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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 229 out of 8,010

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VAERS ID: 1696491 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Hampshire  
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 FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, omega 3 fatty acid, vitamin d3
Current Illness: no
Preexisting Conditions: no
Allergies: sulfa allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reports "weird sensation" on left side of neck and then her entire face went numb. She then reports feeling the "weird sensation" on the right side of her neck. She did not treat this and reports that it went away on its own after about 15 minutes.


VAERS ID: 1696596 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
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 (MODERNA)) / MODERNA 088D21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Ear pain, Eye pain, Fatigue, Headache, Immediate post-injection reaction, Neck pain, Neuralgia, Pain, Pain in extremity, Pyrexia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil, B12, Allegra, BioAstin
Current Illness: No
Preexisting Conditions: No
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness in right arm immediately after injection. Fatigue ensued around 8pm on 9/8/21. Around 4am on 9/9/21 body aches, fever, chills and a head ache came on. Fever rose up to 102* at 10am then up to 103* by 5pm with severe head pains behind the eyes and ears. Nerve pains shot up and down the back of my neck the whole time the fever was active. Took a small dose of Ibuprofen 3 times the day of 9/9/21 along with a cold shower. Fever began to go down around midnight on 9/9/21 and stayed at 101* until it broke at 9am on 9/10/21. Lingering headache and fatigue the following 4 days after fever broke.


VAERS ID: 1696615 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-01-20
Onset:2021-09-09
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EL329 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD45584591 / 1 - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Confusional state, Hypoxia, Pyrexia, SARS-CoV-2 test positive, Somnolence
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HLD BPH, Vitamin D deficiency, OA, HTN, anemia
Allergies: Sulfadiazine
Diagnostic Lab Data: SARS CoV2 PCR COVID 19 detected on 9/9/21
CDC Split Type:

Write-up: He completed Pfizer COVID vaccines on 1/20/21. He lives in the local nursing home, and he was tested COVID positive on 6/7/21. He became hypoxic and was admitted at Hospital on 9/9/21. His symptoms are confused, drowsy, fever 102.6. He is in stable condition on 2L oxygen on hospital day 6.


VAERS ID: 1696668 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-20
Onset:2021-09-09
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

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

Write-up: Client vaccinated for Covid with Moderna vaccines in end of April and end of May, 2021 (not sure of exact dates but knows the months). Tested + for Covid on 9/9/2021. Asymptomatic. Reported as a breakthrough Covid case in vaccinated person.


VAERS ID: 1696687 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-09-09
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Deep vein thrombosis, Dyspnoea, Peripheral swelling, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: patient presented to pulmonology office with significant shortness of breath and bilateral extremity swelling. Found to be COVID+ and have a DVT. Currently undergoing inpatient treatment.


VAERS ID: 1696713 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Illinois  
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 FF2588 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, 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: tetanus toxoid, ages 2 and 5 (approx.)
Other Medications:
Current Illness:
Preexisting Conditions: bronchiectisis
Allergies: No known
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12 hours after the injection, I developed hives - first on my legs, then encompassing my entire body. I''ve had two ER visits and been given Prednisone, as well as anti-histamines. The hives are now subsiding during the daytime, but return at night and early morning. As of today, 9/14/21, I still have hives. Very itchy!!


VAERS ID: 1696807 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Colorado  
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 (MODERNA)) / MODERNA 035C21A / 3 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthma, Blood pressure increased, Blood sodium decreased, Chest X-ray, Condition aggravated, Confusional state, Echocardiogram normal, Ejection fraction decreased, Fibrin D dimer, Full blood count, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Lethargy, Positive airway pressure therapy, SARS-CoV-2 test negative
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Hypertension (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Respiratory failure (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cholecalciferol Tablet 50 MCG (2000 UT) every day, Latanoprost Solution 0.005 % every day both eyes, Cyanocobalamin Tablet 1000 MCG every day, ProAir HFA Aerosol Solution 108 (90 Base) MCG/ACT (Albuterol Sulfate HFA) 2 puffs four times a
Current Illness: Resident has a chronic cough and chronic rhinorrhea. He resides in a nursing home d/t chronic conditions. No major health issues in the past month.
Preexisting Conditions: Recurrent PE, asthma, Obstructive Sleep Apnea, hypertension, GERD, obesity, hyperlipidemia, Benign Prostatic Hyperplasia, gluacoma, chronic pain
Allergies: Fosinopril
Diagnostic Lab Data: CBC- HGB 12.9, HCT- 38.1, Lytes- Sodium 129 D-Dimer 409 Covid-19 - negative CXR Cardiac ECHO- LV size and sytolic function are normal. Estimated LVEF 60%.
CDC Split Type:

Write-up: Resident was noted to have increase in confusion and lethargy with elevated heart rate and BP. Resident was transferred to hospital where he required an increase in supplemental oxygen. Resident was admitted to the hospital and diagnosed with exacerbation of asthma. Uses oxygen for exertion and CPAP at night.


VAERS ID: 1696816 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New Jersey  
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 FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Chills, Dyspnoea, Electrocardiogram normal, Fatigue, SARS-CoV-2 test negative, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: September 9,2021 at Urgent care EKG, Chest Xray, Cover-19 rapid test - all were negative.
CDC Split Type:

Write-up: Woke up in the middle of the night (Thursday going into Friday morning) short of breath Thursday September 9,2021. On Friday throughout the day I felt more short of breath and had chest pain in center of my chest. I felt very fatigued and had chills without a fever. I took tylenol while at work that day and drank a lot of water but still felt the same. I came home and my wife made me an appointment at urgent care. I also took a rapid cover 19 test at home that was negative. That evening I went to my appointment at urgent care. They did a chest X-ray and an EKG that were all normal and also did another cover 19 test that was negative. I still currently have shortness of breath as of today September 14, 2021.


VAERS ID: 1696838 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arizona  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Lethargy, SARS-CoV-2 test negative
SMQs:, Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), COVID-19 (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: Novolog and an Insulin pump for diabetes; Gabapentin; Duloxetine; Levothyroxine; Lisinopril; Pramipexole Dihydrochloride; Multi - Vitamin; Low dose aspirin; Vit D3; iron; calcium, magnesium; zinc
Current Illness: no
Preexisting Conditions: Diabetes type 1; Depression
Allergies: codeine
Diagnostic Lab Data: Urgent Care 9/11/2021 - They did a COVID test - negative results ; blood pressure and oxygen
CDC Split Type: vsafe

Write-up: I woke up with four am and I had diarrhea from that time until about noon. I was lethargic and had chills but no fever. I had the chills and a headache the next day. Saturday, I started feeling better with just a very mild headache. On the 11th, though, I called the doctor in the later afternoon. I went to Urgent Care - where I saw Dr. at 06:00 that night. No treatment. By Sunday, I was okay.


VAERS ID: 1696925 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Polymenorrhoea, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Spironolactone 50 mg once daily (have been taking for 3.5 years for acne)
Current Illness: COVID-19 Infection Tested positive 8/20/21.
Preexisting Conditions: None.
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started my menstrual cycle on Monday, September 6th. My period consistently lasts 6-7 days. On Thursday, September 9th (4th day of my period), I received my Janssen COVID-19 vaccine in the morning. My menstrual flow ceased the remainder of the day on 9/9. I had no flow on 9/10 or 9/11. On 9/12 (day 6), my period began again, after 4 days of bleeding, and 3 days of no bleeding. It wasn''t heavy, just very light. On 9/13 and today 9/14, my period has been so heavy that I am emptying a 30 mL menstrual cup every 50 minutes. It typically takes me 6-12 hours to fill that depending on the day. My period flow consistency right now is extremely abnormal in that it is bright red and watery, with 2-3 quarter sized clots being passed every hour. This is not normal for me. I have had consistently 26-30 day cycles with dark red thick flow for years. Someone has to look into this. Please.


VAERS ID: 1696981 (history)  
Form: Version 2.0  
Age: 35.0  
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 FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Myalgia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Muscle aches and chills followed by hives on hips, legs, stomach and arms


VAERS ID: 1696989 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
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 FC3183 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Discomfort, Fatigue, Headache
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin 600mg 3 times a day; Synthroid 150mcg 1 time a day
Current Illness: No e
Preexisting Conditions: Fibromyalgia Hashimoto''s thyroiditis
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache Severe Joint pain Feet feeling like there was glass inside Extreme fatigue, unable to stay awake Whole body felt heavy


VAERS ID: 1697000 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Arkansas  
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 - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Cough, Diarrhoea, Headache, Hyperhidrosis, Injection site pain, Insomnia, Pyrexia, Respiratory tract congestion, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: Triamcinolone Acetonide Nasal Spray
Current Illness:
Preexisting Conditions:
Allergies: Milk, Eggs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within approximately 8hrs of the shot, I began to have a headache which lasted nearly 24hrs. I had pain in my upper left arm. I ran a temperature throughout the first night between 102 and 104 degrees with profuse sweating and violent shaking. I had trouble sleeping. I had a bout of diarrhea and a persistent cough with slight congestion. The second day/night the cough remained, headache remained and I ran a low grade fever overnight and trouble sleeping. My cough remains persistent and my headache comes and goes.


VAERS ID: 1697159 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Georgia  
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 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Dysarthria, Hypopnoea, Loss of consciousness, Somnolence
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), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: mild reaction to flu vaccine
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: SLE
Allergies: Sulfa Environmental
Diagnostic Lab Data: ER 9/9/21
CDC Split Type:

Write-up: I had an appointment at the local health dept 9/9/21 to receive the Janssen Vaccine. I went in with a friend, completed the required paperwork, and received the injection, 11:16. We sat in the back of the clinic together. At 11:24 I felt odd and sleepy and immediately fell over, unconscious, into my friend''s side. My BP at this time sitting was 182/104 and heart rate 137.- taken by a nurse at the health dept. (My normal is 108/70 and my weight is 105lbs- no history of hypertension, cardiac issues.) My friend said that my speech slurred and then I fell over onto him with him stabilizing me so that I didn''t fall into the floor. After they took my BP he moved me to lie on the floor during which time I was conscious but not able to assist much in the movement. He said that I kept saying , " I am sleepy." My heart rate and BP continued to be elevated and my breathing was shallow and rapid. I recall having diffculty staying awake with my friend telling me to keep my eyes open. I would fade off he said and then he would tap me and call my name and I would open my eyes. My body began to shake and I felt like I was very cold. All of this occurred within approximately 15 mins after the injection and continued on for some time, over an hour lying on the health dept floor with them monitoring me. I was unable to stand and every time they sat me up I would increase BP. They called 911 and I went to the ER.


VAERS ID: 1697370 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
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 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Chills, Confusional state, Fatigue, Gait inability, Laboratory test, Loss of personal independence in daily activities, Muscle spasms, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: axitinib, pembrolizumab, levothyroxine
Current Illness:
Preexisting Conditions: Renal cell carcinoma
Allergies: NKA
Diagnostic Lab Data: ED visit Labs and IV fluids.
CDC Split Type:

Write-up: Severe full body myalgias, muscle spasms, nausea, vomiting, chills, confusion, word finding difficulty, unable to walk unassisted, and fatigue starting evening of vaccine administration (given in AM)


VAERS ID: 1697372 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maryland  
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 EL9267 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3188 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Oropharyngeal pain, Pain, Pain in extremity, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: annual flu and decennial tetanus shots - sore arm
Other Medications: Wellbutrin, Singulair, Pepsid, Claritin, senior multi-vitamin/mineral, D3, Caltrate Plus, flaxseed oil
Current Illness: Depression, GERD, reactive asthma, osteoporosis - treated with medications listed in 9; left shoulder strain and synovial cyst on spine - treated with injected steroids
Preexisting Conditions: See item 11
Allergies: Penicillen, sulfa drugs, clindamycin, oral prednisone
Diagnostic Lab Data: Was surprised I had a cough so got a covid test 9/13 which was negative
CDC Split Type:

Write-up: After 1st does very sore and swollen arm, 2d dose no reaction, 3d dose arm got sore later that and within 2 days had body aches, chills, fatigue, headache, slight cough, sore throat, congestion (no fever)


VAERS ID: 1697595 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Oregon  
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 FC3183 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chills, Diarrhoea, Fatigue, Feeling cold, Flushing, Headache, Influenza, Injection site induration, Injection site warmth, Myalgia, Nausea, Pruritus, Rash erythematous
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu shot more than 8 years ago
Other Medications: Benadryl, Zyrtec
Current Illness: None
Preexisting Conditions: Severe lymphedema, lipedema, hEDS, osteoarthritis and Celiac disease. Thyroid nodules with high risk of cancer, recent epstein barr virus infection and suspected CVID.
Allergies: Aspirin, Ibuprofen, gluten
Diagnostic Lab Data: Consultation with nurse and doctor diagnosed with "COVID arm" signs. Advised to stay on a daily Benadryl regimen to slow and cure the hypersensitive reaction to the shot. I pre-medicated with Benadryl before both doses but stopped the night of 2nd shot, which caused delayed symptoms. Am currently on Benadryl 4x per day and starting to see some improvement. I am diagnosed with MCAS so a large histamine/mast cell reaction was to be expected. Icing and tylenol help with pain reduction, too. Will go to emergency room if symptoms get worse.
CDC Split Type:

Write-up: Developed red rash about 6" in diameter that was very warm with a hard lump under the injection site. Upper arm area was very itchy and progressed from the head to the waist area. Face has been flush with .5 degree elevated temp. Experiencing intermittent chills/feeling cold, muscle aches (all over), nausea, some diarrhea, fatigue and headaches. Generally feels like flu-symptoms. This has been happening from day after shot for next 5 days and may take an additional week (or more) to clear.


VAERS ID: 1697763 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
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 (MODERNA)) / MODERNA 058E21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Fatigue, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Emergen-c B12
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 102.5. Headache. Nausea. Muscle aches, chills. Fatigue. Cough. Dark red, hot, sore, itchy spot on arm where injection site. Fever, chills lasted 30 hours. Nausea, fatigue headache lasted 72 hours. Arm redness, pain itchy lasted 5 days. Antihistamine for arm Tylenol for headache along with Advil for fever.


VAERS ID: 1697948 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Headache, Myalgia, Nasopharyngitis, Nausea, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: within 15 mins of injection slight headache lasting one hour followed by runny nose, cold like symptoms with muscle pain. Following day in the AM, experienced nausea with diarrhea. Nausea symptoms proceeding until PM on September 14, 2021, 5 days. Nausea symptoms were elevated by drinking carbonated water.


VAERS ID: 1697951 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-06
Onset:2021-09-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amenorrhoea, Menstrual disorder
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: Omepraxole, vitamin d, multivitamin
Current Illness: Malabsorption hypoalbumenia, localized swelling
Preexisting Conditions:
Allergies: Flagyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: No menstrual cycle for 32 days abnormal due to consistency and no other issues.


VAERS ID: 1700067 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Negative EKG, 9/13
CDC Split Type:

Write-up: Febrile Sept 9-11th, with General myalgia. Substernal chest pain and SOB with exhertion, began Sept 11, gradually worsening until Sept 13. EKG on Sept 13, "normal". Substernal chest pain continues with exhertion Sept 15., but is gradually improving.


VAERS ID: 1700081 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood glucose normal, Blood test normal, Disability, Dizziness, Electrocardiogram normal, Feeling abnormal, Full blood count normal, Headache, Impaired work ability, Mononucleosis heterophile test, Muscular weakness, Pain, Paraesthesia, Spinal pain, Thyroid function test normal, Urine analysis normal, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topiramate Escitalopram Lamotrigine Clonopin
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: CBC full panel 9/9 & 9/10 - normal Thyroid test - 9/10 - normal Glucose check 9/10 - normal Ekg 9/9 - normal Urine dip 9/10 & 9/14 - negative Mono test 9/15 - pending
CDC Split Type:

Write-up: On 9/9 I had radiating pain down my spine, tingling in my legs and feet. Lower extremity weakness, headache , dizziness , vision impairment and brain fog. I drove myself to the hospital and there was a 5 hr wait. Next day I went back my mom driving me was seen and in ER for 8 or so hours given IV fluids, toridol for pain, meclazine for dizziness and discharged due to all blood work levels being normal and UTI negative. Following days severe brain fog and back pain and dizziness. Followed up with PCP yesterday who advised I stop meclazine and tested again for UTI (neg) and mono test (waiting results) I?m out of work and completely ?out of it? not myself! 8 days onset after 1st shot and several have told me same reactions due to the Pfizer shot. Doctor will set me up with neurologist is this doesn?t clear. Im a healthy 32 years old female who works and lives life snd now I am impaired. Very scary.


VAERS ID: 1700131 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Headache, fatigue, nausea, muscular ache, injection site pain beginning 18 hours after injection. Continued for 1 week.


VAERS ID: 1700132 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-09-09
   Days after vaccination:131
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A PATIENT VAC / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A PATIENT VAC / UNK - / -

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

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

Write-up: Per MCIR patient received two doses of Moderna COVID-19 vaccines on 5/1/2021 and 5/29/2021 at outside facility; subsequently admitted to our hospital and diagnosed with COVID on 9/9/2021


VAERS ID: 1700138 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: risperidone, benztropine, aspirin, carvedilol, cetirizine, digoxin, eliquis, lisinopril, duoneb, dulera, spironolactone, albuterol, flonase
Current Illness: unknown
Preexisting Conditions: afib, chf, paranoid schizophrenia, hypertension, copd
Allergies: no known allergies
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: nausea, malaise, "sick"


VAERS ID: 1700170 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Electrocardiogram normal, Heart rate increased, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: blood work- seemed to be normal Ekg- seemed normal no other tests were done
CDC Split Type:

Write-up: Completely numb left arm, rapid heart rate, leg pain and chest pain starting around 12:30am 9/9/21. Went to the ER and heart rate was high. Blood work looked normal and EKG was normal. That was the only tests done.


VAERS ID: 1700227 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? 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: She thinks she passed out / dizzy, lightheaded, sweaty when she attempted to get up to go to the bathroom on 9/9 in the early morning, woke up on the bathroom floor, no injury. Dizziness.


VAERS ID: 1700239 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-09-09
   Days after vaccination:232
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Fatigue, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID19 molecular NP swab collected on 9/10/21 at clinic with positive result.
CDC Split Type:

Write-up: Pt. fully vaccinated with Pfizer COVID19 vaccine on 12/23/20 and 1/20/21. Pt. reported COVID symptoms of sore throat, fatigue, loss of taste, loss of smell starting 9/9/21 and tested COVID positive via molecular swab on 9/10/21. EE then infected all household members.


VAERS ID: 1700307 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-09-09
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Cardiomegaly, Chest X-ray abnormal, Cough, Diarrhoea, Haemodialysis, Hypoxia, Interstitial lung disease, Lung opacity, Pulmonary vascular disorder, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute renal failure (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications acetaminophen (TYLENOL) 500 MG tablet atorvastatin (LIPITOR) 40 MG tablet bosutinib (BOSULIF) 100 MG TABS insulin glargine (LANTUS SOLOSTAR) 100 UNIT/ML pen-injector insulin lispro (HUMALOG KWIKPEN U-200) 200 UNIT/ML
Current Illness: NA
Preexisting Conditions: ESRD (end stage renal disease) Type 2 diabetes mellitus without complication, with long-term current use of insulin CML (chronic myeloid leukemia) Depression Essential hypertension Morbid obesity At risk for falling Lower GI bleeding Anemia, unspecified type Cognitive impairment Bilateral leg edema History of CVA (cerebrovascular accident) Fistula Alternating constipation and diarrhea History of recurrent UTIs GERD (gastroesophageal reflux disease) Compression fracture of C7 vertebra Hyperlipidemia Renal osteodystrophy Mycotic toenails Pancreatic cyst Chronic midline low back pain without sciatica COVID-19
Allergies: Codeine Rash Keflex Angioedema Lisinopril Cough Zoloft [Serotonin Reuptake Inhibitors] Pollen Sneezing
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized; COVID-19 positive (9.9.21); fully vaccinated Admission Date: 9/10/2021 Discharge Date: 9/14/2021; Discharge Disposition: home health care DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Generalized weakness Acute respiratory failure with hypoxia COVID-19 HOSPITAL COURSE: Patient is a 68F who presents with vomiting, diarrhea, cough, generalized weakness since about 5-6 days PTA. She has a history of ESRD on HD, HTN, CML, hyperlipidemia. She continued to feel considerably weak, so was tested for COVID on 09/08, which was positive. She continued to have cough without production of sputum. She did receive COVID vaccine (Moderna) in March and April. On admission she was hypoxic to 84%, and required 2 L via NC. CXR showed moderate cardiomegaly with central pulmonary vascular prominence and diffuse bilateral interstitial opacities. She was started on decadron 6 mg daily. Nephrology consulted and she underwent HD. She remains stable on 2lpm NC. She denies further diarrhea and no fever.PT recommends home. She was discharged in stable condition on 9/14/21. She is to follow up with COVID at home program on discharge Pt on 9/14. Alert, NAD, Stable for discharge. In agreement with verbal instructions to follow up with her outpatient physicians


VAERS ID: 1700447 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-15
Onset:2021-09-09
   Days after vaccination:206
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / -

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

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

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


VAERS ID: 1700459 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Flushing, Headache, Pharyngeal swelling, Photophobia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal 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:
Other Medications: Medications at the time of vaccination: loratadine 10mg PO daily
Current Illness:
Preexisting Conditions: Patient has no other known medical history.
Allergies: Pt w/ a hx of anaphylactic reaction to Amoxicillin, Penicillin G, and the Moderna Covid Vaccine.
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Pt w/ a hx of anaphylactic reaction to Amoxicillin, Penicillin G, and the Moderna Covid Vaccine. Patient has no other known medical history. Medications at the time of vaccination: loratadine 10mg PO daily Pt presented to the vaccination clinic for Janssen vaccination to complete the Covid vaccination series after having an anaphylactic reaction to the first dose Moderna 3/5/21. Within 5mins of Janssen vaccination, pt c/o swelling in her throat and difficulty swallowing. The patient was noted to have some facial flushing around lips. Assessed by RN/PA: AOx4, VSS, BP 137/77, HR 87 Resp 18 SpO2 97% @1739. Per PA recommendation, PA administered 1 dose 0.3mg EpiPen @1733 to left leg. VSS, SpO2 97-100% on RA, GCS 15, lungs CTAB. @1739 Pt reported that she felt better after Epi injection but still symptomatic. Charge RN called 911 for transport to the hospital for additional evaluation and management. EMS arrival @1747, PA report for EMS transport. Patient left clinic via EMS transport to hospital at approx 1750. In the ED, pt was given another dose of Epi 0.3mg IM, Diphenhydramine 50mg IV x1, famotidine 20mg IV x1, methlprednisolone sod. succ 40mg IV x1, and ondansetron 4mg IV x1. Pt was discharged with a new presciption for EpiPen 0.3mg IM PRN anaphylaxis. 24hrs post vaccination pt developed a HA w/ light sensitivity. Pt returned to the ED 9/14 c/o HAx3 days. Pt was treated and discharged w/ new Rx for APAP 1000mg PO TID PRN HA. Per provider note after D/C, pt HA resolved."


VAERS ID: 1700492 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Dyspnoea, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Mobility decreased, Nausea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: Codeine
Diagnostic Lab Data: covid test negative
CDC Split Type:

Write-up: After receiving the vaccine a couple hours later my left arm started burning and had extreme itching below the site with redness appearing and nausea. About 9 hrs after injection I then spike a temp of 103 that lasted about 7 hr. aching some sob and and was unable to get out of bed no energy. Taking Tylenol and Zophran Nausea continued for 4 days. Redness worsened on day 2 to left arm 4x5 inches was severe tender and extremely hot to touch applied ice pack for 15 -20 min. 3-4 times a day as you could stand to touch your arm. Applied cortisone cream on with no relief . Took Benadryl 50 mg 3xday . To the doctors on Monday 13th


VAERS ID: 1700504 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-09-09
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: PATIENT HAD PFIZER COVID VACCINE ON Dose 1 date: 02/17/2021, Dose 2 date: 03/10/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1700524 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-19
Onset:2021-09-09
   Days after vaccination:233
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest pain, Painful respiration, SARS-CoV-2 test positive
SMQs:, Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA, FIsh Oil, Lopressor, PreserVision, Prinival, Multivit,
Current Illness: Unknown
Preexisting Conditions: COPD, CHF, SSS, Pacemaker, HTN, Dementia, Glaucoma, Macular degeneration, Smoker
Allergies: No known allergies
Diagnostic Lab Data: 09/09/2021 SARS COV2 COVID 19 PCR (POSITIVE)
CDC Split Type:

Write-up: 09/09/21 The patient presents with COVID-19 related sx. Pt tested positive for COVID on 8/19. Pt is experiencing weakness. Pt has had chest pain with deep breaths. Pt has no chest pain or SOB presently. Pt usually wears oxygen at home for CHF. Pt denies any other sx. The onset was 08/19/2021 . Risk factors consist of hypertension and CHF. Prior episodes: none. Therapy today: EMS. Associated symptoms: denies chest pain, denies abdominal pain, denies nausea, denies vomiting, denies shortness of breath, denies fever, denies chills, denies headache, denies dizziness and denies back pain.


VAERS ID: 1700533 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Sinus tachycardia
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ondansetron (Zofran ODT 4 mg oral tablet, disintegrating)
Current Illness: None
Preexisting Conditions: None
Allergies: Adhesive Bandage Iodine Shellfish Sulfa Drugs
Diagnostic Lab Data: EKG Chest Xray
CDC Split Type:

Write-up: Heart palpitations, Sinus Tachycardia


VAERS ID: 1700571 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-09-09
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Anxiety, Arthralgia, Asthenia, Asymptomatic COVID-19, Bordetella test negative, Bradycardia, COVID-19 pneumonia, Chest X-ray abnormal, Chlamydia test negative, Condition aggravated, Coronavirus test negative, Cough, Depression, Dyspnoea, Dyspnoea exertional, Enterovirus test negative, Fatigue, Fibromyalgia, Fluid intake reduced, Human metapneumovirus test, Human rhinovirus test, Hypophagia, Hypoxia, Inflammatory marker increased, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lung infiltration, Myalgia, Mycoplasma test negative, Pulmonary congestion, Pyrexia, Respiratory failure, Respiratory syncytial virus test negative, Respiratory viral panel, SARS-CoV-2 test positive, Sepsis, Viral test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler alendronate (FOSAMAX) 70 mg tablet (Expired) amLODIPine (NORVASC) 5 mg tablet ascorbic acid, vitamin C, (VITAMIN C) 500 mg tablet aspirin 81 mg chewable tablet benzonatate (TE
Current Illness:
Preexisting Conditions: Nervous Breast pain Chest pain Chest wall pain Dysuria Neck pain Fibromyalgia Spasmodic torticollis Acute pain of left knee Respiratory Chronic obstructive pulmonary disease Pneumonia Lung nodule Circulatory Bradycardia Essential hypertension Hypertension Digestive Chronic constipation Irritable bowel syndrome Vitamin D deficiency Genitourinary Infective urethritis Asymptomatic microscopic hematuria Musculoskeletal Actinic keratosis Arthritis Candidiasis of skin Degeneration of intervertebral disc of cervical region Age related osteoporosis Seborrheic keratosis Malignant neoplasm of skin Osteoporosis with current pathological fracture Age-related osteoporosis without current pathological fracture Adult idiopathic generalized osteoporosis Endocrine/Metabolic Pure hypercholesterolemia Familial combined hyperlipidemia Infectious/Inflammatory COVID-19 Other Blood glucose abnormal Depression Depressive disorder Generalized anxiety disorder Hematuria Constricted pupil Need for prophylactic vaccination and inoculation against influenza Posttraumatic stress disorder Spinal stenosis of lumbar region Fall (on) (from) other stairs and steps, initial encounter Need for vaccination Anxiety BMI 24.0-24.9, adult
Allergies: PenicillinsRash
Diagnostic Lab Data: 09/09/21 1042 Respiratory virus detection panel Collected: 09/09/21 0941 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 1 view - Portable [3302054567] Resulted: 09/09/21 1015 Order Status: Completed Updated: 09/09/21 1015 Narrative: XR CHEST 1 VW PORT IMPRESSION: Patchy left basilar infiltrate superimposed upon linear scarring. END OF IMPRESSION: INDICATION: SOB, weakness, fever Sepsis. TECHNIQUE: AP portable erect projection of the chest is acquired. COMPARISON: 1/22/2020 FINDINGS: There is no widening or shift of the mediastinum and the heart size is not enlarged. There is a mild patchy infiltrate superimposed upon linear scarring at the left costophrenic angle. There is no consolidation. There is also a slight prominence of the right basilar lung markings.
CDC Split Type:

Write-up: Note Pt called with Temp of 103 and chest congestion with cough. Difficulty getting anything fluids or food in . C/o some SOB. Advised ER evaluation and pt in agreement. Refuses ambulance but will have family take her in. ED to Hosp-Admission Discharged 9/9/2021 - 9/12/2021 (3 days) Hospital - COVID-19 Presenting Problem/History of Present Illness/Reason for Admission Hypoxia [R09.02] COVID-19 [U07.1] Hospital Course 72-year-old female with a past medical history of hypertension presented to the emergency department with shortness of breath, arthralgias/myalgias, fevers secondary to Covid pneumonia. Patient is vaccinated, received 2 doses of the vaccine with her last dose being in April 2021. She lives by herself, over the past 2 days she began developing worsening fatigue and shortness of breath. This is also worsened by her fibromyalgia, anxiety and depression. Checked temperatures at home when she had a fever up to 103 ?F, she was self treating with Tylenol. She called her PCP who recommended she go to the emergency department for further work-up. In the emergency department, COVID-19 test was positive on 9/9/2021, x-ray showed infiltrates as well as possible linear infiltrate which is consistent with scarring from previous pneumonia. She admitted to the hospital for hypoxia and COVID-19 pneumonia. 1. Hypoxic respiratory failure, COVID-19 infection Patient was admitted to the hospital and started on oxygen, given her hypoxic respiratory failure she was started on Decadron and Remdesivir. Her oxygen was slowly weaned, she was stable on room air but will require oxygen at discharge with ambulation. Her shortness of breath and generalized weakness and fatigue significantly improved during her hospitalization. On her day of discharge, again she was stable on room air but did have significant shortness of breath with ambulation, will be sent home with 2 L nasal cannula with ambulation. Also have bronchodilator therapy as well as send a short course of Decadron as an outpatient. She will follow up with PCP in 1 week who could help manage her oxygen as an outpatient. 2. Hypertension, hyperlipidemia Pressures are stable during hospitalization, can continue lisinopril 20 mg daily, will decrease amlodipine 5 mg daily given some lower blood pressures while hospitalized. Continue Crestor 10 mg daily. 3. Bradycardia Patient bradycardia during hospitalization, she is asymptomatic. Possibly secondary to remdesivir which she was on for her COVID-19 infection. She has significant part of her symptoms, was asymptomatic, stable for discharge. On day of discharge, her symptoms significantly improved from time of admission. Oxygen is weaning down, inflammatory markers trending down, and generalized weakness and fatigue has improved. She is evaluated by PT/OT who cleared her for discharge home. Will be sent home with oxygen with ambulation, oral Decadron, Tessalon Perles, albuterol inhaler.


VAERS ID: 1700583 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry eye, Eyelid margin crusting
SMQs:, Anticholinergic syndrome (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Angioedema of eyelids after first dose of Moderna covid vaccine
Other Medications: xyzal 5 mg BID
Current Illness: none
Preexisting Conditions: HYN Hypothyroidism Allergic contact dermatitits
Allergies: Vitamin A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: She had little bit of dryness and crustiness around her eyes but does not have any actual hives or rashes. I explained to her that the vaccine is causing those reactions in some patients but not anaphylactic and that treatment with antihistamines around-the-clock at the dose of 2 pills of Xyzal as per day, one morning and one evening, helps in controlling the symptoms and preventing worsening reactions.


VAERS ID: 1700739 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan+HCTZ 100/25, Fluvastatin 20mg, Zinc, Quercetin, Multivitamin, Aspirin
Current Illness: None.
Preexisting Conditions: Hypertension.
Allergies: Suspicion of allergy to penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chest pain for approximately 24 hours


VAERS ID: 1700754 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: Pt has c/o Fast Heart rate, HA, dizziness


VAERS ID: 1700821 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Fatigue, Headache, Impaired work ability, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine and Vitamin D3
Current Illness: n/a
Preexisting Conditions: Total Thyroidectomy. Scar tissue from Pericarditis.
Allergies: anesthesia and some high blood pressure medication
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I received the Janssen COVID-19 Vaccine EUA and within 20 minutes because dizzy and had a mild headache. After about an hour, I became extremely tired and went home from work early and took a 3 hour nap. At about 11:30pm, in addition to the dizziness and headache, I got a fever and body aches, and then had bad fever chills for roughly 8 hours. The next day I had a fever, and the body and head aches remained. My dizziness was more mild, but I found it very hard to concentrate on anything. My fever remained with me for the 3rd day, and was accompanied with nausea. After day 4 arrived, my fever was much more mild, but I still had bouts of nausea throughout the day and evening along with extreme tiredness. I am at day 6, and my only remaining symptom now is the extreme tiredness.


VAERS ID: 1700871 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Exforge, Clonidine
Current Illness: None
Preexisting Conditions: HTN and Iron deficiency
Allergies: Seasonal allergies
Diagnostic Lab Data: None at time of event. She went to see her PCP on 9/11/21
CDC Split Type:

Write-up: Patient was monitored for about an hour after the vaccine injection. She complained of chest tightness and had increase in blood pressure and heart rate.


VAERS ID: 1700907 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cough, Dysphagia, Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: routine tests in ED
CDC Split Type:

Write-up: a few minutes after receiving the vaccine, pt had SOB, trouble swallowing, itching. 50 Mg Benadryl given. symptoms continued and 911 was called. 8:40am BP 180/100 8:45am BP 190/102 8:50am BP 180/110 Rescue arrived and took over, administered epiPen and transported to hospital. followup call, pt states had to call 911 again next day and they gave epi again, also precribed a prednisone dosepack. Still has SOB, cough and has a follow up w/PCP for further trearment.


VAERS ID: 1701119 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Hypoaesthesia oral, Lip swelling, Muscle spasms, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Shellfish
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Swollen lower lip with numbness and tingling following morning lasting 16 hours. Fatigue and muscle cramps following morning lasting 72 hrs.


VAERS ID: 1701143 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Heart rate irregular, Pericarditis, Supraventricular extrasystoles
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Phenobarbital, Lipitor, Aspirin, CoQ10
Current Illness: none
Preexisting Conditions: seizure disorder, mitral valve repair in 2011
Allergies: none known
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Irregular heartbeat. Diagnosed as PAC from Pericarditis (VERY rapid onset) after 75 minute treadmill walk less than 48 hours after 2nd dose.


VAERS ID: 1701307 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0058E21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Concussion, Fall, Hyperhidrosis, Loss of consciousness, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not known
Current Illness: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: patient received shot which resulted in low grade fever. fever progressed to 101.6 with sweating and weakness. patient felt need to vomit and passed out when attempting to vomit. that lead her to fall into wall and received a concussion. patient was taken to emergency room and passed out again. inconclusive if 2nd time passing out was from concussion or from immunization. on day 2 symptoms cleared and patient began to feel better.


VAERS ID: 1701322 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oral discomfort, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Patient described burning sensation on skin and lips. She reported that it felt like a bad sunburn on her skin and her lips felt very chapped.


VAERS ID: 1701329 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-08-19
Onset:2021-09-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

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

Write-up: 3 weeks after Moderna injection (8/19/21) and one week after flu shot (Flucelvax Quad-09/2/21) began experiencing vertigo in the morning and night while in bed and dizziness and unsteadiness throughout the day. Symptoms began on 09/09/21. I am scheduling an appointment with my PCP for evaluation.


VAERS ID: 1701506 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Swelling of lymph node on same side as injection, fatigue, sweating, fever, chills and body aches.


VAERS ID: 1701719 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Back pain, C-reactive protein increased, Chills, Fatigue, Headache, Pain in extremity, Red blood cell sedimentation rate increased, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, edarbi, spironolactone, bystolic Crestor
Current Illness: None
Preexisting Conditions: HTn, bladder Ca, Hyper lipidemia prediabetic
Allergies: No
Diagnostic Lab Data: Elevated esr and elevated CRP otherwise normal
CDC Split Type:

Write-up: Day one to twojust sore arm and fatigue. Night of day seven had horrible back pain arthralgias chills vomiting and overwhelming fatigue. Vague abdominal pain. Mild headache. We are both internal medicine doctors. If we were not we would?ve had to go to the emergency room. Got a little better day 8 to 9. He was able to function on day 10. Still with some fatigue today.


VAERS ID: 1701886 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Retching
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Acetomenifen
Current Illness:
Preexisting Conditions: COPD
Allergies: sulfa, codeine, vicodin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, chills, nauseous, dry heaves, no treatment, eventually passed


VAERS ID: 1703542 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210920402

Write-up: VACCINE ADMINISTERED OUTSIDE OF THE RECOMMENDED HOLD TIME; INCORRECT STORAGE OF DRUG; This spontaneous report received from a pharmacist concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: 21-SEP-2021) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-SEP-2021, the patient experienced vaccine administered outside of the recommended hold time. On 09-SEP-2021, the patient experienced incorrect storage of drug. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered outside of the recommended hold time and incorrect storage of drug was not reported. This report was non-serious. This case, from the same reporter is linked to 20210924112.


VAERS ID: 1703543 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Celiac disease; Food allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210920494

Write-up: SEVERE HEADACHE/HURTING; NOT REALLY LOOSE STOOL BUT ALMOST GETTING THERE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: allergy to wheat, and celiac. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 211A21A expiry: UNKNOWN) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-SEP-2021, the patient experienced severe headache/hurting. On 09-SEP-2021, the patient experienced not really loose stool but almost getting there. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe headache/hurting, and not really loose stool but almost getting there. This report was non-serious.


VAERS ID: 1703545 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: SARS-CoV-2 test positive, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient had no known drug allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: COVID-19 virus test positive; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210920642

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient via a company representative concerned a 32 year old male. The patient''s weight was 180 pounds, and height was 74 inches. The patient''s pre-existing medical conditions included: Patient had no known drug allergies. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number:1802070 expiry: 23-AUG-2021) dose was not reported, 1 total administered at right arm on 05-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-SEP-2021, the patient experienced suspected clinical vaccination failure and suspected Covid-19 infection. Laboratory data included: COVID-19 virus test positive (NR: not provided) positive. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected Covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210920642-COVID-19 VACCINE AD26.COV2.S - Suspected clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1703553 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210920791

Write-up: VACCINE WAS ADMINISTERED 1.5 HOUR AFTER BEYOND THE USE TIME; INCORRECT PRODUCT STORAGE; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 09-SEP-2021, the patient experienced vaccine was administered 1.5 hour after beyond the use time. On 09-SEP-2021, the patient experienced incorrect product storage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine was administered 1.5 hour after beyond the use time and incorrect product storage was not reported. This report was non-serious.


VAERS ID: 1703874 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dysstasia, Injection site bruising, Joint range of motion decreased, Neck pain, Pain, Pain in extremity, Product administered at inappropriate site, Sleep disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, minerals, valcyclovir
Current Illness: None
Preexisting Conditions: None
Allergies: Morphine, erythromycin
Diagnostic Lab Data: N/A at this time. Calling my Dr today to report the continuous pain. Doubt anything can be done. Thank you for mandating this vaccine and giving me permanent damage. Unless this goes away - since it''s been continuous, and no sign of it going away, I will consider it permanent.
CDC Split Type:

Write-up: Shoulder, neck, arm pain - continuous, no relief. Issues lifting arm in certain positions, turning head, positional pain while sitting, standing, sleeping. Shot given too high up in my arm. Have picture of the bruised site - possible nerve damage/neuropathy


VAERS ID: 1703942 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-25
Onset:2021-09-09
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol, amlodipine, ascorbic acid, aspirin, calcium carbonate, darbepoetin, insulin aspart, isosorbide mononitrate, metoprolol tartrate, multivitamin, nitroglycerin prn, zofran, simvastatin, tamsulosin
Current Illness:
Preexisting Conditions: Coronary artery disease, CKD stage 4, Type 2 DM, obstructive sleep apnea, pancytopenia, hyperlipidemia, obesity, anemia of CKD, marginal zone lymphoma
Allergies: Penicillins (confusion, hallucinations), Blood-group specific substance (unknown reaction)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to the hospital on 9/14/21 with hypoxia due to pneumonia due to COVID-19.


VAERS ID: 1704231 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Chest pain, Heart rate increased, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pain in extremity, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

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

Write-up: Vaccine side effects 25 min - random chest pain/tightness lasting 5 minutes. Similar to panic, but felt calm during the episode. According to fitness Watch, heart rate stayed steady around 65bpm 1hr sore arm. Red mark at injection site. Upper arm swollen and tender, difficulty with mobility. Typical with vaccinations 29 hours. Arm still sore, swollen, red mark, and difficulty with mobility. Sitting in a colder room skin is cold, but injection site is very warm to the touch (almost fever warm). 36 hours. Arm still swollen/tender. Wider range of motion without pain, but not full range yet. Woke up with chest pain running down right side(5 on the 1-10 pain scale), inner pectoral near the sternum and weaker (3) pain near the appendix. Sat up and felt a similar pain in the left (minus the lower torso pain). Chest and side pain disappeared within 1.5 hours. 48.45 hrs. Significantly wider range of motion without pain. Still hurts for particular exercise (ex push-up). Still red, swollen, tender at injection site. Chest and side pain are gone, but now feeling pain in right hand. Comes and goes. When it comes, it?s a slow pulsing creating a sharp pain on the left side of the left hand middle finger knuckle. Current pattern falls close to an interval of every 2 hours lasting 10-15 minutes each. 72 hrs. While working out, noticing an increased heart rate higher than usual. Using fitness watch to track heart rate. Prior to vaccine, heart rate would spike to 180 and settle between 160and 175during physical training. Continuing the same exercises with the same intensity, heart rate now spikes as high as 210 and settles between 187 and 198. Reported back to pharmacy (vaccine administrator) these findings and was told to continue monitoring my symptoms. 09/12/21 no longer waking with chest pains. Now the pains come and go at random, but still attack the same. Same location, same duration, same intensity. Only difference is no pain in appendix area, just the chest. No other changes. 09/16/21. Full range of motion in arm without pain. Swelling nearly gone entirely and Injection site no longer red. However, injection area still sore presenting a minor tenderness. Still having random chest pains. This morning 0600 possibly the worst. Duration of 2 minutes. Pain on the right edge of the sternum reaching a 7 on the 1-10 pain scale. Breathing had no effect on the pain heart maintained steady pulse. Weaker pain in the left (5) at the same time. Other updates, heart rate still elevated higher than normal during physical training. Hand pains have ceased.


VAERS ID: 1704241 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site rash, Paraesthesia, Rash pruritic, Weight decreased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Soon after the vaccine, I had a rash on the injection site on my arm. The rash became itchy and tingly. I lost weight rapidly but became much more toned. I was getting my herbal medicines from the cabinet when I realize that my hand was stuck to the container. A few days later, I don''t know if its my herbal medicines or not, but I have been feeling incredibly strong. However, my vaccine arm has been tingling anytime I feel like I''m in danger, and lately, I''ve been gaining heightened senses. Of course, this may be because my chakras are aligned, but I strongly believe the vaccine is to blame. These sense are not going away, and I have been waking up with spider web like materials on my wrists.


VAERS ID: 1704351 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-03
Onset:2021-09-09
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram head, Electrocardiogram, Full blood count, Mental status changes, Metabolic function test, SARS-CoV-2 test
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data: CBC, Covid rapid, CMP,, EKG, CT head
CDC Split Type:

Write-up: General weakness, altered mental status


VAERS ID: 1704362 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-09-09
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 - / -

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? 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: Positive COVID test


VAERS ID: 1704402 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Patient came to Clinic today and received his first Pfizer/flu vaccine. During the observation period after the vaccines, he began to c/o itchy throat and feeling a bit tight and dizziness . VS: HR 119-125. O2 sat 100%. BP 135/95 Temp: 98.3 Given Benadryl 25mg 1 tab. Vitals taken every 15 mins, monitoring continue for a hour.


VAERS ID: 1704436 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-09-09
   Days after vaccination:98
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Condition aggravated, Dyspnoea, Hypervolaemia, SARS-CoV-2 test positive
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CHF, Anemia CKD, THN, HLD
Allergies: NKA
Diagnostic Lab Data: SARS CoV2 PCR COVID 19 detected on 9/9/21
CDC Split Type:

Write-up: He completed the series of COVID vaccines in June 2021. He was admitted to another hospital due to COVID pneumonia from 8/9/21-8/13/22 and readmitted with fluid overload from 9/5/21-9/9/21. He came to the Hospital on 9/9/21, complained of SOB. He was tested COVID positive on 9/9/21, and he was given diuretics for CHF. His condition was improved, and he was discharged home on 9/13/21.


VAERS ID: 1704446 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram, Lethargy, Pallor, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: After patient received first dose Pfizer 3ml, Intramuscualr on left deltoid around 1635 on 9/9/2021, patient fainted and seized for about 30 seconds in the COVID shot clinic. When patient regained consciousness he was very pale and lethargic. Patient was transported to a monitoring room. Patient''s BP was 78/35 HR: 38. RN started IV and administered NS bolus. EKG was performed. Dextrose 50% in water push was administered batient was observed for about an hour before being discharged at 1735. Patient''s VS improved BP: 121/57 HR: 69. Patient also refused to go to the ER ***


VAERS ID: 1704449 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: albuterol Prn
Current Illness: none
Preexisting Conditions: Rhumatoid Arthritis
Allergies: iodine
Diagnostic Lab Data: nonne
CDC Split Type:

Write-up: 3 hours after vaccine was given in the right arm employee developed opposite arm numbness. entire arm no dermatome pattern. Later in evening she developed Left facial numbness .feeling /touch Sensation and function are normal but feel as it the areas have fallen asleep. arm has resolved and face is improving.


VAERS ID: 1704563 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-21
Onset:2021-09-09
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Exposure during pregnancy, Foetal death
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, doxylamine, metoclopramide, prenatal vitamins, pyridoxine.
Current Illness: COVID-19 infection 8/26/21, asymptomatic GBS UTI at initial prenatal visit
Preexisting Conditions: Chronic hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fetal demise discovered at 26w4d. EDD 12/12/21. Patient had 2 unremarkable vaginal deliveries, the third vaginal delivery complicated by gestational hypertension. This pregnancy was complicated by chronic hypertension and asymptomatic GBS UTI at initial prenatal visit.


VAERS ID: 1704580 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-09-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Left leg ultrasound: Partially thrombosed peroneal vein. Either a thrombosed second posterior tibial vein versus patient''s variant anatomy.
CDC Split Type:

Write-up: Patient developed left leg and calf pain 2 weeks after vaccination. He was found to have thrombosis of the deep veins of the left calf. He has no risk factors for clotting and has not had any recent prolonged immobilization.


VAERS ID: 1704669 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blindness, Crying, Headache, Insomnia, Migraine, Moaning, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (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: Advil because of Pain
Current Illness: Cough/asthma
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: 09/10/21 5am emergency room visit. Was diagnosed with acute migraine and given a migraine cocktail iv
CDC Split Type:

Write-up: My daughter started feeling achy and nauseous. She couldn?t see and had a terrible headache. She couldn?t sleep for two nights because of the pain. She was throwing up and moaning and crying.


VAERS ID: 1704743 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-09-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Extra dose administered, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Pain, Paranasal sinus discomfort, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Dementia (broad), Medication errors (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxycholorquine Tramadol Flexeril Tizanidine Lyrica Yaz Montekulast Zyrtec Mobic Ativan
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis Fibromyalgia
Allergies: Sulfa Azithromycin Macrobid
Diagnostic Lab Data: 9/9/2021 - home test was positive
CDC Split Type:

Write-up: Received 3rd booster dose of Pfizer vaccine on 8/23/2021. My husband had a laboratory-confirmed breakthrough case of COVID-19 on 8/31/2021, and I was exposed. I limited my exposure to him but developed symptoms on 9/9/2021. I took a home test that was positive on 9/92021. I was not tested any further and am confident in my testing ability due to my licensure as Medical Laboratory Scientist. I have worked in many medical labs that provided this type of testing. I had brain fog, fatigue, chills, sweating, headache, body aches, coughing, sinus pressure, and loss of taste and smell. I received IV Regeneron monoclonal antibody therapy in the early hours of 9/11/2021. My illness lasted from 9/9/2021 to 9/14/2021.


VAERS ID: 1704766 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: rash on shin, fever, muscle aches, headaches


VAERS ID: 1704778 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: pt came in reported his head hurts on the right side in the back after he received the second moderna. the pain recurred since and each time is more painful. he said yesterday he took a "pain killer" and it went ago. I advised pt to contact his doctor asap. I will report to VAERS and contact his doctor also.


VAERS ID: 1704838 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Decreased appetite, Headache, Injection site erythema, Pain in extremity, Somnolence
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate, folic acid, Claritin, synthroid, metoprolol, citalopram, vitamin D, vitamin B, symbicort
Current Illness: Asthma issue
Preexisting Conditions: Rheumatoid arthritis, asthma, chronic kidney, hypertension, allergic rhinitis, hypothyroidism
Allergies: Sulfa, HCTZ, singular, spinach, corn, trees/weeds
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, joint pain, back ache, red injection site and pain down right arm, headache; all of above lasted 48 hours. Right arm pain lasted for 7 days. Slept for 2 days sporadically. Continued prescribed meds. Drank water and did not eat.


VAERS ID: 1704849 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Hypoaesthesia, Paraesthesia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: NUMBESS AND TINGLINGNESS ON FACE, HEAVE WEIGHT OR PRESSURE ON CHEST AREA AND ITCHY THROAT BEGAN AROUND 1 HOUR AFTER VACCINATION. AT 9:30PM PATIENT TOOK 2 TABLETS OF 25MG BENADRYL TO RELIEVE SYMPTOMS. SCRATCHINESS AT THROAT DISAPPEARED AT BEDTIME. NO REDNESS AT SITE OF INJECTION. TOOK ANOTHER 2 TABLETS OF 25MG BENADRYL NEXT MORNING AT 10AM AS PRECAUTION.


VAERS ID: 1705266 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Fatigue, Feeling abnormal, Musculoskeletal chest pain, Myalgia, Nasopharyngitis
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CBD oil, HCG, Tamoxifin, D3
Current Illness: Diagnosed with COVID on May 14, 2021
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe joint pain, exacerbated rib injury, lower back pain, fatigue, fogginess, muscle aches, cold


VAERS ID: 1705901 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / IM

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

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

Write-up: Error: Wrong Vaccine Formulation (ex. different Manu fact. initial and booster)-


VAERS ID: 1705909 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Malaise, Paraesthesia, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: After immuniztion was given. Patient stated that she was not feeling well. She was experiencing some difficulty breathing, lightheadness, tingling all over, sweating. Patient never lost consciousness or fainted; however, there were moments were she couldn''t keep eyes open but upon stimulation she would open them up. Due to difficulty breathing 911 was called. She was transported to ER.


VAERS ID: 1705913 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Head injury, Hypertension, Incontinence, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypertension-Medium, Systemic: Weakness-Medium, Additional Details: Pt fainted within three seconds of receiving J&J vaccine. Slouched down in chair where bowls and urine was released. Guided pt to floor but in that process, pt fell forward hitting his forehead on the bottom of rolling chair. Pt was unresponsive for a total of 10 seconds. Once he came to, feet where elevated on chair and pt layed supine on floor for about 8 minutes. Pt obtained a quarter sized bump on his forehead from fall. once pt left.


VAERS ID: 1705916 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

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

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

Write-up: Error: Booster Given Too Early-


VAERS ID: 1705917 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Arm tingling/numb-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient appeared extremely anxious when going to admit the vaccine. After 115 minutes of monitoring the patient explained she was feeling tingling down her arm. She said she has covid in the past and claimed that "any side effects that occur she was bound to get." She insisted on us calling 911 and was put on a stretcher in an ambulance


VAERS ID: 1705918 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperventilation, Hypotension, Panic attack, Panic disorder, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hyperventilation-Medium, Systemic: Hypotension-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Severe, Additional Details: PER PATIENTS SISTER, THE PATIENT HAS BEEN DIAGNOSED WITH PANIC DISORDER AND SUFFERS FROM PANIC ATTACKS.


VAERS ID: 1705922 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023D21A / 3 LA / IM

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

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

Write-up: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium


VAERS ID: 1705974 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Ear pain, Fatigue, Flushing, Headache, Hyperhidrosis, Illness, Injection site pain, Injection site swelling, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Site: Swelling at Injection Site-Severe, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Fever-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Severe, Systemic: Vomiting-Severe, Additional Details: Patient was out severly sick for 5 days. Experienced severe fatigue, nausea,vomiting, headache, fever and pain at injection site. Arm that it was given in was swollen


VAERS ID: 1705983 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neck pain, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (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: First day swollen face and shooting neck pain down left side of neck


VAERS ID: 1705989 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / IM

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

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

Write-up: Systemic: Lymph Node Swelling-Mild, Additional Details: lemon size bump on left armpit on same side of injection site


VAERS ID: 1705991 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-08-31
Onset:2021-09-09
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

Write-up: Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium


VAERS ID: 1705993 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 3 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (broad)

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

Write-up: Error: Incorrect Reconstitution-


VAERS ID: 1705994 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052321A / 2 LA / IM

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

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

Write-up: Error: Improper Storage (temperature)-


VAERS ID: 1705995 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Paraesthesia, 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Shakiness-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild


VAERS ID: 1705996 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FX3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Fainted about 3 mins after shot administered. blood pressure was low. came to in less than 1 minute. once patient was alert took blood pressure was low so laid patient down with legs elevated and blood pressure returned to normal. patient waited over 40 mins after event in pharmacy then walked around to make sure she was feeling ok then left pharmacy once symptoms resolved


VAERS ID: 1706448 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 3 LA / IM

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

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

Write-up: Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe


VAERS ID: 1706474 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 - HCP N / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Injection site pain, Lip swelling, Malaise, Peripheral swelling, Swelling face, Wheezing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasionally drinks); Allergy to antibiotic; Iodine allergy (had really bad reaction); Non-smoker; Osteoarthritis (rapidly progressing moving too fast); Undifferentiated connective tissue disease (causes a lot of problems)
Preexisting Conditions: Medical History/Concurrent Conditions: Shingles; Comments: The patient was not pregnant at the time of reporting. The patient was on an antiviral drug that patient cannot remember but given for shingles and had no history of drug abuse or illicit drug use. The patient reported that she had fillers on her face. The patient took pain medicine (an OTC).
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210921235

Write-up: SWELLING OF FACE; SWELLING OF TOP LIP/UPPER LIP; FEELING LIKE THERE IS A FEVER WITHOUT A FEVER (FEELING ICKY); MALAISE; MILD HEADACHE; WHEEZING IN BREATHING; HANDS WERE SWOLLEN/SWELLING OF HANDS; VERY LITTLE SORENESS ON THE INJECTION SITE/MILD SORENESS ON THE INJECTION SITE; This spontaneous report received from a patient concerned a 62 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included: shingles, and concurrent conditions included: undifferentiated connective tissue disease, severe osteoarthritis, iodine allergy, alcohol user, non-smoker, and antibiotic allergy, and other pre-existing medical conditions included: The patient was not pregnant at the time of reporting. The patient was on an antiviral drug that patient cannot remember but given for shingles and had no history of drug abuse or illicit drug use. The patient reported that she had fillers on her face. The patient took pain medicine (an OTC). The patient experienced drug allergy when treated with codeine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982 and expiry: UNKNOWN) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination on left deltoid. No concomitant medications were reported. On 09-SEP-2021, the patient experienced very little soreness on the injection site/mild soreness on the injection site. On 11-SEP-2021, the patient experienced hands were swollen/swelling of hands and wheezing in breathing. On 12-SEP-2021, the patient experienced swelling of face, swelling of top lip/upper lip, feeling like there is a fever without a fever (feeling icky), malaise and mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from wheezing in breathing on 11-SEP-2021, and had not recovered from very little soreness on the injection site/mild soreness on the injection site, mild headache, malaise, feeling like there is a fever without a fever (feeling icky), hands were swollen/swelling of hands, swelling of face, and swelling of top lip/upper lip. This report was non-serious.


VAERS ID: 1706485 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204B21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Axillary mass, Blood test, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VALSARTAN
Current Illness: Elevated BP (The patient takes Valsartan 25 mg once daily.)
Preexisting Conditions: Comments: The patient does not have any known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: results not reported
CDC Split Type: USJNJFOC20210921448

Write-up: A BASEBALL SIZE LUMP IN THE RIGHT ARM PIT; MILD HEADACHE; MILD FEVER; This spontaneous report received from a patient concerned a 53 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: elevated bp, and other pre-existing medical conditions included: The patient does not have any known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 204B21A expiry: 11-DEC-2021) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. Concomitant medications included valsartan for elevated bp. On 09-SEP-2021, the patient experienced mild headache. On 09-SEP-2021, the patient experienced mild fever. On 10-SEP-2021, the patient experienced a baseball size lump in the right arm pit. Laboratory data (dates unspecified) included: Blood test (NR: not provided) results not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from mild headache, and mild fever on 11-SEP-2021, and had not recovered from a baseball size lump in the right arm pit. This report was non-serious.


VAERS ID: 1706493 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Injection site erythema, Injection site pain, Injection site swelling, Lethargy, Muscle spasms, Pain, Pain assessment, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Pain scale; Result Unstructured Data: Exceed a 10 on the pain chart
CDC Split Type: USJNJFOC20210921629

Write-up: LETHARGIC; WEAK; SHOT SIGHT PAIN; SEVERE MUSCLE CRAMPS ALL OVER BODY/COULD NOT TELL IF NERVES WERE ON FIRE OR IF MUSCLES HURT OR IF BONES WERE HURTING; WORST PAIN OF LIFE; SHOT SLIGHT REDNESS; SHOT SLIGHT SWELLING; STARTED RUNNING A FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 09-SEP-2021 09:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 09-SEP-2021, the patient experienced severe muscle cramps all over body/could not tell if nerves were on fire or if muscles hurt or if bones were hurting. On 09-SEP-2021, the patient experienced worst pain of life. On 09-SEP-2021, the patient experienced shot slight redness. On 09-SEP-2021, the patient experienced shot slight swelling. On 09-SEP-2021, the patient experienced started running a fever. On 09-SEP-2021, the patient experienced shot sight pain. Laboratory data included: Pain scale (NR: not provided) Exceed a 10 on the pain chart. On 10-SEP-2021, the patient experienced lethargic. On 10-SEP-2021, the patient experienced weak. The action taken with covid-19 vaccine was not applicable. The patient recovered from severe muscle cramps all over body/could not tell if nerves were on fire or if muscles hurt or if bones were hurting on 10-SEP-2021, and the outcome of shot sight pain, shot slight swelling, shot slight redness, started running a fever, weak, lethargic and worst pain of life was not reported. This report was non-serious.


VAERS ID: 1706558 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-09-09
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Eosinophilic esophagitis; Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210925770

Write-up: RASH OVER ANKLES WRISTS AND BACK OF KNEES; FLU LIKE SYMPTOMS/BODY ACHES; MIGRAINE; This spontaneous report received from a patient concerned a 25 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: penicillin allergy, and eosinophilic esophagitis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 09-SEP-2021 for prophylactic vaccination. he batch number was not reported and has been requested. No concomitant medications were reported. On 09-SEP-2021, the patient experienced flu like symptoms/body aches. On 09-SEP-2021, the patient experienced migraine. On 14-SEP-2021, the patient experienced rash over ankles wrists and back of knees. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu like symptoms/body aches, and migraine on SEP-2021, and the outcome of rash over ankles wrists and back of knees was not reported. This report was non-serious.


VAERS ID: 1706902 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Hypotension
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Chest Tightness / Heaviness / Pain-Medium, Additional Details: PT RECEIVED THE 1ST SHOT ON 9/8. STARTED HAVING SXS OF LOW BP AND CHEST PAIN THE NEXT MORNING. WENT TO A HOSPITAL TO RECEIVE TREATMENT


VAERS ID: 1706912 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

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

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


VAERS ID: 1706913 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

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

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

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


VAERS ID: 1706914 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Underdose
SMQs:, Medication errors (broad)

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

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


VAERS ID: 1708248 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-27
Onset:2021-09-09
   Days after vaccination:135
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20641A / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Positive COVID Test


VAERS ID: 1708249 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram normal, Hypoaesthesia, Laboratory test normal, Palpitations
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: None
Current Illness: NOne
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Seen in urgent care ER results not available
CDC Split Type:

Write-up: Within 48 hours she was feeling palpatations that came and went up to 120''s, some SOB and mild left leg numbness, at 72 hours she also was feeling a chest pain. She was seen in the ER and labs EKG reported as normal. She was given fluids and ibuprofen. Seen one week after vaccine and still having numbness of left leg that seems to occur right before the sensation of palpatations and SOB (never over 120) chest pain is no longer as bothersome.


VAERS ID: 1708351 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Period typically lasts 2-3 days. It has now lasted over a week.


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