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

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



Case Details (Reverse Sorted by Onset Date)

This is page 222 out of 8,010

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VAERS ID: 1745269 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Palpitations, Panic attack
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: History Busper Aderal Synthoid
Current Illness: Sinus infection prior to vaccine
Preexisting Conditions: Hashiatos
Allergies: No Known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Very nervous before vaccine. About 7 mins after the vaccine felt S&S of panic attack. Heart racing, chest tighness, dizziness


VAERS ID: 1745332 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-09-10
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Angiogram pulmonary abnormal, Atrial fibrillation, Blood thyroid stimulating hormone normal, COVID-19, Computerised tomogram abdomen abnormal, Condition aggravated, Cough, Diverticulum intestinal, Electrocardiogram abnormal, Fatigue, Fibrin D dimer, Full blood count normal, Heart rate decreased, Hepatic steatosis, Lung opacity, Metabolic function test normal, Pancreatitis acute, Pulmonary mass, SARS-CoV-2 test positive, Troponin normal
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Interstitial lung disease (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (Tylenol 8 Hour Arthritis Pain) 650 MG PO CR tablet take 1 Tablet by mouth every 8 hours as needed for FOR PAIN for up to 10 days. Past Week Unknown time metoprolol (TOPROL XL) 50 MG PO TABLET SR 24 HR TAKE 1 TABLET BY MOUTH E
Current Illness: Atrial fibrillation ? Bradycardia, sinus 12/21/2015 He does have significant asymptomatic bradycardias when he is in sinus rhythm. He is currently in the upper 40s on my exam today. I would continue with her current medications none that time we may have to back down on her negative chronotropic. However since he''s been doing so well from an A. fib standpoint and admits that he had a very good course of the last time I saw him we will continue with ? Cataract 6/3/2019 ? Chronic fatigue 11/8/2016 ? Chronic sinusitis ? Closed fracture of base of fifth metatarsal bone of right foot 6/14/2019 ? Deep vein thrombosis 2013 Lower L leg ? OSA (obstructive sleep apnea) ? Overweight (BMI 25.0-29.9) 3/1/2019 ? Paroxysmal atrial fibrillation 12/2/2015 ? Pulmonary nodules ? S/P ablation of atrial fibrillation ? Syncope 12/3/2020 ? Tinnitus
Preexisting Conditions: Atrial fibrillation ? Bradycardia, sinus 12/21/2015 He does have significant asymptomatic bradycardias when he is in sinus rhythm. He is currently in the upper 40s on my exam today. I would continue with her current medications none that time we may have to back down on her negative chronotropic. However since he''s been doing so well from an A. fib standpoint and admits that he had a very good course of the last time I saw him we will continue with ? Cataract 6/3/2019 ? Chronic fatigue 11/8/2016 ? Chronic sinusitis ? Closed fracture of base of fifth metatarsal bone of right foot 6/14/2019 ? Deep vein thrombosis 2013 Lower L leg ? OSA (obstructive sleep apnea) ? Overweight (BMI 25.0-29.9) 3/1/2019 ? Paroxysmal atrial fibrillation 12/2/2015 ? Pulmonary nodules ? S/P ablation of atrial fibrillation ? Syncope 12/3/2020 ? Tinnitus
Allergies: No Known Allergies
Diagnostic Lab Data: SARS-COV-2 (COVID-19), Micro Status: Final result Visible to patient: Yes (seen) Next appt: 10/25/2021 at 12:00 PM in Cardiovascular Testing (Cardiology) Specimen Information: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19), Micro Not Detected Detected Abnormal Narrative The SARS-CoV-2 (COVID-19) test is for in vitro diagnostic use under the agency Emergency Use Authorization (EUA) for laboratories certified to perform high complexity testing. This test has not been agency cleared or approved. Methodology: Nucleic Acid Amplification/Polymerase Chain Reaction (PCR). Specimen Collected: 09/14/21 5:30 PM Last Resulted: 09/14/21 6:37 PM
CDC Split Type:

Write-up: This is a 72y.o. male with history of atrial fibrillation on Xarelto, SSS with pacemaker, history of DVT, sleep apnea, and recent diagnosis of COVID-19 who presents with left lower quadrant pain in addition to fatigue and cough. His symptoms began about 5 days ago. The patient went to urgent care and he was referred to the ED when he was found to be in atrial fibrillation with RVR. No fever, chills, lightheadedness, chest pain, or palpitations. He denies nausea, vomiting, diarrhea, or constipation. No history of kidney stones. He says he''s been compliant with all of his medications. The patient is a former smoker, quit 35 years ago. On arrival to the ED, RVR confirmed by EKG, HR 126. SpO2 normal on room air. Troponin x 3 negative. D-dimer 1,205. CBC and BMP unrevealing. TSH normal. CT angiogram chest negative for PE, but shows scattered groundglass opacities and multiple pulmonary nodules, largest in the RLL measuring 8 mm. CT abdomen/pelvis revealed acute interstitial pancreatitis and colonic diverticulosis and fatty infiltration of liver. The patient was started on a Cardizem infusion and HR subsequently dropped into the 40''s. Cardiology was consulted.


VAERS ID: 1745356 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-30
Onset:2021-09-10
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Alcohol use, Back pain, Computerised tomogram abdomen abnormal, Condition aggravated, Pain, Pancreatitis, Peripancreatic fluid collection, SARS-CoV-2 test negative
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Carafate 1 GM/10ML PO Suspension TAKE 10 ML BY MOUTH BEFORE MEALS AND AT BEDTIME FOR 14 DAYS. Past Week Unknown time Med Note (Tue Sep 14, 2021 7:17 AM) Last filled 8/31/21 (qyt 420ml, 14 day supply) folic acid (FOLATE) 1 MG PO Tab T
Current Illness: Hypertension ? Pancreatitis
Preexisting Conditions: Hypertension ? Pancreatitis
Allergies:
Diagnostic Lab Data: On presentation, CT of the abdomen and pelvis did reveal findings consistent with interstitial pancreatitis as well as a fluid collection within the pancreatic head. There was no evidence of necrosis at this time. Specimen Information: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19) by NAA, Micro Not Detected Detected Abnormal Narrative The SARS-CoV-2 (COVID-19) by NAA test is for in vitro diagnostic use under the FDA Emergency Use Authorization (EUA) for laboratories certified under a regulatory authority to perform high complexity testing. This test has not been FDA cleared or approved. Methodology: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (PCR).
CDC Split Type:

Write-up: This is a 44y.o. male with a medical history of hypertension and prior pancreatitis as well as alcohol abuse and tobacco abuse who presented to the emergency department secondary to epigastric pain. The patient states that he has had 3 days of Bastrop pain radiating to his back after drinking alcohol during a football game. He states that the symptoms are similar to his previous bout of pancreatitis. He states that he has had multiple episodes of pancreatitis and this is his seventh or eighth episode. He states that his last episode was about 3 months ago. On presentation, CT of the abdomen and pelvis did reveal findings consistent with interstitial pancreatitis as well as a fluid collection within the pancreatic head. There was no evidence of necrosis at this time.


VAERS ID: 1745366 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-02
Onset:2021-09-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Laboratory test, Palpitations, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: Hypertension Hypothyroidism
Preexisting Conditions: Hypertension Hypothyroidism
Allergies: KNDA
Diagnostic Lab Data: EKG and labwork performed on 9/29/21
CDC Split Type:

Write-up: postmenopausal menstrual cyle x 4 days 2-3 weeks after vaccination. She has had no period the past 4 years. She has also had palpitations starting shortly after vaccination, chest pain starting on 9/29/21.


VAERS ID: 1745661 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness unilateral, Extra dose administered, Hypoacusis, Pain in extremity
SMQs:, Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID vaccine #1 - sore arm, COVID vaccine #2 - treated achiness with Tylenal the day after the injection. Both times was back
Other Medications: Metoprolol Succinate 25mg, Vit B12-2000mcg, Vit D3-50mcg
Current Illness: No
Preexisting Conditions: Hypertrophic Cardiomyopathy, Level 3 Liver Scarring due to cardic issues
Allergies: None that I know of.
Diagnostic Lab Data: I did not report the adverse event to my primary physician so no medical testing or lab work was done.
CDC Split Type:

Write-up: Arrived home following the vaccination with a bit of a sore arm. Awoke in the middle of the night with hearing lose in the left ear and muffled hearing in the right ear. Took (1) 500mg Tylenal for achiness. Took another another Tylenal eight hours later. Felt most comfortable spending the day quiet watching TV or reading. My hearing gradually returned through out the day. By 6:00pm hearing in both ears had completely returned. The following morning (September 11, 2021) I felt completely back to my normal self and have no adverse effects since.


VAERS ID: 1746389 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Rapid heartbeat constantly


VAERS ID: 1747509 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-02
Onset:2021-09-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vyvanse , multi vitamin,,Flonase
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Amoxcillian
Diagnostic Lab Data:
CDC Split Type:

Write-up: I never have had COVID until I received the vaccine I was diagnosed on 13 I now have had a severe infection after that has been treated with two different antibiotics and still has not been resolved. I also started having tinnitus..


VAERS ID: 1747974 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-09
Onset:2021-09-10
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Immune thrombocytopenia, Platelet count
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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:
Other Medications: VITAMIN D [ERGOCALCIFEROL]; VITAMIN C [ASCORBIC ACID]; VITAMIN B12 [CYANOCOBALAMIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hashimoto''s thyroiditis; Idiopathic thrombocytopenic purpura
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: platelet; Result Unstructured Data: Test Result:drop from 94 to 30; Comments: in 28 days post 1st vaccine injection
CDC Split Type: USPFIZER INC202101190417

Write-up: Pt has a DX of ITP, had a platelet drop from 94 to 30 in 28 days post 1st vaccine injection; Pt has a DX of ITP, had a platelet drop from 94 to 30 in 28 days post 1st vaccine injection; This is a spontaneous report from a contactable nurse. A 37-year-old female non-pregnant patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration on 09Aug2021 (37-year-old at time of vaccination) as single dose for COVID-19 immunization. Medical history included ITP and Hashimoto thyroiditis. No known allergies. Concomitant medications (Other medications in two weeks) included ergocalciferol (VITAMIN D); ascorbic acid (VITAMIN C); cyanocobalamin (VITAMIN B12). No other vaccine in four weeks. Patient has a DX (diagnosis) of ITP, had a platelet drop from 94 to 30 in 28 days (as reported) post 1st vaccine injection. Adverse event start date was reported as 10Sep2021. Adverse event resulted in Doctor or other healthcare professional office/ clinic visit. Therapeutic measures were taken as a result of the event and included Steroids. The outcome of the event was unknown. Information on the lot/batch number has been requested.; Sender''s Comments: Based on the reported information, the causal association between the events immune thrombocytopenia and condition aggravated and the suspect drug cannot be excluded. The case will be reassessed once new information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1749381 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye irritation, Eye pain
SMQs:, Glaucoma (broad), Corneal 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: Patient stated after receiving her first dose of Pfizer she experienced eye pain/burning a day after the vaccine which lasted 2 days. She had eye surgery on both eyes 15 years ago and believes it wasn''t due to the eye surgery. Patient has since recovered and didn''t follow up with PCP


VAERS ID: 1749419 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Heavy period lasting more then 2 weeks; with large blot clots.


VAERS ID: 1749427 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Nausea, Paraesthesia, Tinnitus, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe vertigo, tinnitus, nausea, painful lymph nodes, paraesthesia


VAERS ID: 1749573 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Insomnia, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: I had a really bad headache that seamed to have started in the front of my head and moved all over my head from front to side and ended at the back of my head, headache last two days could not sleep due to pain also felt nauseous, also had really bid chills and sweating, as well as muscle aches in my arm and legs and back.


VAERS ID: 1749629 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 falsified DOB when registering for vaccination. Stated the child''s DOB was 06/21/2009. Guardian consented to the vaccination. Verified with statistical records the actual DOB is 06/21/2010, which made the vaccine a contraindication. No known adverse reactions noted.


VAERS ID: 1749809 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A-1 / 2 LA / IM

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

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

Write-up: : got second dose of covid vaccine today, having bilateral eye swelling, no throat swelling,able to talk in full sentences History of Present Illness: Pt is a 49 year old female who presents to the ER with eyelid swelling, possible reaction to COVID vaccine. Patient received her 2nd dose of Moderna COVID vaccine at 9:30AM. Was feeling okay during obs period, and then when she went to her care, noted eyelid swelling. Eyes still feel sore and heavy. No lip swelling, no tongue swelling, normal voice. No wheezing or SOB.


VAERS ID: 1749951 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure abnormal, Eye haemorrhage, Nausea, Pain in extremity, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (broad), Retinal disorders (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: last tetanus shot had knot for several months at injection site
Other Medications: Amlodipine, elderberry
Current Illness: None
Preexisting Conditions: Hypertension and hydradenitis
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1 hour after taking vaccine, noticed blood vessel in left eye burst, BP systolic 180, swelling at left arm and pain, and nausea. BP came back to normal 3rd day. Nausea lasted for 2 days. Swelling came down the night of 2nd day.


VAERS ID: 1749952 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Public       Purchased by: ?
Symptoms: Constipation, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None.
Current Illness:
Preexisting Conditions: Low blood pressure.
Allergies: Penicillin, Hydrocodone, Iodine, Iodide, Sulfa.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Uncontrollable diarrhea for 15+ days, turns into constipation.


VAERS ID: 1750039 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301358A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia oral, Paraesthesia oral, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: Pt had a hx of tingling in the tongue, lips ,chest pain and difficulty breathing , given Benadryl & Epipen after 1st dose & sent to ER. Pt .cleared to take the vaccine dose 2 today , Pre-medicated with Benadryl 25 mg & observe for 30 minutes . Pt. was given Benadryl 25 x2.,after feeling tingling of lips , numbness of lips , itchy throat that was relived by 2 dose of benadryl will continue to observe. Continue to feel light itchy all over her body. Pt observed for 15 minutes , D/c home cleared by provider


VAERS ID: 1751949 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-27
Onset:2021-09-10
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: COVID-19 test; Test Result: Positive ; Result Unstructured Data: tested positive for Covid-19
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: I tested positive for COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (I tested positive for COVID-19) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004C21A) for COVID-19 vaccination. No Medical History information was reported. On 27-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, the patient experienced COVID-19 (I tested positive for COVID-19). At the time of the report, COVID-19 (I tested positive for COVID-19) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Sep-2021, SARS-CoV-2 test: positive (Positive) tested positive for Covid-19. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant information was reported. No treatment information was reported. The patient tested positive for Covid-19, and reported that his daughter caught it from school, and the patient caught it from her.; Sender''s Comments: This case concerns a 46-year-old, male patient with no relevant medical history, who experienced the unexpected event of COVID 19. The event occurred approximately four and a half months after the second dose of Moderna COVID-19 Vaccine. The rechallenge was unknown since no information about the second dose was disclosed. Based on the current available information, the mRNA-1273 does not contain a virus capable of causing COVID-19 infection after vaccination. The benefit-risk relationship of Moderna COVID-19 Vaccine is not affected by this report.


VAERS ID: 1752028 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Drug hypersensitivity, Headache, Immunisation, Loss of consciousness, Lower limb fracture, Off label use, SARS-CoV-2 test, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Medical History/Concurrent Conditions: Asthma
Allergies:
Diagnostic Lab Data: Test Date: 20201228; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101218995

Write-up: passed out; Severe allergy(hives all over my body even between my fingers); had a headaches for hours and hours; broke my leg; Severe allergy(hives all over my body even between my fingers); Pfizer Biontech 3rd Booster; Pfizer Biontech 3rd Booster; This is a spontaneous report from a contactable consumer (patient). A 57-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at the age of 57-years old, via an unspecified route of administration, administered in Arm Left on 10Sep2021 13:00 (Batch/Lot number was not reported) as dose 3, single for COVID-19 immunization. Medical history included asthma. The patient had no known allergies. There were no concomitant medications. The patient did not receive other vaccines within 4 weeks prior to the COVID vaccine. No other medications the patient received within 2 weeks of vaccination. The patient experienced severe allergy (hives all over her body even between her fingers). She was still in recuperating; she also had a headaches for hours and hours and then she was taking a shower and passed out and broke her leg multiples places. The events occurred on 11Sep2021 03:00 which resulted to healthcare professional office/clinic visit and emergency room/department or urgent care. The patient received Prednisone 60mg 3 Times a day as treatment. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19. The patient underwent lab test and procedures which included nasal swab: negative on 28Dec2020. The outcome of the events was not recovered. Information on the lot/batch number has been requested.


VAERS ID: 1752040 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-08-12
Onset:2021-09-10
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Ear pain, Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Congestive heart failure; Diabetes; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101219450

Write-up: Bell''s Palsy/Paralyzation/Weakness of left side of face started Sept 15th around 6pm.; Pain behind left ear; numbness in lips; This is a spontaneous report from a contactable consumer (patient). A 46-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW0182), via an unspecified route of administration, in right arm on 12Aug2021 (at the age of 46-years-old) as dose 2, single for COVID-19 immunization. Medical history included diabetes type 2, congestive heart failure, asthma, COVID-19 and allergy to shellfish and codeine. Concomitant medication included lisinopril, metformin and glipizide. No other vaccine was given in 4 weeks. Since vaccination, the patient has not been tested for COVID-19. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EW0170), via an unspecified route of administration, in left arm on 14Jul2021 (at the age of 46-years-old) as dose 1, single for COVID-19 immunization. The patient experienced numbness in lips which started on or around 10Sep2021. Pain behind left ear on or around 14Sep2021. Paralyzation/ Weakness of left side of face started 15Sep2021 around 18:00. The patient went to ER fearing a stroke and was diagnosed with Bell''s Palsy. Therapeutic measures taken as a result of the events included medications valacyclovir, prednisone and amoxiclav. The events resulted in emergency room/ department urgent care. The outcome of the events was recovering. Follow-up attempts are completed. No further information is expected


VAERS ID: 1752084 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-18
Onset:2021-09-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Tuberculosis
SMQs:, Infective pneumonia (narrow), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Depression
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: CXR; Test Result: Negative ; Test Date: 202103; Test Name: TB Gold; Test Result: Negative ; Comments: Have always had negative Mantoux and tb gold tests- last was Mar2021-; Test Date: 20210910; Test Name: TB Gold; Test Result: Positive ; Comments: Last wk I was required to obtain a TB Gold for preemployment screening and my TB Gold was POSITIVE
CDC Split Type: USPFIZER INC202101226455

Write-up: TB Gold was POSITIVE; This is a spontaneous report from a contactable nurse. A non-pregnant 52-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in right arm on 18Aug2021 12:00 (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunisation. Medical history included depression. Concomitant medications included bupropion hydrochloride (WELLBUTRIN), amfetamine aspartate, amfetamine sulfate, dexamfetamine saccharate, dexamfetamine sulfate (ADDERALL) and trazodone, all taken for an unspecified indication, start and stop date were not reported. The patient previously took LYRICA, EES and CELEBREX and known allergies. The patient stated, "I have been a nurse 26 years. Never cared for a TB patient, have always had negative Mantoux and tb gold tests- last was Mar2021- negative. Last week (10Sep2021) I was required to obtain a TB Gold for preemployment screening and my TB Gold was POSITIVE. CXR negative". The patient received no treatment. No COVID prior to vaccination and no post vaccination test. The outcome of the event was unknown. The lot number for BNT162B2, was not provided and will be requested during follow-up.; Sender''s Comments: Based on temporal relationship and previous lab data the role of the vaccine BNT162B2 in triggering TB cannot be completely excluded and also TB could be an intercurrent illness. The case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1752141 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Full blood count, Haematoma, Headache, Investigation, Limb discomfort, Metabolic function test, Nail bed bleeding, Pain, Rash, Ultrasound scan, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; CLONAZEPAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Pituitary microadenoma (I have a pituitary microadenoma); Thyroid cancer (I have history of Thyroid Cancer)
Allergies:
Diagnostic Lab Data: Test Date: 20210913; Test Name: CBP; Result Unstructured Data: Test Result:Stable; Test Date: 202109; Test Name: lab work; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210913; Test Name: CMP; Result Unstructured Data: Test Result:stable; Test Date: 202109; Test Name: ultrasound; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101236091

Write-up: developing vaginal clots/has not stopped bleeding; Body Ache; shortness of breath and breathing; developed TPI in left arm; rash on my toe; blood underneath my nail beds; chest pain; severe headache; Construction in my left arm and bleeding underneath the skin of my left arm/bleeding in my left arm; This is a spontaneous report from a contactable consumer (patient). A 50-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), (at the age of 50 years) via an unspecified route of administration, administered in Arm Right on 09Sep2021 (Batch/Lot Number: FC3184) as dose 1, single for covid-19 immunisation. Medical history included thyroid cancer, pituitary microadenoma and anxiety. Concomitant medications included levothyroxine sodium (SYNTHROID) and clonazepam taken for anxiety. The patient got the Pfizer COVID vaccine on 09Sep2021. The day after she got her shot (10Sep2021), she had severe headache and body ache; she end up with chest pain, "shortness of breath and breathing", she developed "TPI" in her left arm, bleeding in her left arm, had rash on her toes, and blood underneath nail beds. Four days after the vaccine (13Sep2021), she started developing vaginal clots that required her to go the gynecologist because that has not stopped bleeding. She had her lab work done when she went to see her doctor because of the side effects. She went in on 13Sep2021 and listed as CBP, CMP. The result was stable that is all she knows. She has had more lab work yesterday (Sep2021) because she was continually having vaginal clots, she does not know those results yet. On 10Sep2021, she started with a headache and body ache, chest pain shortness of breath, and "construction in my left arm and bleeding underneath the skin of my left arm". As of right now, she was witnessing back to her gynecologist; she had an ultrasound done yesterday (Sep2021) and was waiting for the final result so they know what they have to do. The patient mentioned that the bleeding is persisting. The second dose was scheduled on 30Sep2021, but her doctor has told not to take second dose. The outcome of the events "construction in my left arm and bleeding underneath the skin of my left arm/bleeding in my left arm", and "developing vaginal clots/has not stopped bleeding" was not recovered while the other events were unknown. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752839 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Oropharyngeal pain, Pain in extremity
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Melatonin 5mg, norethindrone acetate and ethical estradiol 1/0.02mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, sore throat for 5 days, headaches ongoing


VAERS ID: 1753397 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mastication disorder, Pain in jaw, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Osteonecrosis (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: None
Diagnostic Lab Data: N/A.
CDC Split Type:

Write-up: Left side of face felt tingly and swelled slightly. One day later I began having a severe pain in my left jaw area making it extremely difficult to open my mouth. Chewing was difficult as well. It lasted for about a week.


VAERS ID: 1753412 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-09-10
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Fall, Mobility decreased, Nucleic acid test, SARS-CoV-2 test positive, Skin laceration, Walking aid user
SMQs:, Parkinson-like events (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nothing on file
Current Illness:
Preexisting Conditions: Nothing on file
Allergies: Heparin, ace inhibitors, iodine
Diagnostic Lab Data: SARS-COV-2 (COVID-19) by NAA, Micro: SARS CoV 2 DETECTED (9/10/2021)
CDC Split Type:

Write-up: Patient is a 78-year-old male who presented with left hip pain after having a mechanical fall at home. He said he was on his deck with his walker and was trying to go back inside. He has small skin tear on his elbow but denies any pain in the left arm. Denies headache, neck pain, chest pain, shortness of breath, abdominal pain. He is only complaining of pain in his left hip. Was unable to get up after the fall. Patient spent several days in the hospital and upon transfer, tested positive for COVID. This led to further hospitalization. Patient is currently admitted at another facility.


VAERS ID: 1753442 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Peripheral swelling, Swelling face, Weight increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports swelling on the right side of face and left arm. Vaccine was administered in the left arm. No swelling of the tongue, no trouble breathing. Swelling started about one week after vaccination and lasted for one week. Patient reports taking tylenol and feeling better. Patient also reports gaining weight.


VAERS ID: 1754135 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Lymphadenopathy, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Inflammation of neck linphatic nodes and discomfort that lasted for 72 hrs. Recurring body fatigue almost daily for the last 3 weeks after the shot.


VAERS ID: 1754239 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Flushing, Hyperhidrosis, Hypersensitivity, Mydriasis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Allergic reaction; flushing, sweating, dilated pupils, dizzy, fell off chair. Patient recovered, 911 was call but cancelled per patient.


VAERS ID: 1754343 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-03
Onset:2021-09-10
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

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

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

Write-up: Breakthrough COVID infection following full vaccination


VAERS ID: 1754354 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-18
Onset:2021-09-10
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

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

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

Write-up: Breakthrough COVID infection following vaccination


VAERS ID: 1754513 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3138 / 1 RA / IM

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

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

Write-up: Sept 10, 2021 patient came to pharmacy for his first does of Pfizer Covid-19 vaccine. He did mark on his immunization administration record that he has not received a Covid-19 vaccine previously. Today 10/1/21 patient called to set up his 2nd dose of Pfizer covid-19 vaccine. When checking into It, to verify is previous vaccine history, it was discovered that the patient has already received a Janssen covid-19 vaccine from a CVS pharmacy on 3/10/2021.


VAERS ID: 1755957 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-09-10
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Chills, Hypoaesthesia, Malaise, Paraesthesia, Peripheral swelling, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Body temperature; Result Unstructured Data: she had a Fever 102F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Sick after 2nd vaccine; Swollen Right Foot after 2nd vaccine; Tingling in arms, feet and legs after 2nd vaccine; Numbness in the arms, feet and legs after the 2nd vaccine; Fever 102F after 2nd vaccine; Chills after 2nd vaccine; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (Sick after 2nd vaccine), PERIPHERAL SWELLING (Swollen Right Foot after 2nd vaccine), PARAESTHESIA (Tingling in arms, feet and legs after 2nd vaccine), HYPOAESTHESIA (Numbness in the arms, feet and legs after the 2nd vaccine) and PYREXIA (Fever 102F after 2nd vaccine) in a 42-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. In August 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced MALAISE (Sick after 2nd vaccine), PERIPHERAL SWELLING (Swollen Right Foot after 2nd vaccine), PARAESTHESIA (Tingling in arms, feet and legs after 2nd vaccine), HYPOAESTHESIA (Numbness in the arms, feet and legs after the 2nd vaccine), PYREXIA (Fever 102F after 2nd vaccine) and CHILLS (Chills after 2nd vaccine). On 12-Sep-2021, MALAISE (Sick after 2nd vaccine), PYREXIA (Fever 102F after 2nd vaccine) and CHILLS (Chills after 2nd vaccine) had resolved. At the time of the report, PERIPHERAL SWELLING (Swollen Right Foot after 2nd vaccine), PARAESTHESIA (Tingling in arms, feet and legs after 2nd vaccine) and HYPOAESTHESIA (Numbness in the arms, feet and legs after the 2nd vaccine) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 10-Sep-2021, Body temperature: 102f (High) she had a Fever 102F. No concomitant product was provided by the reporter. No treatment medication was provided. This case was linked to MOD-2021-330949. Reporter did not allow further contact


VAERS ID: 1756487 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine 20mg twice a day
Current Illness: none
Preexisting Conditions: Smoker
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extremely light-headed for 4 hours starting about 30mins after receiving vax; heart palpitations roughly 5hrs after vax lasting about 30mins on and off


VAERS ID: 1756511 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, Condition aggravated, Confusional state, Dizziness, Dysmenorrhoea, Full blood count abnormal, Haemoglobin decreased, Headache, Heavy menstrual bleeding, Impaired work ability, Insomnia, Loss of personal independence in daily activities, Mean cell volume decreased, Red blood cell abnormality, Red blood cell count decreased
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: CBC 9/29/21 showing low RBC, low Hg, damaged RBC, low mean volume RBC
CDC Split Type:

Write-up: About an hour after receiving the first dose of the Pfizer/BioNTech vaccine, I became dizzy, confused and had a sharp stabbing headache lasting into the night. It has been 3 weeks now since then and I continue to suffer from a headache ranging from mild to severe in intensity that is not relieved by drinking fluids, nutrition or rest. It is also not relieved with any over the counter medications such as tylenol or ibuprophen. I have never suffered from these headaches before. Since receiving the vaccine on 9/10/21, I have had 8 nights where I am unable to fall asleep at all. Being awake for over 40 hours straight, Other nights I have difficulty falling asleep and need to take presribed and/or OTC sleep aids. Which sometimes are still uneffective. I have a history of having mild difficulty falling asleep. I have never been awake for days or have had a problem sleeping after taking a sleep aid. I started my menstral cycle shortly after the vaccine. The first 4 days of my cycle were so extreme I could not go to work. I used size "super" tampons along with wearing 2 pads and needed to change every 30 minutes. If I could not make it every 30 minutes, after 45 minutes I would leak out of the tampon and pads and into my clothing. I ended up wearing depend diapers. I experienced severe debilitating cramping and clots that were large, black and painful to pass. After consulting a Dr and obtaining CBC, I was found to be anemic with very low hemoglobin levels. This vaccine has caused me to experience symptoms that have negatively impacted my daily living and caused reactions to my health that I am not sure will ever go away. After speaking with people around me I am hearing similar stories. I worry no one is reporting these things so nothing will change. Please do further studies to prevent further harm


VAERS ID: 1756680 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray normal, Cough, SARS-CoV-2 test negative, Secretion discharge
SMQs:, Anaphylactic reaction (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/19 - Negative COVID test (nasal swab) 9/24 - Negative for asthma, lung X-ray was clear and breathing treatment checked out
CDC Split Type:

Write-up: Persistent cough with mucus since 9/10 when 2nd dose was administered on 9/7. Tested negative for COVID.


VAERS ID: 1756748 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-09-10
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Dyspnoea, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: He is having red rashes that burn all over and especially in the joints. These have occurred on Sept. 10, 14, 15, 23, 30, 2021 and the last one affected his breathing, shortness of breath. It last from 30 minutes to an hour each time. He had covid Sept. 1 through the 9th, 2021.


VAERS ID: 1756833 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

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

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

Write-up: Patient received 1st dose of pfizer series on 9/10/2021 after receiving completed series of modern vaccine on 4/21/2021 and 5/19/2021


VAERS ID: 1756969 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-09-10
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / UNK LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient was admitted to the hospital with COVID-19 also had respiratory failure he was treated for it. Patient was treated with steroids and oxygen. Once patient was stable he was discharged.


VAERS ID: 1757118 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Every day debilitating headaches. I have to take OTC Excedrin all day or Tylenol but it is not relieved completely. EXTREME fatigue. Spouts of pain in my forearms that randomly happen then go away. Tingles in my face and majority in my forehead.


VAERS ID: 1757141 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol 25 mg. 3X/day Detrol LA 2 mg. 1X/day Ramipril 2.5 mg. 1X/day Fenofibric Acid 45 mg 1X/day Crestor 10 mg. 1X/day Zetia 10 mg. 1X/day Potassium Citrate ER 1,080 mg. 2X/day Aspirin 85 mg. 2X/day Budesonide 6 mg./day Preservision Ar
Current Illness: None
Preexisting Conditions: Heart disease; high blood pressure (controlled); high cholesterol (controlled)
Allergies: Cipro, sulfur drugs
Diagnostic Lab Data: Audiology 9-24-21
CDC Split Type:

Write-up: I developed severe, high-pitched tinnitus in both ears. For a couple of days, it was deafening. Now, it is just loud.


VAERS ID: 1757144 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-04
Onset:2021-09-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Photophobia
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal 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: flu vaccine
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: influenza vaccination, shrimp, sulfa products, salicylic acid, pcn, nuts
Diagnostic Lab Data: none
CDC Split Type:

Write-up: very bad headaches - sensitivity to light


VAERS ID: 1757149 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Nasopharyngitis, Pain, Vertigo
SMQs:, Vestibular 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:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Persistent vertigo, body aches, cold/flu like symptoms


VAERS ID: 1757504 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Muscular weakness, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid-19
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: That night following vaccine, I had chills. The next day, I had injection site soreness and a headache. As the day progressed, I experienced a fever of 101, headache, nausea, muscle weakness. Tylenol was required around 4p. That evening, I continued to have all symptoms. Fever came back up around 11p. Addition Tylenol was taken. Sunday, I had a headache. Muscle weakness was better. Injection site pain was better. Still had a fever. I was very dizzy all day Sunday. On Monday, I felt much better but was fatigued.


VAERS ID: 1757592 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthritis, Condition aggravated, Photophobia, Psoriasis, Uveitis
SMQs:, Systemic lupus erythematosus (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Ocular infections (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: xanax, lexapro
Current Illness:
Preexisting Conditions: psoriasis, uveitis, arthritis
Allergies: cortisone, hydrocodone,codeine
Diagnostic Lab Data: none, I am just letting you know my reaction.
CDC Split Type:

Write-up: at 6:00 pm, my Uveitis flared up in my left eye, which has not happened in a year and a half. I put steroid drops in the eye for a week and it cleared up. eye still sensitive to bright light. My Psoriasis and arthritis have also flared up.


VAERS ID: 1758675 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-1 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Numbness, tingling, burning pain in Left upper extremity, left lower extremity. Ongoing for 3 weeks, first started on day of Covid vaccination.


VAERS ID: 1758873 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Parosmia, Taste disorder
SMQs:, Taste and smell 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: Adderall, norco
Current Illness:
Preexisting Conditions: Lupus fibromyalgia migraine anxiety
Allergies: Vancomycin and fentanyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: Weird smell and taste . Every food smells the same and has a foul odor


VAERS ID: 1758934 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Dysgeusia, Dyspnoea, Extra dose administered, Fatigue, Inflammation, Pain, Parosmia
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Medication errors (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient states he had the first moderna covid vaccine on 6/7/21, he had his second moderna covid vaccine on 8/27/21. Patient states that on 9/9/21 and had a third Moderna Vaccine. patient states within 24 hours he had side effects of shob, body aches, he felt like his bronchials were inflammed, he couldn''t smell anything and lost the taste of somethings. he states since this date he had the horrific smell of metal, he wakes up with the smell and sometimes he can taste it. He feels a fatigue.


VAERS ID: 1758941 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-19
Onset:2021-09-10
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759309 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-17
Onset:2021-09-10
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759361 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: No adverse events or outcome, just that the vaccine was administered after the 30 days of received by our clinic.


VAERS ID: 1759373 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: No adverse events or outcome, just that the vaccine was administered after the 30 days of received by our clinic.


VAERS ID: 1759380 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1759388 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: No adverse events or outcome, just that the vaccine was administered after the 30 days of received by our clinic.


VAERS ID: 1759402 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO198 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, 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:

Write-up: No adverse events or outcome, just that the vaccine was administered after the 30 days of received by our clinic.


VAERS ID: 1759643 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-15
Onset:2021-09-10
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Multiple system atrophy Pituitary adenoma
Allergies: Codeine, hydrocodone, oxycodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented to hospital 9/10/2021 with decreased appetite and increased cough. Her COVID test was positive 9/10/2021. On 9/12/2021 due to fever patient begin Decadron, oxygen per protocol, vitamin C, vitamin D3 and zinc. She had some desaturation and required to transition to oxygen at 2L with continued concern for the possibility of aspiration pneumonia so her antibiotics were adjusted. Patient continues to progress slowly with therapies and was weaned to room air, VSS. Patient discharged on 9/21/21.


VAERS ID: 1759696 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Fatigue, Heart rate increased, Joint swelling, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Extreme fatigue, dizziness, confusion, pins and needles in extremities, rapid heart rate, swelling in feet and ankles


VAERS ID: 1759708 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Dizziness, Haemoptysis, Headache, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Infective pneumonia (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: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: yes, ER did blood work, chest x-rays
CDC Split Type:

Write-up: Had continuous headaches since the took the vaccine, Headaches, dizziness, tingling in chest area. He stated he coughed up some blood about a week ago which a few times then stopped. Went ER and the dr, which stated they couldn''t find anything and he has a 2nd dr appt.


VAERS ID: 1759774 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
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: Chronic respiratory condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received COVID 19 Janssen vaccine on the date mentioned. When the vaccination is entered in the local database, data entry team noticed that the patient was already vaccinated with 1 shot of Moderna vaccine on May 28, 2021. Data team calls the patient to verify the information on record. He confirms his identity and that in fact, he asked for another shot when he missed his second shot of Moderna. He confirms, that when he visited the vaccination facility on September 10, 2021 he didn''t said anything about the Moderna shot received on May because someone told him that because the Moderna shot was a while ago, and he missed it, he had to start over again. In order to avoid from happening the same thing again, he opted for Janssen, because its one shot.


VAERS ID: 1759782 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache
SMQs:

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

Write-up: Chills and Headache: reported 24hrs after Vaccine


VAERS ID: 1760232 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Blood pressure decreased, Dizziness, Electrocardiogram normal, Erythema, Extra dose administered, Feeling hot, Flushing, Head injury, Headache, Injection site erythema, Injection site pain, Injection site swelling, Insomnia, Malaise, Nausea, Peripheral swelling, Product administered at inappropriate site, Pulse abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Medication errors (narrow), 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? No
Previous Vaccinations:
Other Medications: None at time of vaccination. In the evening- Zanaflex, neurotin, liquid tylenol at bedtime.
Current Illness: No illnesses
Preexisting Conditions: MS
Allergies: hornets, wasps and yellow jacket, iodine, sulfur, avonex, interferon based products, statins,
Diagnostic Lab Data: EKG, BP, Blood sugar.
CDC Split Type: 12

Write-up: Vaccine administered at 12:15 pm on 9/10/2021 Approximately around 12:30 pm patient felt stinging sensation in arm at injection site. Had a feeling of being flushed. and warm. Went home : About 2 hours later- felt faint and arm started to burn even more. Looked like her arm was scorched color of red apple and swollen the size of baseball. Swelling and redness lasted 10 days in left arm. That evening- felt dizzy, weak, nausea, headache. Did not sleep all night. On Saturday, attended son''s (coach) high school football game. At game, she felt faint and then fainted on the bleachers. Banged hand on bleachers. Paramedics were called and found that your Blood Pressure was 100/60 and then dropped to 100/58. Blood Sugar okay, Pulse was weak/slow. Paramedics monitored for 45 minutes+ on the field sidelines. Completed Portable EKG. Nothing was found. Patient went home and to bed and rested/feeling ill for 3 days. Then symptoms improved except for left arm which stayed swollen for 10 days. Patient states the injection was given very low in her arm. About 3 inches above the elbow. Different from previous two doses.


VAERS ID: 1760459 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / SYR

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

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

Write-up: Constant headache x 2.5 weeks. Pain level 4/10. Stabbing like to left side of the head. Typical pain medications for headaches did not improve the issue. The pain was constant, sleep did not cause the pain to go away. Each day, I woke up with the same headache. Had appt on 9/20/21 for the annual work exam. The issue was brought up during check-in with the nurse but not discussed or documented during the visit with the doctor.


VAERS ID: 1760642 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pain, Taste disorder
SMQs:, Taste and smell disorders (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: progesterone 200 mg cap, prenatal tablets
Current Illness:
Preexisting Conditions: asthma
Allergies: citrus,shellfish, figs,kiwi,yeast,latex,honeydew,turmeric
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt experienced burning sensation on injection site, body aches and joint pain, took Tylenol for these symptoms. Also experienced taste alteration for over 3 weeks now


VAERS ID: 1761455 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash, Rash pruritic, Skin discolouration
SMQs:, Anaphylactic reaction (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed a rash 5 hours after dose to arms and neck. Continues with itching. Has dark skin where rash was present. Was seen by medical provider and put on 2 medications, but unsure of names.


VAERS ID: 1761540 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-19
Onset:2021-09-10
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs, cephalosporins
Diagnostic Lab Data: US doppler of the lower extremity on 9/10/21
CDC Split Type:

Write-up: Developed a distal DVT (deep venous thrombosis) in tight leg.


VAERS ID: 1761679 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN Z01A21A / 1 AR / IM

Administered by: Military       Purchased by: ?
Symptoms: Electrocardiogram normal, Full blood count normal, Hypoaesthesia, Limb discomfort, Magnetic resonance imaging head normal, Metabolic function test, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: preworkout, protein
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: EKG- sinus tach MRI brain w/ and w/o contrast- wnl CMP/CBC- WNL
CDC Split Type:

Write-up: Pt notes that he had LE numbness (dead feeling) and heaviness 30 min after vaccination and then the Fri afterwards started to feel muscle stiffness which has resolved but he also has been having pretty steady lack of discriminatory sensation in the toes, he has intermittent periods of time where he has numbness and tingling that rapidly involves the upper body and face as well but is intermittent. these episodes last for 30 minutes. He had decreased sharp/dull in the ED in the toes, neuro was consulted and rec MRI which was normal, pt declined LP at that time, distant fam hx of MS potentially. Denies vision changes, HA, chest pain, SOB, wheezing.


VAERS ID: 1761904 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, Headache, Fatigue from the next morning (Friday) until the following morning (Saturday). I ended up sleeping about 8 hours total (not including morning and night). When awake I had a 102 fever on average with a terrible headache and fatigue.


VAERS ID: 1761935 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-09-10
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: + COVID mild sx


VAERS ID: 1762029 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Contusion, Hypoaesthesia, Injection site bruising, Injection site hypoaesthesia, Injection site indentation, Injection site pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Normal side effect at first with an extremely sore arm. A bruise the size of a nickel. Since day 3 aching in the left arm, weakness in that arm, numbness in my left hand. Now 4 weeks later I still have the aching, numbness, bruise and a large dent in my muscle in left arm at location of vaccine.


VAERS ID: 1762501 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chest pain, Headache, Hot flush, Hyperhidrosis, Injection site pain, Pain, Pruritus, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Blurred vision - onset 1420 hours. eyesight still has not returned to baseline Headache - onset 1425 hours. Left side excruciating sharp head pain. Continue to have low-grade head pain on the left side Hot flashes - 1530 hours. Full body sweats for three days. Temperature - 1540 hours. low grade temperature for three days. Body pain -- 2000 hours. Allover body pain lasting 5 days. Left arm pain - 2015 hours. Pain persisted for 10 days. Itching -- 2100 hours. All over body itching for three days. Chest pain -- 2130 hours. Sharp without radiation for three days.


VAERS ID: 1764047 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-09-10
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pyrexia, Suspected COVID-19
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Mild COVID-like symptoms after 2nd shot; Fever 102.8 F after 2nd shot; This spontaneous case was reported by a consumer and describes the occurrence of SUSPECTED COVID-19 (Mild COVID-like symptoms after 2nd shot) and PYREXIA (Fever 102.8 F after 2nd shot) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included COVID-19 in March 2021. In August 2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 10-Sep-2021, the patient experienced SUSPECTED COVID-19 (Mild COVID-like symptoms after 2nd shot) and PYREXIA (Fever 102.8 F after 2nd shot). On 12-Sep-2021, SUSPECTED COVID-19 (Mild COVID-like symptoms after 2nd shot) and PYREXIA (Fever 102.8 F after 2nd shot) had resolved. No relevant concomitant medications were reported. No treatment information was provided. Reporter did not allow further contact; Sender''s Comments: This report concerns a 50 year old male patient with relevant past medical history of COVID-19 disease who experienced unexpected event of mild COVID like symptoms (coded as suspected COVID-19) and expected event of pyrexia. The events occurred on the same day following vaccination with second dose of mRNA-1273. The event pyrexia is consistent with the current understanding of the mechanism of action of the vaccine. The benefit-risk relationship of mRNA-1273 is not affected by this report.


VAERS ID: 1764063 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chromaturia, Haematuria
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hematuria (literally clots of blood and urine was very red/pink). Last from 10 September 2021 to 17 September 2021. Self treated with cranberry juice, vitamin C, 1 gallons of water minimum daily, frequent urination and time. Eventually improved on its own. No medical treatment was administered.


VAERS ID: 1764064 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein increased, Chest pain, Dyspnoea exertional, Echocardiogram normal, Electrocardiogram normal, Fibrin D dimer increased, Troponin normal
SMQs:, Haemorrhage laboratory terms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol inhaler, montelukast, omeprazole
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Amoxicillin
Diagnostic Lab Data: D-Dimer 974 CRP 43.3
CDC Split Type:

Write-up: 2 hours following injection, the patient had onset of chest pain. Chest pain persisted with worsening over the next 48 hours prompting visit to Hospital emergency department. Patient had negative troponin but elevated D-Dimer (974) and elevated CRP (43.3). Echocardiogram as normal. EKG was unremarkable. Chest pain has persisted with spread across the chest wall since that time. She has also developed dyspnea on exertion, starting the day after vaccination. The dyspnea on exertion has increased in severity and is now limiting with minimal exertion.


VAERS ID: 1764306 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 - / IM

Administered by: Private       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: Effexor and adderall
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Primary visit, advised to take Zyrtec and omeperzole everyday and Benadryl as needed.
CDC Split Type:

Write-up: Day after vaccine severe urticaria on torso, bilateral abdominal sides. Urticaria has occurred daily since with areas ranging from groin, legs, ankles, torso, side of torso and chest


VAERS ID: 1764895 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-10
Onset:2021-09-10
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 616M20A / 2 - / IM

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

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

Write-up: COVID POSTIVE


VAERS ID: 1764969 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Hemiplegia, Neurological symptom, Ultrasound Doppler
SMQs:, Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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

Write-up: strange feeling back of left thigh starting on 9/10/21 @ 1015am traveled to calf. called PCP office, they instructed patient to go to ER for US to rule out blood clot. patient arrived with Full Code Stroke symptoms @ 12:45pm with left side paralysis. administered tPA within time window. residual VITT symptons.


VAERS ID: 1764993 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

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

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765024 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, 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: none
CDC Split Type:

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765030 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

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

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

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765044 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

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

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765061 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 RA / IM

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

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

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765069 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Military       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: none
CDC Split Type:

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765080 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM

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

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

Write-up: Pt was given a vaccine past the 6 hour hold time after reconstitution. Pt had no signs or symptoms.


VAERS ID: 1765184 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Loss of taste-Mild, Additional Details: 1 day after 1st shot, patient lost sense of taste for 3 days. It slowly came back and it''s back to normal. Patient doesn''t know if he had COVID before or not. Patient is healthy with no preexisting conditions. This reaction never happened before due to vaccine or otherwise.


VAERS ID: 1766847 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Oregon  
Vaccinated:0000-00-00
Onset:2021-09-10
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dizziness, Dyspnoea exertional, Haemoptysis, Headache, Hyperhidrosis, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210928; Test Name: Chest X-ray; Result Unstructured Data: could not find anything wrong; Test Date: 20210928; Test Name: Blood test; Result Unstructured Data: could not find anything wrong
CDC Split Type: USJNJFOC20211006525

Write-up: TINGLING IN BOTH LEGS FROM THE KNEES DOWN; COUGHED UP BLOOD (TASTED BLOOD AND SPIT UP BLOOD); DIZZINESS; BLURRED VISION; SWEATS; INTERMITTENT CHEST PAIN; SHORTNESS OF BREATH UPON EXERTION; HEADACHE; This spontaneous report received from a patient concerned a 42 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: Patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-SEP-2021, the patient experienced dizziness. On 10-SEP-2021, the patient experienced blurred vision. On 10-SEP-2021, the patient experienced sweats. On 10-SEP-2021, the patient experienced intermittent chest pain. On 10-SEP-2021, the patient experienced shortness of breath upon exertion. On 10-SEP-2021, the patient experienced headache. On 28-SEP-2021, the patient experienced coughed up blood (tasted blood and spit up blood). Laboratory data included: Blood test (NR: not provided) could not find anything wrong, and Chest X-ray (NR: not provided) could not find anything wrong. On 03-OCT-2021, the patient experienced tingling in both legs from the knees down. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from tingling in both legs from the knees down, and the outcome of headache, dizziness, blurred vision, sweats, coughed up blood (tasted blood and spit up blood), intermittent chest pain and shortness of breath upon exertion was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case is assessed as non-serious.


VAERS ID: 1766882 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Loss of personal independence in daily activities, Myalgia, Nausea, Vaccination complication, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), 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: USMODERNATX, INC.MOD20213

Write-up: Can barely walk; Delayed reaction to my first dose; Severe vertigo; cannot drive a motor vehicle; Nausea; Pain and soreness in my right arm; This spontaneous case was reported by a consumer and describes the occurrence of GAIT DISTURBANCE (Can barely walk), VACCINATION COMPLICATION (Delayed reaction to my first dose), VERTIGO (Severe vertigo), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (cannot drive a motor vehicle) and NAUSEA (Nausea) in a 47-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 10-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 10-Sep-2021, the patient experienced MYALGIA (Pain and soreness in my right arm). On 19-Sep-2021, the patient experienced GAIT DISTURBANCE (Can barely walk), VACCINATION COMPLICATION (Delayed reaction to my first dose), VERTIGO (Severe vertigo), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (cannot drive a motor vehicle) and NAUSEA (Nausea). The patient was treated with ONDANSETRON (ZOFRAN [ONDANSETRON]) at an unspecified dose and frequency; MECLIZINE [MECLOZINE] at an unspecified dose and frequency and DIAZEPAM (VALIUM) at an unspecified dose and frequency. On 12-Sep-2021, MYALGIA (Pain and soreness in my right arm) had resolved. At the time of the report, GAIT DISTURBANCE (Can barely walk), VACCINATION COMPLICATION (Delayed reaction to my first dose), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (cannot drive a motor vehicle) and NAUSEA (Nausea) outcome was unknown and VERTIGO (Severe vertigo) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Laboratory data included CT scan of head, MRI of head, Bloodwork, COVID test, and a neurological exam with inconclusive results. Patient had appointment with an ENT specialist and an audiologist and had a hearing exam with inconclusive result. No relevant concomitant medications were reported.


VAERS ID: 1767490 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Axillary mass, Breast mass, Breast pain, Daydreaming, Mental impairment, SARS-CoV-2 test, Taste disorder
SMQs:, Taste and smell disorders (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Lipodystrophy (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101253193

Write-up: Lost in Daydream (Mental Fog); Lost in Daydream (Mental Fog); Lump in left armpit that gradually sent pain and lump into left breast; Lump in left armpit that gradually sent pain and lump into left breast; Lump in left armpit that gradually sent pain and lump into left breast; Change in taste of familiar foods; This is a spontaneous report from a non-contactable nurse (patient). A 39-years-old female patient received bnt162b2 (BNT162B2) (not pregnant), dose 2 administered in Arm Left on 10Sep2021 08:30 (Batch/Lot number was not reported) at age of 39-year-old as DOSE 2, SINGLE for covid-19 immunisation. Facility where the most recent COVID-19 vaccine was administered was Workplace clinic.The patient medical history and the concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine.The patient previously received bnt162b2 dose 1 administered in Arm Left on 20Aug2021 13:00 at age of 39-year-old as DOSE 1, SINGLE for covid-19 immunisation. The patient experienced Lump in left armpit that gradually sent pain and lump into left breast, Change in taste of familiar foods, Lost in Daydream (Mental Fog) on 10Sep2021. The outcome was Resolved with Sequel in Sep2021. No treatment received. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. Covid test post vaccination (Nasal Swab): Negative. No follow-up attempts are possible. Information about lot/batch number cannot be obtained. No further information is expected.; Sender''s Comments: The Company cannot completely exclude the possible causality between the reported Lost in Daydream (Mental Fog) and the administration of the suspect, BNT162B2, based on the reasonable temporal association. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RA, Agency, as appropriate.


VAERS ID: 1767532 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pulmonary embolism, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101259358

Write-up: Pulmonary embolism; Shortness of breath; Fever; This is a spontaneous report from a non-contactable pharmacist. A 61-year-old female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: 30130BA), intramuscularly in the arm left on 03Sep2021 (at the age of 61-years-old) at dose 2, single for COVID-19 immunisation. The patient was not pregnant. Medical history and concomitant medications were not reported. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received the first dose of BNT162b2 (lot number: ew0185) intramuscularly in the arm left on 13Aug2021 for COVID-19 immunisation. The patient experienced shortness of breath, fever and pulmonary embolism on 10Sep2021. The events were reported as non-serious. The adverse events resulted in emergency room/department or urgent care visit. A treatment was received for the adverse events and included ELIQUIS. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information provided, known drug safety profile and plausible temporal association, the causality between BNT162B2 and Pulmonary embolism, dyspnea and pyrexia cannot be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1768093 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-03
Onset:2021-09-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

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

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

Write-up: Broke out in terrible rash starting about 7 days after a third dose of Moderna vaccine. Rash has not gotten any better. Covers my body (hives) and gets worse at night time. Very random spots from back to legs to shoulders, etc. No previous history to allergies and breaking out in hives.


VAERS ID: 1768473 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-18
Onset:2021-09-10
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, HTN
Allergies:
Diagnostic Lab Data: SARS CoV + SARS CoV 2 Antigen Positive
CDC Split Type:

Write-up: Breakthrough case after Covid vaccination, Dose #1 03/25/2021 Dose #2 04/18/2021. C/O loss of taste/smell and stuffy nose/ onset 9/10/2021


VAERS ID: 1768539 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-09-10
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chest pain, Chills, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease and emphysema
Allergies:
Diagnostic Lab Data: COVID 19 Antigen Positive on 9/16/2021
CDC Split Type:

Write-up: Breakthrough case after Covid vaccination. Dose #1 2/24/2021 Dose #2 3/31/2021. C/O fever, chills, cough, wheezing, SOA, and chest pain/ onset 9/10/2021


VAERS ID: 1768582 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-30
Onset:2021-09-10
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Chest pain, Cough, Diarrhoea, Fatigue, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, former smoker
Allergies:
Diagnostic Lab Data: Bio Q Nasal Antigen Positive on 9/15/2021
CDC Split Type:

Write-up: Breakthrough case after Covid vaccination. Dose #1 4/2/2021 Dose #2 4/30/2021. C/O runny nose, fatigue, cough, chest pain, and diarrhea/ onset 9/10/2021


VAERS ID: 1768607 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768614 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768625 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768632 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768644 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768887 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768899 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1768933 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-10
Onset:2021-09-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Ear pain, External ear inflammation, Hypoacusis, Lymphadenopathy, Motion sickness, Respiratory tract congestion, Stomatitis, Swelling face, Vertigo, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Venaflaxine 150, Verapomil 240 ER, collagen, vitamin d, zinc and vitamin C. Amovig 140 injection
Current Illness: No
Preexisting Conditions: Migraine.
Allergies: Iodine contrast, shrimp, salmon, naprosine,, morphine, I carry an epipen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Face swelling/congestion, lymphnodes under my under arm breast left side, right arm nodes at elbow, left neck and sores in mouth. Earpain, inflamation, hard to hear on right ear and vertigo in both ears. vomiting, Visited urgent care on 9/28/2021 prescribed antibiotic, prednisone and meclazine for dizzy/motion sickness. I still have symptoms and follow up visit is on October 15, 2021.


VAERS ID: 1769009 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-08-18
Onset:2021-09-10
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiovascular symptom, Chest pain, Electrocardiogram abnormal, Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: EKG show symptoms
CDC Split Type:

Write-up: feel chest pain, sitting heat rate 140, fever around 10:00am and urgent care found that EKG show symptoms. Went to ER at the same day.


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