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

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



Case Details (Reverse Sorted by Onset Date)

This is page 228 out of 8,010

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VAERS ID: 1693627 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Rash, Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient presented to the pharmacy with a warm itchy rash on the inside of her right arm. The redness didn''t start at the injection site but rather about 2 inches away from injection site and went down and underneath arm.


VAERS ID: 1693632 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
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 - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin, Adderall
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Being allergy tested on September 22nd 2021
CDC Split Type:

Write-up: Hives over 98% of my body.


VAERS ID: 1693687 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
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 - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Fatigue, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Hydromorphone, tizadine, amitiza, Crestor, lyrica
Current Illness: None
Preexisting Conditions: RA, heart disease including two heart attacks, syncope, heart valve problem, previously cancer, pneumonia, lung damage from coma
Allergies: Seafood of all kinds. Not iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness, red englargement of arm , tired


VAERS ID: 1693697 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3/82 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Feeling cold, Headache, Hypopnoea, Malaise, Mobility decreased, Nausea, Pyrexia, SARS-CoV-2 antibody test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 25MG QBREXZA
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Had an Covid-19 anti-body test on Aug. 18th which came back positive. SARS-CoV-2 Semi-Quant Total Ab SARS-CoV-2 Semi-Quant Total Ab 1155.0 Reference Range: Negative<0.8 U/mL Antibodies against the SARS-CoV-2 spike protein receptor binding domain (RBD) were detected. It is yet undetermined what level of antibody to SARS-CoV-2 spike protein correlates to immunity against developing symptomatic SARS-CoV-2 disease. Studies are underway to measure the quantitative levels of specific SARS-CoV-2 antibodies following vaccination. Such studies will provide valuable insights into the correlation between protection from vaccination and antibody levels. Did not want the vaccine because my team of providers said I had a natural immunity already. My wife made me get it and regret my decision .
CDC Split Type:

Write-up: Experienced malaise within two days. The side effects got progressively worse and on the 5th night had 6 vaccine related adverse events- chills, low-grade fever, headache, nausea, GI upset, shallow breathing. Been in bed for 24 hours and limited relief. I would categorize all these side effects as mild-moderate.


VAERS ID: 1693699 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
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 - / 3 LA / SYR
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / 1 RA / SYR
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / 1 LA / -
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Constipation, Cyanosis, Extra dose administered, Fatigue, Feeling abnormal, Headache, Malaise, Nausea, Pain in extremity, Pallor, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None / although I do take some medications but only as needed not on a regular basis .But nothing prior to or during vaccination.
Current Illness: I only have physical impairment s.
Preexisting Conditions: Only physical impairment s
Allergies: None
Diagnostic Lab Data: Haven''t seen a Doctor yet as it is the weekend although called my primary care physician and I will recieve a call back from them tomorrow morning hopefully to schedule an appointment ,my son also called poison control center and they weren''t very helpful and might be taking me to the emergency room if necessary.Ive been trying to contact rite aid with no avail as of yet concerning the vaccinations that they gave me without consent and my authorization.
CDC Split Type:

Write-up: First and foremost I never even scheduled or authorized the vaccine for the shingles vaccine that I was given only the other three vaccines I gave my consent and authorized. On the first evening at 9:00 pm is when I first started feeling bad headaches,chills ,and fever I was also very fatigued went to bed and next day on the tenth and eleventh I was feeling very I''ll still vomiting , constipation,headaches severe nausea,face pale and eyes cyanotic,vomiting ,Very fatigued.soreness severe bilateral arms.


VAERS ID: 1693711 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-01-15
Onset:2021-09-09
   Days after vaccination:237
Submitted: 0000-00-00
Entered: 2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Myalgia, Nasal congestion, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: none known
Diagnostic Lab Data: PCR + for Covid 9/10/2021
CDC Split Type:

Write-up: Client was vaccinated with Moderna vaccines on 1/15 and 2/15/2021 (these are approximate dates give or take a few days per client report). Symptoms of Covid started 9/9 - nasal congestion, feverish x 1 day, myalgia. Tested + with PCR on 9/10. Reported as a case of breakthrough Covid in a previously vaccinated person.


VAERS ID: 1693715 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
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 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspepsia, Dyspnoea, Nausea, Nervousness, Salivary hypersecretion, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: At 1:28PM the client asked RN, "Is it normal to feel nauseous?" and then stated "I was pretty nervous though." RN provided the client with water and the client began drinking it. The client ambulated unassisted and sat down in the anti-gravity chair in a high-fowler''s position. RN asked to check the client''s vital signs and the client declined. The client denied any other s/s of anaphylaxis. The client denied any previous allergies. RN provided the client with an emesis bag.. The client reported feeling "nausea, shortness of breath, and dizziness." RN asked if the client''s vision was clear. The client reported that her eyes were "shaking and a white fog." Vital signs obtained at 1:39 PM were as follows: HR 115 and BP 103/68. The client reported "nausea, excess saliva, heartburn, and dizziness." The client reported a history of anxiety, but does not take any medications currently. The client reports a history of seeking care at the hospital related to her anxiety. The client stated that all of her current symptoms are typical for her when she is experiencing anxiety. The client denied any itchiness in her throat or swelling of her tongue. The client stated that vomiting does sometimes occur related to anxiety. RN responded at 1:40 PM. The client finished drinking the bottle of water provided by RN. The client stated that "water helps." The client began drinking out of her personal water bottle. The client stated it contained a "pink powder drink like Vitamin Water." Repeat vitals obtained at 1:44 PM were as follows: BP 113/67, O2 100%, HR 103. The client began performing breathing exercises. The client stated her symptoms were "mild, I just need to breathe." The client reported that her symptoms related to anxiety typically last 1-2 hours. At 1:48PM RN noted the client coughing and drinking out of her personal container. The client stated "I feel good." The client requested to be reclined. RN and RN reclined the anti-gravity chair to a low-fowler''s position. Vitals obtained at 1:50PM were as follows: BP 108/73, HR 111, O2 100%. The client stated "I can take a deep breath." The client denied any current nausea and stated the heartburn comes and goes. Rn educated the client regarding s/s of anaphylaxis and when to seek EMS. The client voiced understanding of this education. The client stated, "my throat is feeling scratchy." The client stated her throat gets dry with anxiety and that it felt dry at 1:57 PM. The client stated that she is able to swallow. RN offered the client Benadryl, the client declined. The client stated "I don''t feel anxious anymore." Vitals obtained at 2:02PM were as follows: HR 104, O2 100%, BP 107/63. RN and RN adjusted the anti-gravity chair to a high-fowler''s position. The client denied any nausea. The client left the vaccination site at 2:04PM. She ambulated unassisted with a steady gait.


VAERS ID: 1693784 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Connecticut  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Fatigue, Feeling hot, Headache, Injection site pruritus, Intermenstrual bleeding, Muscle spasms, Pain in extremity, Pruritus, Rash, Somnolence
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Reported to VAERS on 9/3/21: Heavy spotting not on the scheduleI have been on for years (re: menstrual cycle each month)
Other Medications: Adderall, Lexapro, Birth Control (Aurovela Fe 1/20)
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin, Welbutrin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Within 5 minutes, my arm became itchy at the injection site. I don''t think that was the shot, more maybe the band-aid. Thought I would mention just incase. The next day when my real symptoms began (9/09) - 10:00/11:00AM-EST: I fell asleep at my computer mid-email. I never do this or get THAT tired, especially after a coffee?! From there, I started getting intense cramping where I would if I were to get my period or right before getting it. I was experiencing HORRIBLE lower back pain along with the cramping, which is a symptom of pre-period signs for me. I had to lay down in the fetal position for a while to ease the pain, and use a heating pad. I began spotting lightly, not as heavy as the first shot post-symptoms; but it was there and should not have been; based my tight, never changing menstrual cycle schedule. I also never get these cramps, or haven''t since I was a bit younger a few years ago. Lastly, my body felt hot to touch. No fever that I noticed/the thermometer caught normal 98 and below all day. My head started to hurt, and progressively went away after a few days. I had a rash on my arm (right forearm around to the top - itchy. Went away when I put an ointment on it. I have photos as well. Lastly, My arm was horribly sore. Which is common of course.


VAERS ID: 1693789 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
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 - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Feeling drunk, Gait inability, Headache, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone 95mgs 1/day Celexa 20mg 1/day
Current Illness: N/a
Preexisting Conditions: High blood pressure
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm pain 1 hour after vaccine. Most severe (to touch to move and at rest) 6 hours post shot. Seemed that when noticed my fever around 7pm after the vaccination that morning and began drinking more water, the water spread the arm pain throughout my body. Fever onset 8 hours post vaccine. Fever range beginning at 100.9 and holding steady at 101-102 for 48 hours. Height of fever 09/10/2 pm at 102.7 Body pain onset 12 hours post vaccine. Worst in legs. Unable to walk due to pain in body and head. Headache onset with fever and remained in sync until offset Drunk feeling in head during entire onset of symptoms 9/12/21 onset of a different feeling headache entirety of day; partial loss of taste and smell


VAERS ID: 1693831 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-07-09
Onset:2021-09-09
   Days after vaccination:62
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY0581 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: My son 20 years old was not ill, no symptoms of flu nothing. Never had covid yet, got the injection and two days later:Passed out for a while suddenly, got heartbeats serious ones got shaking cold feather.Went to hospital, no doctor available, went home and got to dr the next day, Blood pressure and examine was diagnose with side affects due to vaccine, he is having nor a Mild Covid?got meds and went home. He is still scared this will happen again? Must he get the 2nd Vaccine when its time? Will this happen again?


VAERS ID: 1693833 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft Lipitor Atenolol Albuteral Sulfate HFA ASA 18mg
Current Illness: None
Preexisting Conditions: COPD Arthritis
Allergies: Codeine Oxycodone
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Covid Arm. Red raised hard knot, Swelling, reddness, heat, itching at injection site and approx 1 inch circular surrounding injection site.


VAERS ID: 1693848 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-27
Onset:2021-09-09
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Generalised tonic-clonic 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: Lamotrigine
Current Illness: None
Preexisting Conditions: Tonic-clonic seizure (Grand Mal)
Allergies: None
Diagnostic Lab Data: NONE. AWAITING APPOINTMENT WITH NEURO.
CDC Split Type:

Write-up: MY SPOUSE EXPERIENCED A GRAN MAL SEIZURE FOR THE FIRST TIME IN 14 YEARS. HAS BEEN STABLE ON LAMOTRIGINE SINCE CIRCA 2007. CURRENT SEIZURE LASTED FOR MORE THAN 5 MINUTES, AND OCCURRED ABOUT 15 MINUTES INTO NIGHT TIME SLEEP. AID WAS PROVIDE BY MEDFORD FIRE DEPT AND EMS. MY SPOUSE HAS RECOVERED AND SEEMS TO BE BACK TO HER NORMAL SELF TODAY.


VAERS ID: 1694113 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Pyrexia
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Employee calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 09/09/2021 Is this your first or second dose- 3rd Dose Date of symptom onset - ? 09/09/2021 Symptoms - ? arm itchy and red x 3 days, and fever of 99.9 today 9/13/2021 Last day of work and shift - ? NA Home remedies- none Any improvement- Employee stated she had a fever of 99.9 at 2 am this morning but has had no fever since 10 am. Employee stated she has not taken any kind of fever reducing medication. Recommendation- Advised employee to continue to monitor for any additional symptoms and report them. Also advised employee to monitor for return of fever and use Tylenol and or Ibuprofen if tolerated to manage temperature. Advised employee to follow up with PCP is symptoms persist or worsen. Employee voiced understanding Employee of information ? Yes Employee voiced any concerns ? No Employee?s questions answered to employee?s satisfaction -Yes


VAERS ID: 1694126 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Hypoaesthesia, Hypoaesthesia oral, Palpitations
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 0.075mcg, keppra 1000mg, vimpat 150mg, Zyrtec, creator 10mg, Prilosec 40mg.
Current Illness: Back surgery within 1 month
Preexisting Conditions: Arthritis, seizure, seasonal allergies, gerd, sleep apnea.
Allergies: Compazine
Diagnostic Lab Data: Went to ER for evaluation. EKG performed in the hospital.
CDC Split Type:

Write-up: Palpation, dizziness, extreme numbness of my entire face and mouth.


VAERS ID: 1694129 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood culture, Blood glucose normal, Blood pressure decreased, Laboratory test, Mental status changes, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: doxorubicin, ifosfamide, ondansetron, sertraline, albuterol, diphenhydramine, lorazepam, lidocaine, dexametasone, mesna, GCSF
Current Illness: Spindle cell sarcoma
Preexisting Conditions: spindle cell carcinoma, autism spectrum, ADHD, epilepsy, intermittent asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: On day of event, patient received Neulasta and IV zofran approximately 45 minutes prior to event. When getting ready for discharge, he received 1 dose of Pfizer COVID vaccine and then began to feel naseous ~15-20 minutes later. He vomitted x2. BP was 70/40s. Confirmed on manual. Blood glucose normal. Started NS bolus. Afebrile. Blood cultures, labs drawn. Ceftriaxone given for rule out sepsis. Blood pressure not responsive to drip bolus, initiated push pull, with response in BP after 1L. Improved mental status. Patient observed overnight and discharged next day.


VAERS ID: 1694209 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Flonase, Sudafed, Centrum Silver Multi-Vitamin, Biotin, Vitamin D3, Excedrin Extra Strength
Current Illness:
Preexisting Conditions: Chronic sinusitis, chronic lyme disease
Allergies: Cipro antibiotic, alcohol, severe reaction to trees, grass, mold
Diagnostic Lab Data: None yet.
CDC Split Type:

Write-up: 09/08/21 Mild skin irritation, 09/09/2021 Skin irritation and a handful of red, itchy bumps, 09/10/2021 skin irritation and hundreds of red, itchy bumps covering back and torso, started to appear on the front of my torso, 09/11/2021 skin irritation, hundreds of red, itchy bumps covering back and torso, extended to neck and down to feet. Attempted to go to clinic but could not get an appointment, tried to go to Emergency Room but the line was long and into the parking lot.


VAERS ID: 1694240 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Haematochezia, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Varicella (24 years old, Merck, Lot# K003421, 17 December 2014) and some years I react to the flu shot
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Ceclor
Diagnostic Lab Data: Some years when I get the flu vaccine I get hives and itchy In December 2014 when I received the first of 2 doses I was red/hives, itchy and almost fainted
CDC Split Type:

Write-up: Itchiness, lightheaded, hives/red, blood in stool


VAERS ID: 1694254 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: COVID vaccine given to patient under the age of 12. Mother lied about the patients age in order to get vaccine. This was later found out when trying to bill patients insurance and checking database.


VAERS ID: 1694264 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Muscle spasms, Myalgia, Paraesthesia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D3; Acid Reducer; OTC Allergy meds; magnesium; Zinc
Current Illness: No
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Dizziness 6:00 pm two hrs after administration 3:45 AM- 100.3 fever, muscle aches, chills, fatigue Symptoms came and went through out the day. Toward the end of the day: muscle cramping in hands/fingers; tingling in left hand/fingers


VAERS ID: 1694274 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-07-01
Onset:2021-09-09
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Cerebral palsy, Chest X-ray normal, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Congenital, familial and genetic disorders (narrow), 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: albuterol, ASA, Vit C, atorvastatin, citalopram, ezetimibe, HCTS, insulin glargine, isosorbide mononitrate, synthroid, liraglutide, lisinopril, loratadine, metformin, pantoprazole, K-dur, risperidone, tamsulosin, tiotropium, topiramate
Current Illness: DM uncontrolled with multiple ED visits related to no adherence to fiet and medication regimen
Preexisting Conditions: Morbid obesity, COPD, CAD, Hypertension, Diabetes type 2, Hyperlipidemia, Hypothyroidism, anemia, GERD, Nephrolithiasis, Arthritis, Intellectual disability, Depression
Allergies: iodine, hydrocodone, propoxyphene, diatrizoate, bees, lyrica
Diagnostic Lab Data: covid + 9.9.21, CXR clear
CDC Split Type:

Write-up: breakthrough covid + case, asymptomatic, admit for CP r/o MI


VAERS ID: 1694310 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

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

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

Write-up: Medication error in which the vial of vaccine was diluted with 0.18 ml instead of 1.8 ml of normal saline. Resulting in the employee receiving a higher dose of the vaccine.


VAERS ID: 1694319 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Breast pain, Headache, Injection site swelling, Injection site warmth, Neck pain, Paraesthesia, Pruritus, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Hypersensitivity (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Xyzal, HCTZ
Current Illness:
Preexisting Conditions: Hypertension, Sinusitis
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within couple of hours after the vaccine, I started to have tingling/itching all over. Later than night I had a fever, tremors, swelling and warmth at injection site, headache, weakness, and shoulder, neck and breast pain on the same side as the injection.


VAERS ID: 1694344 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-07
Onset:2021-09-09
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.
Current Illness: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.
Preexisting Conditions: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.
Allergies: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient vaccinated for and then tested positive for COVID-19


VAERS ID: 1694409 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Deafness bilateral, Headache, Insomnia, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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. Did not seek a Covid test because symptoms seemed to be similar to what the vaccine administrator told me to expect (except the hearing loss).
CDC Split Type:

Write-up: 11:30 am typical soreness in arm. 11:00 pm Restless sleep, fever, extreme head ache, extreme ache in every part of my body. 9/10/21 Slept all morning too weak to wake up. 1 pm Loss of hearing in both ears. All symptoms gone within 24 hours so I did not see a physician today (Monday).


VAERS ID: 1694433 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Lymphadenopathy
SMQs:, Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: No lab tests just reporting something that doesn?t seem right adding to the new reports coming out about the same thing
CDC Split Type:

Write-up: Noticed Thursday sept 9 while washing my face and neck there was a marble sized lump in my lymph nodes on the left side near my collar bone just feels a little sore?. My left shoulder joint is also sore feels very fatigued I panicked at first but then started reading about some side effects


VAERS ID: 1694434 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-07-15
Onset:2021-09-09
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Alanine aminotransferase increased, Arteriogram coronary normal, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood fibrinogen increased, Blood lactate dehydrogenase increased, Blood triglycerides normal, C-reactive protein increased, Cardiac imaging procedure abnormal, Chest pain, Cytomegalovirus test negative, Discomfort, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Enterovirus test negative, Epstein-Barr virus test, Fibrin D dimer increased, Full blood count normal, Hepatic steatosis, Immunoglobulin therapy, Inflammation, Laboratory test, Left ventricular dilatation, Left ventricular dysfunction, Liver function test increased, Metabolic function test normal, Mitral valve incompetence, Myocarditis, N-terminal prohormone brain natriuretic peptide increased, Oedema, Parvovirus B19 test negative, Pericarditis, Respiratory viral panel, SARS-CoV-2 test negative, Stool analysis, Troponin increased, Ultrasound liver abnormal, Ventricular hypokinesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cholecalciferol 2000 iu qday
Current Illness: Elevated transaminases found in July 2021 - unknown etiology
Preexisting Conditions: obesity, elevated cholesterol, vitamin D deficiency
Allergies: NKA
Diagnostic Lab Data: CBC/BMP 9/9/21 ? all within normal limits AST/ALT (unit/L): 9/9/21 ? 479/238 ; 9/10/21 ? 218/150 ; 9/12/21 ? 113/117 NT pro BNP: 9/9/21 - 596 CRP (mg/dL): 9/9/21 ? 1.8 CK (units/L): 9/9/21 ? 21,100 ; 9/10/21 - 7467; 9/11/21 - 4778; 9/12/21 ?6039 ; 9/13/21 - 5927 LDH (unit/L): 9/9/21 ? 2613; 9/10/21 ? 1758 Troponin: 9/9/21 - 45.9; 9/10/21 -41.5 ; 9/11/21 -13; 9/12/21 ? 1.3 ; 9/13/21 ? 0.8 Triglycerides ? 9/9/21- 83 D-Dimer 9/9/21 ? 0.66 Fibrinogen (mg/dl)-9/9/21 - 391 9/9/21 blood PCRs (adenovirus, parvovirus, SARS Cov2, CMV, enterovirus) ? all negative 9/9/21 EBV and HHV6 blood PCRs, gastrointestinal stool panel = pending 9/9/21 respiratory viral panel = negative 9/9/21 Cardiac MRI = Subepicardial delayed postcontrast enhancement within the lateral and inferolateral left ventricular walls in a nonischemic regional distribution and global relative increased signal of the myocardium relative to skeletal muscle suggestive of edema. In the setting of clinically suspected myocarditis, cardiac MRI findings are consistent with myocardial inflammation. Mild enhancement of the pericardium laterally which can correlate with pericarditis-myocarditis. Mildly depressed left ventricular function. Normal left ventricular size. Normal right ventricular size and function. 9/9/21 CT Angiogram Chest = Breathing artifact is present within the midportion of the exam which somewhat degrades the evaluation of the midportion of the RCA and distal LCA. Normal appearance of the coronary origins, course and caliber. 9/9/21 ECHO - Normal cardiac anatomy Dilated left ventricle, trivial, with mild global hypokinesis, LV ejection fraction 49% The right ventricle is grossly normal size with qualitatively trivial global hypokinesis Structurally normal mitral valve with trivial mitral regurgitation Tricuspid regurgitation gradient is not quantifiable for estimation of RV systolic pressure No pericardial effusion Possible right pleural effusion (image 34) - correlate with chest xray 9/13/21 ECHO (multiple ECHOs in between 9/9/21 and 9/13/21): Left ventricular strain quantification was clinically indicated based upon 2D Echo images. Left ventricular has trivial dysfunction with ejection fraction of 52% and global longitudinal strain of -17.5% (stable to subtle improvement) The right ventricle is grossly normal size with normal systolic function. No significant pericardial effusion.
CDC Split Type:

Write-up: Patient received 1st COVID-19 vaccine on 6/24/21 and 2nd COVID-19 vaccine on 7/15/21. Both at same pharmacy. He had a well child check in July which showed elevated LFTS on baseline labs ( AST was 148, ALT is 161). He was seen by hepatology who obtained a liver ultrasound which demonstrated Echogenic liver, most commonly seen with fatty infiltration. He then presented to our hospital on 9/8/21 with 2 days of chest pain, feeling like pressure, was intermittent, and sometimes sharp. Labs demonstrated significantly elevated AST/ALT, CK, troponin, NT pro BNP, fibrinogen, d-dimer, and CRP. EKG showed ST segment elevation. ECHO showed normal heart structure with EF of 49%. A gated CT angiogram showed normal coronaries. A cardiac MRI showed diffuse inflammation. He was admitted due to concerns for myocarditis and started on ibuprofen on 9/9/21. EKG obtained later in the day on 9/9 was normal. The patient received 70 g (1 g/kg) IVIG on 9/10/21 PM. Hepatology, rheumatology, genetics, and infectious diseases were consulted and recommended a variety of tests. An ECHO on 9/13 demonstrated an EF improved to 52%. The patient remains admitted.


VAERS ID: 1694442 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NKA, NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The patient is 17 years and 9 months old. She was given Moderna; however, Moderna is currently only approved for persons over 18 years of age. The patient did not require any treatment and denies any adverse events related to the vaccination delivery.


VAERS ID: 1694489 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 RA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694497 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 RA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694498 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cyanosis, Hypoaesthesia, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Numb, blue and swollen finger tips and numbness in toes. Toes ache as well.


VAERS ID: 1694499 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 RA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694523 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694526 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 RA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694534 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-29
Onset:2021-09-09
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 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: Patient had a positive COVID test on 9/9/2021.


VAERS ID: 1694536 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694544 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Estimated delivery date 12/2021


VAERS ID: 1694546 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-07
Onset:2021-09-09
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL, ASPIRIN
Current Illness: NONE
Preexisting Conditions: ASTHMA, ALLERGY TO POLLEN, TYPE 2 DM, HTN
Allergies: CODEINE, SHELLFISH
Diagnostic Lab Data: 09/09/21: POSITIVE POC SARS COVID RAPID ANTIGEN
CDC Split Type:

Write-up: FEVER


VAERS ID: 1694550 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694554 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017C21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Have a weakened immune system
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient arrived, stated that they were here for their 2nd Moderna dose, and presented a vaccination card that had 9-9-2021 recorded as their recommended second dose date. The patient signed the consent forms, received the 2nd Moderna dose from myself, waited 15 minutes with no adverse side effects, and departed. After the patient departed, while it was identified that the patient was in fact 1 week early for their second dose and the recommended second dose date on their vaccination card was incorrect. The ordering provider, was notified along with the management team. Reports were filed per clinic procedures and Dr. notified the patient of the adverse event.


VAERS ID: 1694563 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest discomfort, Erythema, Paraesthesia oral
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Tachycardia and rash with vaping and miralax, question PEG sensitivity
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient for first COVID-19 shot per order of doctor with 60 minutes observation time. Moderna vaccine 0.5 ml given IM left deltoid at 0918 AM. Moderna COVID-19 Lot: 048F21A Exp: 10/8/2021 At 0928 AM, patient reports tightness in the chest and tingling at the tip of her tongue. Red patches appeared on the neck and upper chest area. Per order of doctor, Epipen 0.30 mg injected right thigh 0933 AM and benadryl 50 mg/1ml IM injection at 0940 AM. Patient kept in clinic and observed for 2 hours with normal vitals. Patient discharged home at 1140 AM


VAERS ID: 1694565 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694571 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694577 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694582 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-09-09
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: COPD, CKD, Crohns disease, htn
Allergies: cat, animal dander, dogs.
Diagnostic Lab Data: positive covid
CDC Split Type:

Write-up: Patient admitted to hospital with positive covid case. Breakthrough case


VAERS ID: 1694586 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 RA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694605 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694610 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: Vaccine expired


VAERS ID: 1694613 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-03
Onset:2021-09-09
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / -

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

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

Write-up: Pt. came in with fever of 102.1, and cough. Pt. is on zinc, vitamin C, pantoprazole, cefcriaxone, lisinopril, aspirin


VAERS ID: 1694617 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 RA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694636 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694640 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694649 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 1 RA / IM

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

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

Write-up: Patient was given Moderna, was only eligible for Pfizer, no adverse reaction noted, no signs or symptoms of any allergic reaction


VAERS ID: 1694657 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694660 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694662 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 2 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694672 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 RA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694678 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 RA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694683 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694684 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 RA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694693 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694696 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 3 LA / IM

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

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

Write-up: vaccine expired


VAERS ID: 1694733 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-01
Onset:2021-09-09
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I?ve been taking vitamin C vitamin D vitamin zinc vitamin B12 And vitamin omega-3
Current Illness: No
Preexisting Conditions: Yes
Allergies: Penicillin
Diagnostic Lab Data: Home test
CDC Split Type:

Write-up: I have no taste and no smell And breathing problems


VAERS ID: 1694735 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-16
Onset:2021-09-09
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Decreased appetite, Headache, Pyrexia, Respiratory tract congestion, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CHRONIC CONDITIONS INCLUDE DM 2, OBESITY
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This case meets vaccine breakthrough criteria . SXS HEADACHE, COUGH, FEVER, CONGESTION, POOR APPETITE.


VAERS ID: 1694759 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-01
Onset:2021-09-09
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, calcium carbonate, levothyroxine, MVI
Current Illness:
Preexisting Conditions: CKD III, HLD, hypothyroidism, Alzheimer''s disease
Allergies: Imipramine Pamoate, penicillin, clorazepate dipotassium
Diagnostic Lab Data: COVID status positive on 9/9/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 1/11/21 and 2/1/21. Tested positive at her assisted living facility on 9/8/21 after another resident contracted COVID-19. Developed worsening generalized weakness on 9/8/21 but no other characteristic symptoms. Patient admitted to our facility for COVID-19 infection on 9/9/21 (status also positive upon admission) and received REGEN-COV. As of today 9/13/21, patient has been cleared for discharge but still waiting placement at living facility.


VAERS ID: 1694770 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, Fever, Joint pain that remains in hips and hands.


VAERS ID: 1694790 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)

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

Write-up: Pt previously vaccinated with Moderna COVID 19 vaccine 08/11/2021. No reactions. Pt returned to clinic for second injection. Received Pfizer COVID 19 vaccine in error. Vaccine documented as given. No reactions noted. Pt made aware of error. Vaccine not repeated. No further action taken at that time. Pt instructed to call to report any adverse events. No call from pt at time of this report.


VAERS ID: 1694802 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-16
Onset:2021-09-09
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Pneumonia, Productive cough, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: No
Current Illness: No
Preexisting Conditions: I have COPD
Allergies: Not that I''m aware of.
Diagnostic Lab Data: No labs they listened to my chest and took my vitals. 2nd time I went they gave me a chest x-ray.
CDC Split Type: vsafe

Write-up: I was coughing and had a headache, fever and was concerned that it would go to my chest area. It was a wet cough and I went to urgent care then. They gave me steroid, inhaler and antibiotic. This didn''t really help and I went back on Sept 8th because I could still feel it in my chest. They did a chest x-ray and I had pneumonia. They gave me a Zpack and told me to continue with the steroid and inhaler. I''m waiting for Pulmonology appointment. If I don''t feel better by Wed I''ll go back to the urgent care.


VAERS ID: 1694813 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram normal, Fibrin D dimer increased, Myocarditis, Sinus rhythm, Troponin I increased, Troponin increased
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Autism spectrum disorder attention deficit hyperactivity disorder
Allergies: NONE
Diagnostic Lab Data: 9/12: HS-troponin level obtained in emergency department elevated to 9872pg/mL (ref 0-75). Repeat testing at our facility (inpatient hospital) upon arrival revealed a Troponin I level of 10.10 (ng/mL (ref <0.07). D-dimer 804ng/ml (ref 69-580). Elevated troponin levels with symptoms related to chest pain concerning for suspected myocarditis. Electrocardiogram on 9/12 showed normal sinus rhythm without ST changes. 9/13: Troponin I level of 3.01ng/mL (ref <0.07). Echocardiogram on 9/13 showed normal function without effusion.
CDC Split Type:

Write-up: Vaccine administered on 9/8. Developed chest pain and shortness of breath on 9/9 and self resolved. Developed chest pain and burning on 9/10. Symptom duration unknown. Patient without fever, cough, congestion, or other infectious symptoms prior to vaccination and after vaccination. On 9/12 symptoms returned and patient''s father took him to the emergency department.


VAERS ID: 1694816 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-21
Onset:2021-09-09
   Days after vaccination:141
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / 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: Patient tested positive for covid after completing covid series


VAERS ID: 1694845 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: na
Current Illness:
Preexisting Conditions:
Allergies: penicilin,prednisone
Diagnostic Lab Data: patient hospitalized and given bendryl and pepcid for symptoms
CDC Split Type:

Write-up: Patient had hives and swollen lymph nodes.


VAERS ID: 1694862 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 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:
Current Illness:
Preexisting Conditions:
Allergies: NKMA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna 2nd dose vaccine given 1 week early.


VAERS ID: 1694962 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D218 / 2 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Dyspnoea, Nausea, Palpitations
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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

Write-up: palpitations and shortness of breath same day intermittently and daily worse with movement ove rthe last week, also persistent diarrhea nausea and dizziness


VAERS ID: 1694965 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 - / IM

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

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

Write-up: Presented to Hospital for fall from ladder. Incidental COVID positive.


VAERS ID: 1694974 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-16
Onset:2021-09-09
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Musculoskeletal chest pain, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow)

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

Write-up: Patient admitted for PE on 9/9/21 after presenting to ER w/3 day hx of chest wall pain and cough. Risk factors for VTE included: vague hx of clots in her father, use of birth control, and C section on 6/30/21. None of her attending providers included the covid vaccine as part of the differential/etiology of her PE; this is concerning from my perspective given that the patient got her first vaccine dose less than a month before the PE.


VAERS ID: 1694979 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product substitution issue
SMQs:

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

Write-up: Administration error: Patient received the wrong vaccine. She had registered for a Johnson & Johnson vaccine and wanted to receive this one, but was inadvertently injected with a Pfizer vaccine. The patient was observed for 30 minutes following her vaccine and then informed of the error 1 hour after her appointment time when the error was discovered. She did not appear to have any adverse effects of the Pfizer vaccine and did not have any contraindications to the vaccine.


VAERS ID: 1694992 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Injection site mass, Injection site pain, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: Pantoprazole Sod DR (Protonix) 40mg 1tab 1x day Levocetirizine (Xyzal) 5mg 1x day bed Allergist Sertraline HCL (Zoloft) 150mg 1x day Meloxicam (Mobic) 7.5mg 1x day Lyrica 150mg cap 2x day am & bed Lisinopil 20mg tab 1x day am Amlodipine
Current Illness:
Preexisting Conditions: Asthma, chronic sinusitis GERD arthritis migraines
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Golf ball size lump at injection site warm to the touch and sore, joint pain and body ache


VAERS ID: 1695001 (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: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

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

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

Write-up: Complained of dizziness 30 mins following vaccine B/P 152/100 P 120 Given juice and crackers 40min after vaccine b/p 135/94 P 94 feels much better refused to stay longer


VAERS ID: 1695003 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Fatigue, Migraine, Nausea, Pyrexia, Thyroid function test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyamin D, Zinc, vitamin C
Current Illness: Hashimotos Disease
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Thyroid panel
CDC Split Type:

Write-up: Migraine, extreme fatigue, extreme bone and joint pain, nausea, low grade fever, sensitivity to cold


VAERS ID: 1695008 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: Received 2nd dose before 21 days


VAERS ID: 1695020 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 2 LA / IM

Administered by: Work       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: Received Dose 2 prior to 21 days


VAERS ID: 1695025 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UT 0338218 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Delirium, Fatigue, Fear, Feeling abnormal, Influenza like illness, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none morning of vaccine.
Current Illness: pulmonary hypertension,: c.o.p.d : heart failure, diabetes. auto immune destruction of neck and spine.
Preexisting Conditions: pulmonary hypertension , diabetes, c.o.p.d , heart failure, auto immune attack on my neck and spine
Allergies: none on morning of injection. Take 15 prescriptions daily including Janumet and oxycodone and heart medications and anti anxiety medications and gabapentin for seizures.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Began with flu like pains. Woke up later in afternoon and I was delirious. Did not know where I was .Asked concierge to arrange my transport to my home. I was at my only home. Not able to control urine release. Unable to obtain or hold glass of water. Could not find my phone or remote control. Severe tiredness, confusion and fright. Lasted approximately 18 hours with slow recovery and awareness. Returned to normal status within 24 hours.


VAERS ID: 1695497 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, 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), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Marijuana
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated about 24 hours after receiving his 1st Pfizer dose, he got up to use the bathroom and felt dizzy. He woke up laying on the bathroom floor and was mildly shaking - was concerned he may have had a seizure. He believes he was "out" for just a few minutes. No reports of prior fainting or seizure episodes. Patient did report marijuana usage. Patient has not seen a Dr since the incident and is feeling fine currently. I indicated he should follow-up with Dr before receiving a 2nd dose.


VAERS ID: 1695765 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I received the vaccine last Thursday and my left upper arm area is still really swollen, red, and tender. The rash/redness is starting to spread on my arm as well.


VAERS ID: 1695774 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-23
Onset:2021-09-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Menstruation irregular
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

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

Write-up: Sharp pain in lower abdomen. Two days later started period 2 weeks early. Lasted longer than normal.


VAERS ID: 1695775 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Fatigue, Influenza virus test negative, Pharyngeal swelling, Productive cough, SARS-CoV-2 test negative, Throat irritation, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexplanon 10mg implant
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: covid test, flu test both negative
CDC Split Type:

Write-up: Throat swelling, throat itching, chronic fatigue, trouble breathing, wheezing on 9/9/2021 cough, mucus coughing, dizzy spells, fatigue, coughing fits. 9/9/2021- current date of 9/13/2021


VAERS ID: 1695816 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Lymphadenopathy, Myalgia, Oropharyngeal pain, Pyrexia, Sleep disorder, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: acute muscle pain in legs, sides, abs; swollen gland on left side of neck causing pervasive and intense sore throat started day 2 and still ongoing,; pervasive, relentless and strong headache started on day two and ongoing; inability to sleep (due to headache and sore throat) fever and chills on day 4; vomiting; no pain relief with OTC ibuprofen or tylenol. No relief from dr prescribed norco and meloxicam either.


VAERS ID: 1696037 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-15
Onset:2021-09-09
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cardiomegaly, Chest X-ray abnormal, Hypoxia, Lumbar vertebral fracture, Oxygen saturation decreased, Pulmonary oedema, Pyrexia, SARS-CoV-2 test positive, Spinal X-ray abnormal, Spinal compression fracture, Vomiting, X-ray of pelvis and hip abnormal
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Osteonecrosis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PMH of A fib, CLL, HTN, HLD, gout, pHTN, and OA
Allergies:
Diagnostic Lab Data: COVID+ 9/9/21
CDC Split Type:

Write-up: 87 year old female with PMH of A fib, CLL, HTN, HLD, gout, pHTN, and OA who presented to the ED on 9/10 for weakness after testing positive for COVID on 9/9. Symptom onset was 9/9 - fevers, weakness, vomiting x 1. Patient was walked in ED and she de-satted <88%. CXR notable for cardiomegaly with pulmonary edema and possible superimposed infection. XR R hip/pelvis showed chronic L4 fracture. Spine X ray notable for chronic severe burst fracture at L4. Ortho consulted - non-op, will follow up in spine clinic outpatient. Admitted for monitoring of hypoxemia. Patient is hemodynamically stable. Fevered overnight on 9/10 and is on2L O2. Will trend inflammatory markers today. -Wean O2 as needed - previously on 2 L up to 5 L on AM of 09/14; decreased to 3L and was satting at 93%


VAERS ID: 1696057 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: One a day vitamin, Synthroid
Current Illness: Multiple Myeloma
Preexisting Conditions: Multiple Myeloma
Allergies: None
Diagnostic Lab Data: Met with dr. on 9/13/21 to confirm vaccine and was prescribed vlatrex for 10 days. I was also given anti itch cream
CDC Split Type:

Write-up: I developed shingles on the left side of my back around to my left breast.


VAERS ID: 1696084 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206 A21 A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Had a covid in January 2021 (undiagnosed at the time). Natural immunity to covid-19 confirmed on June 11 2021 (66 U/ml) and September 7 before vaccination (63 U/ml). Patient got vaccinated because of the mandate at the University of Cincinnati where he is currently enrolled.
Preexisting Conditions: None. As described above, had stable level of antibodies to covid 19 spike protein.
Allergies: Dairy, erythromycin, fish eggs
Diagnostic Lab Data: See covid antibody tests before the vaccine described above
CDC Split Type:

Write-up: At about 4-5 hours after the shot, Patient started feeling chills, shaking to the point he couldn''t hold a glass, with rapidly rising fever. His temperature readings between 11pm and 8 am next morning were around 106.6, with the highest reading of 107. We were extremely concerned as he has never had a fever that high in his life (I can attest to that as a parent). The fever did not subside with ibuprofen (2x500 mg), aspirin (500 mg), acetaminophen (750mg), given in 1.5-2 hr intervals between 10 pm and 4:30 am. He did not take any medicine after 4:30 am, as it was not having any effect. He was given fluids to drink, 500ml every 30-40 min, for the entire time He remained conscious, but had extreme headache, muscle pain and weakness. Starting at around 9 am (about 15 hrs after the injection), the fever started going down, and remained at 104-105 for the next 18 hrs. The temperature went down to 100-102 the next day, and was down to normal on day 4.


VAERS ID: 1696134 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Gait inability
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: risperidone alprazolalm lamotrigine escitalopram
Current Illness: Not known
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: ER visit. Tests unknown.
CDC Split Type:

Write-up: Patient became very unsteady and unable to walk. Symptoms persisted for 45 minutes in the pharmacy before being transported to ER.


VAERS ID: 1696139 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH P*120VF20809 / 1 LA / IM

Administered by: Private       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: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menses began despite being on progesterone only birthcontrol


VAERS ID: 1696264 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-19
Onset:2021-09-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

Administered by: Public       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 received Pfizer vaccine 3/29/2021, 4/19/2021 and 8/19/2021. 8/19/2021 dose administration is documented in this report.


VAERS ID: 1696281 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-09-09
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, COVID-19, Chest pain, Cough, Diarrhoea, Dizziness, Dyspnoea, Headache, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, HLD, CAD, MI, CHF, hypothyroidism, diabetes, GERD, antiphospholipid syndrome, SLE, COPD, DVT, CVA, TIA,OSA
Allergies: amoxicillin, bactrim, betadine, contrast dye, fish, flagyl,
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/9/21: Patient arrived at the ER due to shortness of breath, chest pain, has had a cough and diarrhea. Also mentions headache and dizziness, abdominal pain, nausea and vomiting. Patient tested positive for COVID on 9/11/2021


VAERS ID: 1696356 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Flushing, Injection site swelling, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Flu shot last year
Other Medications: Synthroid, metoprolol, vitamin D, Zoloft
Current Illness: none
Preexisting Conditions: Hashimoto''s Disease
Allergies: Keflex - medication
Diagnostic Lab Data: None yet. Instructed by Employee Health to report reactions.
CDC Split Type:

Write-up: First noticed left arm (injected arm) - top of shoulder to elbow was swollen the next morning. Nausea. Face periodically feels flush.


VAERS ID: 1696382 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-05
Onset:2021-09-09
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 AR / IM

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

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

Write-up: POSITIVE COVID 09/09/21


VAERS ID: 1696383 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-29
Onset:2021-09-09
   Days after vaccination:254
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 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? 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: Tested positive for COVID


VAERS ID: 1696404 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Condition aggravated, Dysstasia, Flank pain, Hypersensitivity, Pain, Sneezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Allergies
Preexisting Conditions: Asthma
Allergies: Amoxicillin, dust
Diagnostic Lab Data: None
CDC Split Type:

Write-up: He began to feel pain in his back, right side above his hips. He cannot stand for more than 5 minutes without feeling pain. Also his allergies are more frequent and he cannot stop sneezing easily.


VAERS ID: 1696413 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-17
Onset:2021-09-09
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Decreased appetite, Fatigue, Oxygen saturation decreased, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: dexAMETHasone,dextrose, digoxin, famotidine, finasteride, glucagon, glucose, insulin aspart, insulin glargine
Current Illness:
Preexisting Conditions:
Allergies: Allopurinol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 79 y.o. male with a history of A fib on chronic anticoagulation, DM type II on insulin, HTN, GERD, obesity and OSA on CPAP who is transferred for after worsening respiratory status despite Remdesivir and dexamethasone treatment for recently diagnosed COVID-19. He arrives and is on high flow O2 80% at 40L/min. He tells me his symptoms began about a week ago. He noticed that he was fatigued despite using his CPAP at night. He also noticed he had lost his appetite. He denies any loss of taste or smell. He says his cough has been ongoing about a week. He denies any N/V, fever or diarrhea. He says he has been eating now, but not as much as normal. His breathing he t


VAERS ID: 1696438 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-14
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 RA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Lymphadenopathy, Myalgia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Lymph-node swelling within arm pits, congestion, runny nose, muscle aches, chills.


VAERS ID: 1696484 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-24
Onset:2021-09-09
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASPIRIN, FISH OIL, FLUTICASONE, GABAPENTIN, HYDROCHLOROTHIAZIDE, LISINOPRIL, METOPROLOL, MULTIVITAMIN, SIMVASTATIN
Current Illness: NONE
Preexisting Conditions: ADENOCARCINOMA OF PROSTATE, ANEMIA, HYPERCALCEMIA, HYPERLIPIDEMIA, HYPERTENSION
Allergies: NKA
Diagnostic Lab Data: COVID-19 VIRUS MOLECULAR TEST POSITIVE 9/9/21
CDC Split Type:

Write-up: COVID DIAGNOSIS AND HOSPITALIZATION AFTER BEING FULLY IMMUNIZED


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