National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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 227 out of 8,010

Result pages: prev   128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326   next


VAERS ID: 1689371 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyanosis, Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Birth Controls
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: patient has passed out about 2 minutes after administration in the post vaccine waiting area. Pharmacist administered Epi Pen as per protocol. Emergency phone number was called and patient was taken to ER. Patient did gain consciousness few seconds after receiving epinephrine. Paramedics reported low blood pressure and patient was taken for observation to a local hospital. Bottom lip appeared blue in color but patient was aware of her condition and asked for pharmacy staff to call father.


VAERS ID: 1689385 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 UN / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Hypoxia, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Respiratory failure (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: Tylenol only, as needed.
Current Illness: No other illnesses.
Preexisting Conditions: None.
Allergies: NKDA
Diagnostic Lab Data: 12-Lead, temperature, blood glucose analysis, intravenous access with lactated ringers administered. Oxygen for hypoxia.
CDC Split Type:

Write-up: 0200 AM patient awoke to sudden onset left lower quadrant & periumbilical abdominal pain, nausea and vomiting, unable to keep any semisoft food or water down for almost 12 hours. Family took to urgent care. Urgent care discovered hypoxia and called 911. COVID-19 vaccine #1 August 10, 2021, and COVID-19 vaccine #2 September 7, 2021.


VAERS ID: 1689398 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hyperhidrosis, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: xeralto prevacid pravastatin metformin
Current Illness: None
Preexisting Conditions: Those indicated by the meds I take
Allergies: penicillin sulfa drugs
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sweats and headache for the day following the jab. Slept most of that day.


VAERS ID: 1689422 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyskinesia, Feeling hot, Loss of consciousness, Oral pain, Pallor, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Client received Pfizer COVID-19 vaccine. A couple minutes after injection, client reported feeling warm and removed his sweatshirt. A few minutes after that, about 5 minutes after injection, he appeared pale and then lost consciousness. He remained upright in the chair with support and did not sustain any injuries. He was unconscious for about 1 minute, with slight jerking movements prior to regaining consciousness. He was moved to an exam table to lay down, ice packs applied to neck and cheek, and drank a few sips of Sprite. He experienced trembling in his left leg and hands and arms, which subsided after 5-10 minutes. He reported some pain on the inside of his left cheek, possibly from biting his cheek during the jerking movements. No blood or significant injury was observed in that area. After 10-15 minutes, he was stable enough to sit, and then stand, and them ambulate. Client reported eating a small breakfast that morning, and vaccine was given during his normal lunch time at the facility. He had also just come from a stressful meeting.


VAERS ID: 1689427 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

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

Write-up: Patient with L hip pain 1 day after receiving the vaccine that persisted on day 2 post vaccine. Not improved with rest and heat. Patient had not trialed any medications. Pain on exam with no signs of infection or focal neurologic deficits. Will treat with NSAIDs, muscle relaxer, heat, rest. Outcome not assessed at this time


VAERS ID: 1689454 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046C21A / 1 LA / IM

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

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

Write-up: seizure


VAERS ID: 1689460 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bone pain, Chills, Cough, Dizziness, Dyspnoea, Eye pain, Headache, Hypoaesthesia, Myalgia, Peripheral coldness, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Penicillin
Diagnostic Lab Data: Did not go to the hospital yet
CDC Split Type:

Write-up: Severe headache, Muscle pain, bone pain, fewer, dizziness, coughing, Short of breath, Eye ball pain, Severe chills, Cold feet, Numbness in my arms.


VAERS ID: 1689464 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking in the morning of the vaccine vitamin C vitamin D vitamin B12 cod liver oil tablet medical grade cranberry pill
Current Illness: Common cold
Preexisting Conditions: Cerebral palsy, depression urine bag
Allergies: Allergic to latex and hepatitis B vaccine
Diagnostic Lab Data: Went to the emergency room shortly after while experiencing 18 and tingling romance and feet and lips was given a low dose of Benadryl
CDC Split Type:

Write-up: Extreme itchiness throughout the body and a feeling of needles and arms and legs and my lips


VAERS ID: 1689495 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-26
Onset:2021-09-09
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027A21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest discomfort, Chills, Oropharyngeal pain, Productive cough, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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:
Allergies:
Diagnostic Lab Data: COVID pcr ran and was positive on 9/9/2021.
CDC Split Type:

Write-up: Patient presented to facility with weakness, sore throat, congestions, yellow productive cough, chest tightness, fever, chills.


VAERS ID: 1689498 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin (10 days), Flagil (4-5 days)
Current Illness: Cyst in tooth 1 week
Preexisting Conditions:
Allergies: Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 7:00 pm patient noticed itching around his neck and chest. He got up and went and looked in the mirror and noticed tiny red bumps all over his torso from his neck to just above his pants line. He read the information sheet given to him about delayed reactions and started taking Benadril. The itching has subsided and the rash is decreasing. He will continue with Benadril treatment and if symptoms worsen he will contact us again.


VAERS ID: 1689507 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-10
Onset:2021-09-09
   Days after vaccination:211
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

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

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

Write-up: patient tested positive 9/9/21.


VAERS ID: 1689513 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2020-12-12
Onset:2021-09-09
   Days after vaccination:271
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Infection, 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st dose of Pfizer 12/12/20 2nd dose of Pfizer 1/11/21 Breakthrough COVID infection on 9/9/21 (diagnosed 9/9/21)


VAERS ID: 1689530 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Throat irritation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ClonazePAM (KLONOPIN) 0.5 mg Oral Tab-Take 1 tablet by mouth 2 times a day as needed for anxiety
Current Illness: None
Preexisting Conditions: Hx of chronic idiopathic urticaria
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came to Clinic today and received his first Covid vaccine (Pfizer) and an influenza vaccine. During the observation period after the vaccines he began to c/o itchy throat and it feeling a bit tight and dizziness. Has hx of chronic idiopathic urticaria, has not been taking any anti-histamine recently as not getting symptoms. Only medication is prn Clonazepam. Denies any lip or tongue swelling. No wheezing. Felt better when he sat up. Hives present on RUE. Benadryl 25mg 1 tab administered at 1157. Vitals taken every 15 mins. HR 108-126bpm.


VAERS ID: 1689541 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-22
Onset:2021-09-09
   Days after vaccination:199
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea, Lung consolidation, Lung infiltration, Lung opacity, Malaise, Productive cough, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol (zyloprim), amlodipine (norvasc), asprin, atorvastatin (lipitor), benazepril (lotensin), carvedilol (coreg), docusate sodium (colace), doxycycline (vibra-tabs), furosemide (lasix), gylcerin laxative, hydralazine (apresoline), ni
Current Illness:
Preexisting Conditions: Congestive heart failure, chronic kidney disease stage II, hypertension, pulmonary artery hypertension, carotid arterial disease
Allergies: None listed
Diagnostic Lab Data: COVID PCR via Nasopharyngeal swab, collected 9/6 and positive Chest Xray 9/9/21, showing right greater than left basilar opacities favoring multifocal pneumonia including COVID pneumonia CT angiography chest w/o contrast 9/9/21, showing no embolism, no heart strain, extensive infiltrates involving all lobes of lungs. Large dense area of consolidation in the right lower lobe and areas of consolidation and groundglass opacities in the remaining lobes.
CDC Split Type:

Write-up: Patient vaccinated with Pfizer COVID vaccine on 1/27/21 and 2/22/21. Patient and spouse became ill early Sept and admitted to outside hospital with a positive NP collected 9/6. Patient discharged from hospital 9/8 but readmitted to current hospital on 9/9. Patient received dexamethasone but doesn''t believe he received remdesivir from the hospital he was admitted to on 9/6. On admit to current hospital patient has had progressive shortness of breath and productive cough on presentation to ED. Admit diagnosis is acute hypoxemic respiratory failure and patient remains admitted at time of submission


VAERS ID: 1689548 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Dyspepsia, Feeling jittery, Hypoaesthesia oral, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Patient presented for COVID-19 vaccination today. She reported that she has struggled with significant anxiety, with a marked increase in sxs and episodes of profound anxiety within the past years. She noted that anything she ?puts in her body? to include immunizations, and medications may provoke profound episodes of anxiety. She denied any history of suspected adverse reactions to vaccines, but reported significant concern that she would have marked anxiety in association with the COVID-19 vaccine. I discussed the vaccine with the patient, and encouraged her to have something to eat and drink prior to vaccination. Offered option of deferring vaccination on the lanai and choosing a different time/place of her comfort for vaccination. The patient obtained lunch and returned with desire to proceed with vaccination. We discussed a plan for a conservative 30min observation period post-vaccination. Immediately upon vaccination, the patient''s administering team noted the patient to be visibly shaking. She reported feeling unwell/dizzy. She reported tongue numbness, indigestion, GI upset and feeling anxious. She noted that her symptoms were consistent with prior episodes of marked anxiety. She was provided a glass of water and an ice pack to her neck. The team obtained serial VS, which were notable for BPs in the 140s/80s and HRs in the 80s-90s. The patient was speaking easily in full sentences, and seemed to relax when distracted with conversation about her move to HI from WA, her children, and her Son?s planned Birthday party. When not distracted with other topics, the patient expressed concern about her sxs, with corresponding increases in jittering/shaking of her legs. At patient request, the vaccination team phoned her Husband, who joined the patient . Upon her Husband?s arrival, I asked him if he had observed the patient look and feel similarly to her symptoms on the lanai. He reported that indeed, he had been with the patient experiencing the same sxs ?on many occasions?. He immediately felt the patient?s radial pulse, and noted that her appearance and sxs were consistent with prior episodes of anxiety. The patient expressed that with prior similar episodes, her Husband?s support and talking have helped to speed resolution of sxs. She notably had no ocular sxs, nasal sxs, oral sxs, throat sxs, difficulty breathing, or dermatologic sxs. My colleague and I had assessed the patient prior to her Husband?s arrival. Soon after the patient?s Husband?s arrival, I needed to attend a meeting, and therefore my colleague assumed care for the patient. Upon my return to the vaccine site approx 45min after my departure, I learned that the patient had markedly improved once her Husband had arrived. After symptom improvement, the patient and her spouse had walked around the vaccine site, walked within the A/C building, and spoke with the vaccine team prior to departing the area. My colleague obtained VS prior to releasing the patient and patient departure at 1242: HR 149/88, HR 85, Sao2 100% on RA


VAERS ID: 1689556 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dizziness, Dry mouth, Dry skin, Headache, Nausea, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: "NO significant PMH. NO Allergies. S/p COVID Infection Oct 2020 - not hospitalized. NO Current medications. After reaction to first dose of Pfizer, pt was advised to receive Janssen to complete the series. 22min post vaccination, pt c/o chest itching & left arm, throat scratchy, dry mouth, HA, Mild Cough, nausea. Vitals: @9:30 BP 156/90, HR 80, RR 18, O2 Sat 98% -- $g @09:43 BP 114/75, 74, 18, 96% -- $g@9:55 127/83, 71, 18, 98% At 9:43 pts symptoms remained unchanged. No visible rash, skin dry, no resp distress. Pt denies Rx/OTC medications. No hx of vasovagal w/ needles/shots. At 9:45, pt was given benadryl 25mg PO x1 Pt was given apple juice. Pt improved with time. At 10:15 pt reported feeling much better. Nausea and itching resolved; headache and dizziness 1-2/10. Pt ok''d to go home @ 10:20. Pt escorted out of site. NAD. Ambulates fine."


VAERS ID: 1689570 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003F21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Injection site swelling, Injection site warmth, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol; ventolin; tylenol; symbicort; flonase; levothyroxine; cetirizine; lantas; novolog; potassium; furosemide; vitamin b-12; vitamin d; rapamune; eliquis; cellcept; lipitor
Current Illness: none
Preexisting Conditions: liver tx; sickle cell trait; lipoma; thrombocytosis; diabetes; htn; sarcoidosis; hypothyrodism; microcystosis
Allergies: norvasc; effexor
Diagnostic Lab Data: pt was seen today for swelling in the post COVID booster. Her arm is less painful today
CDC Split Type:

Write-up: PPt. calls and reports swelling on right upper arm from covid booster shot has spread towards her neck, she rates the discomfort a 6/10 on pain scale. Area feels warmer to touch then her left upper arm, denies redness. She hasn''t taken anything for it nor was given anything for it in the clinic today. RN will report to PCP and get back to her. PCP is wiriting for as needed tylenol by mouth and RN will bring it to her. She cancontinue to ice it which she reports she can do. Ppt advised to continue applying ice packs to affecte area. Acetaminophen given for pain management . RN did a home visit . Gave continued instruction and comforted ppt . Ppt stated via phone wtith provider that she was feeling better with this visit . Ppt advised to call clinic for any continue significant swelling or SOB. Ppt advised to F/U with clinic . On call team notified .


VAERS ID: 1689580 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Severe headache - midnight 9/10/21 Nauseous - midnight 9/10/21


VAERS ID: 1689586 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Dry skin, Dyspnoea, Pharyngeal swelling, Skin warm, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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: Seroquel Klonopin
Current Illness: Anxiety
Preexisting Conditions: Anxiety
Allergies: Rocephin Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approx 20 minutes after patient received vaccine she complained of not being able to take a deep breath. Patient appeared to be short of breath but no signs of acute respiratory distress. Patient expressed that she had been "extremely anxious" regarding receiving the vaccine. Patients skin was warm and dry to touch Patient''s vital revealed BP 104/80, Respirations 36/minute, pulse 125 beats per minute. Patient stated she was currently seeing a psychiatrist and taking daily meds for anxiety. Patient also stated a history of panic attacks. Upon further assessment patient states her throat feels scratchy and swollen. Benadryl 50mg po was given. Patient attempted controlled breathing exercises and symptoms did subside. Vitals were taken again approx 10 mins after Benadryl was administered, BP 122/78, Pulse 64 beats per minute, respirations 18/ minute. Patient was monitored for approx 20 more mins. Patient denied any complaints, states all symptoms had resolved. Instructed patient to seek medical attention if symptoms returned. Patient discharged home with family member.


VAERS ID: 1689593 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN FC3183 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyskinesia, Eye movement disorder, Hypotonia, Loss of consciousness, Pallor, Urinary incontinence, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: no
Preexisting Conditions: Syncopal episodes,
Allergies: No
Diagnostic Lab Data: No , Provider not recommending the second dose given the severity of reaction.
CDC Split Type:

Write-up: 15 minutes after covid Pfizer had LOC, she had about 3-3 minutes. LC, rolling eyes and head, palor, mild writhing of trunk and arms, head rolling, flaccid muscles tone, she was manually restrained in her chair to prevent falling to ground and injury, there was urinary incontinence, no lip or cheek biting , when she regained consciousness she had emesis x2 (yellow liquidy) She was AOX3 when she came too, no apparent post ictal state,


VAERS ID: 1689617 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient stated that she can provide a detailed list if needed. Patient showed list to pharmacy.
Current Illness:
Preexisting Conditions: Neothphy in fingers in legs Anxiety PSTD depression
Allergies: Patient stated that she can provide a detailed list if needed. Patient showed list to pharmacy.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Five mins after getting the vaccine while waiting the patient stated shaking and coughing. She was stuttering and grab her throat. The pharmacist noticed what was going on and came over to assist. The pharmacist ejected her with a epic pin. Patient became to calm down. Patient stated that she is still stuttering over a few words. Patient also received a dry cough that she did not have until after getting the receiving,


VAERS ID: 1689619 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: No adverse event, Product preparation 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: N/A
Current Illness: None
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: LPN administered an undiluted .5ml of vaccine. No adverse reactions after 15 minute observation. Error was not recognized until the clinic had ended. This patient was the last to be vaccinated. PDPH physician followed up with parent to report error and to provide support and guidance. Was informed that following initial minor post-vaccination complaints treated wtih Tylenol, patient had improved.


VAERS ID: 1689620 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Back pain, Chest pain, Chest wall mass, Fatigue, Headache, Lymphadenopathy, Musculoskeletal chest pain, Oedema peripheral, Pain, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had "expected" reactions the day following my second dose, which included body aches, fatigue, and a headache. However, on the second day I awoke with severe arm and underarm pain. I noticed that my left underarm was swollen, in my armpit area. A few hours later, I noticed that I had a large lump on my chest as well, also on the left side nearest the arm the vaccine was injected. From what I could determine from online searching, these 2 areas are swollen lymph nodes. I contacted my doctor via telephone, and they instructed me to take allergy medicine and Ibuprofen during the daytime, and to take Benadryl at night. I have taken Claritin for 2 days, along with the Ibuprofen every 5-6 hours. The swelling on my chest has gone down some, however my armpit is still swollen and hurts when I move my arm. The pain is all around my upper arm, under arm, chest, upper back/shoulder region, and the area near my ribs under my left arm. I am going to continue taking the medications recommended, and if the swelling has not gone down in about a week, my doctor instructed me to come into the office so it can be checked.


VAERS ID: 1689629 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pt given full Phizer vaccine series after completion of J&J in March 2021.


VAERS ID: 1689632 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Respiratory distress, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Medications: ? albuterol (PROAIR HFA) 90 mcg inhaler ProAir HFA 108 (90 Base) MCG/ACT Inhalation Aerosol Solution INHALE 2 PUFFS EVERY 4 HOURS AS NEEDED
Current Illness:
Preexisting Conditions: Past Medical History: Diagnosis Date ? ADHD, Predominantly Inattentive Type 6/12/2008 ? Asthma 6/12/2008 ? Sesamoiditis 12/27/2018
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Past Medical History: Diagnosis Date ? ADHD, Predominantly Inattentive Type 6/12/2008 ? Asthma 6/12/2008 ? Sesamoiditis 12/27/2018 NKA Current Medications: ? albuterol (PROAIR HFA) 90 mcg inhaler ProAir HFA 108 (90 Base) MCG/ACT Inhalation Aerosol Solution INHALE 2 PUFFS EVERY 4 HOURS AS NEEDED 7mins post vaccination, pt had a vasovagal/syncopal episode w/ clamy skin,respiratory distress and dizziness. Vitals: @17:17 BP 140/87, HR 80, RR 18, Temp 97.7, O2Sat 100% (supine)-- $g @17:22 142/81, 80, 100%-- $g @17:35 142/85, 77 Pt speaking in complete sentences. pt initicaly c/i rapid HR and difficulty breathing but improved rapidly. Pt given juice and water. Pt states he is symptom free @17:35. @17:49 pt standing symptom free. @17:52 pt stable and released from the vaccination site. NAD. Recommended f/u w/ healthcare provider, instructions provided."


VAERS ID: 1689633 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-05
Onset:2021-09-09
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Exposure to SARS-CoV-2, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Ativan, Bactrim, Codeine, Dilaudid, Vicodin, Morphine, Penicillins
Diagnostic Lab Data: COVID-19 09/09/2021
CDC Split Type:

Write-up: Patient received 2nd Pfizer vaccine on 02/05/2021. Patient was exposed to COVID-19 on 09/07/2021. Patient developed shortness of breath and low O2 saturations on 09/09/2021 and tested positive for Covid-19 on 09/09/2021. Patient was admitted to the hospital on 09/09/2021.


VAERS ID: 1689645 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-12-28
Onset:2021-09-09
   Days after vaccination:255
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / IM

Administered by: Unknown       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: Fully vaccinated EE, COVID positive tested on 9/8/2021 PCR


VAERS ID: 1689649 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

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

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

Write-up: Patient received one dose of Pfizer vaccine following previous completion of moderna vaccine series at off campus vaccination clinic location. The error was noted during documentation into patient''s electronic medial record following return to medical campus. Patient was contacted and reported that he had lost his vaccination card and made personal decision to falsify vaccination status on screening form in order to receive additional doses and get a new vaccination card. Patient was reeducated following error. Plan made to have list of personnel pending immunization available at location and recipients will be cross checked against list to verify vaccination status prior to administration. There was no identified harm to patient following administration at this time.


VAERS ID: 1689655 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-16
Onset:2021-09-09
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/10 SARS/COV-2, NAAT positive
CDC Split Type:

Write-up: BREAKTHROUGH COVID


VAERS ID: 1689656 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, 125 MCG Vitamin D 2000 IU
Current Illness: None
Preexisting Conditions: Hypothyroidism Overweight
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Received the booster vaccine, dose number three. Within 24 hours of receiving the booster, I began a menstrual cycle a full 2 weeks ahead of its normal time to begin.


VAERS ID: 1689660 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, vitamin D, Calcium, Glucosamine+chondroitin, super B complex, yearly reclast
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, joint pain, muscle pain, headache, weakness, fatigue


VAERS ID: 1689664 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-09-09
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, Diabetes, Hypertension
Allergies: NKA
Diagnostic Lab Data: SARS COVID19 PRC
CDC Split Type:

Write-up: Cough, Dyspnea, respiratory failure. Patient vaccinated with Moderna and is positive with Covid-19


VAERS ID: 1689666 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-06-24
Onset:2021-09-09
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Respiratory syncytial virus test negative, 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: Albuterol, upropion, Fluticasone/salmeterol, furosemide, Hydroxyzine, lisinopril, sildenafil, spironolactone, torsemide
Current Illness: none
Preexisting Conditions: major deprission, Alcohol dependence, hyperlipidemia, sychotic disorder, alcoholic cirrhosis, COPD, sleep apnea, Obesity, PTSD, HTn (pulmonary) ED, edema lower extremity, Asthma
Allergies: No known allergies
Diagnostic Lab Data: Sept 9, 2021@13:31 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA
CDC Split Type:

Write-up: asymptomatic


VAERS ID: 1689688 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-02-16
Onset:2021-09-09
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

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

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

Write-up: hospitalization with covid after being fully vaccinated


VAERS ID: 1689689 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-01-08
Onset:2021-09-09
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Influenza A virus test negative, Influenza B virus test, Respiratory syncytial virus test negative, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Betamethasone dipro opical cream, calcium, diclofenac, fluticasone, guaifenesin, Ibuprofen, levothyroxine, lisinopril, multivitamin, Vitamin D3
Current Illness: None
Preexisting Conditions: HTN, Hypothroidism, Stress incontinence, obesity, diverticular disease of colon, cramp in lower leg associated with rest, nocturnal
Allergies: No Known Allergies
Diagnostic Lab Data: Sept 9, 2021@09:03 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA
CDC Split Type:

Write-up: patient is presenting cough and runny nose for 2 days


VAERS ID: 1689707 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR, Duloxetine hcl Dr 30 mg, gnc multi vitamin, b complex, fish oil, vitamin d3
Current Illness: No
Preexisting Conditions: Connective tissue and joint pain.
Allergies: Latex
Diagnostic Lab Data: Not yet
CDC Split Type:

Write-up: Burning red rash on arm, left side of neck and face. Skin is hot to touch.


VAERS ID: 1689721 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Headache, Respiratory tract congestion
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: 21 year old female complains of headache, congestion, and abdominal cramping after receiving the first COVID-19 vaccine.


VAERS ID: 1689737 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

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

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

Write-up: Patient received dose at approx 4:10. Patient passed out at approx 4:14pm. Patient was revived in approx 2 minutes. HR-45, BP-90/48, temp 99.2, Pulse ox approx 85%. Patient given water. after 5 minutes HR 65, BP-110/60, Pulse ox 92+. Patient remained for several minutes and taken home by Mom(a nurse). Patient reported by Mom to be fully recovered after 5 hrs. Vaso-Vegal ?


VAERS ID: 1689740 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DR14314 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, 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: pt had a rash on the hands for two days after the 1st pfizer vaccine
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: allergic urticaria the evening of 2nd covid vaccination. Patient has erythematous wheals to the trunk, face, neck, head, arms, hands


VAERS ID: 1689752 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dyspnoea, Sensation of foreign body, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: anaphylactic reaction after HPV vaccine with Bells Palsey
Other Medications: no
Current Illness: no
Preexisting Conditions: Anaphylactic reaction to HPV vaccine with Bells Palsey.
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: shortly after vaccination, pt developed hives all over her body and had SOB. 11:40am BP 158/110 P 130. c/o lump in throat, 50 mg. Benadryl administered, 911 called. 11:50am BP 160/120 p150. Pt transported to ED and they administered epinephrine(per pt). 9/10/21 followed up with pt and she is still taking Benadryl but no more epi needed. will f/u w/PCP. Told her to go to ER if symptoms return.


VAERS ID: 1689755 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

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

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

Write-up: PATIENT CAME IN WITH DAD FOR 2ND COVID VACCINE A WEEK TOO EARLY. WE FAILED TO CATCH IT.


VAERS ID: 1689785 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Dyskinesia, Erythema, Hyperhidrosis, Illness, Tremor, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: COVID PFIZER-BIONTECH vaccine was administered to the left arm of the patient. Right after the shot was given, patient felt sick. He then made some shaking involuntary body movements then passed out right after. We called 911 for an ambulance. In the mean time, patient regained consciousness after a minute, felt dizzy, and threw up. His face was red and sweating. Paramedics arrived and checked his blood pressure and glucose. His blood pressure was abnormally low for the first 2 readings. We waited a couple of minutes to re-measure and it went back to normal. Paramedics. advised him that they transport him to the hospital to get further evaluated, he refused. Pt stated that he is scared of needles because of an incident that happened when he was given IV at the age of 12.


VAERS ID: 1689798 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-05
Onset:2021-09-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast 10 mg. per day Albuterol 2 puffs as needed
Current Illness:
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: Doctor visit with visual inspection of ear 09/10/2021; prescribed Fluticasone and Loratadine; referred to ENT if not better within 15 days
CDC Split Type:

Write-up: Tinnitus - left ear Pain in left ear


VAERS ID: 1689824 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E2A / 2 LA / IM

Administered by: Pharmacy       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? 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 received the Johnson and Johnson shot on 05/24/2021 and then was give the Moderna shot on 9/9/21. No adverse events reported


VAERS ID: 1689830 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: localized rash. body aches


VAERS ID: 1689834 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Contusion, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diclofenac, 75 mg, Lisinopril, 20 mg, Methocarbamol, 750 mg, Nexium, Claritin, 10 mg, Advil PM
Current Illness: None
Preexisting Conditions: No
Allergies: Naprosin adverse reaction, otherwise seasonal allergies.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Extraordinary headache, chest pains (strong but sporadic 3/4 of 1st day), bruising on inside of right leg 2nd morning.


VAERS ID: 1689844 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Head injury, Loss of consciousness, Nervousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cannabis 30 minutes before vaccination
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown, possible allergy
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Person fainted lossing consicousness for several minutes following vaccination during the 15 minute monitoring period. As he fainted he hit his forehead on the ground . Reportedly very nervous about getting the vaccine, had taken cannibas before getting vaccinated to help decrease his anxiety. His diastolic blood pressure was low initially. His O2 saturation decreasedo about 88 percent as he started to develop more anxiety after rising from laying to sitting.


VAERS ID: 1689943 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Dizziness, Nausea, Pruritus, Throat irritation, Tongue pruritus, Urticaria
SMQs:, 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), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Bell''s Palsy from HPV vaccine, Nauseous/ Vomiting after Flu shot
Other Medications: Junel-birth control
Current Illness:
Preexisting Conditions:
Allergies: Latex Sensitivity
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms after vaccination: whole body itchy, tongue and throat scratchy, hives, nauseous and light headed/anxious. Blood pressure: 159/96 and heart rate:156. Took Benadryl before administration. Rescue was called. IV started and given more Benadryl. Taken to emergency room and placed in the critical care observation room. Given more Benadryl, Famotidine, Solumedrol, Zofran and Normal Saline. Observed for 3 hours. Sent home with epi pen. Took Benadryl 2 more times that night. Next day still taking Benadryl because when it starts wearing off itchy symptoms return. Feeling light headed, scratchy throat, anxious and itchy still the next day (9/10/2021). Following up with Primary Doctor on 9/13/2021.


VAERS ID: 1689949 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Confusional state, Dizziness, Fatigue, Headache, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (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: Flu vaccine October 2020, unreported, heart palpatations, shortness of breath, leg spasms.
Other Medications: Vitamin C, Vitamin D3, Zinc, Quercetin, CoQ10, EGCg, Glutathione, Calcium, Magnesium, Turmeric, Resveratrol, Androphraphis, took 1 tylenol
Current Illness: None
Preexisting Conditions: Lymphoedema
Allergies: Epinephrine, naproxen sodium, and codeine (hyper sensitivity)
Diagnostic Lab Data: None - a side effects were minor in nature. Vitals taken by a nurse in the hospital on 9/9 and an ER tech at home on 9/10
CDC Split Type:

Write-up: Paresthesia (numbness/tingling in left hand) Dizziness (minor, lasting about 15 minutes, BP 136/84, Pulse 64, Oxygen 98% after resting 5 minutes) Minor confusion (made many unusual but minor errors in regard to location and date during my evening shift) Second day - minor headache and tiredness, occasional chest pain, pulse 76


VAERS ID: 1690156 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FFZ588 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 50 mcg Immucalm Cayenne Vitamin D Digestive enzymes
Current Illness: None
Preexisting Conditions: Thyroid replacement therapy- 20 yrs
Allergies: Sulfa, Ceclore, Keflex, Pennicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rapid resting heartrate (108 average) beginning 3 hours after injection (1 pm) and lasting 4-5 hours then slowly returned to normal (65-70) over the next 3 hours (by 9 pm). There were also accompanying heart palpitations. No shortness of breath or chest pain. I had already been experiencing some palpitations and raised heartrate on occasion, and suspected my thyroid medication is too high. I had contacted my doctor to lower my dose. But never had my heart raced that fast for that long and while resting. I also read that Cayenne can increase heartrate and I did drink some added to my juice that morning.


VAERS ID: 1690324 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Asthenia, Chest pain, Chills, Dehydration, Diarrhoea, Headache, Hyperhidrosis, Nausea, Pyrexia, Retching
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: Balance of Nature, Alaskan Fish Oil, Vitamin C, Multi Vitamin, K2, Calcium Supplement, Vitimin D supplement, Termeric, Super B supplement, Generic Zyrtec, Sublingual B-12 No prescriptions
Current Illness: None Known
Preexisting Conditions: Hemorrhoid infections
Allergies: Demerol
Diagnostic Lab Data: Did not call 911 on 9/10 when maybe I should have. If fever reaches 99 I will go to the hospital.
CDC Split Type:

Write-up: Intense joint pain at randomly changing locations, intense headache (seems to respond to pain reliever but will not wain), diarrhea, dry heaving nausea, dehydration, fluctuating temperature (between 97.2 and 98.5), chills for a little while and then intense sweating, occasional stabbing pains in chest and gut, intense weakness, nearly lost consciousness 2 times between 7:30 and 9am on 9/10.


VAERS ID: 1690526 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-09
Onset:2021-09-09
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dermatitis allergic, Pruritus, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Both dose I presented with an allergic square breakout big bumps and itching a lot. I had ALLERGRA to relieve the allergy.


VAERS ID: 1690535 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Pruritus, Skin burning sensation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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: Anlodipine Besylate 2.5 mg 1/1 x day Hydroeye dry eye vitamins 2/2 x day
Current Illness: Pinched nerve in neck C5-6 and C6-7 - doing PT 2x/week for 12 sessions causing high blood pressure.
Preexisting Conditions: Back and neck disk issues. Allergies to air born pollen and mold under control.
Allergies: Sulpha drugs Codine and derivatives Gabapentin Mold
Diagnostic Lab Data: Non at this time. Did a thorough check of activities and foods eaten for last two weeks. The only thing out if ordinary was the COVID vaccine. This is day 1 of treatment with instructions to report to sn ER if conditions worsen over the weekend.
CDC Split Type:

Write-up: Noticed a small itchy area on left yhigh around 8:00 pm. Woke up next morning with whelps, burning and itching over and under arms, torso and thighs. Took a cool shower and sat in front of fan until 8am when my sister-in-law took me to dr office. Benadryl shot, cortisone shot when throat began closing and difficultly swallowing. Increased BP meds and bsby aspirin for high BP and Cortizone 1 x day/ 3 days.


VAERS ID: 1690537 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA I DON''T KNOW / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Dizziness, Fatigue, Injection site erythema, Injection site induration, Injection site swelling, Neck pain
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe back, neck, and shoulder pain. Lightheaded and tired for 3 days now. Swollen, red, hard area above injection site Chills


VAERS ID: 1690542 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-04
Onset:2021-09-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bleeding time abnormal, Bleeding time prolonged
SMQs:, Haemorrhage laboratory terms (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: Patient mentioned she is taking tylenol for fever
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was shaving legs and cut herself, her bleeding was abnormal, she experienced bleeding for a longer period of time than she usually does if cut. She wasn''t thinking she needed medical attention, just curious if it was a adverse effect of the immunization.


VAERS ID: 1690668 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TRAZODONE, OLANZAPINE, METOPROLOL
Current Illness: NO KNOWN OTHER ILLNESSES
Preexisting Conditions: HYPERTENSION, INSOMNIA, MOOD DISORDER
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: THE INTENDED VACCINE WAS SHINGRIX. THE ADMINISTERED VACCINE WAS COVID-19. NO SYMPTOMS WERE EXPERIENCED AND NO TREATMENT WAS NECESSARY.


VAERS ID: 1690672 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Asthenia, Balance disorder, Burning sensation, Chills, Dizziness, Fatigue, Feeling abnormal, Headache, Injection site pain, Nausea, Pain, Photophobia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multi-vitamin and no others.
Current Illness: None.
Preexisting Conditions: Constricted bladder (difficulty in urination), insomnia, mild joint pains, trick knees, recent unexplained spikes in cholesterol and blood sugar levels.
Allergies: None.
Diagnostic Lab Data: None to report.
CDC Split Type:

Write-up: Approximately 12 hours after injection, began having weakness, fatigue, chills, nausea. At 14 hours developed dizziness, loss of balance, sensitivity to light, exceptionally painful headache, cycle of shivering and chills to extreme fever, full body pain and feeling as though I were being scalded with hot water. Symptoms continued through the entire night. Arose in the morning at 10:30 am feeling extreme weakness, nausea, loss of balance, fatigue, severe headache, extreme sensitivity to light (which compounded headache pain). Symptoms began subsiding around 1:00 pm. Finally felt normal at approximately 8:00 pm this evening with exception of high level of soreness of right arm at injection site. In short, this was the most horrible feeling I have ever experienced, and I came very close to dialing 911. I did not take anything to try and alleviate any of the symptoms, as I was fearful that it exacerbate some of the conditions.


VAERS ID: 1690675 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Chills, Delirium, Dyspnoea, Muscle spasms, Nausea, Pain, Pulmonary pain, Pyrexia, Retching, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Chronic, undiagnosed stomach pain. Chronic ovarian cysts. Allergy and exercise induced asthma.
Allergies: None
Diagnostic Lab Data: Did not go to ER because of outstanding medical debt.
CDC Split Type:

Write-up: Fever, body aches, chills, difficulty breathing (had to use inhaler three times). Spasms, severe abdominal pain and pain in lungs after inhaler use. Deliriousness from fever. Nausea, dry heaving but no vomiting. The symptoms started around 4:00pm, about two hours after receiving the vaccine. The worst of it lasted for about 14 hours, until around 6:00am the next morning, when I took painkillers to be able to sleep.


VAERS ID: 1691399 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       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: USJNJFOC20210918254

Write-up: EXPIRED VACCINE WAS GIVEN; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: 07-SEP-2021) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-SEP-2021, the patient experienced expired vaccine was given. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired vaccine was given was not reported. This report was non-serious.


VAERS ID: 1691404 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had everything normal after getting vaccine.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210918433

Write-up: RECEIVED THE JANSSEN VACCINE TODAY AFTER HAVING THE MODERNA (POTENTIAL MEDICATION ERROR); This spontaneous report received from a health care professional concerned a 38 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient had everything normal after getting vaccine. The patient was previously treated with mrna 1273 for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 204A21A, expiry: UNKNOWN) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-SEP-2021, the patient experienced received the janssen vaccine today after having the moderna (potential medication error). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of received the janssen vaccine today after having the moderna (potential medication error) was not reported. This report was non-serious.


VAERS ID: 1692444 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chills, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Chills, nausea, vomiting, more muscles pain and back pain


VAERS ID: 1692446 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Arnuity Ellipta, albuterol, prenatal vitamin
Current Illness:
Preexisting Conditions: Asthma
Allergies: Aleve
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Sore arm only. No treatment.


VAERS ID: 1692874 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Ear pain, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Body aches ongoing since initial dose
Other Medications: Na
Current Illness: None
Preexisting Conditions: Polycythemia
Allergies: None
Diagnostic Lab Data: None to date but I plan on going to urgent doc later today if symptoms don?t subside
CDC Split Type:

Write-up: Started with mild to moderate body aches around midnight, then by 3 am I ran a fever over 103, fever continued for several hours, finally dropping below 102 around 24 hours after symptoms began. Continued running fever between 100-102 for the next 24 hours, at this point my fever is generally around 100 or less. The biggest issue now is the sore throat ear ache and cough.


VAERS ID: 1692875 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Chest pain, Diarrhoea, Dyspnoea, Hypoaesthesia, Loss of consciousness, Muscle spasms, Nausea, Pain, Pyrexia, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Nitrofurantoin mono/Mac 100 MG caps
Current Illness: UTI
Preexisting Conditions: Chronic migraines
Allergies: None
Diagnostic Lab Data: None due to no health insurance and did not feel I could afford to go to the emergency room.
CDC Split Type:

Write-up: Nausea, vomiting, diarrhea, passing out, body aches, leg spasms, extreme weakness, difficulty breathing, sharp pains in left side of chest and abdominal area, arms and legs numb, shaking uncontrollably, and fever. These symptoms begin suddenly around 5 PM day of vaccination and went away around 5 AM the following morning. The next day symptoms consistented only of mild body aches and headache.


VAERS ID: 1692889 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-08-29
Onset:2021-09-09
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / IM

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

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

Write-up: Severe pain at injection site day of Delayed pain at injection site 12 days later, with migraine


VAERS ID: 1692931 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (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: Synthoid Gapapentin Estradiol Vaginal Crem Oxcarbazepine Centiriine Pravastatin Amitriptyline Vitamin D3 Culturelle Low Dose Aspiron Vitamin C Quercetin Zinc Citrate
Current Illness: None
Preexisting Conditions: Hoshimoto''s Disease Neuro mediated syncope Arthritis Headaches
Allergies: Clyndamycin Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low blood pressure 80/50 Syncope Swollen gland under right arm


VAERS ID: 1692984 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pyrexia, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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: LEXAPRO AND ALPRAZOLAM
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT HAD COVID ARM. RED, ANGRY RIGHT UPPER ARM. FEVER OF 99 DEGREES. PT TOOK ACETAMINOPHEN AND DIPHENHYDRAMINE. ON 9/11/21 THE REACTION WAS BARELY VISIBLE ON HER ARM.


VAERS ID: 1692988 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Computerised tomogram thorax normal, Electrocardiogram normal, Fibrin D dimer increased, Heart rate increased, Laboratory test, Pain, Pyrexia
SMQs:, Haemorrhage laboratory terms (broad), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: famotidine 20mg twice a day
Current Illness: 1st vaccine horrible side effects of runny nose, fever, headache, body aches, chills, fatigue, metal taste in mouth, magnet sticking to chest,lasted around 4-5 days, reported . 14 days exactly from first vaccine fever, fatigue, runny nose, chills, body aches, headache, shortness of breathe, for 4-5 days tested negative for covid and flu , sick enough to go to urgent care. Second vaccine on 9/8 developed fever and body aches , chills that same night chest pain developed at 1 am that lasted all day on thursday . Went to emergency room to have cardiac work up, heart rate 130s on arrival to emergency room , Iv fluids given with no effect on heart rate , continued chest pain, body aches so bad all 3 of these episodes with no relief with medications given. Fever 101.9 no relief with tylenol, d dimer slightly elevated at 545. Chest Ct done to check for pulmonary embolism negative, EKG negative. 7 hours later they decide to discharge me still with chest pain and hear rate of 120 and continued fever . Symptoms resolved next day.
Preexisting Conditions: GERD
Allergies: Ancef
Diagnostic Lab Data: ekg, chest ct pe, labs
CDC Split Type:

Write-up: see previous section, session timming me out


VAERS ID: 1693020 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-01-26
Onset:2021-09-09
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

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

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

Write-up: Increasing severity of SOB


VAERS ID: 1693030 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Mobility decreased
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Mild lymph node edema
Other Medications: Hydoxyzine, vitamins
Current Illness: NA
Preexisting Conditions: Dermatitis
Allergies: NKA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Swollen armpit lymph nodes, about 1.5 inches ht, 2 inches length. Quite painful, limited movement.


VAERS ID: 1693045 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-14
Onset:2021-09-09
   Days after vaccination:238
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Conjunctivitis, Exposure to SARS-CoV-2, Headache, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Individual''s father tested covid positive on 9/8/21. Individual isolated away in a hotel and tested on 9/9/21 (positive result). He later returned home and continued to isolate. He''s symptomatic with sore throat, pink eye, and HA. Advised individual to continue to isolate from family in separate rooms until 9/19/21 and to callback hotline for further instruction and also to callback when DOH contacts him.


VAERS ID: 1693071 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Headache, Myalgia, Neck pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3/K2 4,000 Vitamin C400 mg Acidophilus Probiotic
Current Illness: GERD, Hiatal Hernia
Preexisting Conditions: GERD hiatal Hernia
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting, 101.8 Fever, shortness of breath, neck pain, headache, sore bicep, sore forearm, chills, dizziness.


VAERS ID: 1693096 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chills, Headache, Hyperhidrosis, Muscle twitching, Neck pain, Oropharyngeal pain, Pain, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 101.5 fever day one of symptoms, severe body aches/twitching, chills/shakes/chattering/sweating, severe headache, throat pain, neck and back pain, 103 fever day 2 of symptoms, 102.5 fever with above symptoms still on day 3. Tylenol and advil switched off throughout the day, does not help the symptoms.


VAERS ID: 1693104 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKOWN / 2 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Referred to emergency room/
CDC Split Type:

Write-up: Shortness of breath with minimal response to inhaler/nebulizer. Patient also had fever and chills but those resolved in about 1 day.


VAERS ID: 1693156 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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: Patient made an appointment for his second Moderna vaccine on the vaccine website. He came in to get his 2nd dose. After patient, the pharmacist, gave him his vaccine, he informed patient that he "had a confession to make and this was not his second dose" but that he had had at least 2 other vaccines. Patient saw he had 2 other Vaccine Cards on his person along with the one patient was giving him. This was the first vaccine our pharmacy had given him. He literally ran from the vaccine room after telling patient this information.


VAERS ID: 1693181 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Dyspnoea, Fatigue, Headache, Illness, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Sick with runny nose cough chills head ach hard to breath tired cough


VAERS ID: 1693186 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

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

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

Write-up: None. Patient received his second dose one day early. My employer said I had to submit a VAERS.


VAERS ID: 1693190 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206 A21 A / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Headache, Impaired work ability, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hashimoto''s disease hypothyroidism Hand arthritis
Preexisting Conditions: Hypothyroidism, hand arthritis. I had a covid in January 2021 (undiagnosed at the time), I tested positive for anti-spike protein antibodies in April 2021 (not quantitative), May 2021 (660 U/ml) and September 7 before vaccination (590 U/ml). I vaccinated because of the mandate at where I work.
Allergies: Erythromycin Insect bites
Diagnostic Lab Data: I have had covid infection 8 months ago and consistent positive titer of antibodies over that time: April 2021 (not quantitative $g250U/ml), May 2021 (660 U/ml) and September 7 right before vaccination (590 U/ml). So my vaccination was done in the presence of a strong natural immunity.
CDC Split Type:

Write-up: Extremely high fever started 6 hours after the shot. The fever was 105F for 10 hours and didn''t go down with any common pain medications (ibuprofen, tylenol, aspirin). I also was vomiting and had extreme headache. The fever started to go down by 24 hours to 103F, with extreme headache, joint and muscle pain. Still not completely gone by 48 hours (100F), with headache, pain continuing. I missed work on Friday, and I not sure what the prognosis is. I couldn''t see a doctor because my PCP recently resigned and I don''t currently have a PCP.


VAERS ID: 1693193 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bronchospasm
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (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: Omeprazole, albuterol
Current Illness:
Preexisting Conditions: Asthma, acid reflux
Allergies: Ultram, neurontin, codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bronchoconstriction (mild)


VAERS ID: 1693215 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0A5C21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cellulitis, Erythema, Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Moderna COVID-19 Vaccine EUA Moderna first dose 9/02, following symtoms occured 7 days later on 9/09 Fever, redness, swelling at injection site, itchy, hot, hard raied area, Was told this was called Covid arm, told to use heat, take pain med, and if area gets bigger in circumference to go to urgent care. Went to urgent care 0n 9/11, prescribed antibiotic for cellulits


VAERS ID: 1693223 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Photophobia, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal 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: birth control- lo lesterin
Current Illness: none
Preexisting Conditions: none
Allergies: analgin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: light sensitives, blind spots in vision


VAERS ID: 1693287 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-29
Onset:2021-09-09
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: positive after vaccination


VAERS ID: 1693295 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Also received Flu vaccination at time of second COVID shot.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, sore, itching and knot formed where shot was given.


VAERS ID: 1693304 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control Topamax Ecitalopram
Current Illness: None
Preexisting Conditions: Asthma Depression Anxiety
Allergies: Amoxicillin
Diagnostic Lab Data: None- asked nurse and have been treating at home with cortisone cream, Benadryl, Tylenol and ibuprofen, ice
CDC Split Type:

Write-up: Swelling to shoulder and down mid arm. Red in uneven circular area around vaccine site, hot to touch, itchy going on 52+ hours. migraine for 24 hours past.


VAERS ID: 1693320 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza 2016/ 2017 Was Voiceless 1 Week
Other Medications: Diosmin and Hesperidin
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache; Dizziness


VAERS ID: 1693332 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Laboratory test, Sensitive skin, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no medications
Current Illness: none
Preexisting Conditions: none
Allergies: morphine - difficulty breathing
Diagnostic Lab Data: troponin, labs, ekg,
CDC Split Type:

Write-up: chest pain, hypersensitivity to touch of skin.


VAERS ID: 1693361 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphthous ulcer, Arthralgia, Diarrhoea, Headache, Hyperhidrosis, Loss of consciousness, Mobility decreased, Nausea, Pain, Pyrexia, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DHEA, NAC, Vitamin D
Current Illness: Hodgins lymphoma survivor (15 years)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nine hours after 2nd dose, I woke up unable to move my arm, I thought it was paralyzed. I felt nauseous and made my way to bathroom. I then blackout lying on the bathroom floor. I came to with ringing in my ears and sweating with a fever. It felt like 2x4 was jamming inside my head. I felt like I was dying and no way to call for help it was so intense at the time. The next day: joint pain and body aches, The following day sore on my tounge and in throat. Day 3;; diarria. Now 4 days later still headache and nit feeling right. My body did not like it and I hope it does not do something weird to my lymph nodes, I am a lymphoma survivor. I take excellent care of myself and I fear that I received something that was meant for the that I did not need. Why do I get the same dose as a 300 pound man?? I am 114 pound female. I am regretting my decision and I know my body. I saw my Dr. the next day and she told me not to get a mammogram for 3 months. Why were we not told all of this?


VAERS ID: 1693364 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chills, Cytomegalovirus test, Dehydration, Dysphagia, Fatigue, Full blood count normal, Headache, Metabolic function test, Night sweats, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Secretion discharge, Streptococcus test, Streptococcus test negative, Tonsillitis
SMQs:, Agranulocytosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), 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: Valsartan 160mg Amlodipine 5mg Crestor 40mg Aspirin 81mg Omeprazole 40mg Repatha 140mg /bi weekly Testosterone Cypionate 100mg/weekly
Current Illness: None
Preexisting Conditions: Hypertension (well controlled on current regimen) Hyperlipidemia (well controlled)
Allergies: None
Diagnostic Lab Data: Mono Spot Test - Negative GAS Strep Test - Negative COVID 19 pcr - Negative x 2 tests CBC with diff - All normal values CMP- All normal values
CDC Split Type:

Write-up: On 9/9/2021, patient developed increased fatigue, headache, and sore throat as the initial symptoms. Sore throat progressed to the point where patient could no longer tolerate swallowing liquids. Patient never felt airway was at risk of being compromised. Fevers developed on 9/10/21 and have persisted, often being refractory to 500mg of Tylenol. Patient went to urgent care clinic believing this could be COVID (patient is ICU nurse that works in a COVID ICU) or strep throat. At the urgent care, rapid strep test was negative. Urgent care MD obtained a sample for a COVID 19 PCR test. In the afternoon of 9/10/2021 fevers elevated to a Tmax of 103.8. Overnight patient experienced chills, night sweats, headache, difficulty swallowing, and thick oral secretions. On the morning of 9/11/2021, patient elected to go to the ED because he felt very dehydrated but could not swallow water without choking. At the ED, several differentials were tested to include: peritonsilar abscess, strep throat, infectious mono, and CMV. All tests were negative. Patient given Augmentin to treat what appeared to be an infected left tonsil. Patient also received decadron to help ease swelling and pain of tonsil. Patient left tonsil is +4. Right tonsil is +2.


VAERS ID: 1693399 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

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

Write-up: fever, chills, body ache, intermittent light-headedness, physical weakness, fatigue. Subsided over a 48 hour period.


VAERS ID: 1693414 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Migraine, Pain in jaw, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: severe headache with intermittent migraines, blurry vision, joint pain, jaw pain,


VAERS ID: 1693448 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 3 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Body temperature increased, Chest X-ray, Consciousness fluctuating, Crepitations, Full blood count, Oxygen saturation decreased, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bacitracin Ointment 500 UNIT/GM Apply to hematoma on right shin topically every evening shift for laceration with stitches Clean hematoma area on right shin, apply bacitracin and cover with xeroform and wrap in kerlex. Pharmacy Active 9/2/
Current Illness: PARKINSON''S DISEASE (G20) 8/16/21 Primary/Principal/Admission (67) Primary/Principal/Admission CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED (J44.9) 8/17/21 Secondary #1 Primary/Principal/Admission HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE (I13.0) 8/16/21 Secondary #2 Admitting Dx (69) ACUTE ON CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE (I50.33) 8/16/21 Secondary #3 Admitting Dx (69) CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED (N18.30) 8/16/21 Secondary #4 Admitting Dx (69) DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE WITHOUT BEHAVIORAL DISTURBANCE (F02.80) 8/16/21 Secondary #5 Admitting Dx (69) MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED (F33.9) 8/16/21 Secondary #6 Admitting Dx (69) INSOMNIA, UNSPECIFIED (G47.00) 8/16/21 Secondary #7 Admitting Dx (69) DYSPHAGIA, UNSPECIFIED (R13.10) 8/16/21 Secondary #8 Admitting Dx (69) ALZHEIMER''S DISEASE, UNSPECIFIED (G30.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) GENERALIZED ANXIETY DISORDER (F41.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) INTERSTITIAL PULMONARY DISEASE, UNSPECIFIED (J84.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) MUSCLE WEAKNESS (GENERALIZED) (M62.81) 8/16/21 Secondary 9 Or More Admitting Dx (69) NEED FOR ASSISTANCE WITH PERSONAL CARE (Z74.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBAR REGION (M51.36) 8/16/21 Secondary 9 Or More Admitting Dx (69) OTHER SYMBOLIC DYSFUNCTIONS (R48.8) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH DIABETIC CHRONIC KIDNEY DISEASE (E11.22) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH DIABETIC NEUROPATHY, UNSPECIFIED (E11.40) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATION (E11.69) 8/16/21 Secondary 9 Or More Admitting Dx (69) UNSTEADINESS ON FEET (R26.81) 8/16/21 Secondary 9 Or More Admitting Dx (69)
Preexisting Conditions: PARKINSON''S DISEASE (G20) 8/16/21 Primary/Principal/Admission (67) Primary/Principal/Admission CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED (J44.9) 8/17/21 Secondary #1 Primary/Principal/Admission HYPERTENSIVE HEART AND CHRONIC KIDNEY DISEASE WITH HEART FAILURE AND STAGE 1 THROUGH STAGE 4 CHRONIC KIDNEY DISEASE, OR UNSPECIFIED CHRONIC KIDNEY DISEASE (I13.0) 8/16/21 Secondary #2 Admitting Dx (69) ACUTE ON CHRONIC DIASTOLIC (CONGESTIVE) HEART FAILURE (I50.33) 8/16/21 Secondary #3 Admitting Dx (69) CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED (N18.30) 8/16/21 Secondary #4 Admitting Dx (69) DEMENTIA IN OTHER DISEASES CLASSIFIED ELSEWHERE WITHOUT BEHAVIORAL DISTURBANCE (F02.80) 8/16/21 Secondary #5 Admitting Dx (69) MAJOR DEPRESSIVE DISORDER, RECURRENT, UNSPECIFIED (F33.9) 8/16/21 Secondary #6 Admitting Dx (69) INSOMNIA, UNSPECIFIED (G47.00) 8/16/21 Secondary #7 Admitting Dx (69) DYSPHAGIA, UNSPECIFIED (R13.10) 8/16/21 Secondary #8 Admitting Dx (69) ALZHEIMER''S DISEASE, UNSPECIFIED (G30.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) GENERALIZED ANXIETY DISORDER (F41.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) INTERSTITIAL PULMONARY DISEASE, UNSPECIFIED (J84.9) 8/16/21 Secondary 9 Or More Admitting Dx (69) MUSCLE WEAKNESS (GENERALIZED) (M62.81) 8/16/21 Secondary 9 Or More Admitting Dx (69) NEED FOR ASSISTANCE WITH PERSONAL CARE (Z74.1) 8/16/21 Secondary 9 Or More Admitting Dx (69) OTHER INTERVERTEBRAL DISC DEGENERATION, LUMBAR REGION (M51.36) 8/16/21 Secondary 9 Or More Admitting Dx (69) OTHER SYMBOLIC DYSFUNCTIONS (R48.8) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH DIABETIC CHRONIC KIDNEY DISEASE (E11.22) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH DIABETIC NEUROPATHY, UNSPECIFIED (E11.40) 8/16/21 Secondary 9 Or More Admitting Dx (69) TYPE 2 DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATION (E11.69) 8/16/21 Secondary 9 Or More Admitting Dx (69) UNSTEADINESS ON FEET (R26.81) 8/16/21 Secondary 9 Or More Admitting Dx (69)
Allergies: Fentanyl, predniSONE, Milk & Milk Products, tape
Diagnostic Lab Data: STAT CXR, CBC, And Covid Swab- ordered 9-9-2021
CDC Split Type:

Write-up: Temp 100.5 - O2 Sats fluctuating in the 80''s. Scattered crackles noted. Alertness fluctuating as well.


VAERS ID: 1693486 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-21
Onset:2021-09-09
   Days after vaccination:231
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: PATIENT HAD COVID VACCINE ON Dose 1 date:01/21/2021, Dose 2 date: 02/11/2021, AND TESTED POSITIVE TOCOVID.


VAERS ID: 1693491 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: No adverse event, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: Patient received 0.3 mL undiluted Pfizer vaccine x 1 injection. Facility contacted Poison Control center for direction. Contacted Medical Director for further instructions. No adverse effect resulted from adverse event.


VAERS ID: 1693504 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-07-21
Onset:2021-09-09
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7484 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Infection, Injury, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Hostility/aggression (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: APAP, norvasc, ASA, atorvastatin, coreg, fluoxetine, HCTZ, insulin glargine, insulin lispro, losartan, synthroid, metformin, pantoprazole
Current Illness: no
Preexisting Conditions: 1. HTN 2. HLD 3. CHF 4. NIDDM2 5. Hypokalemia 6. Hyperglycemia 7. hypocalcemia
Allergies: nka
Diagnostic Lab Data: PCR + 9/9/2021
CDC Split Type:

Write-up: breakthrough covid positive, asymptomatic case, hospitalized secondary to traumatic injury


VAERS ID: 1693520 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Namenda 5mg Fosamax 70mg Decadron 1mg Ascorbic Acid 100mf SO-Cal Krill Oil Multi Vit Zing Sulfate
Current Illness: Alzheimer''s Dementia Osteoporosis Hyperlipopterinemia Adrenal nodule
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came into COVID vaccine clinic at 2 weeks for her 2nd COVID vaccination. She was told that she was too early and demanded she get her vaccination. Nurse gave it to her without going over education.


VAERS ID: 1693525 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Inflammation, Mesenteric vein thrombosis, Vasodilatation
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: insulin
Current Illness: n/a
Preexisting Conditions: diabetes, emphysema
Allergies: n/a
Diagnostic Lab Data: cat scans, blood work
CDC Split Type:

Write-up: Inflamed blood vessel, blood clot in vein leading to rectum


VAERS ID: 1693576 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Allergies: no known drug allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient came in today (9/12) to report that around 2-3 days after this 3rd Moderna COVID vaccine (immunocompromised booster), he got a red, raised rash on his arm. The rash appeared consistent with the "covid arm" being reported for Moderna vaccines that we have seen in the past. It started at mid deltoid and went down to about 1 inch above the elbow. I advised he use an over the counter oral antihistamine (benadryl) and topical hydrocortisone cream. I told him if it didn''t resolve over the next 2-3 days to call his doctor.


VAERS ID: 1693590 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-07
Onset:2021-09-09
   Days after vaccination:245
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, COVID-19, Chills, Cough, Impaired work ability, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: 9/12: Called to report covid positive result from 9/10/21. Still having cough, chills, fever, body aches, loss of taste. She is currently quarantining/isolating. Felt like she got it from her husband. Discussed f/u with PCP. Discussed she will need to quarantine/isolate x10 days since s/s first appeared and will need to be 24hrs passed since last fever without use of fever-reducing medications. States her last day of work was 9/7/21. She normally works Tues-Fri and immediately left work when she found out her husband was positive. She has not had contact with her coworkers outside of work. Eats in her breakroom at work, but tables are separated with designated area to sit. She has been taking OTC cold/flu medicines, which has been helping. instructed to call hotline when released from quarantine and discussed RTW clearance through when s/s improved/resolved. not part of study- antibodies testing ordered. 9/10: reporting cough, chills, low grade fever, body aches. Onset 9/9/21. had an exposure to husband who tested positive on 9/7/21. Last close contact was on 9/7/21. currently in quarantine, if tests positive her scheduled post 5-day test for 9/12 will need to be cancelled. 9/7: called hotline to report that she just found out today (9/7) that her husband had tested positive for covid. was at work but left work. last direct contact with her husband was this morning. is asymptomatic. instructed that she needs to quarantine and isolate from her husband which she states she can do until she is tested for covid and gets her test results back. parents also live with her and her husband and they are also able to isolate from one another. given community hotline number for her parents for further instructions and guidance. scheduled at on 9/12 for covid testing for post direct exposure. instructed to call the hotline should she become symptomatic and we can schedule her for testing earlier. instructed to inform her manager she will be off of work and to call hotline with her test results for further instructions/ guidance.


VAERS ID: 1693604 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Pain, Pruritus, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 1st soreness- immediately, 2nd fatigue and headache within hour, 3rd- bump and itching within 7 days, 4- rash , birthmark extending from shot location to the bicep around 2x3 inches in size & muscle pain with rash in that area.


VAERS ID: 1693609 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Impaired work ability, Paraesthesia oral
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel; Flonase; Zyrtec
Current Illness: No
Preexisting Conditions: No
Allergies: Mold; Seasonal allergies; Food sensitivity to milk/egg
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tingling around mouth 9/9 @ 10:13; C/o dizziness; 10:20 BP 152/100 Pulse 120; 10:40 BP 132/94. Pulse 94; Urgent Care visit 9/12/21; Advised to complete VEARS 1300: BP 136/86 Pulse 123 R 16 T 98.3; Prescribed Meclizine for dizziness; Excuse from work note


Result pages: prev   128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=227&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166