Dysphagia, Tongue disorder
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: vitals and PO diphenhydramine
CDC Split Type:

Write-up: patient complained of feeling pressure on her tongue when swallowing post vaccine. Patient given PO diphenhydramine and felt better


VAERS ID: 1484647 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-19
Onset:2021-07-14
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Headache, Nausea, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test date: 7/14/2021. Test performed: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT). Route: swab of internal nose Result: Positive.
CDC Split Type:

Write-up: Symptoms onset 7/15/2021: cough, sore throat, fever, chills, headache, nausea, vomiting, abdominal pain, loss of smell and loss of taste. Tested 7/14/2021 for COVID-19 after being in close contact with a positive case.


VAERS ID: 1484649 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-05
Onset:2021-07-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Miliaria
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: 2006, MMR, Tetanus, etc prior to entering college. Age 45
Other Medications: Vit c, d, b12, kyolic, cod liver oil
Current Illness: Allergies. Feeling like crap.
Preexisting Conditions: Stomach removed 2007, gallbladder removed 1990''s
Allergies: Bananas, all antibiotics except amoxicillin, mold, yeast, pollen, most if not all drugs, asphalt, industrial chemicals, etc
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7-14 "heat rash" in crotch, behind knees. Gets worse daily


VAERS ID: 1484653 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-07-14
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, Chills, Cough, Exposure to SARS-CoV-2, Headache, Nausea, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test date: 7/14/2021 Test performed: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT) Route: swab of internal nose Result: POSITIVE
CDC Split Type:

Write-up: Tested after being in close contact with a COVID + patient. Tested on 7/14/21. Sx onset was 7/15/2021 with cough, fever, chills, headache, sore throat, nausea, vomiting, abdominal pain, loss of smell & loss of taste.


VAERS ID: 1484683 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-07-12
Onset:2021-07-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Decreased appetite, Dry mouth, Fatigue, Feeling hot
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazadone, Prozac, Spironolactone, YAZ
Current Illness: N/a
Preexisting Conditions: Migraines Chronic Undiagnosed Right Flank Pain Kidney Stones Spinal Fusion 2020
Allergies: Doxycycline, Ibuprofen, Hydrocodone, Sulfa
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 30 minutes post Pfizer COVID-19 Vaccine, burning/warm sensation in chest for 2-3 minutes. No pain. Extreme Fatigue for 4 days post vaccine Severe Cotton Mouth for one week and ongoing Severe loss of apatite for a week and ongoing


VAERS ID: 1484691 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0196 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anion gap, Antineutrophil cytoplasmic antibody increased, Basophil count decreased, Blood calcium normal, Blood chloride normal, Blood creatine normal, Blood glucose increased, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Carbon dioxide normal, Computerised tomogram head, Ear pain, Eosinophil count normal, Glomerular filtration rate, Haematocrit normal, Haemoglobin normal, Immature granulocyte count, Lymphocyte count decreased, Mean cell volume, Neutrophil count, Neutrophil count increased, Paraesthesia, Platelet count normal, Red blood cell count normal, White blood cell count increased
SMQs:, Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Vasculitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D and vitamin C supplement
Current Illness: none
Preexisting Conditions: eczema
Allergies: none
Diagnostic Lab Data: Ref Range & Units 1 d ago WBC 3.7 - 11.1 K/uL 10.6 RBC''S 4.10 - 5.70 M/uL 5.23 HGB 13.0 - 17.0 g/dL 16.2 HCT 39.0 - 51.0 % 46.7 MCV 80 - 100 fL 89 RDW, RBC 12.0 - 16.5 % 11.7Low (L) PLT 140 - 400 K/uL 232 NRBC <=0 /100WC 0 Specimen Collected: 07/18/21 2:40 PM NEUTROPHILS % AUTO 42 - 76 % 79High (H) LYMPHS % AUTO 15 - 47 % 14Low (L) MONOS % AUTO 5 - 13 % 5 EOS % AUTO 0 - 7 % 1 BASO''S % AUTO 0 - 1 % 0 IMMAT GRANULO % AUTO 0 - 1 % 0 See comments ANC 1.8 - 7.9 K/uL 8.4High (H) PHOS 2.7 - 4.5 mg/dL 3.4 MG 1.7 - 2.3 mg/dL 2.0 CA 8.8 - 10.5 mg/dL 10.1 NA 135 - 145 mEq/L 138 K 3.5 - 5.3 mEq/L 4.0 CL 100 - 111 mEq/L 100 CO2 24 - 33 mEq/L 28 ANION GAP4 SERPL 5 - 16 mEq/L 10 BUN 7 - 27 mg/dL 12 GLUC 60 - 159 mg/dL 113 See comments CREAT <=1.34 mg/dL 0.92 GFR NONAFR AMER $g=60 mL/min $g60 GFR-AFRAM $g=60 mL/min $g60 COMMENT, GLOMERULAR FILTRATION RATE SEE Narrative CT HEAD WITHOUT CONTRAST ** HISTORY **: 27 years old, bilateral ear pain after Pfizer vaccine ** TECHNIQUE **: CT images of the head acquired without intravenous contrast. CTDI: 53.26 mGy DLP: 856.9 mGy-cm COMPARISON: 5/26/2018. ** FINDINGS **: BRAIN PARENCHYMA: No acute hemorrhage. No mass effect or herniation. Gray-white differentiation is maintained. White matter is within normal limits for age. VENTRICLES/EXTRA-AXIAL SPACES: No hydrocephalus or extra-axial fluid collections. EXTRACRANIAL STRUCTURES: Normal soft tissues. Old right lateral orbital wall fracture. Visualized paranasal sinuses and mastoids are clear.
CDC Split Type:

Write-up: Left arm and hand with tingling sensation which spread to right arm and legs the following day. no overt rash. Intermittent bilateral ear pain. started 3 days later lasting 20 minutes to an hour then resolves then recurs. seen in ER 7/18/2021 for this, benign work-up.


VAERS ID: 1484776 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Chills, Dyspnoea, Headache, Myalgia, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: flu shot--- Got three different flu''s after the shot
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: chills, fever, nausea, headache, bodyaches, muscle pain, sore arm, chest pains, shortness of breath


VAERS ID: 1484804 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-27
Onset:2021-07-14
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Productive cough, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: SARS-CoV-2 RdRp Resp Ql NAA+probe~COVID-19 rapid diagnostic test (nucleic acid amplification test NAAT) performed on 7/17/21, most likely done at a . Test came back positive. Case investigation interview conducted and based on case manager documentation on July 19th at 11:15, "Advised of test results. Client stated that symptoms (runny nose, congestion, productive cough) began 7/14 and continue today.


VAERS ID: 1484808 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPAKOTE ER 500MG 1 TAB PO TID, TRAZADONE 100MG 1 TAB PO QHS, RISPERDAL 3MG 1 TAB PO BID, VITAMIN C, VITAMIN D, ZINC, TYLENOL 500MG Q 4 HRS PRN, IBU 200MG 2 TABS PO PRN
Current Illness: Schitzophrenia
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A No adverse reactions reported
CDC Split Type:

Write-up: Resident had previously received 2 Moderna Covid vaccines in January and March 2021. There was no documentation in his chart stating he had previously received them. He was previously asked if he had received them and he stated he had not. He consented and received a Pfizer vaccine on 7/14/21. The administering entity did not inform us until 4-5 hours after administration when they were entering the data in the system that he had previously received 2 vaccines.


VAERS ID: 1484850 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Anticoagulant therapy, Incoherent, Motor dysfunction, Speech disorder
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fish Oil
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: NKDA
Diagnostic Lab Data: I do not have the specific information regarding tests at the hospital.
CDC Split Type:

Write-up: within 10 minutes of vaccine administration, patient could not communicate verbally. She could understand questions being asked and shake her head, but she could not speak. She was given benadryl which she swallowed with no issues. 911 was called to the scene. Blood pressure was taken and SBP $g200 using a wrist monitor. Blood pressure was taken again with traditional monitor and SBP $g190. Baby Aspirin 81mg was given orally, and the patient swallowed with no issues. While waiting for EMS to arrive, patient continued to understand questions being asked and was able to shake head yes/no. She would try to speak, but words were incoherent. She was asked to squeeze both hands, she recognized the request and acknowledged that she was squeezing, but minimal force was being applied. EMS arrived by 11:30am and patient was taken to the hospital.


VAERS ID: 1484881 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-06
Onset:2021-07-14
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/20/21.pfizer,Lot#EK5730 2nd dose: 01/06/2021 ,Pfizer,Lot# EL3248 Diagnosed covid positive:07/14/21 Exposure:Home exposure Symptoms: Asymptomatic.


VAERS ID: 1484906 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-06-07
Onset:2021-07-14
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

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

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

Write-up: Heart palpitations


VAERS ID: 1485015 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-07-08
Onset:2021-07-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: RASH OVER ARMS AND LEGS. STARTED 6 DAYS AFTER VACCINE.


VAERS ID: 1485029 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-07-14
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Hepatic artery thrombosis, Pericardial effusion
SMQs:, Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth control, Levothyroxine, Amitriptyline, Magnesium, V Complex, Multivitamin, Fish Oil
Current Illness:
Preexisting Conditions: Hashimoto?s thyroiditis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood clot in liver and fluid around heart


VAERS ID: 1485065 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Cough, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt states she began to experience minor cold symptoms starting on 7/9 but denies fever. Pt took J&J vaccine on 7/14. Beginning on 7/14, pt notes she developed a fever and acute worsening in cold symptoms. Pt reports congestion, sore throat, and dry cough. Highest home temp was 101.2. Pt reports that these symptoms lasted from 7/14 to 7/17 and have since resolved. Pt denies swelling or abscess at injection site. Denies chest pain, SOB, rash, itching, swelling, anaphylaxis, LOC, syncope, chills, body aches, fatigue.


VAERS ID: 1485120 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C2A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Foetal hypokinesia, Heart rate, Pain in extremity, Peripheral swelling, Pregnancy
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow), Tendinopathies and ligament disorders (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: Prenatal vitamins
Current Illness: N/A
Preexisting Conditions: Anemia
Allergies: Gabapentin
Diagnostic Lab Data: Heart rate monitored.
CDC Split Type: vsafe

Write-up: After day of vaccine, swelling in arm and soreness, baby stopped moving, or very small movements, very unusual for a highly active baby. Baby was able to move around more, and I was participant. Pregnancy: Currently 31 weeks pregnant, due September 18th, 2021. Normal pregnancy.


VAERS ID: 1485161 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C1A / 1 LA / IM

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

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

Write-up: 30 minutes after injection had lots of soreness. Later on developed hot red and itchy spot around injection site. Was recommended by doctor to put warm compresses, took Tylenol and Benadryl for 4days.


VAERS ID: 1485201 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: California  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Discomfort, Neck pain
SMQs:, Anaphylactic reaction (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer- BioNTech lot#EW0187 on 06/23/2021 when client was 17 years old. Client presented to the vaccination site with her mother
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported chest pressure from her neck to her chest to the EMT''s at 4:47 PM. The client was alert and oriented to person, place, time, and event. The client stated her current symptoms were less intense than her initial reaction. Vitals obtained at 4:49 PM were as follows: BP 126/78, HR 64, and O2 98%. The client denied any other s/s of anaphylaxis. At 4:52 PM the client stated the chest pressure was still present but mild. The client reported less chest pressure at 4:54PM. At 4:58 PM the client reported mild neck pain and chest pressure. At 4:59PM activated EMS. The client denied feeling cold or clammy. Vitals obtained at 5:03PM were as follows: BP 130/70, HR 64, and O2 96%. Felt similar chest pressure after she received the four doses of vaccines at her medical provider in the beginning of July but did not report the chest pressure to her mother. Fire Dept assumed care at 5:09PM. Client and mother refused medical transport at 5:16PM. At 5:20PM the client denied any chest tightness or pain in her neck. The client ambulated unassisted with a steady gait out of the observation area at 5:23PM.


VAERS ID: 1485652 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-07-05
Onset:2021-07-14
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049CTIA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Chest pain, Myalgia, Vaccine positive rechallenge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: same thing happened after first dose of the moderna vaccine. onset was roughly one to two weeks after injection.
Other Medications: Cymbalta 60mg daily
Current Illness: none other than medication dosage increase
Preexisting Conditions: generalized anxiety
Allergies: none
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: chest pain and tightness on left side, Left shoulder hurts(not at injection site), around pectoral muscle. The feeling is identical to the same thing happening to me after the first dose so I am sure it was the vaccine that is the cause.


VAERS ID: 1485832 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arteritis, Carditis
SMQs:, Optic nerve disorders (broad), Vasculitis (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocortisone ointment Benzoyl Peroxide Wash Clindamycin Gel
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s Mom Reported on 7/19/2021 Heart/Artery inflammation


VAERS ID: 1485969 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered, Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210734145

Write-up: VACCINATED WITH EXPIRED JANSSEN COVID-19 VACCINE; ADMINISTERED 20.5 HOURS AFTER FIRST PUNCTURE; This spontaneous report received from a health care professional concerned an 18 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21, and batch number: 206A21 expiry: 07-AUG-2021) dose was not reported, administered on 14-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the subject experienced vaccinated with expired janssen covid-19 vaccine. On 14-JUL-2021, the subject experienced administered 20.5 hours after first puncture. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccinated with expired janssen covid-19 vaccine and administered 20.5 hours after first puncture was not reported. This report was non-serious.


VAERS ID: 1485993 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-06
Onset:2021-07-14
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: COVID test positive on 07/18/21
CDC Split Type:

Write-up: patient developed sore throat, headache, and new loss of taste / smell on 07/14/21. He tested positive for COVID on 07/18/21.


VAERS ID: 1486788 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-06
Onset:2021-07-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Drospirenone-ethinyl estradiol 3mg Losartan potassium 100mg Atorvastatin 40mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA. About 1 week after receiving the vaccine, the injection site on my left arm turned bright red and extremely itchy. One week later, the redness has expanded around the site and is still itchy, but my skin is not as bright red. Skin is pink with a distinct line circling the affected area.


VAERS ID: 1486905 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-22
Onset:2021-07-14
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: NSTEMI (non-ST elevated myocardial infarction)


VAERS ID: 1486959 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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

Write-up: Moderna vaccine given out of the recommended age group. No adverse reaction noted per mother. Child had a sore arm.


VAERS ID: 1486973 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Moderna vaccine given outside recommended age group. No adverse reactions noted per dad.


VAERS ID: 1486989 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Moderna vaccine given outside of recommended age range. Child felt feverish the next day only per mom.


VAERS ID: 1487079 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-07-14
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Exposure to SARS-CoV-2, Headache, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Unknown
Diagnostic Lab Data: Novel Coronavirus PCR: SARS-COV-2 detected (7/14/2021)
CDC Split Type:

Write-up: Pt is 36 yo female employee at this institution. She is s/p Moderna COVID-19 full vaccination: first dose on 12/31/2020, second dose on 1/29/2021. Underwent voluntary COVID-19 rapid testing on 7/14 after experiencing symptoms including headache, fever, and congestion/runny nose. Pt reported exposure to COVID-19. PCR test resulted positive.


VAERS ID: 1487080 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-11
Onset:2021-07-14
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fatigue, Myalgia, Oropharyngeal pain, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Novel Coronavirus PCR: SARS-COV-2 detected (7/14/2021)
CDC Split Type:

Write-up: Pt is 46 yo male, employee at this institution. He is s/p Pfizer COVID-19 full vaccination: first dose on 1/21/2021, second dose on 2/11/2021. Underwent voluntary COVID-19 rapid testing on 7/14 after experiencing symptoms including fatigue, muscle or body aches, sore throat, diarrhea and congestion/runny nose. Pt reported possible exposure to COVID-19. PCR test resulted positive.


VAERS ID: 1487105 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-01
Onset:2021-07-14
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ESRD, CAD, Afib
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is now hospitalized with COVID -19, after having completed both doses of Moderna vaccine earlier in the year (per patient report- I can not confirm)


VAERS ID: 1487134 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen Cetirizine Flonase Guaifenesin Saline Mist
Current Illness: NONE
Preexisting Conditions: Covid-19 Exposure on 10/02/2020. Negative Covid-19 Test on 10/02/2020
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pfizer Covid Vaccine given to an 11 y.o. & 7 month old child, after mother and child stated that he was 12 y.o. Calculated DOB after injection given and realized that child was not 12 y.o. No adverse reactions.


VAERS ID: 1487276 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21! / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Fatigue, Herpes zoster, Hyperhidrosis, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: D3. Wellbutrin. Cymbalta. Metrolol. Hydrochlorothiazide. Synthroid.
Current Illness: No.
Preexisting Conditions: Chronic shingles since 26 yo.
Allergies: No.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea. Terrible muscle aches for 2 nights. Fever for 7 days. Profuse sweating. Weakness. Shingles. Sore arm. Extremely tired. Ibuprofen. Zovirax. Pepto Bismol.


VAERS ID: 1487282 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Erythema, Fatigue, Headache, Nodule, Pain in extremity, Product preparation error, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine 20mg, simvastatin 20mg. gabapentin 100mg TID, vitamin D, vitamin C.
Current Illness: NA
Preexisting Conditions: high cholesterol, depression, back nerve pain.
Allergies: penicillin
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: patient receive full concentrated vial of Pfizer vaccine. Patients s/s over 4 day extreme fatigue, head ache, body aches, extreme arm pain with raised bump that was red and warm to touch that has become itchy. 2 days after diarrhea and loss of apatite. Which has resolve.


VAERS ID: 1487287 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Injection site rash, Injection site swelling, Pain, Pain in extremity, Rash erythematous, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pain at injection site, pain radiating to elbow and shoulder on same arm, red itchy area around injection site (baseball size), swelling around injection site, small patch of hives on right side of upper body.


VAERS ID: 1487397 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / UNK - / IM

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

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

Write-up: Patient received Moderna as 1st dose. Patient came through for 2nd dose and reported that she had received Pfizer. 2nd dose given. When it was verified in patient had received Moderna as first dose not Pfizer. Vaccine had already been given before verifying.


VAERS ID: 1487426 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 1 LA / IM

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

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

Write-up: Moderna vaccine given outside of the recommended age range.


VAERS ID: 1487430 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: No allergic reaction to vaccines in the past
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna vaccine given out of recommended age range


VAERS ID: 1487463 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035L21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Polycystic Ovarian Syndrome Type 2 Diabetes
Allergies: Penicillin Flagyl Monistat
Diagnostic Lab Data:
CDC Split Type:

Write-up: The injection site started to itch about two hours after the injection. Today 7/20/2021, continuing itching and it is red circle that seems to have a bruised look under it. The circle has grown in size within the last few days. Its about 2 inches wide and about 1 inch in height.


VAERS ID: 1487478 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-07-14
Onset:2021-07-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain
SMQs:, 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: Esomeprazole and Itopride.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: From July 14 to July 20, 2021 intense mid back pain, low back pain. Does not improve with medication or relaxing creams. It does not go away, it was not there before getting the Covid-19 vaccine.


VAERS ID: 1487481 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-01
Onset:2021-07-14
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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: I now have shingles


VAERS ID: 1487563 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-01-29
Onset:2021-07-14
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: COPD
Allergies: Unknown
Diagnostic Lab Data: 07/18/2021 SARS-CoV-2 RNA results detected
CDC Split Type:

Write-up: Patient tested positive for COVID-19 on 07/18/2021


VAERS ID: 1487995 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-07-13
Onset:2021-07-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient had pericarditis after the 2nd dose of the Pfizer-BioNtech Covid-19 vaccine. He had chest pains 24 hours after the vaccine and so he went to ER where he was diagnosed with pericarditis (mild heart attack). He received treatment


VAERS ID: 1489539 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Injection site pain
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: USJNJFOC20210734185

Write-up: UPSET STOMACH/SLIGHT BUTTERFLY PAIN; AREA OF PAIN AROUND THE INJECTION SITE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 14-JUL-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 14-JUL-2021, the subject experienced upset stomach/slight butterfly pain. On 14-JUL-2021, the subject experienced area of pain around the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from upset stomach/slight butterfly pain, and area of pain around the injection site on 14-JUL-2021. This report was non-serious.


VAERS ID: 1489558 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-07-14
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821281 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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: Allergy to nuts; Brain tumor
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210738857

Write-up: ACHY; FEVER; This spontaneous report received from a parent concerned a 26 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included brain tumor, and allergy to tree nuts. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821281, and expiry: UNKNOWN) dose was not reported, administered on 14-JUL-2021 for prophylactic vaccination. No concomitant medications were reported. On 14-JUL-2021, the subject experienced achy. On 14-JUL-2021, the subject experienced fever. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and achy. This report was non-serious. This case, from the same reporter is linked to 20210738675.


VAERS ID: 1489618 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-13
Onset:2021-07-14
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: body temperature; Result Unstructured Data: fever of 102?F
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: on her arm, a hot red rectangle that looks like cellulitis; fever of 102?F; This spontaneous case was reported by a consumer and describes the occurrence of CELLULITIS (on her arm, a hot red rectangle that looks like cellulitis) in a 73-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. No Medical History information was reported. On 13-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Jul-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 14-Jul-2021, the patient experienced PYREXIA (fever of 102?F). On an unknown date, the patient experienced CELLULITIS (on her arm, a hot red rectangle that looks like cellulitis) (seriousness criterion medically significant). On 15-Jul-2021, PYREXIA (fever of 102?F) had resolved. At the time of the report, CELLULITIS (on her arm, a hot red rectangle that looks like cellulitis) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, Body temperature: 102?f (High) fever of 102?F. No concomitant medications were reported. No treatment information was provided. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


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