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

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



Case Details (Reverse Sorted by Onset Date)

This is page 220 out of 8,010

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VAERS ID: 1718164 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / UNK - / OT

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

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

Write-up: 2 patients administered dose out of a vial that was in the fridge for 31 days; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (2 patients administered dose out of a vial that was in the fridge for 31 days) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (2 patients administered dose out of a vial that was in the fridge for 31 days). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (2 patients administered dose out of a vial that was in the fridge for 31 days) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant information provided by the reporter No treatment information provided by the reporter It was reported that Pharmacist did not know if it was consumer''s 1st or second dose .2 doses administered out of a vial that was in the adverse events fridge for 31 days.


VAERS ID: 1718330 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-30
Onset:2021-09-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Limb discomfort, Vaccination site irritation
SMQs:, Dementia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma (Diagnosed as a child)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101198062

Write-up: This is a spontaneous report received from a contactable consumer or other non-health care professional. A 31-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: FC3182), via an intramuscular route of administration, administered in Arm Left on 30Aug2021 (at the age of 31-years-old) as dose 2, single for COVID-19 immunisation. Medical history included , asthma from an unknown date and unknown if ongoing Diagnosed as a child. The patient concomitant medications were not reported. Patient received vaccine facility in Pharmacy. The patient previously took first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: FA7485) via an unknown route of administration, administered in Arm left on 09Aug2021 (at the age of 30-years-old) as dose 1, single for COVID-19 immunisation. The patient would like to report that she got her last dose 30Aug2021, and for the past couple of days, at the injection site, after a long period, left arm feels like pressure and is irritated and tight. It feels weird like and when she just gets shot where it is irritated. It was right where she got the last dose. She wanted to know if that was normal to feel this after such a long period of time. She stated she is a biomedical technician. Patient not visited emergency room and physician office. The outcome of the event limb discomfort was reported as not recovered and while for other events was unknown.


VAERS ID: 1718363 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Diplopia, Hypoaesthesia, Magnetic resonance imaging, Metamorphopsia, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Retinal disorders (narrow), Ocular motility disorders (broad), Hypoglycaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure; Egg allergy; Food allergy; Penicillin allergy; Seafood allergy
Allergies:
Diagnostic Lab Data: Test Name: CT Scan; Result Unstructured Data: Test Result:Unknown result; Test Name: MRI; Result Unstructured Data: Test Result:Unknown result; Test Date: 20210913; Test Name: Nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101212420

Write-up: The hospital thought I had a stroke; My entire right side of my face went numb including my throat, tongue and behind my right eye into my head,; causing the vision in my eye to become distorted and double vision.; causing the vision in my eye to become distorted and double vision.; This is a spontaneous report from a contactable consumer reporting for herself. A 53-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 10Sep2021 17:00 (at the age of 53-year-old) (Lot Number: FC3182) as DOSE2, SINGLE for covid-19 immunization. The patient was nonpregnant. Medical history included high blood pressure. The patient was allergy to Penicillin, nuts, seafood and egg yolks. Historical vaccine included BNT162B2(first dose, lot number:FC8448) administered in Arm Left on 13Aug2021 14:30. The patient''s concomitant medications included lisinopril (LISINOPRIL) 10 mg. Clinical course: her entire right side of her face went numb, including throat, tongue and behind right eye into the head on 10Sep2021 18:30, and that cause the vision in her eye to become distorted and double vision on 10Sep2021 18:30. Then she visited an Emergency room/department or urgent care and the hospital thought she had a stroke on 10Sep2021 18:30. Adverse event resulted in hospitalization for 1 day. Outcome of all the events was recovering and therapeutic drug was administrated. The patient underwent lab tests included computerized tomogram (CT) scan and magnetic resonance imaging (MRI) on an unspecified date with unknown result and Nasal Swab (SARS-CoV-2 test) showed negative on 13Sep2021.


VAERS ID: 1718557 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pyrexia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Severe, Additional Details: Pt received prevnar 13 and flulaval quad at our store but received covid at another location. Pt states she felt feverish and ended up fainting later that day. At the hospital, they stated that her getting 3 shots that day may have resulted in her body being overloaded.


VAERS ID: 1718559 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pyrexia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Severe, Additional Details: Pt received prevnar 13 and flulaval quad at our store but received covid at another location. Pt states she felt feverish and ended up fainting later that day. At the hospital, they stated that her getting 3 shots that day may have resulted in her body being overloaded.


VAERS ID: 1718568 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Contusion, Ear pain, Feeling of body temperature change, Headache, Hypoacusis, Muscular weakness, Nausea, Pain in extremity, Temperature regulation disorder, Tinnitus, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (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: Birth Control (Oral 1/35 dose)
Current Illness: N/A
Preexisting Conditions: Overactive Bladder due to hypertonic pelvic floor
Allergies: Wheat/Gluten
Diagnostic Lab Data: -Complete Blood Panel | September 14th
CDC Split Type:

Write-up: 7:00PM (9 hours after shot) -Ringing in Ears -Muffled Hearing -Ear Pain/Ache (Dr. Recommended taking a decongestant) This did not help the situation and this symptom is still occurring as of 9/21/21. 7:00PM (9 hour after shot) -Extreme nausea -Severe Headache (Dr. Recommended taking Tylenol for this during appointment--Tylenol did not greatly help headache) Saturday 9/11 at 9:00AM (All other symptoms persisted along with....) -Blurry Vision -Unable to regulate temperature. Very hot/very cold---did not have a temperature. Sunday 9/12 (All other symptoms persisted along with...) -Spontaneous unexplained bruises over night. Appeared on thighs, 9 large bruises the size of a quarter or larger. (Did not participate in any activity that would explain bruises) -Dr. Ordered a Complete Blood Panel. Numbers came back "ok". Will be asking for another test in a few weeks to confirm numbers are "ok". Tuesday-Wednesday 9/14-9/15 (All other symptoms with the exception of blurry vision persisted along with...) -More bruises appeared on the back of right upper arm, lower right leg near ankle, calf of left leg -Injection Arm Pain and Weakness (from elbow to shoulder)


VAERS ID: 1718713 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arrhythmia, Condition aggravated, Ear infection, Headache, Impaired work ability, Injection site pain, Lethargy, Oropharyngeal pain, Pain, Sinusitis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram, orilissa, adderall, ibuprofen
Current Illness: none
Preexisting Conditions: depression, A.D.D., heart palpitations, mild asthma, seasonal allergies
Allergies: sulfa, codeine, spinach
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sore throat; severe untreatable headache; body aches; ear infection; sinus infection,; lethargy.; heart arrhythmia. Pain at injection site was also an issue, however, it is understandable that this happens with most injections. The first symptom experienced was sore throat and headache. These started 2-3 days following the first vaccine on 9/7/21 and they continue today (9/21/21). My headache continually got worse to the point where I have had to miss work and despite taking ibuprofen alternated with Tylenol around the clock, I have not been able to get relief. The heart palpitations had already been an issue for which I was tested by a cardiologist earlier in the summer months of 2021. These symptoms had improved approx a month or 6 weeks prior to receiving the vaccine, but they reoccured following the first vaccine. On 9/20/21, I finally decided to contact my PCP.


VAERS ID: 1718757 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-18
Onset:2021-09-10
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/10/21 COVID positive test
CDC Split Type:

Write-up: COVID vaccine breakthrough case


VAERS ID: 1718812 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-09-10
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B2IA / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017EZIA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstrual disorder
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: NP Thryoid - 90 MG
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I believe the vaccine greatly impacted my menstrual cycle. I got my period twice over the course of one month; that has never happened to me. The time span between the first day of my period in August (8/29) and first day of my subsequent period in September (9/10) was approximately two weeks. This was especially upsetting as I had been trying to conceive and may have been pregnant.


VAERS ID: 1718815 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Extra dose administered, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, aspirin, atorvastation, biotin, carvediol, clonidine, clortrimazole cream, culturelle, diclofenac cream, docusate, doxazosin, famotidine, hydralazine, lisinopril, ondansetron, miralax, tylenol, neosporin, vitamin d3
Current Illness:
Preexisting Conditions: Anemia, thrombocytopenia, hyperlipidemia, hyponatremia, heart failure
Allergies: Nifedipine, Codeine
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received an entire diluted vial of the Pfizer vaccine (6 doses). Nursing facility contacted the physician and patient was monitored. Local pain and swelling at the injection site was only adverse effect noted.


VAERS ID: 1718841 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-08
Onset:2021-09-10
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, Alanine aminotransferase increased, Anaemia, Angiogram pulmonary abnormal, Anosmia, Anticoagulant therapy, Aspartate aminotransferase increased, Asthenia, Atrial fibrillation, Blood bilirubin increased, Blood sodium decreased, COVID-19, COVID-19 pneumonia, Cardiac telemetry, Chest X-ray abnormal, Chills, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Critical illness, Decreased appetite, Diabetes mellitus, Dizziness, Dyspnoea, Echocardiogram normal, Essential hypertension, Fatigue, Fluid intake reduced, Haemoglobin decreased, Haemoptysis, Headache, Hypercoagulation, Hyperglycaemia, Hypertension, Hyponatraemia, Hypophagia, Hypoxia, Insomnia, Intensive care, Legionella test, Leukocytosis, Lung opacity, Malaise, Metabolic function test, Nasal congestion, Oropharyngeal pain, Oxygen saturation decreased, Pleural effusion, Procalcitonin normal, Productive cough, Pulmonary haemorrhage, Pyrexia, Rheumatoid arthritis, SARS-CoV-2 test positive, Sputum culture positive, Streptococcus test negative, Tachycardia, Tachypnoea, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (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), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications Ascorbic Acid (VITAMIN C) 500 MG CAPS cholecalciferol (VITAMIN D3) 50 MCG (2000 UT) tablet dilTIAZem (CARDIZEM CD) 180 MG 24 hr capsule diphenhydramine-acetaminophen (TYLENOL PM EXTRA STRENGTH) 25-500 MG TABS folic ac
Current Illness: 9.10.21: Urgent Care due to cough fever and chills. Patient states he started not feeling well last week. Has had nasal congestion and cough starting 4 days ago. Is fully vaccinated for COVID. Patient states he has been sporadically coughing up pink to blood-tinged mucus, this has worsened today. He did develop some shortness of breath last night. He is anticoagulated on Eliquis. 9.10.21: Sent to ED - diagnosed with COVID-19 - CT was negative for PE but does show signs of COVID pneumonia and also Left lower lobe opacities that could similarly be related to pneumonia or pulmonary hemorrhage given the history of hemoptysis. Patient has not had any gross hemoptysis at home or here. Vital signs are stable. He is not tachypneic tachycardic or hypoxic on my evaluations of him. He is not in any respiratory distress. I discussed the case with the internal medicine physician in house who did not feel patient needed to be admitted. 9.12 - admitted to hospital
Preexisting Conditions: Hospital Problem List: Essential hypertension Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia due to COVID-19 pneumonia Rheumatoid arthritis Paroxysmal atrial fibrillation Drug or chemical induced diabetes mellitus with hyperglycemia Anemia
Allergies: Aspirin Codeine Nausea/Vomiting/Diarrhea
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.12.21 - present); COVID-19 positive (9.10.21); Fully Vaccinated HISTORY OF PRESENT ILLNESS: Patient is a 78 y.o. male with a past medical history of rheumatoid arthritis on methotrexate, AFib and a flutter on Xarelto, and hypertension who presents today with lightheadedness, weakness and shortness of breath. The patient states that symptoms started around 9/6. Symptoms started with a sore throat and developed into a persistent cough. He has had intermittent episodes of hemoptysis. He states that he has severe loss of appetite and loss of taste and smell. He has had difficulty sleeping secondary to his persistent cough. He has felt weak and lightheaded. Today he told his wife that he thought he was going to die today. The patient is previously vaccinated for COVID-19. He was seen at urgent care on 09/10 where he was officially diagnosed with COVID-19. He was sent to the ER for evaluation given his hemoptysis. A CTA thorax was obtained which showed no PE. Peripheral predominant opacities in the bilateral lungs are nonspecific, but presumed to be related to the patient''s diagnosis of Covid 19. Left lower lobe opacities could similarly be related to pneumonia or pulmonary hemorrhage given the history of hemoptysis. Small left pleural effusion. He was not hypoxic nor tachypneic on exam so he was discharged. The patient states that he has been increasingly more lightheaded and weak over the past few days prompting his visit today. In the ER, the patient was tachycardic with a pulse of 131, tachypneic with a respiratory rate of 35 and hypoxic with an SpO2 of 88%. He was placed on 2 L nasal cannula. Labs significant for Na 129, AST 70 ALT 51 bilirubin 1.1, hemoglobin 11.6. CXR 9/12 with left basilar pneumonia. The patient was given 1 L of IV fluids, Decadron, Tessalon Perles, Tylenol and albuterol. ASSESSMENT / PLAN: Pneumonia due to COVID-19 virus Acute Respiratory Failure with Hypoxia Pleural Effusion, left small Hemoptysis Vaccinated Immunocompromised CXR 9/12 with left basilar pneumonia. SpO2 in ER 88% on room air, RR 35 CTA Thorax on 9/10 with no PE. Peripheral predominant opacities in the bilateral lungs are nonspecific, but presumed to be related to the patient''s diagnosis of Covid 19. Left lower lobe opacities could similarly be related to pneumonia or pulmonary hemorrhage given the history of hemoptysis. Small left pleural effusion. Date of symptoms onset: 9/6/21, tested positive 9/10 Symptoms: Sore throat, fevers, cough, dyspnea, lightheadedness, anorexia, loss of taste and smell, headaches Treatment: Remdesivir (started 9/12), Decadron x 10 days (started 9/12), VTE prophylaxis with the patient''s Xarelto, Supplemental Oxygen - wean as able, continuous pulse oximetry and telemetry (given A-fib with RVR in ER), Daily CMP while on Remdesivir, supportive care with PRN anti-tussives, PRN anti-emetics, PRN anti pyretics, IS. -Hold methotrexate -Given hemoptysis and primarily left sided pneumonia - will obtain sputum culture, procalcitonin - consider starting Azithromycin Hyponatremia -NA 129 - s/p 1 L of IVF - re-check in AM - patient has had very poor oral and liquids intake Rheumatoid Arthritis -Hold methotrexate, has not been on prednisone in over a year. Paroxysmal A-fib History of A-flutter -Continue Cardizem, Metoprolol, Xarelto -On telemetry Hypertension -Continue Cardizem, Metoprolol and Lisinopril progress note (9.21.21) - still admitted: Pneumonia due to COVID-19 Acute respiratory failure with hypoxia due to COVID-19 pneumonia Overview CTA on admission without PE, infiltrates consistent with COVID-19 pneumonia. Steptococcus and legionella urine antigen negative. Procalcitonin negative. Echocardiogram with normal RV and LV function, negative bubble study. Assessment & Plan Worsening hypoxemia with difficulty recovering after minimal activity led to transfer to MICU 9/15, mild improvement with self-proning - Continue HFNC/NRB mask and self-proning or laying on his side - At significant risk of needing intubation - Added empiric antibiotics--ceftriaxone-- $g changed to cefepime 9/20, given length of hospital stay and significant worsening of leukocytosis and Gram-negative rods in sputum * Pneumonia due to COVID-19 virus Overview 1/11/21, 2/8/21: received COVID-19 vaccine 9/6/21: symptoms developed 9/10/21: diagnosed with COVID-19 9/12/21: admitted to the hospital 9/15/21: transferred to the ICU for desaturation despite 95% high flow NC Assessment & Plan Decadron 6 mg daily (started 9/12/21), will need to decide if course is prolonged past normal 10d Remdesivir (started 9/13/21), completing 9/17 On heparin ggt for atrial fibrillation, and was on xarelto as outpatient. Changed to lovenox to reduce blood draws This is a 78 y.o. who has a past medical history significant for RA immunosuppressed on Methotrexate, Afib on xarelto, HTN. He was admitted for dyspnea after presenting to the ED 9/12 with symptoms of dyspnea, fatigue and intermittent small hemoptysis since 9/6, had been diagnosed with COVID 9/10 (previously vaccinated). He has since been started on dexamethasone since 9/12 and remdesevir since 9/13 (completed course), initially needing nasal cannula, and later required transfer to the MICU for persistent hypoxia on 9/15 requiring HFNC. Key Plan for Today September 20: --respiratory rate self prone in --problem combination of high-flow nasal cannula oxygen/breather face mask --at high risk for requiring intubation/mechanical ventilation, but does not appear to be required at this time --goal even to negative fluid balance with Lasix (currently 40 mg once daily), severe as tolerated --change ceftriaxone to cefepime, given rising white blood count, worsening chest radiograph --continue full-dose Lovenox for atrial fibrillation and hypercoagulable state of COVID--well --dexamethasone day 9 --advanced diet --patient indicates he would be okay with intubation and mechanical ventilation but would not wish for tracheostomy tube. Family is supportive this incision. I discussed with patient and also updated his daughter at bedside. She understands patient is critically ill and is supportive of the plan. This patient is critically ill and is requiring active support and intensive surveillance to prevent life threatening clinical deterioration.


VAERS ID: 1718882 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-02
Onset:2021-09-10
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Dyspnoea, Hypophagia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

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

Write-up: SOB. poor p.o intake, diarrhea and vague abdominal pain. Hospitalization


VAERS ID: 1718885 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-21
Onset:2021-09-10
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Dyspnoea, Evidence based treatment, Fibrin D dimer increased, Full blood count, Headache, Hypoxia, Lung opacity, Nasopharyngitis, Procalcitonin decreased, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Ultrasound Doppler abnormal, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (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), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications cephALEXin (KEFLEX) 250 MG capsule metoprolol succinate-XL (TOPROL-XL) 25 MG 24 hr tablet Psyllium (METAMUCIL FIBER PO) triamterene-hydrochlorothiazide (MAXZIDE) 37.5-25 MG per tablet
Current Illness: NA
Preexisting Conditions: Hospital Osteoarthritis of left hip Paroxysmal atrial tachycardia Essential hypertension COVID-19 Pneumonia due to COVID-19 virus Acute respiratory failure with hypoxia Acute thrombosis of superficial vein of both upper extremities Obesity Non-Hospital Malignant neoplasm of prostate-RRP 9/2005,Gleason 3+3=6, pT2a, negative margins, nerve sparing Epididymal head cyst. Palpable area appears correspond to a more prominent left epididymal head cyst measuring 10 mm Meniere''s disease Status post total hip replacement, left
Allergies: Penicillins Rash Celecoxib Rash Sulfa Drugs Swelling
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.11.21 - present); COVID-19 positive; Fully Vaccinated History of Present Illness Patient is a 85 y.o. male with a history of HTN, paroxysmal atrial tachycardia and prostate cancer s/p prostatectomy who presents today with cough and shortness of breath. Symptoms started about a week ago and patient thought he had a mild head cold with congestion, rhinorrhea, and headaches. His symptoms continued throughout the week, but he noted they were "up and down" and he initially felt he was improving. However, he then began to have more shortness of breath and coughing. He tested positive for COVID on 9/10. Shortness of breath worsened, prompting ED presentation. Initially planned for monoclonal antibodies, but he then became hypoxic and was placed on 3 L NC. CXR showing bilateral groundglass opacities suggestive of COVID. WBC 14.3. He was given decadron and hospitalists were asked to admit for further care. Chief complaint COVID-19 Assessment and Plan Covid-19 pneumonia Acute respiratory insufficiency with hypoxia - symptom onset about 1 week ago - (+) PCR 09/10 - fully vaccinated with Pfizer (2/25/21 and 3/25/21) - Chest xray consistent with COVID pneumonia - started on decadron - start remdesivir - supportive measures - prone positioning - daily labs Leukocytosis - WBC 14.3 - will check procal - trend CBC - hold off on antibiotics for now Progress note 9.20.21: This is a 85 y.o. who has a past medical history significant for remote history of Prostate Cancer s/p Resection, HTN, who presented to the ED 9/11 with dyspnea, testing positive for COVID on 9/10, was admitted for hypoxia and started on dexamethasone/remdesevir 9/11, and empiric antibiotics on 9/13. His oxygen requirement has worsened and Pulm/Crit Care was asked to see for his respiratory failure. He ultimately worsened and required transfer to the MICU. D-Dimer significantly elevated, superficial clots seen in upper extremities. Key Plan for Today September 20: Continue high-flow nasal cannula oxygen/non-rebreather face mask At high risk for requiring intubation/mechanical ventilation Begin amiodarone for atrial fibrillation with RVR Decadron day 10/14 tentative course Continue empiric heparin drip given superficial clots and markedly elevated D-dimer Status post empiric ceftriaxone/azithromycin through September 17 Fluid balance -400/24 hours -- $g goal even to negative fluid balance, as tolerated Advanced diet, as tolerated Add Pepcid, given steroids and anticoagulation Acute respiratory failure with hypoxia Assessment & Plan 2/2 COVID Pneumonia despite vaccination. Question additional issues, maybe some reticular changesin the bases bilaterally - Continue HFNC + NRB Mask and wean for goal sats$g90%. At significant risk of decompensation requiring intubation - Completed empiric antibiotics, started 9/13 for 5d course. Procal is low - UE dopplers with superficial clots, question PE given elevated D-Dimer, starting empiric heparin gtt. Echo Pending. Hold on CTPE for now given tenuous status - Continue intermittent lasix for euvolemia Pneumonia due to COVID-19 virus Assessment & Plan - despite vaccination, very ill, no evidence of immunocompromise. Tested positive 9/10 - Continue dexamethasone, started 9/11, expecting 10d course, will extend depending on his trajectory - s/p remdesevir 5d, started 9/11


VAERS ID: 1718896 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling abnormal, Feeling hot, Immediate post-injection reaction, Limb discomfort
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, klonopin, remeron, multivitamin, vitamin d, zinc, vitamin c
Current Illness: None
Preexisting Conditions: None
Allergies: Antihistamines (all)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately heat like fire rushed from feet to head, got dizzy, had to sit for 45 mins at the riteaid, my boyfriend picked me up I went home to bed. I had a hard time breathing it was as an elephant was sitting on my chest, I felt completely out of it legs and ankles felt like a million pounds.. After about 4 hours the reactions started to get better but I had issues breathing on and off since September 10, 2021. I am not covid 19 positive and I don''t have asthma. It feels as if the air is Thicker to breathe nowadays.


VAERS ID: 1718907 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Pain in extremity, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: progesterone only birth control, prenatal vitamin, iron
Current Illness:
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate severe pain in the right thumb joint lasting 1 day, then intermittently returning over the course of the last 11 days. Cough that started 2-3 days after injection and has persisted despite no other signs of illness. Black vaginal bleeding that began 1 week after injection and lasted x 5 days.


VAERS ID: 1719012 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fibrin D dimer normal, Headache, Heart rate irregular, Palpitations, X-ray normal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Premature Ventricular Contractions Bundle branch block
Allergies: None
Diagnostic Lab Data: no blood clots, no heart attack. D-dimer labs and xrays normal.
CDC Split Type:

Write-up: Pain in chest. Irregular heartbeat. Pounding heartbeat, short of breath. headache. Patient did not seek treatment for 1 week after symptoms began, did not understand the seriousness of the symptoms. Symptoms decreased with time.


VAERS ID: 1719107 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

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

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

Write-up: Patient should have gotten Moderna Vaccine but was mistakenly given the Pfizer.


VAERS ID: 1719223 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-16
Onset:2021-09-10
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood lactic acid, COVID-19, Electrocardiogram, Full blood count, Lipase, Metabolic function test, Troponin
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: insulin aspart insulin degludec
Current Illness: None documented
Preexisting Conditions: Diabetes Type I
Allergies: No known allergies
Diagnostic Lab Data: CBC, CMP, Lipase, lactic acid, troponin EKG
CDC Split Type:

Write-up: Patient contracted COVID after being fully vaccinated


VAERS ID: 1719425 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21D / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Rash, Rash erythematous, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea the same day, then 1 week later experienced a red, warm rash on the arm, hives on feet and legs. All resolved except for a little rash on the legs when pt reported side effects 10 days after vaccine.


VAERS ID: 1719479 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Computerised tomogram head normal, Electrocardiogram normal, Full blood count normal, Headache, Mental status changes, Metabolic function test, Pyrexia, Troponin normal, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin C, CoQ10, fish oil tabletes, tylenol, hair and nails vitamin daily, baby aspirin, calcium, vitamin B12, magnesium, cranberry supplement
Current Illness: none
Preexisting Conditions: neuropathy, diabetes, gout, sjogren''s syndrome, HTN, mild renal failure, peripheral vascular disease
Allergies: morphine, naproxen, nsaids, terbinafine, vicodin
Diagnostic Lab Data: head CT, CBC, CMP, troponin, EKG, TSH, urinalysis all unremarkable
CDC Split Type:

Write-up: headache, fever, altered mental status x 3 days


VAERS ID: 1719488 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019B21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 58E21A / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: n/a
Preexisting Conditions: thyroid
Allergies: Sulfa medications, amoxicillin, gold, formaldehyde, synthetic fragrances
Diagnostic Lab Data: none so far, they are trying to say the rash is not from the vaccine despite not having the rash until I got the vaccine
CDC Split Type:

Write-up: With the first shot, I had some rash, mostly on my stomach, however the 2nd shot I had A LOT of rash on my stomach, back, neck , and also several blood red dots


VAERS ID: 1719520 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-09-10
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: shortness of breath, sore throat and mild cough for approximately 9 days, yesterday developing worsening shortness of breath


VAERS ID: 1719597 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Dyspnoea, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Per ED provider notes. 34 y.o. female who presented to the emergency department for Shortness of breath. Patient states that she received her second monitor and a shot yesterday. She was feeling achy and sore yesterday evening but is significantly gotten worse today has generalized myalgias, fever, shortness of breath and feels that she cannot take a deep breath. Now feels like her chest is very tight. She denies similar symptoms in the past. Denies history of bleeding or clotting disorder. States that with her first shot she did receive a injection and then had swelling about her arm but denies similar issues or problems. After fluids and medication patient feeling much better at present time. Discussed feel this is likely combination of immunologic response to vaccine as well as patient feeling very anxious secondary to shortness of breath which has precipitated worsening symptoms. She is feeling much better now recommended continued supportive care at home and close monitoring.


VAERS ID: 1719632 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Systemic lupus erythematosus
SMQs:, Systemic lupus erythematosus (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Plaquenil, Lexapro, Wellbutrin, Protonix, Propranolol
Current Illness: N/A
Preexisting Conditions: SLE
Allergies: Sulfa antibiotics, Macrobid antibiotics, Bell Peppers
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: "COVID arm" reaction. Flare of Lupus symptoms.


VAERS ID: 1719811 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-30
Onset:2021-09-10
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Breast mass, Personality change, Tenderness
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (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: Elderberry
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pending ultrasound/mammogram
CDC Split Type:

Write-up: Approximately 10 days after Initial Covid vaccination I developed a tender lump under my right nipple. It is painful to the touch and approximately 1 inch by .5 inches large. I have had a noticeable change in behavior as pointed out by my wife of 12 years as I am normally a go go go person. I have not wanted to leave the house or workout (which is a huge stress relief for me as I am a first responder).


VAERS ID: 1719815 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Diarrhoea, Headache, Myalgia, Oropharyngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, sore throat, cough, headache, diarrhea, muscle pain


VAERS ID: 1720539 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Chills, Dyspnoea, Fatigue, Headache, Heart rate, Hyperhidrosis, Irritability, Pyrexia, Temperature intolerance
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), 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: Cymbalta
Current Illness: None
Preexisting Conditions: None
Allergies: Pencillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, sweats, headache, irritability. Events were cyclical and repeating. Days later, extreme fatigue, labored breathing, elevated heart rate to point of being painful. Accustomed to working outside. 3 days after second injection, just walking outside to inspect building led to needing 45 minutes in full fan AC in truck and 30 oz water. Not normal.


VAERS ID: 1721588 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia, Vaccination site pain
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:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: tingling in my left arm/tingling in my left hand; pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (tingling in my left arm/tingling in my left hand) and VACCINATION SITE PAIN (pain at the injection site) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 017B21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced PARAESTHESIA (tingling in my left arm/tingling in my left hand) and VACCINATION SITE PAIN (pain at the injection site). At the time of the report, PARAESTHESIA (tingling in my left arm/tingling in my left hand) and VACCINATION SITE PAIN (pain at the injection site) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication provided. No treatment medication provided.


VAERS ID: 1721614 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-13
Onset:2021-09-10
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Body temperature; Result Unstructured Data: Fever of 101F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: pain; fever of 101F; Chills; Headache; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (pain), PYREXIA (fever of 101F), CHILLS (Chills) and HEADACHE (Headache) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 052E21A) for COVID-19 vaccination. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced PAIN (pain), PYREXIA (fever of 101F), CHILLS (Chills) and HEADACHE (Headache). The patient was treated with IBUPROFEN (MOTRIN [IBUPROFEN]) for Pain and Fever, at an unspecified dose and frequency. At the time of the report, PAIN (pain), PYREXIA (fever of 101F), CHILLS (Chills) and HEADACHE (Headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Sep-2021, Body temperature: 101f (High) Fever of 101F. No concomitant medications were provided


VAERS ID: 1721622 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-09-10
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Laboratory test, Nasal congestion, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Vaccination site pain
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALBUTEROL [SALBUTAMOL]
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Antigen test; Test Result: Positive ; Result Unstructured Data: Antigen test(home) - Positive; Test Name: RT-PCR test; Test Result: Negative ; Result Unstructured Data: RT-PCR test - Negative; Test Name: Chest x-ray; Result Unstructured Data: Chest x-ray was clear.; Test Name: Laboratory test; Result Unstructured Data: normal
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: pain in the arm on all doses/arm hurt for 2 days; slight grade fever; stuffy; This spontaneous case was reported by a consumer and describes the occurrence of NASAL CONGESTION (stuffy), VACCINATION SITE PAIN (pain in the arm on all doses/arm hurt for 2 days) and PYREXIA (slight grade fever) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 038CZ4A, 039K20A and 012L20A) for COVID-19 vaccination. Concurrent medical conditions included Asthma. Concomitant products included ALBUTEROL [SALBUTAMOL] for Asthma. On 07-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 06-Aug-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced NASAL CONGESTION (stuffy). On an unknown date, the patient experienced VACCINATION SITE PAIN (pain in the arm on all doses/arm hurt for 2 days) and PYREXIA (slight grade fever). At the time of the report, NASAL CONGESTION (stuffy), VACCINATION SITE PAIN (pain in the arm on all doses/arm hurt for 2 days) and PYREXIA (slight grade fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Chest X-ray: normal (normal) Chest x-ray was clear.. On an unknown date, Laboratory test: normal (normal) normal. On an unknown date, SARS-CoV-2 test negative: negative (Negative) RT-PCR test - Negative. On an unknown date, SARS-CoV-2 test positive: positive (Positive) Antigen test(home) - Positive. Concomitant medications reported includes, steroids. Treatment information was not provided by the reporter. This case was linked to MOD-2021-316515, MOD-2021-316581 (Patient Link).


VAERS ID: 1721641 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: broke out with rash/rash all over back, neck, under his arm; sick with fever all weekend; This spontaneous case was reported by a consumer and describes the occurrence of RASH (broke out with rash/rash all over back, neck, under his arm) and PYREXIA (sick with fever all weekend) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced PYREXIA (sick with fever all weekend). On 12-Sep-2021, the patient experienced RASH (broke out with rash/rash all over back, neck, under his arm). At the time of the report, RASH (broke out with rash/rash all over back, neck, under his arm) and PYREXIA (sick with fever all weekend) outcome was unknown. It was reported as Patient has no known allergies and has not taken any medications as treatment. No Concomitant medications were reported. No Treatment medications were reported.


VAERS ID: 1721667 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Hypersensitivity, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient believes she had an allergic reaction; Hard chest pain; Difficulty breathing; Swollen arm; Itching; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Hard chest pain), DYSPNOEA (Difficulty breathing), PERIPHERAL SWELLING (Swollen arm), PRURITUS (Itching) and HYPERSENSITIVITY (Patient believes she had an allergic reaction) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Food allergy. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced CHEST PAIN (Hard chest pain), DYSPNOEA (Difficulty breathing), PERIPHERAL SWELLING (Swollen arm) and PRURITUS (Itching). On 13-Sep-2021, the patient experienced HYPERSENSITIVITY (Patient believes she had an allergic reaction). At the time of the report, CHEST PAIN (Hard chest pain) and HYPERSENSITIVITY (Patient believes she had an allergic reaction) outcome was unknown, DYSPNOEA (Difficulty breathing) was resolving and PERIPHERAL SWELLING (Swollen arm) and PRURITUS (Itching) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient had certain food allergies, but not to medications. No Treatment information was provided. No concomitant information was provided


VAERS ID: 1721671 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-14
Onset:2021-09-10
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027O21A / 1 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Back pain, Body temperature, Cardiospasm, Chest pain, Chills, Discomfort, Dizziness, Fatigue, Hyperhidrosis, Impaired work ability, Myalgia, Nausea, Pain, Pain in extremity, Peripheral swelling, Pruritus, Pyrexia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Fever; Result Unstructured Data: 103.5 F fever around 1 am; Test Date: 20210912; Test Name: Fever; Result Unstructured Data: fever dropped to 100.1?F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: itchy; arm is swollen; eyes are so blurry which impeded her ability to work; Legs and calves are killing her; throbbing pain in back; still exhausted; a lot of pressure; sudden pain in her chest; everything hurts/achy/sore; dizzy; blurry eyes/can barely see their computer; fever dropped to 100.1?F; sweating a lot/they were like in a puddle of water; body aches; chills; nausea; 103.5?F fever, 105-degree feve; sudden pain in their heart/heart hurt so bad/not like chest pain,but like a stabbing pain in the heart that lasted for 36 hours; like a spasm in their heart; This spontaneous case was reported by a consumer and describes the occurrence of ANGINA PECTORIS (sudden pain in their heart/heart hurt so bad/not like chest pain,but like a stabbing pain in the heart that lasted for 36 hours) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A and 027O21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021 at 10:30 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced ANGINA PECTORIS (sudden pain in their heart/heart hurt so bad/not like chest pain,but like a stabbing pain in the heart that lasted for 36 hours) (seriousness criterion medically significant) and CARDIOSPASM (like a spasm in their heart). On 11-Sep-2021, the patient experienced HYPERHIDROSIS (sweating a lot/they were like in a puddle of water), MYALGIA (body aches), CHILLS (chills), NAUSEA (nausea) and PYREXIA (103.5?F fever, 105-degree feve). On 12-Sep-2021, the patient experienced PYREXIA (fever dropped to 100.1?F). On 13-Sep-2021, the patient experienced DIZZINESS (dizzy), VISION BLURRED (blurry eyes/can barely see their computer) and PAIN (everything hurts/achy/sore). On an unknown date, the patient experienced PRURITUS (itchy), PERIPHERAL SWELLING (arm is swollen), IMPAIRED WORK ABILITY (eyes are so blurry which impeded her ability to work), PAIN IN EXTREMITY (Legs and calves are killing her), BACK PAIN (throbbing pain in back), FATIGUE (still exhausted), DISCOMFORT (a lot of pressure) and CHEST PAIN (sudden pain in her chest). The patient was treated with FAMOTIDINE (PEPCID [FAMOTIDINE]) for Adverse event, at an unspecified dose and frequency and IBUPROFEN for Adverse event, at an unspecified dose and frequency. On 10-Sep-2021, ANGINA PECTORIS (sudden pain in their heart/heart hurt so bad/not like chest pain,but like a stabbing pain in the heart that lasted for 36 hours) and CARDIOSPASM (like a spasm in their heart) had resolved. On 12-Sep-2021, PYREXIA (fever dropped to 100.1?F) had resolved. At the time of the report, DIZZINESS (dizzy), VISION BLURRED (blurry eyes/can barely see their computer), HYPERHIDROSIS (sweating a lot/they were like in a puddle of water), PAIN (everything hurts/achy/sore), PRURITUS (itchy), PERIPHERAL SWELLING (arm is swollen), IMPAIRED WORK ABILITY (eyes are so blurry which impeded her ability to work), PAIN IN EXTREMITY (Legs and calves are killing her), BACK PAIN (throbbing pain in back), FATIGUE (still exhausted), DISCOMFORT (a lot of pressure) and CHEST PAIN (sudden pain in her chest) outcome was unknown and MYALGIA (body aches), CHILLS (chills), NAUSEA (nausea) and PYREXIA (103.5?F fever, 105-degree feve) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Sep-2021, Body temperature: 103.5 f (High) 103.5 F fever around 1 am. On 12-Sep-2021, Body temperature: 100.1 f (High) fever dropped to 100.1?F. No relevant concomitant medications were reported Company comment: This case concerns a 60 year old female patient, who experienced unexpected serious events of ANGINA PECTORIS. The serious event occurred same day after the second dose of mRNA-1273 vaccine. The patient also experienced non-serious events of CARDIOSPASM, HYPERHIDROSIS, MYALGIA, CHILLS, NAUSEA, PYREXIA, DIZZINESS, VISION BLURRED, PAIN, PRURITUS, PERIPHERAL SWELLING, IMPAIRED WORK ABILITY, PAIN IN EXTREMITY, BACK PAIN, FATIGUE, DISCOMFORT, CHEST PAIN, ANGINA PECTORIS. The non-serious events occurred on 1-3 days after the second dose of mRNA-1273 vaccine. Limited information regarding the events have been provided at this time. The benefit-risk relationship of the vaccine is not affected by this report. Most recent FOLLOW-UP information incorporated above includes: On 13-Sep-2021: FU received and contains new events: Peripheral swelling, Impaired work ability, Pain in extremity, Back pain, Fatigue, Discomfort, Chest Pain.; Sender''s Comments: This case concerns a 60 year old female patient, who experienced unexpected serious events of ANGINA PECTORIS. The serious event occurred same day after the second dose of mRNA-1273 vaccine. The patient also experienced non-serious events of CARDIOSPASM, HYPERHIDROSIS, MYALGIA, CHILLS, NAUSEA, PYREXIA, DIZZINESS, VISION BLURRED, PAIN, PRURITUS, PERIPHERAL SWELLING, IMPAIRED WORK ABILITY, PAIN IN EXTREMITY, BACK PAIN, FATIGUE, DISCOMFORT, CHEST PAIN, ANGINA PECTORIS. The non-serious events occurred on 1-3 days after the second dose of mRNA-1273 vaccine. Limited information regarding the events have been provided at this time. The benefit-risk relationship of the vaccine is not affected by this report.


VAERS ID: 1721754 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Expired product administered, Headache, Inappropriate schedule of product administration
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: Comments: No medical history was provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Chills; Headache; expired vaccine used; received 2 doses on same day; This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills), HEADACHE (Headache), EXPIRED PRODUCT ADMINISTERED (expired vaccine used) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 2 doses on same day) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was provided by the reporter. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced CHILLS (Chills), HEADACHE (Headache), EXPIRED PRODUCT ADMINISTERED (expired vaccine used) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 2 doses on same day). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (expired vaccine used) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (received 2 doses on same day) had resolved. On 12-Sep-2021, CHILLS (Chills) had resolved. At the time of the report, HEADACHE (Headache) had not resolved. No concomitant medication provided. No treatment information provided. The patient said that the first dose was an expired dose and therefore on the same day, another dose was injected.


VAERS ID: 1721786 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Condition aggravated, Myalgia, Oropharyngeal discomfort, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore arm; Symptoms kept on getting worse; Throat started closing up 15 to 20 minutes after the shot; Developed chills; Body aches/Body was aching really bad; Fever; This spontaneous case was reported by a consumer and describes the occurrence of CONDITION AGGRAVATED (Symptoms kept on getting worse), OROPHARYNGEAL DISCOMFORT (Throat started closing up 15 to 20 minutes after the shot), PAIN IN EXTREMITY (Sore arm), CHILLS (Developed chills) and MYALGIA (Body aches/Body was aching really bad) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Diabetes. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced OROPHARYNGEAL DISCOMFORT (Throat started closing up 15 to 20 minutes after the shot), CHILLS (Developed chills) and PYREXIA (Fever). 10-Sep-2021, the patient experienced MYALGIA (Body aches/Body was aching really bad). On 11-Sep-2021, the patient experienced CONDITION AGGRAVATED (Symptoms kept on getting worse). On 12-Sep-2021, the patient experienced PAIN IN EXTREMITY (Sore arm). On 12-Sep-2021, PYREXIA (Fever) had resolved. At the time of the report, CONDITION AGGRAVATED (Symptoms kept on getting worse), OROPHARYNGEAL DISCOMFORT (Throat started closing up 15 to 20 minutes after the shot) and CHILLS (Developed chills) outcome was unknown and PAIN IN EXTREMITY (Sore arm) and MYALGIA (Body aches/Body was aching really bad) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant product information was provided. No treatment information was provided.


VAERS ID: 1721801 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Sore arm/Still slightly sore; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (Sore arm/Still slightly sore) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Heart disease, unspecified. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced MYALGIA (Sore arm/Still slightly sore). At the time of the report, MYALGIA (Sore arm/Still slightly sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No Concomitant medications were reported. No Treatment information was reported. Reporter did not allow further contact


VAERS ID: 1722160 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Paraesthesia, Swelling, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Sexual dysfunction (broad)

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

Write-up: Tingling sensation on her face / Forearm was tingling / Fingertips were tingling; Numb Face, felt like she had a Novocain shot / Forearm was numb / Fingertips were numbing; Head is Lumpy / head is swollen; The injection site hurts; Pain at the top of her head / Even when she moves her hair, it hurts / head is tender; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (Tingling sensation on her face / Forearm was tingling / Fingertips were tingling), HYPOAESTHESIA (Numb Face, felt like she had a Novocain shot / Forearm was numb / Fingertips were numbing), SWELLING (Head is Lumpy / head is swollen), VACCINATION SITE PAIN (The injection site hurts) and HEADACHE (Pain at the top of her head / Even when she moves her hair, it hurts / head is tender) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced HEADACHE (Pain at the top of her head / Even when she moves her hair, it hurts / head is tender). On 11-Sep-2021, the patient experienced PARAESTHESIA (Tingling sensation on her face / Forearm was tingling / Fingertips were tingling), HYPOAESTHESIA (Numb Face, felt like she had a Novocain shot / Forearm was numb / Fingertips were numbing), SWELLING (Head is Lumpy / head is swollen) and VACCINATION SITE PAIN (The injection site hurts). The patient was treated with ACETAMINOPHEN for Adverse event, at a dose of 500 mg. At the time of the report, PARAESTHESIA (Tingling sensation on her face / Forearm was tingling / Fingertips were tingling), HYPOAESTHESIA (Numb Face, felt like she had a Novocain shot / Forearm was numb / Fingertips were numbing), SWELLING (Head is Lumpy / head is swollen), VACCINATION SITE PAIN (The injection site hurts) and HEADACHE (Pain at the top of her head / Even when she moves her hair, it hurts / head is tender) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication information was not provided by the reporter.


VAERS ID: 1722175 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037L21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Pyrexia, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chills; Tiredness; Nausea; Low grade fever; Pain at the site of the injection (upper left body); This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills), FATIGUE (Tiredness), NAUSEA (Nausea), PYREXIA (Low grade fever) and VACCINATION SITE PAIN (Pain at the site of the injection (upper left body)) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037L21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced CHILLS (Chills), FATIGUE (Tiredness), NAUSEA (Nausea), PYREXIA (Low grade fever) and VACCINATION SITE PAIN (Pain at the site of the injection (upper left body)). At the time of the report, CHILLS (Chills), FATIGUE (Tiredness), NAUSEA (Nausea), PYREXIA (Low grade fever) and VACCINATION SITE PAIN (Pain at the site of the injection (upper left body)) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication were reported. No treatment information was provided by the reporter.


VAERS ID: 1722176 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Insomnia, Oropharyngeal pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Insomnia; Sore throat; Runny nose; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore throat), RHINORRHOEA (Runny nose) and INSOMNIA (Insomnia) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat) and RHINORRHOEA (Runny nose). On an unknown date, the patient experienced INSOMNIA (Insomnia). At the time of the report, OROPHARYNGEAL PAIN (Sore throat), RHINORRHOEA (Runny nose) and INSOMNIA (Insomnia) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medication details was reported. No treatment medication details was reported.


VAERS ID: 1722227 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNK / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site pain
SMQs:

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

Write-up: Covid Arm; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a health care professional and describes the occurrence of VACCINATION SITE PAIN (Covid Arm) in an adult patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unk) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced VACCINATION SITE PAIN (Covid Arm). At the time of the report, VACCINATION SITE PAIN (Covid Arm) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medication was reported. No Treatment medication was reported.


VAERS ID: 1722249 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine given after manufacturer beyond use date exceeded by 2 days (product expired on 9/8/21 but was given on 9/10/21).


VAERS ID: 1722252 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 3 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine given after manufacturer beyond use date exceeded by 2 days (product expired on 9/8/21 but was given on 9/10/21).


VAERS ID: 1722254 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine given after manufacturer beyond use date exceeded by 2 days (product expired on 9/8/21 but was given on 9/10/21).


VAERS ID: 1722256 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine given after manufacturer beyond use date exceeded by 2 days (product expired on 9/8/21 but was given on 9/10/21).


VAERS ID: 1722257 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vaccine given after manufacturer beyond use date exceeded by 2 days (product expired on 9/8/21 but was given on 9/10/21).


VAERS ID: 1722265 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Back pain, Headache, Heavy menstrual bleeding, Malaise, Menstruation delayed, Oropharyngeal pain, Skin warm, Uterine spasm
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Fertility disorders (broad)

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

Write-up: Uterus cramps, abdomen felt warm in the days following the vaccination, lower back pain, Delayed Period by 2 days. I track my cycle and have been regular with no cramping for 3 years. since being vaccinated, my period is heavier and the cramps are significantly worse Also experienced sore throat for 4 days after the vaccination, and a headache. Have had an overall unwell feeling since the vaccination


VAERS ID: 1722268 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-21
Onset:2021-09-10
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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? 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-19 test
CDC Split Type:

Write-up: Employee tested positive for COVID-19 after being fully vaccinated


VAERS ID: 1722445 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-27
Onset:2021-09-10
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053EZCA / 1 LA / SYR

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

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

Write-up: I developed a pain in my back on the right side. Then developed a rash on Wednesday, Sept 15. I was then given an antiviral by my dr for the shingles that had developed.


VAERS ID: 1722470 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-17
Onset:2021-09-10
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Fall, Hypoxia, SARS-CoV-2 test positive, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol (VENTOLIN HFA) 108 (90 BASE) MCG/ACT HFA inhaler albuterol (VENTOLIN) (2.5 mg/3 mL) 0.083% nebulizer solution apixaban (ELIQUIS) 2.5 MG TABS tablet donepezil (ARICEPT) 5 MG tablet DULoxetine (CYMBALTA) 30 MG DR capsule famotidine
Current Illness: None known
Preexisting Conditions: Type 2 diabetes mellitus without complication Essential hypertension Hyperlipidemia BPH (benign prostatic hyperplasia) Primary insomnia OSA on CPAP CKD (chronic kidney disease) stage 3, GFR 30-59 ml/min Dehydration Chronic obstructive pulmonary disease, unspecified COPD type Vitamin B12 deficiency anemia due to intrinsic factor deficiency Falls frequently Hyperkalemia Syncope, unspecified syncope type Idiopathic gout, unspecified chronicity, unspecified site Chronic pain syndrome Seizure Lumbar radicular pain Syncope and collapse COPD with acute exacerbation PAF (paroxysmal atrial fibrillation) Paroxysmal atrial flutter NSVT (nonsustained ventricular tachycardia)
Allergies:
Diagnostic Lab Data: COVID-19 test positive on 9/10/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 9/10/2021 after falling at his home. He was found to be tachypneic and hypoxic at home and was transported to emergency department. He was admitted previously from 8/25/21 to 9/3/21 for COPD exacerbation. Patient was found to be COVID-19 positive and in a. fib. He was admitted for further management. He was treated with remdesivir and dexamethasone. He was discharged to an extended care facility on 9/21/2021.


VAERS ID: 1722483 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Impaired work ability, Musculoskeletal pain, Myalgia, Neuropathy peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune 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: Humira, Diclofenac, Cetirizine, Vitamin D
Current Illness:
Preexisting Conditions: Ankylosing Spondylitis
Allergies: Naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme joint/muscle pain. Musculoskeletal flare. Back, bilateral hip, neck and bilateral shoulder pain. Pain in knees, toes, ankles and wrists. Joints felt like they were on fire. Severe myalgia in back, legs and shoulders. Muscles hurt to touch. Neuropathy in hips and legs. Hurt to walk, sit, bend and lay down. Symptoms lasted for 8 days. Physician prescribed Prednisone to treat symptoms. Unable to work for several days.


VAERS ID: 1722583 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: fatigue, fever, chills, headache, myalgia for 3 days fatigue, low grade temperature, chills, and headache for 9 days


VAERS ID: 1722591 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-16
Onset:2021-09-10
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: Birth control pills
Current Illness: none
Preexisting Conditions: Granulomatosis with Polyangiitis
Allergies: Latex, Vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: First Covid vaccine on 8/16/21. Menstrual period started 3 weeks later (which came 1 week early) Heavy bleeding and cramping for 11 days. On Oral contraceptives without missing any pills.


VAERS ID: 1722661 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Bursitis
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Lesion drained and testing pending but does not appear infectious.
CDC Split Type:

Write-up: Patient developed olecranon bursitis a day after Moderna injection in left arm. Non infectious bursitis.


VAERS ID: 1722758 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-09-10
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: Coronavirus 2 PCR Detect, V symptomatic POSITIVE
CDC Split Type:

Write-up: CHIEF COMPLAINT/REASON FOR VISIT Weakness - Generalized HISTORY OF PRESENT ILLNESS This is a 74-year-old male who was diagnosed with COVID-19 back on September 10th. He presents the emergency department because of progressive dyspnea with minimal exertion. The patient reports that he has had a dry cough as well. He denies any frank chest pain however. Patient did receive a Johnson and Johnson vaccine several months ago. He denies any new peripheral edema, but does have chronic lower extremity edema. He denies any high fevers or chills. He denies a headache, nausea vomiting, abdominal pain, or diarrhea.


VAERS ID: 1723047 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, COVID-19, Diarrhoea, Fatigue, Injection site pain, Migraine, Pyrexia, SARS-CoV-2 test positive
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Stress B-Complex plus Zinc, spironolactone
Current Illness: N/A
Preexisting Conditions: Adult ADD, acne
Allergies: N/A
Diagnostic Lab Data: COVID-19 rapid test positive for COVID-19 on 09/16/2021
CDC Split Type:

Write-up: Extreme fatigue, migraine, feeling of burning bones, feeling of burning muscles, diarrhea, extreme pain in shoulder of injection site, fever 102. The diarrhea subsided after 36 hours, all other symptoms eased after 36 hours but remained for 5 days


VAERS ID: 1723066 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood creatine phosphokinase, Chest pain, Dyspnoea, Echocardiogram, Fibrin D dimer, Flank pain, Flushing, Full blood count, Headache, Metabolic function test, Nodule, Palpitations, Troponin I
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (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: Testosterone IM, temazepam, Ambien, Juluca, Viagra, Lyrica, Adderall XR, Adderall
Current Illness:
Preexisting Conditions: HIV infection, anxiety, ADHD, neuropathy, erectile dysfunction, hypogonadism, cervical and lumbar disc disease
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, CPK, troponin I, and d-dimer; transthoracic echocardiogram - all of these still pending and not yet obtained.
CDC Split Type:

Write-up: shortness of breath, chest palpitations, chest pain, flushing, headaches, pain in RUQ abdomen and right flank, and dime-sized testicular nodule. Shortness of breath, chest palpitations, and chest pain began evening he received the Pfizer COVID-19 vaccine. Patient has significant skepticism and anxiety about receiving the COVID-19 vaccine, which he received because it was required by employer.


VAERS ID: 1723141 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-02-24
Onset:2021-09-10
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL 3248 / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN 6203 / 2 AR / IM

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

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

Write-up: FULLY VAXED AS OF 2/24/2021 AND DEVELOPED COVID SXS 9/10/2021 AND DIAGNOSED 09/12/2021. ADMITTED TO HOSPITAL 9/15/2021 DUE TO COVID.CURRENTLY STILL HOSPITALIZED, IMPROVING AND HAS PLANS FOR BEIGN DISCHARGED TO REHAB WITHIN THE WEEK


VAERS ID: 1723184 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-09-10
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Angiogram, Blood test, Cerebrovascular accident, Computerised tomogram normal, Electroencephalogram, Magnetic resonance imaging
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalopathy/delirium (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Oral 2000 units daily (most days) Fluticasone Nasal Spray each nostril daily (AM) Allergy Shots (environmental) on Monday--prior to this FRIDAY AM stroke. Been on allergy shots for 2-3 years this time around Estrace vaginal cream
Current Illness: March 1, 2021 Otitis Media Vaccine 1 (Moderna) on 2/23/21
Preexisting Conditions: Left Knee Osteoarthritis Very mild psoriasis controlled by occasional steroid cream or ointment. Sinusitis or Otitis Media about once every 12-18 months as long as I am on allergy shots. Overweight for about 9 years. DIzziness about 8 years ago-tumor ruled out with MRI. Just balance exercises prescribed. Rarely ever a problem now with or without the balance exercises. Overall, very good health. Risk Factors Preexisting for Stroke: Age, Weight, Family History (Father family side)
Allergies: Sulfa (Hives)
Diagnostic Lab Data: 9/10/2021: CT CTA EEG MRI, TTE. Full blood work, vitals. All WNL except for MRI
CDC Split Type:

Write-up: Stroke. Lacunar Left Hippocampus. Memory loss/failure to make new memories for about 6-8 hours. Started about 1230 AM on September 9, 2021. No changes in motor function. All other tests (CT CTA, TTE, EEG, CBC, LFT, Kidney Glucose, HR, BP, etc) all WNL Lucanar spot found on MRI with and without contrast only. Admitted for about 37 hours. Back to normal but have NOT regained that period of time lost. Only a few "snapshots" of events do I have. My husband was the history provider. I did apparently have to give my medical info at hospital (husband not immediately allowed inside) but I do NOT remember what I told the, that I gave them my insurance cards, the ED doc, nurse, etc. Started remembering folks (new folks) about 8 hours after husband identified first problems at home.


VAERS ID: 1723191 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-23
Onset:2021-09-10
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / -

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

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

Write-up: Patient is hospitalized due to COVID-19. Patient is fully vaccinated.


VAERS ID: 1723244 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-08-03
Onset:2021-09-10
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, lamotrigine
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Penicillin, amoxicillin
Diagnostic Lab Data: Urgent care visit 09/15/2022
CDC Split Type:

Write-up: Hives on all body parts (legs, trunk, arms, face). Diphenhydramine 25 mg relieves hives. They started 09/10/2021 and are still present.


VAERS ID: 1723620 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Extra dose administered, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd vaccine
Other Medications: Amlodipine,; levothyroxine; Alendronate Sodium; Atorvasttatin; Vascepa, Valcyclovir; magnesium; vit C; D3, bitter melon; calcium; msm; zinc; glucosamine; tumerice
Current Illness: breast cancer
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Nausea, vomiting, diarrhea; severe unremitting headache


VAERS ID: 1723821 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO187 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Autonomic nervous system imbalance, Blood pressure increased, Condition aggravated, Eye pain, Fatigue, Flushing, Headache, Immediate post-injection reaction, Mental fatigue, Myalgia, Neck pain, Neurological examination, Pain in extremity, Palpitations, Post concussion syndrome, Stress, Tinnitus, Toothache
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (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: Atenolol 25 mg, Gabapentin 300 mg a.m. & 600 mg p.m., Zrytec, Amitriptyline 25 mg, Curcumin, Total L-Carnitine (Nutri-West), CoQ10, Methyl-SP (Apex Energetics), Magnesium, Vitamin E, Selenium, Trizomal Glutathione, Vitamin C, Vitamin D
Current Illness: Mild head congestion, mild sore throat, headaches, and mild stomach upset-was tested for COVID on August 29th. PCR was negative.
Preexisting Conditions: Post-concussion syndrome-first concussion January, 2019, second concussion February, 2021. Dysautonomia since January, 2019.
Allergies: Gluten & dairy No known medical allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate significant arm pain which progressed up into shoulder and neck. Lasted for several days. Aching teeth for first 48 hours. Headache began within 45 minutes after vaccination which has continued off and on daily since vaccination. It includes pain on the right side of head and at times pain behind right eye. Increased mental & physical fatigue daily since vaccination. Increased daily tinnitus. Daily symptoms from dysautonomia-facial flushing & heart pounding. Occasional elevated blood pressure with increased stress. Daily muscle aches- shoulders & legs. I have seen my chiropractic neurologist & functional medicine doctors who have successfully helped me with treating my prior concussions as these symptoms are all reminiscent of my prior concussions. I am also receiving dry needling from physical therapy. I am managing my symptoms by avoiding excessive physical & mental stress.


VAERS ID: 1723842 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-09-10
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flucocinonide, Albuterol, Floven; Atorvastatin
Current Illness: Prostatectomy, bilateral lymph node dissection, possible conversion to open and umbilical repair. Date of Surgery: 3/26/2021.
Preexisting Conditions: mixed hyperlipidemia; eczema; adenamatous colonic polyps; prostate cancer
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Called into clinic to report he tested positive 9/21/21. Symptoms started about 2 weeks ago


VAERS ID: 1723860 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-09-10
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea, Dyspnoea exertional, Hypoxia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presenting with worsening shortness of breath and detected hypoxic and at home monitoring with confirmed COVID-19 5 days ago. On arrival to the emergency department he is oxygenating at low 90''s on room air, he dips to 87% with ambulation. Placed 3 L via nasal cannula and he has oxygen 97% at rest. If get tachypnea or increased work of breathing. Abdomen is soft and nontender. Afebrile, normotensive in overall well-appearing. He x-ray a confirms COVID pneumonia, No Lot # . Vaccine administered at Outside facility.


VAERS ID: 1723871 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-15
Onset:2021-09-10
   Days after vaccination:207
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fall
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow)

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

Write-up: presents emergency department today after having fallen at home. He reports that he fell in the bathroom and slipped on some water or urine that was on the floor and fell into a heap on the floor. He reports he did not hit his head. He denies loss of consciousness. He did not experience any tunneling of vision. No history of seizures. No urinary incontinence during the episode. He denies pain anywhere currently. He reports he has been feeling weaker in the last day


VAERS ID: 1724294 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN O43A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Chills, Dyspnoea, Fatigue, Injection site pain, Oxygen saturation decreased, Pain, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (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: TDAP 47 YRS late amount of swelling at injection site fever and chills Flu several years I had injection site swelling chills
Other Medications: Levothyroxine meloxicam detrol vit D vit c magnesium zonc elderberry clonidine zyrtec
Current Illness: None
Preexisting Conditions: Restless leg syndrome hashimoto''s arthritis
Allergies: Sulfa wheat eggs milk corn
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, body aches, injection site pain, chest pain, fatigue, shortness of breath decrease oxygen level tachycardia with exertion.


VAERS ID: 1724443 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Injection site pain
SMQs:, Retroperitoneal fibrosis (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: PT ALLEGES SHE EXPERIENCED PAIN TO THE LEFT SHOULDER AND BACK 7 DAYS AFTER RECEIVING HER FIRST DOSE OF COVID PFIZER VACCINE.


VAERS ID: 1725252 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-16
Onset:2021-09-10
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Body temperature, Gait disturbance, Mobility decreased, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Started to feel very weak; Can barely move the body; Almost can not walk; 100.2? fever; This spontaneous case was reported by a consumer and describes the occurrence of ASTHENIA (Started to feel very weak), MOBILITY DECREASED (Can barely move the body), GAIT DISTURBANCE (Almost can not walk) and PYREXIA (100.2? fever) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 059E21O, 021M20A and 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced ASTHENIA (Started to feel very weak), MOBILITY DECREASED (Can barely move the body), GAIT DISTURBANCE (Almost can not walk) and PYREXIA (100.2? fever). At the time of the report, ASTHENIA (Started to feel very weak), MOBILITY DECREASED (Can barely move the body), GAIT DISTURBANCE (Almost can not walk) and PYREXIA (100.2? fever) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Sep-2021, Body temperature: 100.2 (High) High. No concomitant medications were reported. No treatment medications were reported. Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Follow up received contain no new information. On 12-Sep-2021: Follow up received contain updated event out case as recovered/resolved.


VAERS ID: 1725305 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 RA / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D3; LEXAPRO; PROTOPIC
Current Illness: ADD; Allergy to gold (Allergy to gold salts); Drug allergy (allergy to lisinopril); Drug allergy (Allergy to Balsam Peru-zinc Oxide); Hypertension; Latex allergy; Perioral dermatitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: expired vaccine administered; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (expired vaccine administered) in a 40-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001B21A) for COVID-19 vaccination. Co-suspect product included non-company product LOSARTAN for an unknown indication. Concurrent medical conditions included Allergy to gold (Allergy to gold salts), Latex allergy, Drug allergy (allergy to lisinopril), Drug allergy (Allergy to Balsam Peru-zinc Oxide), ADD, Hypertension and Perioral dermatitis. Concomitant products included TACROLIMUS MONOHYDRATE (PROTOPIC) for Perioral dermatitis, VITAMIN D3 and ESCITALOPRAM OXALATE (LEXAPRO) for an unknown indication. On 10-Sep-2021 at 10:00 AM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose and LOSARTAN (Oral) 50 mg once a day. On 10-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (expired vaccine administered). On 10-Sep-2021, EXPIRED PRODUCT ADMINISTERED (expired vaccine administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment drug was provided by reporter. concomitant medication include Multivitamin. Most recent FOLLOW-UP information incorporated above includes: On 15-Sep-2021: Patient initial, demographic details, Allergy (Gold Salts, Latex, Lisinopril & Balsam Peru-zinc Oxide) and current conditions (HTN, facial dermatitis) added. Concomitant medications (Vitamin D3, Lexapro, Losartan, Protopic and Multivitamin) added.


VAERS ID: 1725313 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-05
Onset:2021-09-10
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007D21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Dysphagia, Injection site rash, Palpitations, Pyrexia, Rash, Somnolence
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (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), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Body temperature; Result Unstructured Data: low grade fever of 99.9
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: "All he does is sleep"; Racing heart; Swallowing difficult; severe rash on his arms, chest, back and neck; low grade fever of 99.9; he noticed a rash under the band-aid after removing band-aid (on the injection arm).; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE ("All he does is sleep"), DYSPHAGIA (Swallowing difficult), PALPITATIONS (Racing heart), INJECTION SITE RASH (he noticed a rash under the band-aid after removing band-aid (on the injection arm).) and RASH (severe rash on his arms, chest, back and neck) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045C21A and 007D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 05-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced INJECTION SITE RASH (he noticed a rash under the band-aid after removing band-aid (on the injection arm).). On 11-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DYSPHAGIA (Swallowing difficult), RASH (severe rash on his arms, chest, back and neck) and PYREXIA (low grade fever of 99.9). On 12-Sep-2021, the patient experienced PALPITATIONS (Racing heart). On an unknown date, the patient experienced SOMNOLENCE ("All he does is sleep"). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Adverse event, at an unspecified dose and frequency; IBUPROFEN for Adverse event, at an unspecified dose and frequency and CORTISONE for Adverse event, at an unspecified dose and frequency. At the time of the report, SOMNOLENCE ("All he does is sleep"), DYSPHAGIA (Swallowing difficult), PALPITATIONS (Racing heart), INJECTION SITE RASH (he noticed a rash under the band-aid after removing band-aid (on the injection arm).), RASH (severe rash on his arms, chest, back and neck) and PYREXIA (low grade fever of 99.9) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 11-Sep-2021, Body temperature: 99.9 (High) low grade fever of 99.9. Concomitant medication were not reported by the reporter.


VAERS ID: 1725333 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-08-10
Onset:2021-09-10
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045821A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Vaccination site pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN; MULTIVITAMINS [VITAMINS NOS]; B COMPLEX (B50)
Current Illness: Pollen allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Headache; Pain at the injection site; This spontaneous case was reported by a consumer and describes the occurrence of HEADACHE (Headache) and VACCINATION SITE PAIN (Pain at the injection site) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030B21A and 045821A) for COVID-19 vaccination. Concurrent medical conditions included Pollen allergy. Concomitant products included METFORMIN, MULTIVITAMINS [VITAMINS NOS] and VITAMIN B COMPLEX (B COMPLEX (B50)) for an unknown indication. On 10-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced HEADACHE (Headache) and VACCINATION SITE PAIN (Pain at the injection site). The patient was treated with PARACETAMOL (TYLENOL) (oral) for Adverse event, at a dose of 2 tablets. At the time of the report, HEADACHE (Headache) and VACCINATION SITE PAIN (Pain at the injection site) outcome was unknown. Concomitant medications also include Thyroid medications Patient had a suspect that the pharmacist injected a different vaccine. She was with her husband who was scheduled to get the vaccine for shingles on the same schedule of her second dose. As per patient, the pharmacist brought out three syringes at the same time, 1 for her husband which was a shingles vaccine and the other two which were Moderna vaccine, one for her and one for the other patient. She noticed that the pharmacist was kind of confused that time. She said she already informed the manager of the facility but they cannot prove yet if she got the Moderna vaccine or a different one.


VAERS ID: 1725353 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New York  
Vaccinated:2021-01-28
Onset:2021-09-10
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Cerebrovascular accident, Incoherent, Memory impairment, Paralysis, Pyrexia, Vaccination site erythema, Vaccination site inflammation, Vaccination site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Body Temperature; Result Unstructured Data: 103 F.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Paralyzed for 2 days after 3rd dose/Could not move after 3rd dose; Stroke after 3rd dose; Fever 103 F after 3rd dose; Incoherent on the floor; Does not remember what happened after 3rd dose/No recollection of what happened on 9 & 10SEP2021; Hot left arm injection site after 3rd dose; Inflamed left arm after 3rd dose; Red injection site shoulder to elbow after 3rd dose; This spontaneous case was reported by a patient and describes the occurrence of PARALYSIS (Paralyzed for 2 days after 3rd dose/Could not move after 3rd dose), CEREBROVASCULAR ACCIDENT (Stroke after 3rd dose) and PYREXIA (Fever 103 F. after 3rd dose) in a 69-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 28-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced PARALYSIS (Paralyzed for 2 days after 3rd dose/Could not move after 3rd dose) (seriousness criteria hospitalization prolonged and medically significant), CEREBROVASCULAR ACCIDENT (Stroke after 3rd dose) (seriousness criteria hospitalization prolonged and medically significant), PYREXIA (Fever 103 F. after 3rd dose) (seriousness criterion hospitalization prolonged), INCOHERENT (Incoherent on the floor), MEMORY IMPAIRMENT (Does not remember what happened after 3rd dose/No recollection of what happened on 9 & 10SEP2021), VACCINATION SITE WARMTH (Hot left arm injection site after 3rd dose), VACCINATION SITE INFLAMMATION (Inflamed left arm after 3rd dose) and VACCINATION SITE ERYTHEMA (Red injection site shoulder to elbow after 3rd dose). The patient was hospitalized from 10-Sep-2021 to 12-Sep-2021 due to CEREBROVASCULAR ACCIDENT, PARALYSIS and PYREXIA. The patient was treated with DOXYCYCLINE (oral) for Adverse event, at an unspecified dose and frequency. On 12-Sep-2021, PARALYSIS (Paralyzed for 2 days after 3rd dose/Could not move after 3rd dose), CEREBROVASCULAR ACCIDENT (Stroke after 3rd dose), INCOHERENT (Incoherent on the floor) and MEMORY IMPAIRMENT (Does not remember what happened after 3rd dose/No recollection of what happened on 9 & 10SEP2021) had resolved, PYREXIA (Fever 103 F after 3rd dose) outcome was unknown. At the time of the report, VACCINATION SITE WARMTH (Hot left arm injection site after 3rd dose), VACCINATION SITE INFLAMMATION (Inflamed left arm after 3rd dose) and VACCINATION SITE ERYTHEMA (Red injection site shoulder to elbow after 3rd dose) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Sep-2021, Body temperature: 103 (High) 103 F. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Patient reported that he received the third dose of Moderna Covid-19 Vaccine and 10 hours later, he had to go to the hospital, and he was released from the hospital on Sunday 12-Sep-2021 with a prescription for Doxycycline oral. Company Comment: o~This case concerns a 69 year-old, male subject with no relevant medical history reported, who experienced the unexpected events of cerebrovascular accident, paralysis and pyrexia leading to hospitalization after the third dose of mRNA-1273. The events occurred approximately 7 months and 14 days after the first dose, 6 month and 15 days after the second dose, and between a few hours and one day after the third dose of mRNA-1273. The benefit-risk relationship of the product is not affected by this report. Further information has been requesting regarding the events and patient?s medical history. Most recent FOLLOW-UP information incorporated above includes: On 14-Sep-2021: Hospitalization start date was updated.; Sender''s Comments: o~This case concerns a 69 year-old, male subject with no relevant medical history reported, who experienced the unexpected events of cerebrovascular accident, paralysis and pyrexia leading to hospitalization after the third dose of mRNA-1273. The events occurred approximately 7 months and 14 days after the first dose, 6 month and 15 days after the second dose, and between a few hours and one day after the third dose of mRNA-1273. The benefit-risk relationship of the product is not affected by this report. Further information has been requesting regarding the events and patient?s medical history.


VAERS ID: 1725367 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Rash papular, Vaccination site discomfort, Vaccination site pain, Vaccination site pruritus, Vaccination site swelling, Vaccination site warmth
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: bumps around the place of the vaccine, like mosquito bites; warm to the touch; was itchy - ongoing; it hurt if she moved or touched it; The site of injection got swollen; chills; a little bit of a headache; general discomfort in the area; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE DISCOMFORT (general discomfort in the area), RASH PAPULAR (bumps around the place of the vaccine, like mosquito bites), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PRURITUS (was itchy - ongoing) and VACCINATION SITE PAIN (it hurt if she moved or touched it) in a 48-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 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced VACCINATION SITE DISCOMFORT (general discomfort in the area), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PRURITUS (was itchy - ongoing), VACCINATION SITE PAIN (it hurt if she moved or touched it), VACCINATION SITE SWELLING (The site of injection got swollen), CHILLS (chills) and HEADACHE (a little bit of a headache). On 12-Sep-2021, the patient experienced RASH PAPULAR (bumps around the place of the vaccine, like mosquito bites). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency and HYDROCORTISONE (CORTISONE [HYDROCORTISONE]) at a dose of Cream. On 11-Sep-2021, HEADACHE (a little bit of a headache) had resolved. On 14-Sep-2021, CHILLS (chills) outcome was unknown. At the time of the report, VACCINATION SITE DISCOMFORT (general discomfort in the area), RASH PAPULAR (bumps around the place of the vaccine, like mosquito bites), VACCINATION SITE WARMTH (warm to the touch), VACCINATION SITE PRURITUS (was itchy - ongoing), VACCINATION SITE PAIN (it hurt if she moved or touched it) and VACCINATION SITE SWELLING (The site of injection got swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant products included Heart burn medications


VAERS ID: 1725386 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-14
Onset:2021-09-10
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Discomfort, Erythema, Fear, Pain, Pruritus, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PERTUZUMAB; TRASTUZUMAB
Current Illness: Breast cancer (on Chemotherapy); Chemotherapy (Chemotherapy Pertuzumab IV, Trastuzumab IV every 2 weeks)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Her biggest fear is that the rash comes back.; Pain after 3rd vaccine; Discomfort after 3rd vaccine; Rash spread even more and it was itching; Rash got worst, Rash spreading into genital and upper thighs, Rash spread even more 5 hours after took medicine, Rash spread again despite taking oral steroid/ Rash around hip; Mild itching and had mild redness on both hands; Mild itching and had mild redness on both hands; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (Pain after 3rd vaccine), DISCOMFORT (Discomfort after 3rd vaccine) and RASH (Rash got worst, Rash spreading into genital and upper thighs, Rash spread even more 5 hours after took medicine, Rash spread again despite taking oral steroid/ Rash around hip) in a 71-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 045B21A, 032B21A and 046B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Chemotherapy (Chemotherapy Pertuzumab IV, Trastuzumab IV every 2 weeks) since 2020. Concurrent medical conditions included Breast cancer (on Chemotherapy) since 2020. Concomitant products included PERTUZUMAB from 2020 to an unknown date and TRASTUZUMAB from 2020 to an unknown date for Breast cancer. On 14-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Jun-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced PRURITUS (Mild itching and had mild redness on both hands) and ERYTHEMA (Mild itching and had mild redness on both hands). On 11-Sep-2021, the patient experienced RASH (Rash got worst, Rash spreading into genital and upper thighs, Rash spread even more 5 hours after took medicine, Rash spread again despite taking oral steroid/ Rash around hip) (seriousness criterion medically significant). On 12-Sep-2021, the patient experienced DISCOMFORT (Discomfort after 3rd vaccine) (seriousness criterion medically significant) and RASH PRURITIC (Rash spread even more and it was itching). On 13-Sep-2021, the patient experienced PAIN (Pain after 3rd vaccine) (seriousness criterion medically significant). On 14-Sep-2021, the patient experienced FEAR (Her biggest fear is that the rash comes back.). The patient was treated with LORATADINE (CLARITINE) on 12-Sep-2021 for Adverse event, at an unspecified dose and frequency; DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) on 12-Sep-2021 for Adverse event, at an unspecified dose and frequency; FAMOTIDINE (PEPCID [FAMOTIDINE]) on 12-Sep-2021 for Adverse event, at an unspecified dose and frequency; PREDNISONE (oral) on 12-Sep-2021 for Adverse event, at an unspecified dose and frequency and METHYLPREDNISOLONE SODIUM SUCCINATE (SOLUMEDROL) (intravenous) on 13-Sep-2021 for Adverse event, at an unspecified dose and frequency. At the time of the report, PAIN (Pain after 3rd vaccine), DISCOMFORT (Discomfort after 3rd vaccine), RASH (Rash got worst, Rash spreading into genital and upper thighs, Rash spread even more 5 hours after took medicine, Rash spread again despite taking oral steroid/ Rash around hip), PRURITUS (Mild itching and had mild redness on both hands), ERYTHEMA (Mild itching and had mild redness on both hands) and RASH PRURITIC (Rash spread even more and it was itching) was resolving and FEAR (Her biggest fear is that the rash comes back.) outcome was unknown. The patient did not have any side effects after the first two doses. On Saturday night 11 SEP 2021, She started having a rash around her hip. On 12 SEP 2021, she got worst, the rash was spreading into genital and upper thighs. She visited Urgent care and the doctor prescribed medications.She took the medications but 4 - 5 hours later the rash spread even more and it was itching. On same day they visited the ER again. This time they gave her Prednisone Pack, after taking the oral prednisone, she was a little better. On 13 SEP 2021 around 6-7PM, the rash spread again, and she had pain this time. At 10 PM same night, went back to the ER again and received IV solumedrol and fluids. On 14 SEP 2021, she is doing better. She cancelled the chemotherapy infusion for 14 SEP 2021 and rescheduled it for next day. On 14 SEP 2021, at the time of reporting she was fine, and her biggest fear was that the rash comes back. Other treatments reported included IV fluids. This case concerns a 71 year-old, female with a history of breast cancer under chemotherapy, who experienced the unexpected serious events of pain, discomfort and rash (criteria: medically significant based on info avail and medical judgment). The events occurred between 2-4 days after the 3rd dose of mRNA-1273 Moderna vaccine. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report.; Sender''s Comments: This case concerns a 71 year-old, female with a history of breast cancer under chemotherapy, who experienced the unexpected serious events of pain, discomfort and rash (criteria: medically significant based on info avail and medical judgment). The events occurred between 2-4 days after the 3rd dose of mRNA-1273 Moderna vaccine. The benefit-risk relationship of mRNA-1273 Moderna vaccine in not affected by this report.


VAERS ID: 1725574 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Erythema, Flushing, Headache, Lymphadenopathy, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Medical History/Concurrent Conditions: Asthma; Sulfonamide allergy (Known allergies: Sulfa drugs)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101226147

Write-up: Headache; Flush red face; Flush red face; Low fever; Swollen lymph nodes under arm on right and left side; Low energy; This is a spontaneous report from a contactable consumer, the patient. A 64-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the right arm on 10Sep2021 at 16:00 (at the age of 64-years-old) as a single dose for COVID-19 immunisation. Medical history included asthma and known allergies to sulfa drugs. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. The patient received unspecified concomitant medications. On 10Sep2021 at 21:00, the patient experienced headache, flush red face, low fever, swollen lymph nodes under arm on right and left side and low energy. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events headache, flush red face, low fever, swollen lymph nodes under arm on right and left side and low energy was not resolved at the time of this report.


VAERS ID: 1725602 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Maternal exposure during pregnancy, Product use issue, Rash pruritic, Rash pustular
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Medication errors (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:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101227825

Write-up: Cluster and single pustules, red in color, raised off the skin, itchy, scattered all over the body; Cluster and single pustules, red in color, raised off the skin, itchy, scattered all over the body; Patient was pregnant at the time of vaccination/ Gestation period: 16 weeks; COVID-19 vaccine start date: 10Sep2021 and Flu vaccine start date: 10Sep2021; This is a spontaneous report from a contactable consumer, the patient. A 23-year-old pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 10Sep2021 at 18:00 (at the age of 23-years-old) as a single dose for COVID-19 immunisation. The patient did not have any medical history and known allergies. The patient''s last menstrual date was 18May2021, gestational period was 16 weeks and expected delivery date was 22Feb2022. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient received other vaccine within four weeks prior to the COVID-19 vaccine which included first dose of influenza vaccine (FLU; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 10Sep2021 for an unknown indication. The patient did not receive any concomitant medications. On 11Sep2021 at 11:00, the patient experienced cluster and single pustules, red in color, raised off the skin, itchy and scattered all over the body. The events resulted in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events cluster and single pustules, red in color, raised off the skin, itchy, scattered all over the body was not resolved at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow-up.


VAERS ID: 1726275 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide, Chest X-ray, Chest discomfort, Chest pain, Differential white blood cell count, Discomfort, Dyspnoea, Electrocardiogram, Fibrin D dimer, Full blood count, Human chorionic gonadotropin, Impaired work ability, Laboratory test, Metabolic function test, Pain in extremity, Painful respiration, Paraesthesia, SARS-CoV-2 test negative, Troponin I
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lamotrigine 100mg 1 tab bid Buspirone hcl 15 mg 1 tab tid Quetiapine Fumarate 25mg prn for sleep Levonorgestrel and Ethinyl Estradiol Tablets USP 0.15mg/0.03mg OTC: Ibuprofen 400mg prn headache Nasacourt Nasal Spray
Current Illness: N/A
Preexisting Conditions:
Allergies: mango, poison ivy
Diagnostic Lab Data: Labs: B-type Natriuretic Peptide, BMP, CBC w/Diff, D Dimer Deep Vein Thrombus Level, HCG, Qualitative, Serum, Troponin I Imaging: EKG, Chest X-Ray
CDC Split Type:

Write-up: Began having chest heaviness and shortness of breath that night. It continued all weekend. I stayed out of work Monday the 13th, because it was very uncomfortable and I couldn''t take deep breaths. Thursday the 16th, I left work early to go to an urgent care because my chest was starting to hurt in addition to the heaviness and inability to take deep breaths. Because of long wait times at the 3 clinics I tried, I went to Hospital and spent the night there. At that point, I was having trouble breathing, my chest hurt and my left arm hurt and my left palm was tingling. After they ran all their tests (listed below), they discharged me. Friday, I went to a respiratory clinic where they gave me treatments, a covid test, and 2 prescriptions: Albuterol inhaler and prednisone 10mg 1 tab tid. The covid test came back negative 3 days later. Today it is 09/23/2021, almost 2 weeks since receiving the vaccine, and I still cannot take deep breaths or yawn without it hurting. I am using the inhaler daily, and am on the last dose of the prednisone they ordered last Friday (09/17/2021).


VAERS ID: 1726339 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-22
Onset:2021-09-10
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7534 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Flank pain, Heart rate increased, Pneumonia, SARS-CoV-2 test negative, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, Zyrtec, Meloxicam, Amitriptyline, Birth control pills
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Covid test: 9-1-21. CT scan, X-ray, blood work, and Covid test: 9-10-21
CDC Split Type:

Write-up: I started having rapid heart rate and shortness of breath (8-31-21). I thought it was the Sudafed I was prescribed for an ear infection. After a few days of taking, I stopped the Sudafed but still had the symptoms. I went to a walk-in clinic for poison ivy and had a rapid Covid test, too, to make sure my symptoms weren''t from Covid (9-1-21). My test was negative. On 9-10-21, I woke up with a terrible pain in my side and went to the ER. After different tests were ran, it was determined I had pneumonia. I had another Covid test and it also came back negative.


VAERS ID: 1726376 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-09-08
Onset:2021-09-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Dysphagia, Eye inflammation, Fatigue, Inflammation, Joint stiffness, Lymphadenopathy, Mastication disorder, Migraine, Neurological examination, Orbital myositis, Pain in extremity
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), Corneal disorders (broad), Ocular motility disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu Vaccine (5 years ago ), Shingrix Vaccine ( Dec 2017 ). I had severe inflammation, severe migraine, bad skin rashes, hives, e
Other Medications: Losartan ( 100mg 1xday ) Spiriva ( 1.25mcg 2xday ) Albuterol Sulfate ( 90mcg 2xday )
Current Illness: NA
Preexisting Conditions: Kidney Disease Asthma High BP
Allergies: Shingrix Vaccine Flu Vaccine Gabapentin
Diagnostic Lab Data: Multiple Ocular Test
CDC Split Type: vsafe

Write-up: I experienced a severe migraine, inflammation, swollen lymph glands, and stiff jaw. I have also experienced difficulty swallowing and chewing, weakness on the right side of body, leg pain, severe fatigue. I got inflammation in the muscle around my eyeballs. I went to eye doctor for treatment for my eye and was diagnosed Ocular Myositis and was prescribed 800mg of ibuprofen 3xday for the inflammation. I walked to my PCP to try to be seen but they were so busy they couldn''t see me. I was able to do the virtual the appointment but the MD couldn''t do anything virtually. I had a neurologist appointment on 9/21/21 @ 9:45AM and he advised me that I do need to see my PCP in regards to the issues that I am having.


VAERS ID: 1726437 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Injection site rash, Menstruation irregular, Mobility decreased, Neuralgia, Pain, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Fertility 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Gluten
Diagnostic Lab Data: I?ve reached out to my dr twice now. He suggested ibuprofen
CDC Split Type:

Write-up: Day 1: couldn?t lift arm, beyond a ?little? sore Day 2: arm pain and rash around injection site Day 3: menstrual cycle starts 2 weeks early is incredibly painful Day 5: localized skin rash around arm gets worse and body aches start, arm still in pain Day 10: sacral nerve pain begins rash around my neck appears. Body aches still present Day 13 today: still on my menstrual cycle it is heavier and more painful that usual. Heavy bleeding for 10 days no end in sight still experiencing sacral nerve pain


VAERS ID: 1726506 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-09-10
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital with COVID symptoms and was treated with typical COVID medications. Patient discharged home.


VAERS ID: 1726517 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-09-10
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted for COVID pneumonia. Fully vaccinated March 2021.


VAERS ID: 1726550 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood cholesterol increased, Dizziness, Drug screen negative, Dyspnoea, Full blood count abnormal, Hypertension, Palpitations, Paraesthesia, Sexually transmitted disease test, Vaccination complication, Vitamin D decreased
SMQs:, Anaphylactic reaction (broad), Dyslipidaemia (narrow), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Codeine. Adverse reaction, diaphragm goes into spasms.
Diagnostic Lab Data: A complete bloodwork was conducted on me. Results only showed low on vitamin D and slightly high cholesterol. Everything else was normal. Drug screen was negative as well as STDs.
CDC Split Type:

Write-up: Within five minutes I suffered an adverse reaction to the vaccine. I experienced heart palpitations, high blood pressure, dizziness, shortness of breath, and tingling sensation in my hands. Lasted approximately 2 hours.


VAERS ID: 1726556 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)

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

Write-up: patient was given expired vaccine


VAERS ID: 1726622 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-09-10
   Days after vaccination:63
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 39B4A1-21 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Anxiety, Confusional state, Mobility decreased, Musculoskeletal stiffness
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Pain in stomach, loss of mobility, confusion, stiffness in muscles, anxiety.


VAERS ID: 1726662 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-17
Onset:2021-09-10
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (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:
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 dose02/24/21 2nd dose03/17/21 Diagnosed covid positive:09/15/21 Symptom onset:09/10/21 Exposure:Travel Symptoms:cough,fatigue,loss of smell and taste,HA


VAERS ID: 1726718 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-12
Onset:2021-09-10
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed and admitted to hospital while fully vaccinated


VAERS ID: 1726761 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-18
Onset:2021-09-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED 1 DOSE OF MODERNA ON 08/18/2021 AND RECIEVED ANOTHER DOSE OF JANSSEN ON 09/10/2021


VAERS ID: 1726799 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Speech disorder
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ruling out stroke
CDC Split Type:

Write-up: Inability to form spoken words


VAERS ID: 1726944 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-07-01
Onset:2021-09-10
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Colectomy, Colon gangrene, Intestinal ischaemia
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Ischaemic colitis (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: furosemide, gaapentin, glimepiride, methotrexate, ozepmic, pravatatin, relafen, vascepa, venlafaxine, verapamil
Current Illness: lupus, dm, htn
Preexisting Conditions: lupus, dm, htn
Allergies: codeine, lisinpril
Diagnostic Lab Data:
CDC Split Type:

Write-up: remote sudden mesenteric ischemia 2 1/2 months after vaccination with subsequent gangrenous colon and hemicolectomy


VAERS ID: 1726994 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-05-17
Onset:2021-09-10
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 LA / IM

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

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

Write-up: Hospitalized and diagnosed with COVID


VAERS ID: 1727013 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took OTC Acetaminophen tablet. Before been vaccinated with the janssen Covid 19 dose.
Current Illness: I was recovering from a shoulder injury prior to the vaccination date.
Preexisting Conditions: Hemorrhoids.
Allergies: I had severe reaction to the chickenpox vaccine in 2020
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had a big rash in my left forearm that lasted 11 days.


VAERS ID: 1727235 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-13
Onset:2021-09-10
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety
SMQs:, Hypoglycaemia (broad)

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

Write-up: Ever since the vaccine I experience anxiety at night. It can last anywhere from 3 hours to 5 hours.


VAERS ID: 1727301 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NKDA
Diagnostic Lab Data: PATIENT HAS NOT SEEN A DOCTOR
CDC Split Type:

Write-up: PATIENT STATES THAT AFTER HER 2ND DOSE OF PFIZER COVID VACCINE STARTING ON 9/10/21 SHE STARTED TO EXPERIENCE MORE NOTICEABLE HAIRLOSS. SHE SAID HER SCALP IS ITCHY AND HER HAIR HAS BEEN SHEDDING MOST NOTICEABLY WHEN SHE TAKES A SHOWER. SHE SHED A LARGE AMOUNT OF HAIR ON 9/19/21 AND SHOWED US DOCUMENTED PICTURES.


VAERS ID: 1727356 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 7405 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Muscle spasms, Neck pain, Pharyngitis streptococcal, Sleep disorder, Streptococcus test positive
SMQs:, Agranulocytosis (broad), Peripheral neuropathy (broad), Dystonia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol cold and flu severe; day and nightquil liquid caps, Phentermine 37.5 mg
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I ended up testing positive with strep six days after my 2nd shot. All of the Covid and flu tests were negative(also tested six days after shot). I was given ammox and am no longer suffering from strep. I have a strange pain in the opposite side of my neck/shoulder that I cant get to go away. It started after my first shot, then went away after the first night, but it has stuck around since my second shot. Not extreme pain, but it is hard to stay sleeping. My arm will go numb if I sleep on that side. Very annoying. The right side of my chest gets cramped now and again. I am not sure if any of this is related to the shot, but I did not know it before getting it.


VAERS ID: 1728684 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Electrocardiogram, Laboratory test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG, chest xray and labs -9/21/21
CDC Split Type:

Write-up: dyspnea


VAERS ID: 1728696 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Pericarditis, Ultrasound scan
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Trip to the ER confirmed pericarditis via EKG, ultrasound, bloodwork
CDC Split Type:

Write-up: acute pericarditis was diagnosed. Toradol injection was given, followed up by high-dose ibuprofen for 10 days.


VAERS ID: 1729048 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-24
Onset:2021-09-10
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation delayed, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility 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: Pre natal vitamins, slow fe, Flonase, citalopram 20mg
Current Illness: None
Preexisting Conditions: None
Allergies: Doxycycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual period two weeks late and very heavy with cramping. Period is normally always regular with barely any cramping.


VAERS ID: 1729053 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-01
Onset:2021-09-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse reaction, Angiogram, Chest X-ray, Chest discomfort, Electrocardiogram, Laboratory test, Mouth swelling, Ocular hyperaemia, Oropharyngeal pain, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 9/11/2021: EKG, labs, chest xray, CTA of the chest
CDC Split Type:

Write-up: On 9/10, 9 days after vaccination, I developed tightness in my chest mid morning as well as a mild sore throat. I left work. Went home, slept, woke up around 2:00 with persistent tightness in my chest and sore throat. I rested. That evening I woke up in the night, the left side of my mouth was swollen and my left eye was bloodshot. I put an ice pack on my face and went back to sleep. Next morning, I woke up (9/11), still had tightness in my chest and a sore throat and additionally my hands and feet were swollen. It was painful to walk and open and close my hands. I went to immediate care. They ran an EKG, labs, did a chest X-ray. EKG and chest xray came back clear but my labs revealed a d-dimer value of $g3,800 (normal <400) which they said was indicative of me possibly having a pulmonary embolism, especially because I had just gotten the J&J vaccine. I was sent to the hospital immediately. They did additional blood work, EKG, and a chest CT which revealed no PE. I was told it was likely just a bad vaccine reaction and sent home. I followed up with my PCPs office on 9/20 who also believed it was an adverse vaccine reaction.


VAERS ID: 1729072 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939402 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chromaturia, Laboratory test
SMQs:, Rhabdomyolysis/myopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantaprazole 40mg, Hydrochlorothiazide 12.5 mg, Anastrazole 1 mg, Montelukast 10 mg, vitamin B12, 500 mcg
Current Illness: None
Preexisting Conditions: Asthma, one kidney, Muir-Tottr syndrome, Lynch Syndrome. Multiple cancers: kidney, colon, breast, stomach..
Allergies: No, just molds and pollens.
Diagnostic Lab Data: Many tests. Contact Hospital or health center for the results. I give you mt permission.
CDC Split Type:

Write-up: Went to ER based on advice with on-call nurse. Urine was red. With one kidney and having the Muir-Torre syndrome, this was a reason to panic. Life without a working kidney could be very difficult.


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