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From the 7/16/2021 release of VAERS data:

Found 479,813 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 221 out of 4,799

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VAERS ID: 1374645 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Nausea, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Extreme fatigue and body aches began about 6 hours after the injection. About 24 hours after injection, he had low grade fever (100.3), severe fatigue, body aches, sore throat, and nausea. These symptoms lasted until about 36 hours after injection. Called physician and was instructed to continue with giving Advil and Tylenol on a rotating basis and have him rest and hydrate. I am a registered nurse and was comfortable caring for him at home with this guidance.


VAERS ID: 1374717 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Swelling, tenderness, redness, and warmth at injection site. The affected area is progressively getting bigger.


VAERS ID: 1374726 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Mobility decreased
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Swelling, tenderness, redness, warmth at the injection site, difficulty moving injected arm. Symptoms began after vaccination, and have progressively gotten worse/affected site has gotten bigger.


VAERS ID: 1374755 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

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

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

Write-up: Incorrect brand given for second dose. Received Moderna for first dose and Pfizer for second dose.


VAERS ID: 1375041 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Mobility decreased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Within an hour I was light headed, followed by extreme aches and fever, then chills. Unable to get out of bed. 60 hours duration.


VAERS ID: 1375087 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram normal, Full blood count normal, Immediate post-injection reaction, Injection site haemorrhage, Loss of consciousness, Syncope, Urine analysis normal
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data: CBC with diff on 6/2/21 at the hospital - normal UA at the hospital normal except for trace of blood in urine( patient on her period) on 6/2/21 12 Lead EKG at the hospital 6/2/21- WNL
CDC Split Type:

Write-up: excessive bleeding immediately the needle was withdrawn. then 9 hrs later when the bandage was being removed patient fainted for 5 mins associated with LOC.


VAERS ID: 1375296 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pneumothorax
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Ibuprofen 800mg Cyclobenzaprine 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: Cats
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced left sided chest pain that started a few hours prior to getting his second dose of the covid vaccine on June 1, 2021. Patient states the pain worsened after receiving his second dose of the vaccine. He was admitted for a small pneumothorax on his left side.


VAERS ID: 1375308 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Other       Purchased by: ?
Symptoms: 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel FE birth control
Current Illness:
Preexisting Conditions: Autoimmune disease
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 3 days after first dose, had sudden and severe menstrual bleeding through clothing.


VAERS ID: 1375310 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-06-01
   Days after vaccination:57
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Basedow's disease, Iodine uptake increased, Thyroid gland scan abnormal, Thyroid stimulating immunoglobulin increased, Thyroxine normal, Tri-iodothyronine increased
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Optic nerve disorders (broad), Hypothyroidism (broad), Hyperthyroidism (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu like symptoms with Covid vaccine
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Thyroid uptake scan, T3, Thyroid stimulating immunoglobulins (all elevated) Normal T4, scan showed no nodules over 1 cm
CDC Split Type:

Write-up: I was diagnosed with Graves disease on 01Jun2021. Symptoms began after the vaccine, however I do have a family history of thyroid disorder (mother)


VAERS ID: 1375328 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Feeling abnormal, Panic attack
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Customer not a patient for rite aid. He says he is on diabetic medication and anxiety medicines.
Current Illness: unknown
Preexisting Conditions: diabetic and mood
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt experienced extreme panic attack right after vaccination. Contacted 911, and paramedics were dispatched from Delaware County Memorial Hospital. Pt alleges he "can''t breathe and don''t feel right. Never felt like this before." Epipen was really to be administered.


VAERS ID: 1375604 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033821A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: husband reported swollen axillary glands later that day after she was vaccinated. She also had throat pain and body aches. She took some advil for her pain


VAERS ID: 1375631 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Movement disorder, Muscle twitching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Three to five minutes following vaccine administration patient was collapsed to the ground then immediately got up and sat on the floor. When I got to him he was sweating and his arms were twitching. Even though he was alert, he was struggling to straighten his arms. I made a 911 call and then administered one dose of epipen then within a minute he thanked me for the epipen and he said he is feeling much better. Finally the paramedics came in and asked him if he still wants to go for further checkups. He agreed and left the store with the paramedics.


VAERS ID: 1375689 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210604919

Write-up: COVID 19 VACCINE SYRINGE WAS PLACED IN A COOLER WITH LOWEST TEMPERATURE 20.6 F AND HIGHEST 40.8 F FOR APPROXIMATELY 1 HOUR AND 15 MINUTES; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980 expiry: 20-JUN-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced covid 19 vaccine syringe was placed in a cooler with lowest temperature 20.6 f and highest 40.8 f for approximately 1 hour and 15 minutes. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of covid 19 vaccine syringe was placed in a cooler with lowest temperature 20.6 f and highest 40.8 f for approximately 1 hour and 15 minutes was not reported. This report was non-serious. This case, from the same reporter is linked to 20210605045, 20210603408 and 20210602705.


VAERS ID: 1375691 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A214 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Eye disorder, Feeling hot, Headache, Pain in extremity
SMQs:, Corneal disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210604965

Write-up: WARM ARM; EYES WERE BOTHERING; LEFT ARM PAIN THAT WENT UP TO SHOULDER TO BACK AND DOWN TO HAND; HEADACHE; This spontaneous report received from a patient concerned an 85 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A214 expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced warm arm. On JUN-2021, the subject experienced eyes were bothering. On JUN-2021, the subject experienced left arm pain that went up to shoulder to back and down to hand. On JUN-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, left arm pain that went up to shoulder to back and down to hand, warm arm and eyes were bothering was not reported. This report was non-serious.


VAERS ID: 1375695 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1821288 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210605149

Write-up: This spontaneous report received from a pharmacist concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821288, expiry: 01-AUG-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced stored in the fridge for over 6 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of stored in the fridge for over 6 hours was not reported. This report was non-serious.


VAERS ID: 1375801 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood urine, Complement factor C3, Complement factor C4, Full blood count, Metabolic function test, Prothrombin time, Streptococcus test, Ultrasound kidney, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (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: sertraline
Current Illness: otitis media, cold
Preexisting Conditions: anxiety, asthma
Allergies: none
Diagnostic Lab Data: cbc, cmp, pt, ptt, c3, c4, aso titer, Ua, microscopic urine, renal ultrasound
CDC Split Type:

Write-up: blood in the urine


VAERS ID: 1375843 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. patient returned on 6/4/21 to re-vaccinate


VAERS ID: 1375919 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Feeling hot, Peripheral swelling, Skin induration, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: Nothing
Current Illness: None
Preexisting Conditions: None
Allergies: PCN (hives)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Annular redness and swelling of upper arm, 5.5 cm in diameter (increasing in size since 6/1/21), no streaking, positive warmth, no tenderness, slight hardening /induration under skin


VAERS ID: 1375938 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Client immediately fainted upon receiving the vaccination in his right deltoid.


VAERS ID: 1375950 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Chest pain, Deafness, Headache, Loss of consciousness, Nausea, Productive cough, Sputum discoloured
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

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

Write-up: Within the first 24 hours after the vaccine patient experienced: blackout 1.5 hours after the vaccine headache loss of vision, hearing, and sensations, nausea chest pain productive cough of different color sputum. Currently patient is experiencing productive cough and headache


VAERS ID: 1375971 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Hypersensitivity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: I takeatorvastatin and a multivitamin.
Current Illness: None
Preexisting Conditions: Foot problems
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: By the evening on the day of the shot I noticed my arm getting red and swollen. It continued swelling until I went to the doctor today June 4th. He said I was having an allergic reaction and to take Benadryl. Started Benadryl at 4:45 this evening.


VAERS ID: 1376287 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN (E.C.); KLONOPIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: temperature; Result Unstructured Data: Test Result:38; Comments: at night 22:00, 38 degrees celsius
CDC Split Type: USPFIZER INC2021640870

Write-up: headache; fever; This is a spontaneous report from a contactable consumer (patient) from Pfizer. A 45-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Lot Number: ER8736, Expiration date: Unknown), via an unspecified route in the Arm right on 18May2021 as 2nd dose, single for COVID-19 immunisation. The patient''s medical history was not reported. Concomitant medications included ongoing acetylsalicylic acid (ASPIRIN (E.C.)) at unknown dose daily for having some troubles with his heart (Has been taking this medication for about one month) and clonazepam (KLONOPIN), 7.5mg daily dose for mental care (Has been taking this medication for about one month). Historical vaccine included the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Lot Number: ER8736, Expiration date: Unknown) via an unspecified route in the Arm right on 21Apr2021 as, single for COVID-19 immunisation. On 01Jun2021, the patient experienced headache and fever. The patient confirmed he was calling in regard to Pfizer covid-19 vaccine. The patient received his second dose of the vaccine on 18May2021. However, last night he experienced a lot of headaches and fever. The patient asked that if it was normal that he received second dose of Pfizer Covid Vaccine 2 weeks ago and he started having a headache and a fever. The patient reported his headache has completely went away, but stated it was kind of hard yesterday. He clarified the headache hit him hard. The patient confirmed the fever also started last night, and it also went away. The patient clarified the headache and fever began last night around 18:00 or 19:00, stated he checked temperature at 22:00 last night and it was 38 degrees Celsius and he took the temperature with the one they point at the head with the light. Stated he was unsure of the time the symptoms went way, just when he woke up. He did not do anything for the headache or fever. He just wanted to know if this was normal. Outcome of the events was reported as resolved on an unspecified date in Jun2021. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1376290 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Temperature; Result Unstructured Data: Test Result:100.8; Comments: fever
CDC Split Type: USPFIZER INC2021642214

Write-up: running fever/Temperature is 100.8; This is a spontaneous report from a contactable consumer (patient herself). A female patient of an unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) via an unspecified route of administration on 01Jun2021 09:30 as, single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) on an unspecified date (about four weeks ago as reported), as single dose for COVID-19 immunisation. Patient had the reactions. The patient had the Pfizer Shot on 01Jun2021 (yesterday) about 9:30 in the morning then she started running fever last night about 7 o''clock (01Jun2021). This morning (on 02Jun2021) her temperature was 100.8. This was the second time she has a reaction to this shot and last time was about four weeks ago, when she got her 1st shot. The outcome of event was unknown. Information about lot/batch number has been requested.


VAERS ID: 1376321 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 AR / IM

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

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

Write-up: Systemic: Swelling of hand on side of injection-Medium


VAERS ID: 1376364 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

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

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

Write-up: Received her first dose Pfizer vaccine (LOT#: EW0187 EXP: 8/2021) at 1519 on 6/01/21. Patient alerted EMT at 1535. Patient stated that she felt dizzy about 10 minutes after receiving the vaccine. PHN asked patient to stay an extra 30 minutes for observation. Patient agreed to stay. EMT assessed and took patient vital signs at 1540. BP: 111/65, pulse: 86, O2: 99%. Patient stated that she had not eaten anything before her vaccine. Patient was given a snack and water. Patient finished her snack and drank her water. EMT reassessed and retook patients vital signs at 1550. BP: 105/62, pulse: 85, O2: 99%. Patient stated that her symptoms had subsided. EMT reassessed and retook patients vital signs at 1600. BP: 100/65, pulse: 85, O2: 99%. Patient stated that she no longer had symptoms and did not want to stay the full 30 minutes anymore. Patient was educated on worsening signs and symptoms of the vaccine side effects and when to call EMS or go to the ED/urgent care. Patient verbalized understanding of education. PHN advised patient to stay her full 30 minutes and if she left she would be leaving AMA. Patient agreed and decided to leave vaccination site at 1603. Patient left vaccination site at 1603 unassisted and with a steady gait.


VAERS ID: 1376384 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Nervousness, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Patient DOB: 11/09/1967. Received her first dose Pfizer vaccine (LOT#: EW0187 EXP: 8/2021) at 15:26 on 6/01/21. Patient alerted EMT at 16:05. Patient stated that she felt a closing sensation in her throat. Patient was able to talk and did not have SOB. Patient stated she also felt nauseous and shaky. Patient stated that she felt very nervous before receiving the vaccine. PHN asked patient to stay an extra 30 minutes for further observation. Patient agreed to stay. EMT took patient vital signs. BP: 120/65, pulse: 76, O2: 96%. PHN assessed patient. PHN offered patient Diphenhydramine. Patient stated she was allergic to Diphenhydramine. Patient could not recall signs and symptoms that occurred with Diphenhydramine intake. Patient refused Diphenhydramine at 14:12. PHN offered patient EpiPen. Patient denied EpiPen at 16:13. Patient stated she was feeling better. PHN gave patient water. Patient was able to swallow water without any trouble. Patient stated her throat no longer felt like it was closing. Patient was talking the entire time with PHN and EMT. Patient denied any SOB or difficulty swallowing. EMT reassessed patient and retook vital signs at 16:25. BP: 120/68, pulse: 79, O2: 97%. Patient stated that she no longer felt any of her initial symptoms. EMT reassessed and retook patients vital signs at 16:36. Patient stated that she no longer had any symptoms. Patient completed her 30 minutes of observation. Patient was educated on worsening signs and symptoms of the vaccine side effects and when to call EMS or go to the ED/urgent care. Patient verbalized understanding of education. Patient left vaccination site at 16:40 unassisted and with a steady gait.


VAERS ID: 1376564 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-21
Onset:2021-06-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Herpes zoster
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Opportunistic infections (broad)

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

Write-up: Upset stomach for 1 week then broke out with shingles.


VAERS ID: 1376609 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

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

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

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


VAERS ID: 1376636 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Trouble breathing


VAERS ID: 1376695 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-29
Onset:2021-06-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient has had nausea, vomiting, and fatigue for 5 days after getting vaccine. Patient thinks he may have COVID. Patient vaccinated at different facility. limited info


VAERS ID: 1376705 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-30
Onset:2021-06-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. notified pt to get re-vaccinated


VAERS ID: 1376725 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1376774 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Severe, Error: Wrong Dose of Vaccine - Too Low


VAERS ID: 1376794 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 AR / IM

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

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

Write-up: Systemic: Swelling of hand on side of injection-Medium


VAERS ID: 1376863 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec 40mg Ibuprofen 2 tablets
Current Illness: None
Preexisting Conditions: GERD Iron deficiency anemia Irregular heartbeat Anxiety Migraine
Allergies: Azithromycin Imitrex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Heart palpitations, began an hour after vaccine. Heart palpitations still occur sporadically along with some pain. No treatment.


VAERS ID: 1376892 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-06-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Fibrin D dimer normal, Full blood count normal, Metabolic function test, Pericarditis, Troponin normal
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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 06/02/21; normal CBC, normal BMP, normal (negative) d-dimer, normal (negative) troponin
CDC Split Type:

Write-up: Patient presented to Urgent Care and then was sent to the ED for evaluation. Found to have pericarditis on EKG. Labs including troponin reassuring. Patient discharged home with referral to Cardiology for outpatient follow up.


VAERS ID: 1376916 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Injection site rash, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA Covid Arm: Approx 4" circular painful and itchy rash around injection site. See https://www.health.com/condition/infectious-diseases/coronavirus/covid-arm-rash-moderna


VAERS ID: 1377015 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient briefly fainted post Covid vaccination. Spoke to her mother later that evening, feeling much better.


VAERS ID: 1377016 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Vomiting-Mild, Additional Details: Patient briefly fainted post Covid vaccination, then vommited, stated that his head felt hot. Spoke to mother later in the evening. Patient felt much better.


VAERS ID: 1377028 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Systemic: Weakness-Mild


VAERS ID: 1377343 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-13
Onset:2021-06-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Injection site mass, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto, Oxycontin, Oxycodone, aspirin 81, azathioprine, calcium, colace, estroven, folic acid, Gabapentin, Marinol, magnesium citrate, probiotics, Ocrevus infusion, Synthroid, Triliptal, volteran, vitamin C & D3, Zanaflex, Depakote, mecli
Current Illness: MS, trigeminal neuralgia, Factor V Leiden, Hypothyroidism, fibromyalgia, degenerative disc disorder, TMJ, vasovagal syncope, asthma, migraines, rheumatoid arthritis, prosthetic left eye
Preexisting Conditions: MS, Trigeminal Neuralgia, Rheumatoid Arthritis, Hypothyroidism, Fibromyalgia, Factor V,
Allergies: Codeine, Wellbutrin, Topamax, NSAIDS, sulfa antibiotics, morphine, methotrexate, hydroxychloroquine, Leflumonide, mycophenolate, Food - pumpkin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore hard lump at the site of the injection lasting for 12 days after the injection. Extreme/severe full body tremors -30 minutes, 3 times during that day, two and a half weeks after the injection.


VAERS ID: 1377719 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA MODERNA 003C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dry mouth, Dysphagia, Immediate post-injection reaction, Injection site pain, Myalgia, Nodule, Oropharyngeal discomfort, Sensory disturbance, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), 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), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: First dose was 5/4/21. No side effects until the next day. Side effects include intense fatigue and soreness on entire left si
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa, Iodine
Diagnostic Lab Data: Paramedics took my vitals and they were normal.
CDC Split Type:

Write-up: Immediate pain in injection site, felt the vaccine travel through left side of body, when it reach my neck, I felt a tightening around my throat and I could not swallow. The length of time it took to reach this point was within 5 minutes or so of the shot. Paramedics came and checked my vitals, which were normal. Eventually, tightness loosened and I felt better. The next day, there was a knot in my throat/neck that subsided by afternoon. It felt like I was punched in the throat. I also had dry mouth for about 24 hours. In addition, I felt muscle and joint aches for six days.


VAERS ID: 1377802 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Inflammation, Injection site erythema, Injection site warmth, Joint range of motion decreased, Magnetic resonance imaging, X-ray
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol 50mg, Zolpidem 5mg, Alprazolam 0.25mg
Current Illness: acute otitis media treated with antibiotics on 4/10/21
Preexisting Conditions: Hypertension
Allergies: penicillin, sulfa antibiotics
Diagnostic Lab Data: Patient to have MRI this week - pending results X-ray done the week of 5/31-6/6 showed signs of inflammation in the shoulder joint area
CDC Split Type:

Write-up: Patient initially had redness and warmth at the injection site, this went away after a week. Recently the patient has noticed some loss of mobility with the left shoulder accompanied with pain in the shoulder joint.


VAERS ID: 1377809 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Cold sweat, Fatigue, Headache, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Moderna
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I am in the process of trying to get a doctors appointment, as I have been in denial for the past six days that I should be concerned over these continuing symptoms.
CDC Split Type:

Write-up: Immediate adverse effects were consistent with what is considered to be normal. I am not here to complain about the immediate adverse effects. The EXTREME fever, chills, fatigue, and extreme headache went away after a day. I can continue to experience a mild form of all of these symptoms since day one. I am now on day six. I am also on day six of experiencing swelling in my feet and my legs. As of day two or three, I am experiencing increasing chest discomfort and my fevers and clamminess are beginning to increase. After gaslighting myself and telling myself everything from I am experiencing allergies too maybe I have a tight bra on... I am now trying to make an appointment with my doctor because I believe I might have a heart infection. Myocarditis. Fingers crossed cause a heart issue would... kill me.


VAERS ID: 1377863 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 88mcg
Current Illness: None
Preexisting Conditions: Hashimoto?s. I may have NF-1. I have had several schwannomas removed from my body, the most invasive of which was from my spinal cod (c4-6 area).
Allergies: None
Diagnostic Lab Data: I did not visit a medical facility post reaction.
CDC Split Type:

Write-up: 5 minutes following the shot in my left arm, the left side of my throat, tongue and face (from underneath eye, down to mandible, across from ear to nose) went numb. Feeling was similar to that of being frozen for a dental procedure. It lasted 48 hours. My left hand and foot also went numb and remain mildly numb. Similar to feeling I had when my spinal court tumor was discovered 15 years ago. Post resection, it subsided as pressure on nerves was alleviated. Very scary. I won?t return for a second shot.


VAERS ID: 1377902 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine 10mg
Current Illness: none known
Preexisting Conditions: depression
Allergies: none known
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Itchy patches of rash on forearms, chest, legs, and abdomen. Rash resolving on 6/5/21


VAERS ID: 1378027 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Fatigue, Myalgia, Nasal congestion, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (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), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apri Multivitamin
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None
Diagnostic Lab Data: ID NOW SARS-CoV-2 Molecular PCOT Covid19 Negative 06/07/2021
CDC Split Type:

Write-up: Reports myalgia, fatigue, fever, nasal congestion. sore throat, fatigue, cough


VAERS ID: 1378034 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Chills, Crying, Daydreaming, Distractibility, Disturbance in attention, Dizziness, Feeling abnormal, Hallucination, Headache, Hyperhidrosis, Hyperventilation, Initial insomnia, Nausea, Nightmare, Soliloquy
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: 1) sweating, chills, some difficult to describe feelings, dizziness, light headache, light nausea 2) difficulty in going to sleep, abnormal dreams, nightmares, hallucinations, unusual/bizarre images, preoccupied, day dreaming 3) Occasional hyperventilation 4) Unable to focus. I am slow to understand/comprehend/react. 5) Sometimes when I wake up, I find myself crying. 6) During the day, sometimes I find myself talking to myself when there is nobody else in the room but me.


VAERS ID: 1378058 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tramadol, Irbesartan, Lipitor, omeprazole, Celexa
Current Illness: low back pain/hip pain
Preexisting Conditions: htn, chronic low back pain, hyperlipidemia, depression, GERD
Allergies: nkda
Diagnostic Lab Data: dopplers
CDC Split Type:

Write-up: DVT- developed leg pain and swelling for several days. Presented to ED for evaluation. Found to have RLE DVT


VAERS ID: 1378169 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-26
Onset:2021-06-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Hemiplegia, Magnetic resonance imaging, SARS-CoV-2 test negative
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI - 6-2-21 to rule out other cause, SARS-CoV2 by PCR - negative
CDC Split Type:

Write-up: Seen in ED for Bells Palsy 1 week after 2nd Covid-Moderna dose. Follow up with provider on 6/7 and still has right side paralysis


VAERS ID: 1378190 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036LZ1A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Vaccination complication
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: Benadryl 3/day
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Covid Arm


VAERS ID: 1378235 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1378238 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immunisation, Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1378255 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1378297 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Pyrexia, Vomiting
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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: COMPAZINE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: FEVER OVER 102 DEGREES FOR APPROXIMATELY 72 HOURS. NAUSEA AND VOMITTING FOR OVER 72 HOURS. UNABLE TO KEEP DOWN ANY LIQUIDS OR TYLENOL. VOMITTING EVERY 15 MINUTES OVER A 5 HOUR PERIOD BETWEEN HOURS 48 AND 53. FINALLY ABLE TO GET ACCESS TO ONDANSETRON TO ALLEVIATE VOMITTING AND KEEP FROM GOING TO URGENT CARE FOR DEHYDRATION.


VAERS ID: 1378392 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-13
Onset:2021-06-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Tested for COVID and Strep test - last two (June 1st) - negative
CDC Split Type: vsafe

Write-up: Runny nose - four - five days; sore throat for two days. Treatment - increased water intake and rest. Went to doctor on June 1st


VAERS ID: 1378467 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient got 2nd shot 12 days after the 1st dose. 1st dose was given 05/20/2021, 2nd dose was given 06/01/2021. He had typical second dose adverse effects such as fever, chills, fatigue that lasted 24-48 hours.


VAERS ID: 1378513 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-15
Onset:2021-06-01
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 2 RA / SYR

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

Write-up: Patient experienced hives all over body about 2 weeks after second vaccine dose. Patient received steroids but hives have not yet resolved.


VAERS ID: 1378515 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-24
Onset:2021-06-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Pain in jaw, Tinnitus
SMQs:, Hearing impairment (narrow), Osteonecrosis (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: metformin, lisinopril, Effexor, Lipitor,
Current Illness:
Preexisting Conditions: type 2 diabetes, arthritis, depression. low thyroid, high blood pressure, high cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: migraine, thought stroke was had, jawline pain, tinnitus


VAERS ID: 1378746 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Erythema, Feeling abnormal, Feeling hot, Headache, Myalgia, Nausea, Pain, Pyrexia, Restlessness, Sensitive skin, Sleep disorder, Spider vein
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), 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: Flu Vaccine - CVS fall of 2020 (severe headache and nausea - could not stop throwing up for a day/two due to headache)
Other Medications: Gummi vitamins Anti-histamine (Zytec) because I have to take it daily
Current Illness:
Preexisting Conditions: Autoimmune disease (ulcerative colitis) Unknown allergy/illness - skin rash/dermagraphia (noted sensitivity to nightshade products) Previous lab testing showed antiphospholipid antibodies, but more recently, these have been better
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6/7 hours after vaccine- chills, fever (100.8), very weak *Felt miserable and restless, radiating heat in body *Trouble sleeping *Small pinpricks of pain in different parts of body *Muscle soreness *Blood seemed to be throbbing *Nausea in morning, but ate crackers (so did not throw up like after flu vaccine) *Skin more sensitive than normal (when shaving and when bumped foot into wall accidentally) Next day (6/2)- no energy, easily overexerted; had to sit down after standing, like in shower 6/3- light-headedness after eating chocolate products 6/4- light-headedness, blood appeared to be pooling in legs some when standing (legs would turn red) *Blood still feels weird 6/5- Pinprick feeling in parts of body, still feeling weak during the day 6/6- Weak feeling/headache (stamina is bad still), veins look more red than usual (existing spider veins) 6/7- Feel much better, still feeling rough in the morning when I wake up (Monitored own symptoms, but need not need to go to Dr. or hospital)


VAERS ID: 1378753 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Miralax PRN
Current Illness: 1st dose 4/29/21 Pfizer 2nd dose 5/28/21 Pfizer
Preexisting Conditions: Patient Active Problem List Diagnosis ? CARPAL TUNNEL SYNDROME ? ANGIOEDEMA ? HEADACHE ? Abnormal glucose tolerance test in pregnancy, antepartum
Allergies: NKA
Diagnostic Lab Data: 1. Dizziness -COVID: 4/29 and 5/28 and since her 2nd vaccination + dizziness -she was fine after vaccination/later that day had eye exam with no issues as she uses contacts/glasses/they did not dilate eyes and then that afternoon noted dizziness -notes with turning head abruptly like when driving having to turn side to side/last seconds -denies any head trauma, no change in vision from baseline-she does have slight left eye inward turn and her baselinen from youth/pt well aware with minimal impact on vision per pt -she says week prior just routine/not taking any otc meds/no allergy meds/no current dizziness -no gait changes/no neurological changes BP Readings from Last 3 Encounters: 06/02/21 126/82 12/03/20 132/78 08/21/20 130/81 1. Intermittent dizziness -sounds more Like BPPV with nl neurological exam, no red flags -suspect no related to recent vaccination but will still have team report to VAERS -given so mild rec obsv next 1-2 weeks as suspect will resolve/see Chart details -she does not really drink alcohol/rec stay hydrated 1. Your dizziness seems more like BPPV. Less likely related to yoru vaccine but none the list we will report
CDC Split Type:

Write-up: Pt received vaccine doses at pharmacy came in for OV having dizziness after second dose for more than 3 days


VAERS ID: 1379029 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Discomfort, Dyspnoea, Electrocardiogram, Laboratory test, SARS-CoV-2 test, Urine analysis, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Childhood asthma. Has not exacerbated in over 10 years.
Allergies: Hydrocodone
Diagnostic Lab Data: Labs - 2 ER visits EKG - all 3 ER visits COVID Test - 1 ER visit Urine sample - 1 ER Visit X-Ray - 2 ER visits
CDC Split Type:

Write-up: Extreme chest burning/pain/tightness, shortness of breath, pressure in my neck around my throat. Persistent nearly 7 days after 2nd vaccine.


VAERS ID: 1379039 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-24
Onset:2021-06-01
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: Disseminated herpes zoster/ shingles , valacyclovir


VAERS ID: 1379061 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: vaccine was administered outside of storage recommendations. Notified pt to return for re-vaccination


VAERS ID: 1379528 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Sharp pain in chest especially when inhaling; clicking at left of sternum with heart beat; unable to get deep breath. Given IV anti-inflammatory.


VAERS ID: 1379754 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Headache
SMQs:, Glaucoma (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: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute headache on right side of head and eye. Today after one week I still have severe headaches daily.


VAERS ID: 1380637 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Wrong 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: USJNJFOC20210604872

Write-up: WRONG VACCINE ADMINISTERED; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient was previously treated with mrna 1273 for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the subject experienced wrong vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wrong vaccine administered was not reported. This report was non-serious. This case, from the same reporter is linked to 20210603388.


VAERS ID: 1380654 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ear pain, Fatigue, Headache, Pain in jaw, Paraesthesia oral, Pruritus, Rash, Rash macular, Skin discolouration, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (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: ALBUTEROL [SALBUTAMOL]
Current Illness: Abstains from alcohol; Asthma; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: The patient had no history of drug abuse or illicit drug use and also had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210607495

Write-up: PAIN IN EAR; PAIN IN JAW; STRANGE FEELING IN BACK OF THROAT AS IF SOMETHING WAS STUCK BOTTOM OF THROAT; ITCHING; TINGLING IN LIPS; BLOTCHING FLANK (UPPER BACK, NECK AND FACE); DISCOLORATION; RASH ALL OVER ARM (ARM OF VACCINE); TIREDNESS; HEADACHE; This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included covid, and concurrent conditions included asthma, non-alcoholic, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use and also had no known allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. Concomitant medications included salbutamol for asthma. On 01-JUN-2021, the subject experienced strange feeling in back of throat as if something was stuck bottom of throat. On 01-JUN-2021, the subject experienced itching. On 01-JUN-2021, the subject experienced tingling in lips. On 01-JUN-2021, the subject experienced blotching flank (upper back, neck and face). On 01-JUN-2021, the subject experienced discoloration. On 01-JUN-2021, the subject experienced rash all over arm (arm of vaccine). On 01-JUN-2021, the subject experienced tiredness. On 01-JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced pain in ear. On 02-JUN-2021, the subject experienced pain in jaw. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from strange feeling in back of throat as if something was stuck bottom of throat on 02-JUN-2021, and itching, and blotching flank (upper back, neck and face) on 01-JUN-2021, was recovering from rash all over arm (arm of vaccine), tiredness, and headache, had not recovered from pain in ear, and pain in jaw, and the outcome of tingling in lips and discoloration was not reported. This report was non-serious.


VAERS ID: 1380669 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210608105

Write-up: This spontaneous report received from a pharmacist concerned a 67 year old male. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A expiry: 23-JUN-2021) dose was not reported, administered on 03-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced incorrect product storage. On 03-JUN-2021, the subject experienced vaccine administered past the 6 hours frame inside the fridge. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered past the 6 hours frame inside the fridge and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1380671 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Therapy non-responder
SMQs:, Lack of efficacy/effect (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: Alcohol use (He drinks a glass of wine occasionally.); Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no drug abuse or illicit drug use. The patient had no health conditions and exercises regularly.
Allergies:
Diagnostic Lab Data: Test Date: 20210601; Test Name: Antibody test; Result Unstructured Data: No antibodies; Comments: Healthcare
CDC Split Type: USJNJFOC20210608194

Write-up: SUSPECTED IMMUNOLOGICAL VACCINE FAILURE; This spontaneous report was received from a 62-year-old American Indian or Alaskan native, not Hispanic/Latino male patient. The patient''s height, and weight were not reported. The patient drinks a glass of wine occasionally, and does not smoke. He had no known drug allergies and no drug abuse or illicit drug use. The patient had no health conditions and exercises regularly. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: 043A21A, and expiry: 21-JUN-2021) dose was not reported, 1 total, administered on left arm on 05-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-JUN-2021, the patient got an antibody test done which showed no antibodies (suspected immunological vaccine failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of suspected immunological vaccine failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0- 20210608194-Covid 19 vaccine-Suspected immunological vaccine failure This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1380685 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210611752

Write-up: EXPIRED VACCINE ADMINISTERED; PUNCTURED VIAL WAS STORED IN THE REFRIGERATOR FOR 6 HOURS AND 36 MINUTES; This spontaneous report received from a pharmacist concerned a 56 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced punctured vial was stored in the refrigerator for 6 hours and 36 minutes. On 02-JUN-2021, the subject experienced expired vaccine administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the expired vaccine administered and punctured vial was stored in the refrigerator for 6 hours and 36 minutes was not reported. This report was non-serious.


VAERS ID: 1380696 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Headache, Piloerection
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: USJNJFOC20210612255

Write-up: GOOSEBUMPS THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; CHILLS THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; STRONG HEADACHE THROUGHOUT THE NIGHT AND THE FOLLOWING DAY; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 01-JUN-2021, the subject experienced goosebumps throughout the night and the following day. On 01-JUN-2021, the subject experienced chills throughout the night and the following day. On 01-JUN-2021, the subject experienced strong headache throughout the night and the following day. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the strong headache throughout the night and the following day, chills throughout the night and the following day and goosebumps throughout the night and the following day was not reported. This report was non-serious. This case, from the same reporter is linked to 20210611877.


VAERS ID: 1381296 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Skin discolouration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021634762

Write-up: Caller developed a tiny little area which is grayish somehow like a bruise on her left arm, on the same arm where she got the vaccine; Caller developed a tiny little area which is grayish somehow like a bruise on her left arm, on the same arm where she got the vaccine; This is a spontaneous report from a contactable consumer (patient) or other non hcp. A 75-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number and Expiry date: not provided), dose 2 via an unspecified route of administration, on 01Jun2021 at 07:30 (age at the time 75-year-old), as single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number and Expiry date: not provided), dose 1 via an unspecified route of administration, on an unspecified route (age at the time 75-year-old), as single dose for COVID-19 immunization. On 01Jun2021, the patient experienced a tiny little area which was grayish somehow like a bruise on her left arm, on the same arm. It was reported that, she was just alarmed as what she had read on the vaccination sheet was just injection site redness and not that one like patient. The patient would like to know if there were reports like the side-effect she had experienced. The outcome of the events was unknown. Information on lot/Batch number has been requested.


VAERS ID: 1381306 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2016-04-01
Onset:2021-06-01
   Days after vaccination:1887
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain lower, Abdominal pain upper, Memory impairment
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: USPFIZER INC2021636178

Write-up: Stomach cramps increased; Upset stomach; Memory is not good/sometimes she remember things that amazes her and sometimes she cannot remember what happened yesterday; Pain in lower abdomen; This is a spontaneous report from a contactable consumer (patient) and physician. A female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0167), dose 2 via an unspecified route of administration, administered in Arm Left on 29Apr2021 12:00 as 2nd dose, single dose for COVID-19 immunization; palbociclib (IBRANCE), via an unspecified route of administration from Apr2016 (Batch/Lot number was not reported) to 27May2021, at 125mg caplets oral with water for 21 days on and seven days off once a day for stage IV metastatic breast cancer. The patient''s medical history and concomitant medications were not reported. No patient history. Family Medical History Relevant to AE(s): None. No other products. History of all previous immunization with the Pfizer vaccine considered as suspect: None. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot Number: EW0153), dose 1 via an unspecified route of administration, administered in Arm Left on an unspecified date 12:05 as 1st dose, single dose for COVID-19 immunization and had stomach cramps. The patient stated that she was on Ibrance. The patient stated that she had second shot on 29Apr2021. Since the second vaccine, she had so much trouble with her stomach. The patient stated that this had been an ongoing thing. Her stomach cramps increased, and she had pain in her lower abdomen. The patient stated that she had the first shot three weeks before the second shot and had stomach cramps. The patient stated that stomach would not settle down. The patient stated that she would get some good days. The patient stated that last week on Thursday that she was in downward spiral and could not get out of it. The patient stated that she was being careful with what she ate. The patient stated that she stopped the Ibrance. The patient stated that this week was her seven days off and she would call today to ask for next month but wanted to take a reduced amount. The patient stated that when she saw her oncologist that she asked if people ever stop taking Ibrance and was told no that if one has a reoccurrence that it may not work as well. The patient stated that she did not ask for a reduction at that time but intends to. It was a temporary stop. The patient stated that this was more about Ibrance than the vaccine. The patient stated that she had pain in lower abdomen that started 10 days ago. The patient stated that she gets upset stomach from time to time but that it had been pretty constant since the first week in May. The patient stated that sometimes she remembers things that amazes her and sometimes she cannot remember what happened yesterday. The patient stated that other factors were involved (memory) at that time that her husband was ill. The patient stated that the stomach cramps started again 6 days after second vaccination and resolved last week. Recovered with lasting effects of upset stomach. The patient stated that she changed from capsules to caplets in 2020. The patient was treated with Mylanta. The patient stated that she had a video call scheduled with her nurse practitioner. Is eating soft foods and keeps drinking water. Relevant Tests: None. The event did not result in Emergency Room/Physician Office. The outcome of the events stomach cramps increased was recovered with sequelae, pain in lower abdomen, upset stomach was recovered, memory is not good/sometimes she remember things that amazes her and sometimes she cannot remember what happened yesterday was unknown. Follow-up attempts are possible. Further information is expected.


VAERS ID: 1381311 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-10
Onset:2021-06-01
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021638474

Write-up: Severe migraine; This is a spontaneous report from a non-contactable consumer (patient herself). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number: not reported), via an unspecified route of administration on 10May2021 as 1ST DOSE, SINGLE DOSE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 01Jun2021 (reported as today), the patient experienced severe migraine. She wanted to know if she can take Advil but fully aware as well that they should not take medicines in between doses so should she wait 1 more week after taking the 2nd dose. The outcome of the event was unknown. No follow-up attempts are Possible; information about lot/batch number cannot be obtained.


VAERS ID: 1381348 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anosmia, Body temperature, Chills, Fatigue, Headache, Injection site pain, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Osteoarthritis
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (in march (year unspecified))
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: Body temperature; Result Unstructured Data: 99; Test Date: 20210602; Test Name: Body temperature; Result Unstructured Data: 100.9; Test Name: COVID-19 virus test; Result Unstructured Data: positive; Comments: covid-19 positive in march (year unspecified)
CDC Split Type: USJNJFOC20210604721

Write-up: BODY ACHES; CHILLS; FEVER; HEADACHE; FATIGUE; SORENESS AT INJECTION SITE; NO SENSE OF SMELL; This spontaneous report received from a patient concerned a male. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19, and concurrent conditions included osteoarthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 01-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On JUN-2021, the subject experienced no sense of smell. On 02-JUN-2021, the subject experienced body aches. On 02-JUN-2021, the subject experienced chills. On 02-JUN-2021, the subject experienced fever. On 02-JUN-2021, the subject experienced headache. On 02-JUN-2021, the subject experienced fatigue. On 02-JUN-2021, the subject experienced soreness at injection site. Laboratory data included: Body temperature (NR: not provided) 99, 100.9. Treatment medications included: naproxen sodium. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from soreness at injection site, fever, body aches, headache, and chills, and the outcome of fatigue and no sense of smell was not reported. This report was non-serious. This case, from the same reporter is linked to 20210604773.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case is assessed as non serious.


VAERS ID: 1381406 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-05-27
Onset:2021-06-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DOXYCYCLINE MONOHYDRATE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021649907

Write-up: severe dizziness; vertigo; This is a spontaneous report received from a contactable female consumer (patient). A 31-year-old (non-pregnant) female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of ad-ministration, administered in arm right on 27May2021 15:00 (at the age of 31-year-old) as a 2nd dose, single dose for COVID-19 immunization. The patient ''s medical history was not reported. The patient had no known allergies. The patient''s concomitant medication included doxycycline monohydrate 100 mg. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm right on 06May2021 (at the age of 31-year-old) for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced severe dizziness and vertigo on 01Jun2021 10:00 PM. Patient was not diagnosed for COVID-19 prior to vaccination. The patient had not tested COVID-19 post vaccination. The patient did not receive any treatment medication for the events. Outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1381414 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Dizziness, Eye disorder, Fatigue, Feeling cold, Feeling hot, Head discomfort, Headache, Hypertension, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021650356

Write-up: dizziness; did not allow me to have my eyes open; blood pressure was high; felt my body very cold; arm was very swollen; pain, a sharp pain, especially on the right side of the brain and the part of my head; tiredness; heaviness in the head; anxious; felt a lot of heat in my body; One hour later in her right arm she had a lot of pain; This is a spontaneous report received from a contactable consumer or other non hcp. A female patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/lot number was not reported), via an unspecified route of administration on 01Jun2021 as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient had first dose of the Pfizer COVID 19 vaccine on 01Jun2021 and ten minutes after that she started feeling dizzy and could not keep her eyes open and since she was still at the vaccination facility, they took her blood pressure, and it was high. One hour later in her right arm she had a lot of pain and it was swollen she felt the pain was a sharp pain that was on her right arm which was the arm she had the injection. Caller also felt pain in her brain and part of the head. Caller also reported being tired and had dizziness. Caller stated the headache and dizziness was constant, but she felt it mostly on the right side of her body which was the side she received the injection. Caller had to close her eyes so the dizziness would stop. Caller stated this happened on 01Jun2021 and 02Jun2021 and it was making her feel very anxious and she felt really really hot and when she had her blood pressure high, she felt her body cold. The clinical outcome of the events were unknown. Follow-up 2 (PRD 03Jun2021): This is a spontaneous report from a contactable consumer. This consumer (patient) reported that: dizziness, did not allow me to have my eyes open, blood pressure was high, felt my body very cold, arm was very swollen, pain, a sharp pain, especially on the right side of the brain and the part of my head, tiredness, heaviness in the head, anxious, felt a lot of heat in my body, one hour later in her right arm she had a lot of pain. Information on the lot/batch number has been requested. further information has been request-ed.


VAERS ID: 1381719 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-08
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: No adverse event that we are yet aware of. Patient was inadvertently given 1 dose of Pfizer 4 weeks after having received 1 dose of Moderna Covid-19 vaccinations.


VAERS ID: 1381730 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-02-02
Onset:2021-06-01
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test negative
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: celebrex, plaque nil, Lipitor, warfarin
Current Illness: fibrillation
Preexisting Conditions: RA, HimCholesterol, sleep apnea
Allergies: None
Diagnostic Lab Data: No other test was performed beyond the antibody presence tests. QUESTIONS TO CDC: what should be the next steps, alternative vaccines or medications to ensure immunity against Covid 10?
CDC Split Type:

Write-up: Three months after completion of vaccination 2 doses of Moderna, a blood test for CoviD 19 antibodies showed a totally negative result. Both types of antibodies (IgG and IgM) were tested and found negative.


VAERS ID: 1381733 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Disorientation, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (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: PATIENT ORIENTED, VISIT YOUR PHYSICIAN FOR FOLLOW-UP
Current Illness: PATIENT REFERS THAT PREVIOUSLY, HE SUFFERED DIZZINESS CAUSING HIM LOSS OF CONSCIOUSNESS AND FRACTURES IN THE RIGHT ARM FOR APPROXIMATELY 1 MONTH.
Preexisting Conditions: PATIENT VERBALIZES THAT HE DOES NOT SUFFER FROM ANY CHRONIC CONDITION AT THE MOMENT OF EVALUATION. THEREFORE INDICATING HE HAS NOT VISITED ANY DOCTOR.
Allergies: Penicillin
Diagnostic Lab Data: NO LABORATORY DONE
CDC Split Type:

Write-up: PATIENT PRESENTED WITH NAUSEA, VOMITING AND DISORIENTATION.


VAERS ID: 1381886 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Menstruation delayed
SMQs:, 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: Na
Current Illness: Na
Preexisting Conditions: Na
Allergies: Na
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: After my second dose my next period did not start. I took pregnancy test every day for 10 days starting 2 days prior to period as my husband and I are trying. I am not pregnant and have yet to start a period. It is now 9 days late. I spoke to my OBGYN and after a series of questions she concluded its probably a side effect from vaccine.


VAERS ID: 1381909 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-06-01
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine (5 mg) Carvedilol (3.125 mg) Rosvustatin (5 mg) Baby Aspirin
Current Illness: Heart disease, sleep apnea, hypertension
Preexisting Conditions: N/A
Allergies: None
Diagnostic Lab Data: Visual inspection
CDC Split Type:

Write-up: Shingles developed on my left lower back and torso approximately three month after receiving the Covid-19 vaccine.


VAERS ID: 1381946 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

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

Write-up: Error: Improper Storage (temperature)


VAERS ID: 1381958 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Body temperature increased, Dizziness, Electrocardiogram abnormal, Heart rate increased, Hyperventilation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram 10mg once daily.
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Penicillin & pethidine
Diagnostic Lab Data: ECG performed found an arterial flutter.
CDC Split Type:

Write-up: I had my injection 5 minutes after, I fainted and began hyperventilating. Heart spiked to 160bpm, blood pressure 180/90, Temperature spiked to 38.9. Heart rate kept spiking on and off for hours I was transferred to hospital for monitoring and after and I was dizzy for 4 days still after vaccine.


VAERS ID: 1381982 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 3 RA / IM

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

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

Write-up: Error: Booster Given Too Early


VAERS ID: 1381996 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Mouth ulceration, Muscle swelling, Musculoskeletal discomfort, Myalgia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: as a child unknown which no records
Other Medications: vitamin C, Verapamil 160 mg , Bumex 2 mg , Potassium chloride 20 mu, on these since I was 35 yrs old, Metopolol 25 mg (on it since Feb 2020), allopurinol ( on it since I was 14)
Current Illness: NONE
Preexisting Conditions: hypertension, SI joint dysfuntion
Allergies: statins, losartan
Diagnostic Lab Data:
CDC Split Type:

Write-up: mouth ulcers going on 7 weeks, worsened after snd shot, myalgia, selling of righht shoulder back muscles


VAERS ID: 1382007 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: senna
Current Illness:
Preexisting Conditions: vitamin D deficiency, dyuria
Allergies: cashews, avocado, pollen, watermelon
Diagnostic Lab Data: PO diphenhydramine
CDC Split Type:

Write-up: patient felt numbness and tingling in Left arm


VAERS ID: 1382015 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-01
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

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

Write-up: 1140 Medical Technologist from HCF calling to report that a patient who received the J&J covid vaccine in March now tests positive for Covid 19. Patient started having a cough and shortness of breath on June 1st. Arrived at the hospital June 4th. Diagnosis : Covid pneumonia. Patient is improving on 3 liters of oxygen via nasal cannula. Meds: albuteral, decadron, apap , zofran, Remdesivir . Patient has history of being overweight , diabetic , and hypertensive.


VAERS ID: 1382058 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-31
Onset:2021-06-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has had a rash show up on both arms. The rash is primarily on the inside of the arm. It has been red, very itchy, and painful. The rash has improved as of today 6/8/21 but is still present.


VAERS ID: 1382077 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Guillain-Barre syndrome, Immunoglobulin therapy, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Hypoglycaemia (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received covid vaccine (Pfizer) on 5/18/21. About 2 weeks prior to admission to hospital patient began having leg weakness and unsteady gait which has progressively gotten worse. Patient is beginning IVIG treatment for Guilian Barre syndrome.


VAERS ID: 1382088 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-28
Onset:2021-06-01
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Hyperhidrosis, Injection site discolouration, Injection site erythema
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Pt c/o of severe abdominal cramping on day 5 post covid vaccination. Pt also had a c/o sweating. Pt feeling better now but still not 100%. Had red and purple at the injection site that was the size of a "playing card".


VAERS ID: 1382234 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-24
Onset:2021-06-01
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-thyroid antibody, Blood thyroid stimulating hormone increased, Hypothyroidism, Thyroxine normal
SMQs:, Hypothyroidism (narrow), Hyperthyroidism (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: June 1, 2021; LabCorp THYROID CASCADE PROFILE THYROID PEROXIDASE(TPO)AB THYROXINE(T4)FREE,DIRECT,SERUM
CDC Split Type:

Write-up: ELEVATED - TSH 10.300 uIU/mL ELEVATED - Thyroid Peroxidase Ab 198 IU/mL NORMAL - T4, Free (Direct) 0.94 ng/dL * An elevation of TSH with a normal FT4 in the presence of antithyroid peroxidase antibody is suggestive of Subclinical Hypothyroidism. ** NO SYMPTOMS *** NO PREVIOUS ISSUES; NO FAMILY HISTORY


VAERS ID: 1382351 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: headache, body aches, fever, chills, loss of appetite, loss of energy


VAERS ID: 1382361 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuralgia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), 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:

Write-up: Patient reported having nerve pain and tingling the same day as she received the vaccine


VAERS ID: 1382382 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-25
Onset:2021-06-01
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Eye pain, Facial asymmetry, Nightmare, Taste disorder
SMQs:, Taste and smell disorders (narrow), Glaucoma (broad), Hearing impairment (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Urgent Care and ER visual evaluation.
CDC Split Type:

Write-up: The night after the shot, I have extremely vivid and lucid dreams. The following week on June first, I notice that the texture of food felt different. I was still able to taste, but my tongue felt numb, almost. On June 3, my eye began to hurt...like I had something in it. I added a couple eye drops and took some Advil, and that seemed to work. On June 4th, my eye became worse, and eye drops were not helping. On the morning of June 5th, I noticed my smile was off and I could not drink out of a straw properly. Food textures were still off and my eye was much worse. I went to the Urgent Care, and they advised me to go to the ER to rule out anything neurological. The symptoms I was and still am experiencing, and was diagnosed with was Bell''s Palsy. I have never had this happen before and rarely get sick. During this time I have had not other illness.


VAERS ID: 1382484 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-30
Onset:2021-06-01
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Amenorrhoea, Angina pectoris
SMQs:, Other ischaemic heart disease (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:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart pain Missing period/menstruation


VAERS ID: 1382514 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-06-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder
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:
CDC Split Type:

Write-up: I have yet to get my period and I?ve always been on time since it began. Other women have also told me they experienced pain or no period after as well


VAERS ID: 1382648 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Decreased appetite, Dizziness, Dysstasia, Gait inability, Nausea, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: (Moderna COVID-19 Vaccine EUA). EVENT: Fever. SYMPTOMS: chills, overall weakness, body aches and pain (stomach, head, muscles, leg soreness/aches), mild to moderate congestion, little to no appetite nausea, dizziness. SIGNS: gradual development of mild to severe chills and overall body ache, nausea and dizziness at moving or walking. TIME COURSE: 4-5 Days. TREATMENT (Personal-no health insurance): Bed rest and sleep, at-home remedies, elderberry, otc medications (robitussin and alka seltzer), more rest. OUTCOME: weakness and no appetite, constant inability to get up or walk even for simple tasks, little to no energy, slow movements; faster recovery began on the 4th day with over-the counter medications.


VAERS ID: 1382664 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PE, migraines, allergies, hypotension, Asthma
Allergies: Albuterol, ASA, augmentin, cipro, compazine, levsin, Phenergan, Reglan, ketorlac, vicodin, cephalosporins, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylactic reaction, sent to ED. Received Epi pen, dexamethasone, benadryl, pepcid, methylprednisolne. Sx resolve after observation and pt sent home


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