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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 232 out of 8,010

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VAERS ID: 1734832 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ear swelling, Eye swelling, Myalgia, Neck pain, Pain in extremity, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Eosinophilic pneumonia (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: Tylenol
Current Illness: None
Preexisting Conditions: None
Allergies: codeine
Diagnostic Lab Data: Treated at home with Tylenol & HCI 25 mg Benadryl tablets, Diclofenac Sodium topical gel.
CDC Split Type:

Write-up: Hives , swelling of left ear & eye. Extreme Muscle pain mainly in neck and arm right side and muscle pain throughout my body.


VAERS ID: 1734855 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-30
Onset:2021-09-09
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH TW0179 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash papular
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: Iron Pills 65mg/daily
Current Illness: None
Preexisting Conditions: Iron Deficiency Anemia
Allergies: Compazine and Ice Cream
Diagnostic Lab Data: Urgent Care since rash wasn''t going away. 9/24/2021
CDC Split Type:

Write-up: I developed a rash on my stomach and waist (raised red bumps). This didn''t happen right away, I received the vaccine 8/30/2021 a(not 100% on time I got the rash) and the rash started like September 9th. The rash is still there but it''s finally starting to go away. I did go to Urgent Care on 9/24/21 thinking maybe I had shingles but they said that I didn''t and did prescribe me some cream anyway called triamcinolone.


VAERS ID: 1735118 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-19
Onset:2021-09-09
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / SYR

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

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

Write-up: Employee tested positive for COVID-19


VAERS ID: 1735170 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Cough, Eye irritation, Fatigue, Headache, Hyperhidrosis, Impaired work ability, Malaise, Nausea, Pain, Pyrexia, SARS-CoV-2 test, Swelling
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen and Tylenol
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Covid test 9/25/2021 pending results, expect to be negative.
CDC Split Type:

Write-up: 30 minutes after injection headache started, nausea. That evening headache increase, felt like my head would explode. Temples felt swollen. Eyes burned, 101 fever chills and sweats. Last 2 days. On the second day a developed a deep croupy cough and chest hurt. Every part of my body hurt. Missed another 1/2 day of work due to cough and feeling sick, this was on 9/24/2021. 3 days after receiving the vaccine. Next day 9/25/2021 still coughing, and headache. Feel tired with body aches.


VAERS ID: 1735469 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Complex regional pain syndrome, Condition aggravated, Confusional state, Dizziness, Headache, Hypoaesthesia, Myalgia, Pain, Paraesthesia, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Gabapentin , baclofen, nortriptyline, low dose naltrexone, xanax
Current Illness: N/a
Preexisting Conditions: Crps, migraine, peripheral neuropathy
Allergies: Latex, shellfish, Lyrica, iodine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Muscle pain and weakness. Numbness and tingling throughout entire body, pins and needles throughout body, headache, vomiting. Dizziness, unable to focus eyes. Confusion, intense flare in crps effected limbs, burning pain. Stared day after first injection. It got progressively worse in the days and weeks following. Sought treatment in the e.r. was not able to be seen due to the hospital being too full. Primary care physician booked until October. Sent an email to my specialist and they could also not see me on an emergency basis. Documented through email. Still suffering without treatment.


VAERS ID: 1735472 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-18
Onset:2021-09-09
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NOT SURE / 3 LA / IM

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

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

Write-up: Shingles left arm


VAERS ID: 1735511 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Pain, Psoriatic arthropathy
SMQs:, Arthritis (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Age 52, January 2015, TDap
Other Medications:
Current Illness: Psoriatic Arthritis, Seasonal allergies
Preexisting Conditions: Psoriatic Arthritis
Allergies: Humira injection, Mobic , Wellbutrin, Pepcid, Allegra,neutontin,fish oil, aspirin,zinc, vitamin d, magnesium, calcium, seasonal allergy injections
Diagnostic Lab Data:
CDC Split Type:

Write-up: Psoriatic arthritis pain returned. The pain was under control with Mobic and Humira injections.


VAERS ID: 1735823 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-20
Onset:2021-09-09
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Ringing in my ears


VAERS ID: 1735831 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-06
Onset:2021-09-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Seasonal allergies
Allergies: N/A
Diagnostic Lab Data: N/A because there is no health insurance at this time.
CDC Split Type:

Write-up: Dizziness, vomiting, and fever 3 days after the shot, starting 09/09/2021. Felt a little better the following week, (09/13/2021) then a little better this past week, (09/20/2021) with some Dizziness, light vomiting lingering. Second shot scheduled for 09/27/2021, was asked to hold off until seen by a doctor by the local department of health.


VAERS ID: 1736050 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Falmina birth control
Current Illness: None
Preexisting Conditions: IBS
Allergies: Intolerance to codeine, minocycline and lorazepam
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 10 minutes of vaccination, chest pressure and burning with shortness of breath. This lasted for around 12 hours. I also had extreme fatigue for 2 days


VAERS ID: 1736258 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-02-02
Onset:2021-09-09
   Days after vaccination:219
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Headache, Motor dysfunction, Nausea, Pain in extremity, Pyrexia, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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: ENTYVIO; PREGNENOLONE; ESTROGEN NOS;TESTOSTERONE; PROGESTERONE
Current Illness: Allergy to nuts; Fish allergy; Fruit allergy; Penicillin allergy; Ulcerative colitis (In remission due to Entyvio infusions)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: she was very faint; Diarrhea; weakness; had a fever of 100 degrees; headache; Nausea; Loss use of right hand; sore arm; it was very painful like some stepped on her right hand, hand started hurting and continued to get worse; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (it was very painful like some stepped on her right hand, hand started hurting and continued to get worse), DIZZINESS (she was very faint), MOTOR DYSFUNCTION (Loss use of right hand), DIARRHOEA (Diarrhea) and ASTHENIA (weakness) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014FZ1A, 012M20A and 003A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Penicillin allergy, Allergy to nuts, Fish allergy, Fruit allergy and Ulcerative colitis (In remission due to Entyvio infusions) since May 2019. Concomitant products included VEDOLIZUMAB (ENTYVIO), PREGNENOLONE, ESTROGEN NOS;TESTOSTERONE and PROGESTERONE for an unknown indication. On 02-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021 at 10:15 AM, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced PAIN IN EXTREMITY (it was very painful like some stepped on her right hand, hand started hurting and continued to get worse) and VACCINATION SITE PAIN (sore arm). On 09-Sep-2021 at 4:00 PM, the patient experienced MOTOR DYSFUNCTION (Loss use of right hand). On an unknown date, the patient experienced DIZZINESS (she was very faint), DIARRHOEA (Diarrhea), ASTHENIA (weakness), PYREXIA (had a fever of 100 degrees), HEADACHE (headache) and NAUSEA (Nausea). On 10-Sep-2021, PAIN IN EXTREMITY (it was very painful like some stepped on her right hand, hand started hurting and continued to get worse), MOTOR DYSFUNCTION (Loss use of right hand) and VACCINATION SITE PAIN (sore arm) had resolved. At the time of the report, DIZZINESS (she was very faint), DIARRHOEA (Diarrhea), ASTHENIA (weakness), PYREXIA (had a fever of 100 degrees), HEADACHE (headache) and NAUSEA (Nausea) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medication included Thyroid, Desiccated taken daily orally started in year 2011 No treatment information was not provided. Patient reported to have taken an Entyvio infusion earlier that same week on 9/7/2021. Most recent FOLLOW-UP information incorporated above includes: On 21-Sep-2021: Follow up received on 21-09-2021 contains significant information: Event information, Concomitant medication, Patient history updated, Batch number updated


VAERS ID: 1736477 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Diarrhea-Medium, Systemic: Fever-Medium, Systemic: Vomiting-Severe


VAERS ID: 1736822 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8UU8 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Agitation, Asthenia, Fatigue, Fear, Headache, Hyperhidrosis, Nausea, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Real Puffy Face, Excessive Sweating, Severe Fatigue, Extreme Agitation, Fluctuating Fever, Nausea, Debilitating Headaches, afraid.


VAERS ID: 1736852 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Gait inability, Pain in extremity, Peripheral swelling, Thrombosis, Ultrasound Doppler abnormal, Wheelchair user
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
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: Fish oil, one a day, magnesium, lexapro, lisinopril, metoprolol, amlodipine
Current Illness: HTN, Anxiety, Hyperlipidemia, Hypomagnesemia
Preexisting Conditions:
Allergies: KNDA
Diagnostic Lab Data: 9/20/21: Vas lower EXT right: positive exam, acute occlusive DVT throughout right thigh, knee, and calf. 9/23/21: Vas lower Ext LEFT: negative
CDC Split Type:

Write-up: Pt reported immediately after rec''ing vaccine develped sever pain in left arm , which extended to bilateral legs. Pt was seen at Urgent care on 9/20/2021: dx with Large thrombosis of right calf to thigh, eloquis initiated. Pt has since has pain and swelling spread to both legs and feet is unable to walk on her own, is currently having to use a wheelchair. Pt was seen on 9/21/2021 at PCP office, was referred to Vascular (Dr.) Pt has been seen by vascular 9/24/2021: continue eliquis, start ASA 81mg, compression hose, and followup 9/29/2021.


VAERS ID: 1736924 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstrual disorder, Menstruation irregular
SMQs:, Fertility 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: Vitamin D3, Milk Thistle, Berberine, Magnesium, Lysine
Current Illness: None
Preexisting Conditions: None
Allergies: Tahini allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Menstrual Cycle, which is ALWAYS extremely regular and fluctuates at most by 1 day in either direction, arrived 11 days early - which was 8 days post 1st vaccine shot. It proceeded to last 8 days, although it was more mild and less flow than a normal period.


VAERS ID: 1737115 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-23
Onset:2021-09-09
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Rapid test collected 9-9-2021, resulted positive
CDC Split Type:

Write-up: asymptomatic


VAERS ID: 1737284 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-09-09
   Days after vaccination:182
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 3 - / -

Administered by: Private       Purchased by: ?
Symptoms: Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol Amloride aspirin atorvastatin azelastine nasal bifidobacterium-lactobacillus biotin Symbicort Calcium-Vitamin D Carvediol Clonazpam Clopidogrel Persantine Duloxetine fluticasone nasal furosemide hydrochlorothiazide insulin levothy
Current Illness:
Preexisting Conditions: Patient admitted for CABG and MVR surgery, history of CAD, MI, PAD, diabetes, asthma, hypertension, hyperlipidemia, hypothyroidism, sleep apnea, Barrett''s esophagur
Allergies: Diamox
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccines 3/11/21, 4/8/21, and 8/19/21 according to data base. Patient was admitted to hospital 9/9/21 for elective CABG and MVR surgery. When patient was opened in OR pericarditis was found and noted in the patient operative report. Patient did not report any recent viral/infectious illness in the month leading up to surgery.


VAERS ID: 1737315 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Malaise, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: Trulance
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None to date.
CDC Split Type:

Write-up: After receiving the vaccine I felt sick, which I thought was normal. The issue I?m having is still pain at injection site that I can still feel down my left arm. This is two weeks AFTER the injection.


VAERS ID: 1737628 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chest discomfort, Condition aggravated, Cough, Dizziness, Dyspnoea, Fatigue, Headache, Pain in extremity, Peripheral swelling, Throat clearing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer Covid 19 vaccine 57 yrs old, 01/13/2021
Other Medications: Topomax, Lexapro, Benedryl
Current Illness: none
Preexisting Conditions: asthma, anxiety, seasonal allergies/hay fever
Allergies: Compazine, Simvastatin, Sulfites, Penicillin,Pfizer Cov 19 vac
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine given, 20 min later chest tightening, cough, breathing difficulty. EPI-Pen administered. Chest still tight, nebulizer treatment. 30 min later ambulance to the Emergency Room. Received IV benedryl, IV steroids. Observation x 2.5 hours then discharged home. Fatigue x 3 weeks and counting. Asthma flare ups daily x 2.5 weeks. Increased need for Albuteral inhaler, now using Alvesco inhaler daily. Sporadic dizzyness upon standing since 09/09/2021 after vaccine. Dull headache. Noticed small area of swelling and pain in lower left leg, no bruise or injury to that area.


VAERS ID: 1737642 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood test, Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Headache, light headed, dizzy, nausea


VAERS ID: 1740031 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-26
Onset:2021-09-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood test, Dizziness, Intermenstrual bleeding, Menstruation irregular, Multiple sclerosis, Muscular weakness, Physical examination
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Demyelination (narrow), Vestibular disorders (broad), Fertility disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Multiple sclerosis; Reaction to previous exposure to any vaccine
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Blood work; Result Unstructured Data: blood work with no abnormal findings.; Test Date: 202109; Test Name: physical exam; Result Unstructured Data: weaker than normal
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Irregular menses; lots of spotting recently; Dizziness; Exacerbation of her multiple sclerosis; Progressive leg weakness; Weaker than normal; This spontaneous case was reported by a physician and describes the occurrence of MULTIPLE SCLEROSIS (Exacerbation of her multiple sclerosis) in a 51-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Multiple sclerosis and Reaction to previous exposure to any vaccine. On 26-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Sep-2021, the patient experienced MULTIPLE SCLEROSIS (Exacerbation of her multiple sclerosis) (seriousness criterion medically significant), MUSCULAR WEAKNESS (Progressive leg weakness), ASTHENIA (Weaker than normal) and DIZZINESS (Dizziness). On an unknown date, the patient experienced MENSTRUATION IRREGULAR (Irregular menses) and INTERMENSTRUAL BLEEDING (lots of spotting recently). The patient was treated with METHYLPREDNISOLONE SODIUM SUCCINATE (SOLUMEDROL) for Adverse event, at an unspecified dose and frequency. At the time of the report, MULTIPLE SCLEROSIS (Exacerbation of her multiple sclerosis), MUSCULAR WEAKNESS (Progressive leg weakness), ASTHENIA (Weaker than normal), MENSTRUATION IRREGULAR (Irregular menses), INTERMENSTRUAL BLEEDING (lots of spotting recently) and DIZZINESS (Dizziness) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In September 2021, Blood test: normal (normal) blood work with no abnormal findings.. In September 2021, Physical examination: abnormal (abnormal) weaker than normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication information provided. For the past 7 days Patient had experienced progressive leg weakness and dizziness. Leg weakness was mostly over the past 48 hours, and felt similar to past MS exacerbations. Reported that, brain and spine MRI ordered but those have not been done yet. Patient''s husband does not think patient was pregnant. Patient had a known prior vaccine sensitivity but was instructed by neurologist to get the vaccine anyways. Company comment: This case concerns a patient of 51-year-old female patient with relevant medical history of who experienced the unexpected event of Exacerbation of her multiple sclerosis. The event occurred 14 days after the first dose of the administration of mRNA-1273. The rechallenge was not applicable considering that the patient was not eligible for second dose at the time of the events. Causality for the reported events was not provided by the reporter. The benefit-risk relationship of mRNA-1273 is not affected by this report. Some vaccines have been found to be associated with reactivation of some immune mediated diseases.; Sender''s Comments: This case concerns a patient of 51-year-old female patient with relevant medical history of who experienced the unexpected event of Exacerbation of her multiple sclerosis. The event occurred 14 days after the first dose of the administration of mRNA-1273. The rechallenge was not applicable considering that the patient was not eligible for second dose at the time of the events. Causality for the reported events was not provided by the reporter. The benefit-risk relationship of mRNA-1273 is not affected by this report. Some vaccines have been found to be associated with reactivation of some immune mediated diseases.


VAERS ID: 1740164 (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: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Confusional state, Dizziness, Feeling abnormal, Laboratory test, Paraesthesia, SARS-CoV-2 test
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, she was diagnosed with COVID-19)
Allergies:
Diagnostic Lab Data: Test Name: laboratory work; Result Unstructured Data: Test Result:unknown results; Test Date: 20210906; Test Name: Pcr; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101199031

Write-up: Confusions; Dizziness; Weakness in lower extremities; Back pain; Tingling legs and arms; Brain fog; This is a spontaneous report from a contactable Other HCP (patient herself). A 32-year-old female patient (not pregnant) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number unknown), via an unspecified route administered in the arm, on 01Sep2021 (at the age of 32-year-old) at single dose for COVID-19 immunisation. Historical vaccination includes the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number unknown), via an unspecified route administered in the left arm, on unknown date at single dose for COVID-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Relevant medical history included COVID-19 on unknown date (before vaccination). No known allergies. The patient did not have concomitant medications. On 09Sep2021 at 16:45, 8 days after the shot she suffering with confusions and dizziness. She was in the emergency room with weakness in lower extremities, back pain and tingling legs and arms. The events were reported as non-serious. It was reported that the events required also physician office visit. Therapeutic measures taken as result of events included intravenous (IV) fluids, dizziness medications, ketorolac tromethamine (TORADOL). Laboratory work was done but results were not provided. On 06Sep2021, a PCR Nasal swab was done and resulted negative. The patient was recovering from back pain while she had not recovered from the other events. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Based on plausible dose- event relationship post-vaccination the causal role of BNT162B2 vaccine cannot be excluded for the reported events The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate


VAERS ID: 1740178 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-09-01
Onset:2021-09-09
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Private       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101206565

Write-up: I have broken out in a serious rash from head to toe; This is a spontaneous report from a contactable consumer (patient). A 39-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in the right arm on 01Sep2021 10:00 (at the age of 39-year-old) (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Relevant medical history included asthma and penicillin allergy. There were no concomitant medications. The patient had broken out in a serious rash from head to toe (medically significant) on 09Sep2021 12:00 with outcome of not recovered. Within 10 days of receiving then vaccine, the patient had broken out in a serious rash from head to toe, he has been seen in the Emergency Room, where a benadryl shot and a steroid shot was given to him; he has seen no relief from either. The patient never had a rash like this in his entire life. The event resulted in Doctor or other healthcare professional office/clinic visit and Emergency room/department or urgent care. If covid prior vaccination: No. If covid tested post vaccination: No. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.


VAERS ID: 1740849 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-19
Onset:2021-09-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose increased, Chest X-ray normal, Chest pain, Cough, Dyspnoea, Electrocardiogram abnormal, Leukocytosis, Pneumonia, SARS-CoV-2 test, Tachycardia, Troponin
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), 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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol (PROVENTIL, VENTOLIN, PROAIR) HFA 108 (90 Base) MCG/ACT INHAL Aero Soln inhale 2 Puffs into the lungs as needed for FOR SHORTNESS OF BREATH. (disp insurance-pref prod) 9/9/2021 Unknown time Med Note ( Fri Sep 10, 2021) Last
Current Illness: Past Medical History: Diagnosis Date ? Anemia ? CHF (congestive heart failure) preserved EF ? CKD (chronic kidney disease) stage 4, GFR 15-29 ml/min ? Diabetes mellitus ? Hypertension ? Obesity
Preexisting Conditions: Past Medical History: Diagnosis Date ? Anemia ? CHF (congestive heart failure) preserved EF ? CKD (chronic kidney disease) stage 4, GFR 15-29 ml/min ? Diabetes mellitus ? Hypertension ? Obesity
Allergies: Iodine Hives
Diagnostic Lab Data: Status: Final result Visible to patient: No (inaccessible) Next appt: None Specimen Information: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19) Not Detected Detected Abnormal Narrative The SARS-CoV-2 (COVID-19) test is for in vitro diagnostic use under the FDA for laboratories certified to perform high complexity testing. This test has not been FDA cleared or approved. Methodology: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (PCR). Specimen Collected: 08/23/21 Last Resulted: 08/23/21
CDC Split Type:

Write-up: This is a 88y.o. female The patient has a past medical history of congestive heart failure anemia CKD diabetes mellitus hypertension the patient comes in secondary shortness of breath has been experiencing intermittent shortness of breath from almost greater than 2 months the patient has been getting worse with cough nonproductive sputum the patient has any chest pain. Patient was also recently treated for underlying pneumonia at hospital. In the ED the patient''s labs were obtained the patient''s glucose 264 troponin 0.04 troponin On further repeat was 0.10 patient leukocytosis was noted. Patient''s chest x-ray did not show any acute cardiopulmonary process EKG shows tachycardia patient was given DuoNebs aspirin hydralazine labetalol Solu-Medrol and placed on heparin infusion


VAERS ID: 1740914 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole 40mg
Current Illness: none
Preexisting Conditions: Acid Reflux
Allergies: none
Diagnostic Lab Data: no tests yet, awaiting appointment
CDC Split Type:

Write-up: Diarrhea for 3 weeks straight after the vaccine


VAERS ID: 1740951 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-31
Onset:2021-09-09
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Basophil count normal, Basophil percentage, Differential white blood cell count, Dysmenorrhoea, Eosinophil count normal, Eosinophil percentage, Fatigue, Full blood count, Haematocrit normal, Haemoglobin normal, Heavy menstrual bleeding, Immature granulocyte count, Intermenstrual bleeding, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin decreased, Mean cell volume decreased, Monocyte count normal, Monocyte percentage, Neutrophil count normal, Neutrophil percentage, Pallor, Platelet count normal, Red blood cell count normal, Red cell distribution width increased, Thrombosis, White blood cell count normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Hypotonic-hyporesponsive episode (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: Norethindrone acetate and ethinyl estradiol tablets and ferrous fumarate tablets
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hemoglobin test CBC With Differential/Platelet WBC 6.6 3.4 x10E3/uL 10.8 x10E3/uL RBC 5.22 3.77 x10E6/uL 5.28 x10E6/uL Hemoglobin 12.9 11.1 g/dL 15.9 g/dL Hematocrit 41.4 34.0 % 46.6 % MCV 79 79 fL 97 fL MCH 24.7 - Low 26.6 pg 33.0 pg MCHC 31.2 - Low 31.5 g/dL 35.7 g/dL RDW 16.2 - High 11.7 % 15.4 % Platelets 353 150 x10E3/uL 450 x10E3/uL Neutrophils 58 Not Estab. % Lymphs 34 Not Estab. % Monocytes 6 Not Estab. % Eos 1 Not Estab. % Basos 1 Not Estab. % Neutrophils (Absolute) 3.8 1.4 x10E3/uL 7.0 x10E3/uL Lymphs (Absolute) 2.2 0.7 x10E3/uL 3.1 x10E3/uL Monocytes(Absolute) 0.4 0.1 x10E3/uL 0.9 x10E3/uL Eos (Absolute) 0.1 0.0 x10E3/uL 0.4 x10E3/uL Baso (Absolute) 0.1 0.0 x10E3/uL 0.2 x10E3/uL Immature Granulocytes 0 Not Estab. % Immature Grans (Abs) 0.0 0.0 x10E3/uL 0.1 x10E3/uL
CDC Split Type:

Write-up: Began heavy flow menstruation with large clots, two weeks before cycle was to begin. Bled through super heavy tampons within an hour for 12 days straight. Clots passed were larger than a coin at each time of changing tampon. Severe cramping, fatigue and pale skin. Symptoms lessened but period continued for a total of 17 days


VAERS ID: 1741019 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 3 RA / 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? 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: Right axillary lymphadenopathy occurred about 24 hours after vaccination, worsened at 36-48 hours, then began to improve over the next 5 days.


VAERS ID: 1741207 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-26
Onset:2021-09-09
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, COVID-19, Chest X-ray, Computerised tomogram thorax, Diarrhoea, Dyspnoea, Fatigue, Nausea, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol HFA 108 (90 Base) MCG/ACT inhaler INHALE 2 INHALATION BY MOUTH EVERY 4 HOURS AS NEEDED alendronate (FOSAMAX) 70 MG tablet Take 1 tablet by mouth every 7 days. Ascorbic Acid (VITAMIN C) 500 MG tablet Take 500 mg by mouth 2 (two) t
Current Illness: No known
Preexisting Conditions: 9/9/21-hx of PAF on Eliquis and who was vaccinated against COVID-19 earlier this month, was admitted to NBH for + COVID-19 and a lung mass. Hyponatremia Sodium 121 on admission Allergic rhinitis ? Asthma ? BPH (benign prostatic hyperplasia) ? Chronic sinus infection ? Diverticulosis ? Hearing loss LEFT EAR/HAS HEARING AID USES PRN ? History of chicken pox MEASLES, MUMPS AS A CHILD ? History of pneumonia ? Hyperlipidemia ? Insomnia ? Lower back pain ? Neck pain DDD ? OSA on CPAP ? Osteopenia ? Osteoporosis 10/15/2012 ? Paroxysmal atrial fibrillation ? Pseudomonas aeruginosa infection SINUSES/DIAGNOSED X 8-9 YEARS/CURRENTLY HAS ? Swelling of both ankles
Allergies: Penicillins
Diagnostic Lab Data: 9/9/21- COVID-19 Result Detected 9/9/21-CT CHEST W/O CONTRAST DATE: 9/9/2021 4:45 PM CLINICAL HISTORY: lung nodule; COVID-19 +. COMPARISONS: CT chest October 30, 2014, chest x-ray September 9, 2021 Technique: Noncontrast CT images of the chest are provided. Dose reduction technique was utilized per ALARA protocol. FINDINGS: Centered in the superior aspect of the right lower lobe is a 4.2 x 2.1 cm mass. There is focal abutment of the pleura. Surrounding groundglass predominantly extending inferiorly is suspicious for additional areas of neoplasm. A pleural-based pulmonary nodule on series 2 image 62 is stable. Partially calcified nodules in the right lower lobe are not significant change in the prior. There is subtle increased linear bandlike interstitial thickening adjacent to these nodules, however there are several foci of calcification within it which would favor a chronic process. Small pleural nodule in the left series 2 image 79 is stable. Calcified pleural plaques in the apices are unchanged. There are chronic right hilar and mediastinal calcified lymph nodes. No discrete new hilar or mediastinal adenopathy is evident within the limits of noncontrast technique. Multiple midthoracic compression fractures are not significant change from the prior. Lucency of the inferior aspect of the T3 vertebral body appears chronic. Visualized upper abdomen is unremarkable. Coronary artery calcifications are present. 1.IMPRESSION: 2.There is a 4.2 x 2.1 cm mass in the superior aspect of the right lower lobe consistent with carcinoma. Adjacent areas of groundglass attenuation predominantly extending caudally are nonspecific but are suspicious for additional areas of neoplastic involvement. No discrete mediastinal or hilar adenopathy. 3.Numerous scattered nodules including cluster of calcified nodules in the right lower lobe. Adjacent to these calcified nodules there is an area of increased bandlike interstitial thickening which is favored to be chronic. Chronic calcified pleural plaques in the apices. 4.Chronic midthoracic compression fractures. 5.Coronary artery atherosclerosis. 9/9/21-09/09/2021 at 1009 hours HISTORY: Fatigue. COMPARISON: Chest x-ray performed on December 20, 2018 FINDINGS: There is been interval development of a right perihilar nodule. This measures 3.0 x 3.2 cm. The lungs are hyperexpanded. The heart size within normal limits. There is no evidence of pneumothorax or pleural effusion. Mild biapical pleural scarring is demonstrated. IMPRESSION: Interval development of a right perihilar pulmonary nodule. This measures 3.0 x 3.2 cm. CT of the chest would be best able to evaluate.
CDC Split Type:

Write-up: 9/9/21-77 y/o male with hx of PAF, HTN and hyperlipidemia presents body aches, SOB, and fatigue. He recently traveled with his wife. Last Thursday, he started to feel fatigued and lost his taste. He also started developing SOB. He returned and called his ENT who prescribed him Cipro and steroids due to hx of Pseudomonas sinus infection. Despite taken these meds, he hasn''t felt any better. He admits to nausea, but no vomiting. He is having loose stools. Review of Systems: Constitutional: Denies fever or chills Eyes: Denies change in visual acuity HENT: Denies nasal congestion or sore throat Respiratory: + dry cough + SOB Cardiovascular: Denies chest pain, palpitations, or edema GI: Denies bloody stools GU: Denies dysuria Musculoskeletal: Denies back pain or joint pain Integument: Denies rash Neurologic: Denies headache, focal weakness or sensory changes Endocrine: Denies polyuria or polydipsia Lymphatic: Denies swollen glands Psychiatric: Denies depression or anxiety


VAERS ID: 1741330 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-09-09
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Hypertension, Urinary tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: Ursodiol 300 mg 3 times a day Synthroid 150 mg 1 time per day calcium 500 mg 2 times per day d3 2000 mg 1 per day
Current Illness: none
Preexisting Conditions: thalassemia trait
Allergies: Omnicef Kenalog Lidocaine Marcaine raw almonds raw cherried
Diagnostic Lab Data:
CDC Split Type:

Write-up: In September i was diagnosed with High Blood pressure and a UTI. Have not had high blood pressure prior to vaccine or UTI. Not sure if these are related to Moderna vaccine or not.


VAERS ID: 1741623 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-02-16
Onset:2021-09-09
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

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

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

Write-up: hospitalization with covid after being fully vaccinated


VAERS ID: 1741668 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-09
Onset:2021-09-09
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Anaemia, Blood thyroid stimulating hormone, Full blood count, Hypochromasia, Lipids, Macrocytosis, Menstruation delayed, Metabolic function test, Platelet count increased, Poikilocytosis
SMQs:, Haematopoietic erythropenia (broad), Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: no known allergies
Diagnostic Lab Data: CMP, CBC, Lipid profile, TSH
CDC Split Type:

Write-up: For the past 26 years I have had a strict 28 menstrual cycle. 28 days every month, without fail. I have not had a period since the initial vaccination. It was due to begin 9/9/21. It is now 9/28/21. While this is a relief for me, for a woman in her child bearing years this would be greatly concerning. More research needs to be conducted on the effects of these vaccinations on women''s menstrual cycles. I have also had labs conducted recently due to my hypertensive concerns and the results are as follows: mycrocytotis, hypchromia, platelet increase, poikilocytosis. Essentially this means that I have too many platelets, and too many small, pale, oddly shaped red blood cells. I''m anemic. I only mention due to having had these labs drawn post vaccination.


VAERS ID: 1741986 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event
SMQs:

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: cologne, lilacs, lilies, penicillin, cinnamon
Diagnostic Lab Data: ambulance transport by local EMS
CDC Split Type:

Write-up: Client ambulated on her own to clinic check-in and stated that she wanted her vaccine but was also anxious about receiving it. During the pre-screening she stated she had history of anaphylaxis to the following: cinnamon, lilacs, lilies and colognes but no other substances. She filled out the rest of her paperwork without assistance; there were no documented reasons to refuse vaccine administration. She ambulated normally to vaccination station and received vaccine without complications and then ambulates self to observation area for normal 15 minute observation period. After normal 15 minute observation period was over she was noticed by clinic staff to not look well: she was pale and looked "sick". Clinic staff questioned her about how she felt and stated that she, "felt woozy". Staff brought cot to her side and she sat down and stated she felt like her throat was closing so staff immediately called emergency number for EMS assistance. Client started to list to her left side and staff aided her in laying down, she did not lose consciousness. Staff retrieved cool packs for her and helped her to remain still until EMS arrived. Prior to EMS arrival staff see red blotchy patches appear on her neck and chest and she again stated that she felt "foggy". Epinephrine was prepared for administration but was never given. Fire EMS arrives at 1747 hrs who assess until ambulance arrives shortly later. No difficulty breathing was found and she developed no signs of wheezing or rales. She is overheard by clinic staff to admit to Fire personnel that she has anaphylaxis to penicillin, this is not declared on her written paperwork or to clinic staff at time of check-in. V/S: 1738 hrs BP 159/62 P 110 bounding 1740 hrs BP 155/81 P 118 bounding


VAERS ID: 1742186 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 6 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Blood pressure increased, Blood test normal, Echocardiogram normal, Electrocardiogram normal, Extra dose administered, Extrasystoles
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Tachyarrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (narrow), Medication errors (narrow), 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: MULTI VITAMINS D3 ZINC C B COMPLEX
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: ALL TEST NEGATIVE FOR HEART ISSUES, EKG ECHOCARDIGRAM, BLOOD WORK DONE FOR HEART ATTACK.
CDC Split Type:

Write-up: SHARP ELECTRICAL TYPE PAIN IN HEART / AREA. SPLIT SECOND PAIN THAT CAME ON INTERMITENT LASTING UP TO 20 MINUTES. HEART DID STOP BEATING ONCE WHILE SHARP PAIN CAME ON SPLIT SECOND THEN STARTED. BLOOD PRESSURE WAS ELEVATED TO 180 OVER 60 FOR EVENING ON 9/12/21. SYMPTOMS STOPPED 926/21


VAERS ID: 1744152 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-09-09
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Condition aggravated, Feeding disorder, Nausea, Pancreatitis, SARS-CoV-2 test
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: APIXABAN (ELIQUIS) 5 MG PO TAB take 1 Tablet by mouth twice daily. ASPIRIN 81 MG PO CHEW TAB take 81 mg by mouth once daily. ATORVASTATIN (LIPITOR) 80 MG PO TAB take 1 Tablet by mouth once every night at bedtime. GLIPIZIDE (
Current Illness: Acute pancreatitis 05/15/2018 ? Bilateral pulmonary embolism 01/09/2018 ? GERD (gastroesophageal reflux disease) ? Hypercholesterolemia ? Hypertension ? Leg DVT (deep venous thromboembolism), acute, left 01/09/2018 ? Renal stone Feb 2004 ? Type 2 diabetes mellitus
Preexisting Conditions: Acute pancreatitis 05/15/2018 ? Bilateral pulmonary embolism 01/09/2018 ? GERD (gastroesophageal reflux disease) ? Hypercholesterolemia ? Hypertension ? Leg DVT (deep venous thromboembolism), acute, left 01/09/2018 ? Renal stone Feb 2004 ? Type 2 diabetes mellitus
Allergies: No Known Allergies
Diagnostic Lab Data: SARS-COV-2 (COVID-19) by NAA, Micro Status: Final result Visible to patient: Yes (seen) Next appt: 10/01/2021 at 02:20 PM in Internal Medicine Specimen Information: Nasopharyngeal; Swab 0 Result Notes Ref Range & Units SARS-CoV-2 (COVID-19) by NAA, Micro Not Detected Detected Abnormal Narrative The SARS-CoV-2 (COVID-19) by NAA test is for in vitro diagnostic use under the FDA Emergency Use Authorization (EUA) for laboratories certified to perform high complexity testing. This test has not been FDA cleared or approved. Methodology: Nucleic Acid Amplification (NAA)/Polymerase Chain Reaction (PCR). Specimen Collected: 09/12/21 5:55 PM Last Resulted: 09/12/21 6:56 PM
CDC Split Type:

Write-up: This is a 60-year-old male thats presents to the ED complaining of back pain as well as abdominal pain. Onset of symptoms within the past 3 days. States that he drove up to his cottage 3 days prior & developed symptoms on arrival. He has not been able to eat for the past 3 days. There is associated nausea but no vomiting or diarrhea. He has recurrent bouts of pancreatitis, but is unsure of the cause. He denies alcohol use. He states he is vaccinated for COVID with Pfizer. Review of Systems Constitutional: Negative for chills, fatigue and fever. HENT: Negative for facial swelling and trouble swallowing. Respiratory: Negative for cough, shortness of breath and wheezing. Cardiovascular: Negative for chest pain and palpitations. Gastrointestinal: Positive for abdominal pain. Negative for diarrhea, nausea and vomiting. Genitourinary: Negative for dysuria and frequency. Musculoskeletal: Positive for back pain (right paraspinal thoracic). Negative for neck pain. Skin: Negative for rash and wound. Neurological: Negative for weakness, light-headedness and headaches. Psychiatric/Behavioral: Negative for confusion. The patient is not nervous/anxious.


VAERS ID: 1744155 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control, anxiety meds
Current Illness: Strep throat prior to vaccine
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever of 104. Chills and shaking throughout the night. Fever went down after a day and a half. Body weakness and headache took three days to go away.


VAERS ID: 1744363 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-08-25
Onset:2021-09-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Electrocardiogram normal, Hepatic enzyme increased, Joint swelling, Oedema peripheral, Peripheral swelling, Rhabdomyolysis, X-ray limb abnormal
SMQs:, Rhabdomyolysis/myopathy (narrow), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methylphenidate hydrochloride CD 60 mg XR, Albuterol
Current Illness: n/a
Preexisting Conditions: ADHD, asthma
Allergies: Penicillins, decadron, omnicef
Diagnostic Lab Data: 9/13/21 XR radius Ulna (nearly healed distal and ulnar fractures. Subcutaneous edematous change in the proximal forearm. 9/13/21 EKG normal
CDC Split Type:

Write-up: Had Rhabdomyolysis with swelling from shoulder to wrist of the left arm 19 days after his 2nd Covid vaccine had been given in the same arm. He had done a workout with small weights the day before, his liver enzymes were also increased after 2 days of hospitalizations and hydration the CK dropped to acceptable levels. His arm was also broken at the wrist on the same side 2 months prior to the vaccination. His other arm did the same workout routine and never had swelling or pain.


VAERS ID: 1744424 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-03
Onset:2021-09-09
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Ageusia, Anosmia, COVID-19, Cough, Fatigue, Headache, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: PCR collected on 9-15-2021 and positive.
CDC Split Type:

Write-up: runny nose, cough, headache, fatigue, abdominal pain, loss of taste and smell


VAERS ID: 1744682 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adverse drug reaction, Chest pain, Dyspnoea, Feeling abnormal, Headache, Heavy menstrual bleeding, Hypoaesthesia, Menstruation irregular, Oligomenorrhoea, Paraesthesia, SARS-CoV-2 test negative, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Fertility disorders (broad), Hypoglycaemia (broad), COVID-19 (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: No.
Current Illness: No.
Preexisting Conditions: No.
Allergies: No.
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I went to get my first shot of the covid vaccine on 9/8/21 I was not sick. I got the shot and immediately after getting the shot that next morning I started to feel and experience things that weren''t and aren''t normal in me. I started to get chest pains, shortness of breath, numbness in my left arm, and started my menstrual cycle two weeks early. My menstrual cycle was very heavy and clotty. I just stopped my cycle 9/20/21. I have started to experience blurriness in my vision and my arm will go numb with pins and needle feeling in my hand that shoots up to my elbow that last no longer than a minute. I experience sharp pains in my chest that nearly bring me to my knees. I get short of breathe easily and especially in the shower. I was tested for covid many times and all came back negative. I have frequent headaches, which I never get. These side effects that I have been feeling have only started the day after I got my first covid vaccine (Moderna). I am a very healthy young women.


VAERS ID: 1744998 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF 2588 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre 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? 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: Sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 100 degrees. Chills & sweating. Headache. Achiness, weakness, and fatigue.


VAERS ID: 1745023 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-04
Onset:2021-09-09
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ECO0217 / UNK LA / IM

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

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

Write-up: I experienced shingles.


VAERS ID: 1745052 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-23
Onset:2021-09-09
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Drainage, Echocardiogram abnormal, Intensive care, Pericardial effusion, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis Stage 4 cervical cancer
Allergies:
Diagnostic Lab Data: 2D echo Cardiac ICU admission
CDC Split Type:

Write-up: Pericarditis and pericardial effusion requiring drainage


VAERS ID: 1745109 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Ear pain, Facial paralysis, Hypoaesthesia, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Arthritis (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: saw a provider for sore throat and swollen tonsils with 3weeks of the vaccine
Preexisting Conditions: NA
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient experience unilateral droopiness, numbness, and tingling in the face; neck and ear pain, one week after vaccine, and was rushed to ER. A diagnosis of Bells Palsy and treated with oral steroid x 6-7 days and acyclovir x 10 days.


VAERS ID: 1745140 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Hypoaesthesia, Injection site erythema, Injection site nodule, Injection site swelling, Lymphadenopathy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: KNOT/REDNESS/SWELLING LOCALLY THE DAY AFTER EVENT, LASTED 4 DAYS. NUMBNESS ON SAME SIDE AS VACCINE MIDDLE FINGER HAPPENED 2 DAYS AFTER, LASTED 3-4 DAYS. SWOLLEN LYMPH NODES ON VACCINE SIDE HAPPENED 2 DAYS AFTER , LASTED 3-4 DAYS. LOWER BACK WEAKNESS HAPPENED THE DAY AFTER, LASTED 3-4 DAYS.


VAERS ID: 1745200 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Mobility decreased, Peripheral swelling, Pruritus, Rash, Skin irritation, Skin oedema, Skin tightness, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Moderna vaccine 009C21 2ND DOSE
Current Illness: NONE
Preexisting Conditions: Blood Pressure labile , mild palpitations
Allergies: Sulfur drugs, Bee stings, Syntetic Vit A, breakthrough reaction to Iodine CT contrast
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: my arm started to swell the 2nd day after shot, it swelled from shoulder down to elbow and I couldnt bend it or touch it. It was hot , red, tender to touch and a rash happened near to shoulder which was irritating. The skin was tight and edematous. It lasted more then a week... it sure was itchy like because of the skin being so tight. I could not really bend my arm.


VAERS ID: 1745459 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-25
Onset:2021-09-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anaemia, Anion gap, Aspartate aminotransferase increased, Barbiturates negative, Basophil percentage decreased, Benzodiazepine drug level, Bilirubin conjugated increased, Bilirubin urine, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate decreased, Blood bilirubin increased, Blood calcium decreased, Blood chloride normal, Blood cholesterol normal, Blood creatinine normal, Blood ethanol normal, Blood glucose normal, Blood lactate dehydrogenase increased, Blood lactic acid, Blood magnesium normal, Blood pH normal, Blood phosphorus normal, Blood potassium normal, Blood sodium decreased, Blood triglycerides normal, Blood urea normal, Brain natriuretic peptide increased, C-reactive protein normal, COVID-19, Carbon dioxide decreased, Computerised tomogram head normal, Condition aggravated, Drug screen negative, Eosinophil percentage, Fibrin D dimer, Glomerular filtration rate decreased, Glucose urine absent, Haematocrit decreased, Haemoglobin decreased, High density lipoprotein decreased, Hypoglycaemia, Hypophagia, Immature granulocyte count, Immunosuppression, International normalised ratio increased, Lipase normal, Low density lipoprotein normal, Lymphocyte percentage decreased, Mean cell volume increased, Mental status changes, Monocyte percentage, Neutropenia, Neutrophil count normal, Neutrophil percentage increased, Nitrite urine absent, PCO2 decreased, PO2 normal, Platelet count decreased, Protein total decreased, Prothrombin time prolonged, Red blood cell count decreased, Red cell distribution width increased, SARS-CoV-2 test positive, Serum ferritin increased, Specific gravity urine normal, Staphylococcus test, Tachypnoea, Thrombocytopenia, Transaminases increased, Troponin I normal, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine, White blood cell count decreased, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Asthma/bronchospasm (broad), Dyslipidaemia (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (narrow), Dementia (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications: confirmed with Patient Prior to Admission Medications Outpatient Home Medications Taking? Alendronate (FOSAMAX) 70 mg Oral Tab Takes Regularly Sig: Take 1 tablet by mouth every week on Saturday Azithromycin (ZITHROMA
Current Illness: Hypoglycemia
Preexisting Conditions: h/o type II DM, OSA, HTN and idiopathic pulmonary fibrosis s/p double lung transplant (8/8/16) on Myfortic, tacrolimus, prednisone
Allergies: nkda
Diagnostic Lab Data: Results for patient (MRN 110003018821) as of 9/29/2021 13:05 9/9/2021 23:35 NA: 132 (L) K: 3.7 CL: 104 CO2: 20 (L) BUN: 16 CREAT: 0.98 ANION GAP4 SERPL: 8 GLUC: 131 TROPONIN I: <0.02 ALT: 36 AST: 115 (H) ALKP: 66 LIPASE: 24 TBILI: 1.4 (H) BILID: 0.6 (H) GFR-AFRAM: $g60 GFR NONAFR AMER: 59 (L) COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE WBC: 4.5 RBC''S: 3.66 HGB: 11.9 HCT: 36.2 MCV: 99 RDW, RBC: 14.6 PLT: 83 (L) IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 80 (H) ANC: 3.6 LYMPHS % AUTO: 11 (L) MONOS % AUTO: 6 EOS % AUTO: 2 BASO''S % AUTO: 0 PT: 16.4 (H) INR: 1.4 ETHANOL %, BLOOD: <0.01 ETOH, BLD QN: <10 9/9/2021 23:50 LACTATE: 1.6 9/10/2021 05:42 NA: 132 (L) K: 4.1 CL: 105 CO2: 19 (L) BUN: 15 CREAT: 0.84 ANION GAP4 SERPL: 8 GLUC: 94 LDH: 212 BNP: 127 (H) ALT: 33 AST: 100 (H) ALKP: 62 TBILI: 1.3 (H) BILID: 0.6 (H) COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE ALB: 3.0 (L) CRP, SER QL: 0.6 TP: 5.1 (L) WBC: 3.9 RBC''S: 3.56 (L) HGB: 11.7 HCT: 34.4 MCV: 97 RDW, RBC: 14.5 PLT: 71 (L) IMMAT GRANULO % AUTO: 0 NRBC: 0 NEUTROPHILS % AUTO: 81 (H) ANC: 3.1 LYMPHS % AUTO: 12 (L) MONOS % AUTO: 5 EOS % AUTO: 1 BASO''S % AUTO: 0 PT: 16.4 (H) INR: 1.4 D-DIMER: 2.81 (H) 9/10/2021 05:42 D-DIMER: 2.76 (H) 9/10/2021 07:19 FK506 (TACROLIMUS): 5.4 9/10/2021 20:15 S AUREUS METHICILL RESIST ISLT: Final Report... 9/10/2021 21:53 APPEARANCE UR: CLEAR COLOR UR: AMBER (A) HGB, UR QL: NEGATIVE LE, UA: NEGATIVE PH UA: 5.0 UA BILI: NEGATIVE UA GLUC: NEGATIVE UA KETONES: 20 (H) UA NO2: NEGATIVE UA PROT: 30 (H) UA SP GR: 1.027 UA UROBILINOGEN: <2.0 AMPHET UR SCREEN: NEGATIVE BARBITURATES, UR QL: NEGATIVE BENZODIAZ UR SCREEN: T''FOLLOW COCAINE UR QL: NEGATIVE METHADONE UR SCREEN: NEGATIVE METHAMPHETAMINE, UR QL: NEGATIVE OPIATES UR SCREEN: NEGATIVE OXYCODONE, UR QL SCRN: NEGATIVE PCP UR SCREEN: NEGATIVE THC UR SCREEN: NEGATIVE COMMENT, DRUG PANEL: SEE NOTE ALPRAZOLAM CONFIRM, URINE, LCMS, QUAL: UNDETECT CLONAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT FLUNITRAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT LORAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT NORDIAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT OXAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT TEMAZEPAM CONFIRM, URINE, LCMS, QUAL: UNDETECT TRIAZOLAM CONFIRM, URINE, LCMS, QUAL: UNDETECT COM 29: SEE NOTE SP SOURCE: CLEAN 9/11/2021 06:35 NA: 133 (L) K: 4.0 CL: 107 CO2: 18 (L) BUN: 16 CREAT: 0.91 ANION GAP4 SERPL: 8 GLUC: 94 LDH: 233 ALT: 36 AST: 113 (H) ALKP: 60 TBILI: 1.1 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 0.8 FERRITIN: 156 WBC: 3.4 (L) RBC''S: 3.46 (L) HGB: 11.4 (L) HCT: 33.8 (L) MCV: 98 RDW, RBC: 14.6 PLT: 83 (L) IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 74 ANC: 2.5 LYMPHS % AUTO: 17 MONOS % AUTO: 6 EOS % AUTO: 2 BASO''S % AUTO: 0 D-DIMER: 1.70 (H) FK506 (TACROLIMUS): 7.0 9/11/2021 16:00 TEMP: 99.1 (H) INSPIRED O2: 21 PH CORR ART BLD: 7.44 PCO2 CORR ART BLD: 26 (L) PO2 ADJUST TO PT''S TEMP, BLD-A: 84 PH ABLD: 7.44 PACO2: 26 (L) PO2-A: 83 HCO3 BLD: 20.3 (L) BE BLD: -6.0 (L) SO2, CALCULATED, ARTERIAL: 96.9 9/12/2021 06:26 NA: 135 K: 4.0 CL: 109 CO2: 19 (L) BUN: 17 CREAT: 0.87 ANION GAP4 SERPL: 7 GLUC: 82 LDH: 247 ALT: 36 AST: 103 (H) ALKP: 60 TBILI: 1.1 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 0.8 FERRITIN: 169 WBC: 2.5 (L) RBC''S: 3.48 (L) HGB: 11.4 (L) HCT: 34.4 MCV: 99 RDW, RBC: 14.9 PLT: 87 (L) IMMAT GRANULO % AUTO: 2 (H) NRBC: 0 NEUTROPHILS % AUTO: 55 ANC: 1.4 (L) LYMPHS % AUTO: 32 MONOS % AUTO: 8 EOS % AUTO: 3 BASO''S % AUTO: 0 D-DIMER: 1.44 (H) 9/13/2021 06:15 NA: 139 K: 3.9 CL: 112 (H) CO2: 20 (L) BUN: 15 CREAT: 0.82 ANION GAP4 SERPL: 7 GLUC: 80 LDH: 295 (H) ALT: 33 AST: 89 (H) ALKP: 63 TBILI: 1.1 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 0.8 FERRITIN: 138 WBC: 4.0 RBC''S: 3.51 (L) HGB: 11.8 HCT: 34.1 MCV: 97 RDW, RBC: 14.8 PLT: 92 (L) IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 65 ANC: 2.6 LYMPHS % AUTO: 23 MONOS % AUTO: 7 EOS % AUTO: 4 BASO''S % AUTO: 0 D-DIMER: 1.17 (H) 9/14/2021 06:13 NA: 138 K: 3.8 CL: 112 (H) CO2: 17 (L) BUN: 14 CREAT: 0.81 ANION GAP4 SERPL: 9 GLUC: 85 ALT: 29 AST: 74 (H) ALKP: 63 TBILI: 1.2 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE WBC: 4.2 RBC''S: 3.52 (L) HGB: 11.5 HCT: 34.2 MCV: 97 RDW, RBC: 14.7 PLT: 99 (L) IMMAT GRANULO % AUTO: 2 (H) NRBC: 0 NEUTROPHILS % AUTO: 63 ANC: 2.6 LYMPHS % AUTO: 24 MONOS % AUTO: 6 EOS % AUTO: 4 BASO''S % AUTO: 0 9/27/2021 07:53 NA: 142 K: 4.2 CL: 108 CO2: 25 BUN: 16 CREAT: 1.09 CA: 9.9 MG: 1.4 (L) PHOS: 3.7 GLUC: 108 CHOL: 73 TRIG: 59 HDL: 29 (L) LDL CALC: 32 ALT: 30 AST: 69 (H) ALKP: 103 TBILI: 1.3 (H) BILID: 0.5 (H) GFR-AFRAM: 60 GFR NONAFR AMER: 52 (L) COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE ALB: 3.1 (L) TP: 5.5 (L) WBC: 5.7 RBC''S: 3.47 (L) HGB: 11.3 (L) HCT: 34.9 MCV: 101 (H) RDW, RBC: 14.6 PLT: 114 (L) IMMAT GRANULO % AUTO: 1 NRBC: 0 NEUTROPHILS % AUTO: 73 ANC: 4.1 LYMPHS % AUTO: 18 MONOS % AUTO: 4 (L) EOS % AUTO: 3 BASO''S % AUTO: 1 PT: 16.9 (H) INR: 1.4 FK506 (TACROLIMUS): 12.4 9/27/2021 07:53 FK506 (TACROLIMUS): 12.6
CDC Split Type:

Write-up: 69 Y female with h/o type II DM, OSA, HTN and idiopathic pulmonary fibrosis s/p double lung transplant (8/8/16) on Myfortic, tacrolimus, prednisone who presented to the ED secondary to AMS in the setting of hypoglycemia and decreased po intake found to have COVID 19 disease COVID 19 disease - Symptom onset on 9/4. COVID positive on 9/10. No reported fevers." Given her lack of hypoxia and need for supplemental oxygen, she did not meet criteria for Decadron. Remdesivir was indicated given the patient''s tachypnia with RR 30 on presentation. D/w transplant physician who agreed with starting Remdesivir and recommended at least a 5 day course. (9/10 - 9/14) for which she remained hospitalized. Mild transaminitis but improving. 9/13 Dr. advised that pt was a candidate for monoclonal antibodies (Regeneron) so this was administered after. D/w lung transplant pulmonologist who agreed. - at discharge satting well with exertion and at rest - 20 day isolation from symptom onset - f/u with COVID transitions team AMS Patient presented due to AMS, likely secondary to hypoglycemia. CTH negative and mental status improved following administration of D50. Also presented to the ED 7/8 also for AMS which was also deemed to be secondary to hypoglycemia. - Mental status now normal Hypoglycemia / Type II DM (HbA1C 5.7 8/9/21) BG 36 upon presentation to the ED in the setting of decreased po intake and continued insulin use. Received D50 in ED with improvement. Patient was on PTA NPH 28 units in AM, Humalog 10 units for breakfast and 16 units for lunch and dinner. Her evening NPH was stopped 8/10/21 due to AM hypoglycemia. - Blood sugars consistently between 80 and 160 here and she only requires a few units of insulin a day - discharged and told to hold NPH and f/u with diabetic educator Thrombocytopenia, anemia, nutripenia. Patient with chronic thrombocytopenia, plt ~100s. Down to 71 early in her course, possibly related to COVID infection. Myfortic dose lowered and counts slowly increasing. - CTM closely. plt 99K at discharge and are slowly uptrending. She is to continue lowered dose of 180 mg BID rather than her usual 540 mg bid. Check labs in 2-3 days and f/u with transplant team Idiopathic pulmonary fibrosis s/p double lung transplant (8/8/16) - Continue PTA prednisone 7.5 mg daily, prograf and myfortic (lower dose) for immunosuppression. - Continue CMV prophylaxis with Valcyte 450 mg BID - Continue PCP prophylaxis with Bactrim MWF - Continue Azithromycin for BOS prophylaxis. HTN - resume PTA Coreg


VAERS ID: 1745497 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Chest pain, Condition aggravated, Dry mouth, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Immediate post-injection reaction, Memory impairment, Pain in extremity, Palpitations
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: xyzal, Adderall xr 30 mg, oral birth control- ogesterol low?
Current Illness: No other known illness for a few years
Preexisting Conditions: hypermobile ehlers-danlos syndrome, allergies, POTS, ADHD
Allergies: Allergies to foods the release histamines- cured meats/fermented
Diagnostic Lab Data: Nothing yet- plans to see her provider.
CDC Split Type:

Write-up: Heart palpitations that started instantly after (hx of pots), chest pain- did not report this because this is something that happens to her related to the POTS, sweats, dry mouth, arm pain- left side. Whole body was "on fire" starting the next day- felt sweaty all over. Lingering constant headache in the front of the head, exhausted and forgetting things. Reports she feels a "burning brain feeling" which she has had in the past. Foggy brain.


VAERS ID: 1745557 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiac monitoring, Chest X-ray, Chest discomfort, Dysphonia, Echocardiogram, Electrocardiogram, Heart rate increased, Oxygen saturation decreased, Respiratory rate increased, Sleep disorder, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Benedryl, dulcolax, mirolax
Diagnostic Lab Data: EKG, bloodwork, echocardiogram, 24 hour chest harness / heart rate monitor, chest x-ray
CDC Split Type:

Write-up: Tightness in throat and change of voice (inability to project voice); tightness in chest; disrupted sleep patterns, jolted awake essentially every 2-3 hours every night with increased respiration rate, heart rate and lower than normal O2 levels. This has continued for 20 days.


VAERS ID: 1745574 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Angina pectoris, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Other ischaemic heart disease (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: Got flu symptoms after taking flu shot
Other Medications: High BP medication
Current Illness: Heart palpitations
Preexisting Conditions: Heart palpitations
Allergies: None I know of.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Occasional waves of nausea, headaches, heart pain


VAERS ID: 1745968 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Medial tibial stress syndrome, Muscle contractions involuntary, Muscle tightness, Myalgia, Nervousness, Neurological examination normal, Pain in extremity, Reflex test normal
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin
Current Illness: Runny nose, slight cough, sore throat, and diarrhea.
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data: Involuntary Reflex Test with Reflex Hammer (9/15/21) Sensation Test on Foot (Choosing Dull vs. Sharp Object) (9/15/21)
CDC Split Type:

Write-up: 10:00 pm on 9/9/21: Two and a half hours after receiving the Janssen COVID-19 vaccine, my legs started to become increasingly sore and tight. Because I had not done any intense physical activity earlier that day or the day prior, I was quite confused as to why these symptoms were occurring. Since my legs felt sore, I attempted to stretch them to alleviate the soreness. Unfortunately, this did not work; so, I decided to sleep instead. 9:00 am on 9/10/21: The following morning, along with my leg soreness (like feeling nervous before giving a public speech), I felt intense muscle contractions in numerous regions of my legs (particularly, my calves and thighs: anterior and posterior). These muscle contractions would vary in quality (strength of contraction) and quantity (number of contractions per event and frequency of each event occurring). For the most part, the muscle contractions (spurt of two or three contractions) would last two seconds and occur every ten seconds. Regarding where the muscle contractions would occur, it was completely random: no distinct pattern of event location (besides the general regions of my calves and thighs: anterior and posterior). Also, I realized that the muscle contractions only occurred while I remained stationary (i.e., sitting or lying down); in contrast, when I was standing or moving around on my feet, I would not feel any muscle contractions (although, I still felt slight leg soreness while standing). 9/11/21-9/12/21: Symptoms remained the same as 9/10/21 9/13/21: On the thirteenth, my symptoms vastly increased: in terms of overall discomfort. The quality (strength: more intense contractions) and quantity (time span of each event: event length increased ($gtwo seconds) and occurred more frequently (


VAERS ID: 1747521 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-09-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Myalgia, Pain in extremity, Paraesthesia, Restlessness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kirkland sleep aid, melatonin, vitamin c
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Telecare from UHC insurance got Diclofenac. But it does not help.
CDC Split Type:

Write-up: I had pain on my left should for couple of days but it was expected. And I started having joint pain on my feet and hands but It was sporadic and can be ignored. But maybe after 3 weeks from the 1sf shot, I started having tingling sensation on my left leg and arm. It started at night, and I was restless and had to do something. The frequency became more often, especially at night. I remember I woke up at 3 am and had to walk to calm it down. I thought it could go away but still have it. I had to climb a ladder several time for house work yesterday and noticed left leg has stronger muscle pain compared to right leg.


VAERS ID: 1747899 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-02-26
Onset:2021-09-09
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Antibody test, Antibody test negative
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Antibody test for COVID-19; Test Result: Negative ; Result Unstructured Data: test showed no Ab levels against COVID-19
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Ab test came back negative; This spontaneous case was reported by a consumer and describes the occurrence of ANTIBODY TEST NEGATIVE (Ab test came back negative) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 26-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 26-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced ANTIBODY TEST NEGATIVE (Ab test came back negative). At the time of the report, ANTIBODY TEST NEGATIVE (Ab test came back negative) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 09-Sep-2021, Antibody test: negative (Negative) test showed no Ab levels against COVID-19. Patient had already discussed Ab test results with both Cardiologist and Family Physician. Patient was scheduled to receive monoclonal Ab treatment on 22Sep2021. No concomitant drugs were reported. No treatment drugs were reported. This case was linked to MOD-2021-035928, MOD-2021-329925 (Patient Link).


VAERS ID: 1747992 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EVV 0217 / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Bone pain, Extra dose administered, Headache, Myalgia, Night sweats, Off label use, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high (other medical history: Hashimoto''s, Mast Cell act, High BP); Drug allergy (known allergies: Often have adverse reactions to meds); Hashimoto''s disease (other medical history: Hashimoto''s, Mast Cell act, High BP); Mast cell activation syndrome (other medical history: Hashimoto''s, Mast Cell act, High BP)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101206103

Write-up: FYI: I had a very strong reaction to the Booster (3rd shot) Vaccine.; FYI: I had a very strong reaction to the Booster (3rd shot) Vaccine.; severe HA''s; achy bones/muscles; achy bones/muscles; weak; sleeping for sev days; night sweats; This is a spontaneous report from a contactable other hcp (patient). A 72-year-old (non-pregnant) female patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EVV 0217) via an unspecified route of administration, administered in arm left on 08Sep2021 12:00 at dose 3 (booster), single for covid-19 immunisation. Medical history included Hashimoto''s, Mast Cell act, High BP, often have adverse reactions to meds (known allergies: Often have adverse reactions to meds). Patient did not have other vaccine in four weeks. Patient did not have covid prior vaccination. Patient was not tested for covid post vaccination. Concomitant medications included levothyroxine sodium (LEVOTHYROXINE SODIUM); lisinopril (LISINOPRIL) both taken for an unspecified indication, start and stop date were not reported (other medications in two weeks). Patient previously received first and second dose of BNT162B2 for COVID-19 immunization. On 09Sep2021 12:00 the patient experienced had severe HA''s, achy bones/muscles, weak, sleeping for sev days, night sweats. Adverse event: FYI: I had a very strong reaction to the Booster (3rd shot) Vaccine. Starting following day I had severe HA''s, achy bones/muscles, weak, sleeping for sev days, night sweats. I had no reaction to the 1st two shots, so surprised with reaction. Adverse events resulted in: Doctor or other healthcare professional office/clinic visit. Patient did not receive treatment for the adverse events. Outcome of the events was resolving. Follow-Up (16Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1747994 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis, Pustule, Skin weeping
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101206773

Write-up: It is bubbling with pus bubbles and weeping; It is bubbling with pus bubbles and weeping; Two large patches of itchy skin started day after shot- on left arm/elbow area and right knee/Still itchy and irritated and inflamed/ Skin continued to be itchy and hot; This is a spontaneous report from a contactable consumer (patient). A 57-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: FC3182), via an unspecified route of administration in left arm on 08Sep2021 09:30 (at the age of 57-years-old) as dose 2, single for COVID-19 immunization. Medical history included none. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: FA7485), via an unspecified route of administration in right arm on 18Aug2021 15:30 (at the age of 57-years-old) as dose 1, single for COVID-19 immunization. Prior to vaccination, the patient was not diagnosed with COVID-19, did not receive any vaccines within four weeks nor any other medications within two weeks prior. The patient experienced two large patches of itchy skin started day after shot- on left arm/elbow area and right knee, skin continued to be itchy and hot on 09Sep2021. Five days later, it is bubbling with pus bubbles and weeping on 13Sep2021. It was Still itchy and irritated and inflamed from 09Sep2021. The events resulted in doctor or other healthcare professional office/clinic visit. The patient received treatment with antibiotic and steroid. Since the vaccination, patient has not been tested for COVID-19. Outcome of events It is bubbling with pus bubbles and weeping was unknown. Outcome of remaining events was not resolved. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1747999 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 3 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Dysmenorrhoea, Extra dose administered, Fatigue, Heavy menstrual bleeding, Off label use, Pain, SARS-CoV-2 test, Vaccination site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow), 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: Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034; Pfizer, Inc. EUA 027034
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bee sting; Degenerative disc disease (Degnerative Disc & Joint Disease); Diabetic peripheral neuropathy; Emphysema; Fibromyalgia; Food allergy (Hazel nuts); Gastroparesis; IgG (IgG disorder/Immunogammaglobulemia); Joint disorder (Degnerative Disc & Joint Disease); RA; Retinopathy; Shellfish allergy (shrimp); Type 1 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210914; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101207275

Write-up: Felt fatigued; Had body aches/pains; Site injection pain; heavy flow for 3 days; Started having menstrual cramps & flow; I received my 3rd dose of the Pfizer vaccine (not a booster per my physician but a 3rd dose because I have Immunogammaglobulemia); I received my 3rd dose of the Pfizer vaccine (not a booster per my physician but a 3rd dose because I have Immunogammaglobulemia); This is a spontaneous report from a contactable consumer or other non hcp (patient reported for herself). A 50-year-old non-pregnant female patient received third dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for Injection, Batch/Lot Number: ER8732), via an unspecified route of administration, administered in arm left on 09Sep2021 at 13:00 (01:00 PM) (at the age of 50-year-old) as dose 3 (booster), single for COVID-19 immunization. The patient medical history included juvenile type I diabetes (1972), IgG disorder/immunogammaglobulemia, diabetic peripheral neuropathy, emphysema, RA, fibromyalgia, degnerative disc and joint disease, gastroparesis, retinopathy; allergy to hazel nuts, shrimp, bee stings. The patient received concomitant medications within 2 weeks of vaccination which included insulin glargine (LANTUS); insulin human (NOVOLIN R); levothyroxine sodium (LEVOTHYROXIN); modafinil; acetylsalicylic acid (ASPIR), all drugs taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was not diagnosed with COVID prior vaccination. Patient was COVID tested post vaccination. The patient previously took acetaminophen, bactrim, flonase, cymbalta and experienced allergy for all the drugs. The patient previously took first and second dose of bnt162b2 for COVID-19 immunization and experienced menstrual cramps and flow. On 09Sep2021 at 13:00 (01:00 PM), the patient experienced I received my 3rd dose of the pfizer vaccine (not a booster per my physician but a 3rd dose because I have immunogammaglobulemia). On 09Sep2021 at 17:00 (05:00 PM), the patient experienced felt fatigued, had body aches/pains, site injection pain, heavy flow for 3 days, started having menstrual cramps and flow. Reported Event: I received my 3rd dose of the Pfizer vaccine (not a booster per my physician but a 3rd dose because I have Immunogammaglobulemia) & then felt fatigued, had body aches/pains, & site injection pain (all expected side effects and not adverse) but started having menstrual cramps and flow (adverse I believe) that same evening with increased flow through 13Sep21. I''ve had a normal 6 day medium to light flow period per month for the last 20 years always 21 days apart with no spotting or unexpected bleeding except for prior Covid-19 vaccinations, so this is not coincidental since its happened with each of the 3 doses. The last day of my last normal period was 02Sep2021 and this was totally unexpected as well as heavy flow for 3 days, lessening to medium thereafter but still ongoing at day 6 today and expecting it may continue for weeks. The patient underwent lab tests and procedures which included nasal swab was unknown results (pixel COVID test, result: pending) on 14Sep2021. No treatment was received for the events. Outcome of the event heavy flow for 3 days was not recovered; extra dose administered, off label use was unknown; outcome of remaining events was recovered with sequelae. Device date was 14Sep2021. Follow-Up (PRD/SRD 16Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1749362 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-09-09
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Ageusia, Anosmia, COVID-19, Chills, Ear congestion, Fatigue, Lacrimation increased, Nasal congestion, Nausea, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sensory loss, Sinus congestion, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lacrimal disorders (narrow), Hypersensitivity (broad), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: Sudafed; venomous bite like spider or bee bite
Diagnostic Lab Data: COVID test- 09/09/2021 positive; COVID test- 09/23/2021 negative.
CDC Split Type: vsafe

Write-up: 8 hours after the vaccine I had a low-grade temperature, chills, nausea, body aches, and fatigue. That lasted for 24 hours. Interestingly enough, my Covid symptoms started the same way my symptoms started after getting the vaccine. That lasted for 24 hours too. After that I started with a runny nose, low grade temperature for 4 days, watery eyes. Lost of taste and smell on day 7. Fatigue. Irritable stomach. Sneezing and congestion in my nose, sinuses, and ears. I got a COVID test on 09/09/2021 and it came back positive. I contacted my doctor as soon as I got the positive test result. I worked with my homeopathic doctor to take natural remedies for treating COVID. I tested again last week on 09/23/2021 and I tested negative. I still have stomach issues.


VAERS ID: 1749900 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-06
Onset:2021-09-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram abnormal, Anticoagulant therapy, Cardioversion, Chest pain, Coronary artery occlusion, Electrocardiogram abnormal, Resuscitation, Thrombectomy, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amitriptyline 10 mg QD, Aspirin 81 mg QD, Azelastine Nasal, rosuvastatin 5 mg MWF, Isosorbide Mononitrate 15 mg QD, Levothyroxine 75 mcg QD, Tizanidine 4 mg QD.
Current Illness:
Preexisting Conditions: H/O A-FIb, Bladder Cancer, CKD, CAD, Enlarged Prostate, Gout, History of Prior Ablation, Hyperlipidemia, hypothyroid, Pneumonia due to COVID-19 in July 2020, Sleep apnea, History of stroke, Thoracic aortic aneurysm, Lumbar radiculopathy.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Moderna COVID-19 Vaccine EUA: Inpatient hospitalization or prolongation of existing hospitalization (ST Elevation MI) Patient received Moderna Vaccines on 8/9/2021 and 9/6/2021. Presented to ED after waking with severe chest pain. Initial EKG showed possible ST elevation MI. he was given aspirin. While in transit to ED and while in ED, he went into ventricular tachycardia required cardioversion as well as CPR. In the ED, he required additional cardioversion due to VT. Patient underwent intervention to the RCA with thrombectomy and intracoronary tPA. However, blood flow was not reestablished and patient was brought back to the cath lab the next day. An angiogram showed total occluded RCA with some collaterals from left to right. He did have an angiogram in July of 2021 that showed moderate disease in the RCA with positive remodeling. Showed no significant stenosis in the RCA. He had COVID-19 vaccination 3 days before that. The concern was that his MI may be due to hypercoagulable state, therefore, he will be on Eliquis and Plavix, but not aspirin.


VAERS ID: 1749961 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blepharospasm, Computerised tomogram, Ear discomfort, Ear pain, Headache, Hypoaesthesia, Insomnia, Laboratory test, Migraine, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ER visit 9/14 CT scan, labs, given Toradol and Phenergan and D/C''d. Express care visit 9/20 started on steroids and given IV steroid shot. PCP visit 9/23 and MRI ordered, labs ordered, set up with neurologist. 9/27 started on more steroids. 9/30- saw Neurologist who is ordering CT-V, MRI, EEG, starte don Topamax and indomethacin and increased steroids, r/o cerebral venous thrombosis/ microclots, set up eye appt also to check for clots in eye vessels.
CDC Split Type:

Write-up: severe headaches, migraines, tinniuts, ear pressure/pain, eye twitching, insommia, numbness tingling arms at night


VAERS ID: 1749965 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-25
Onset:2021-09-09
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking Abillafi, Armodafinil, Atorzastim, Pasaglar, Cetitizine, Coleselalm, Coreg, Cymbalta, Lanaprolozol, Medical Marijuana, Memantine, Metformin, Brimidone, Prolia Shot, Synthroid, Propamax, Alpha-Biaoc, Ammioacid-HCTYL-CY-STINE, E
Current Illness: None
Preexisting Conditions: I have diabetes, Sleep apnea, Bad back problems, trimmers, heart burn, acid reflux, osteoporosis.
Allergies: I am allergic mold foods and Darvon, Topazine, Celezine
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: 09/09/2021 my shortness of breath had become severe. I was already at the hospital because I was having an angiogram, but sine it was an out patient procedure I went home, I called my doctor-a pulmonologist. I sent a message vie email to my regular MD as well. I was given prednisone, a z-pack, they gave me a cymbacort inhaler. I am still on these medications and I still have shortness of breath.


VAERS ID: 1749967 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypersensitivity, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: NKA at the time of vaccination
Diagnostic Lab Data: PATIENT TOLD US THEY GAVE HER SEVERAL MEDS AT THE HOSPITAL ER, BUT SHE DID NOT KNOW WHAT THEY WERE. SHE DIDN''T SPEAK OF ANY OTHER TESTS THAT SHE HAD.
CDC Split Type:

Write-up: PATIENT SELF REPORTED ON 9/30/21, DATE SHE WAS TO BE DUE TO 2ND DOSE OF COVID VACCINE, DUE TO HER HUSBAND WAS SICK IN THE HOSPITAL UNABLE TO COME TO RECEIVE 2ND DOSE OF PFIZER VACCINE. PATIENT STATES, " APPROX. 6PM ON 9/9/21, THE DATE OF HER FIRST DOSE OF PFIZER, SHE FELT LIKE HER THROAT WAS TRYING TO CLOSE ON HER." PATIENT WAS TAKEN TO ER VIA EMS AND TREATED FOR ALLERGIC REACTION AND WAS D/C HOME. PATIENT AGAIN SAME FEELING EARLY MORNING ON 9/10/21, AND WAS TOLD BY HOSPITAL TO TAKE BENADRYL ORALLLY AROUND THE CLOCK FOR 24 HOURS. SHE WAS FULL RECOVERED BY THAT EVENING ON 9/10/21. RN SUPERVISOR CALLED DR., MEDICAL DIRECTOR. WITH THE EVENTS THAT OCCURED AFTER RECEIVING THE FIRST DOSE OF PFIZER VACCINE, SHE DOES NOT RECCOMEND PATIENT GETTING 2ND DOSE OF PFIZER. PATIENT WAS THEN CALLED AND COMMUNICATED THESE RECCOMENDATIONS. PATIENT VERBALIZED UNDERSTANDING.


VAERS ID: 1750096 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dysphagia, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Throat swelling; difficulty swallowing (lasted 6-8 hours).


VAERS ID: 1750185 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bursitis, Eye swelling, Hyperhidrosis, Hypersensitivity, Hypoaesthesia, Immediate post-injection reaction, Injected limb mobility decreased, Injection site pain, Nausea, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Loestrin, desoximetasone ointment vitD zyrtec eye drop
Current Illness: none reported
Preexisting Conditions: multiple allergies and sensitivities
Allergies: Crisaborole, dyes, fabrics, scents, colors, makeup, environmen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness right hand immediately after injection for a few seconds, next am inability to move left arm without pain or numbness, had to lift arm, next day motion returned but still sore lateral superior deltoid/subacromial area now worse with abduction and rotation on 9-28-2021 at time of assessment. Had initial sweating and nausea resolved within 1 day. Also had typical allergic reaction the next am of swollen eyes, rash around face, upper anterior chest hands and scalp. This is her typical reaction to her other allergens. That has resolved by 9-28-2021. Likely post injection bursitis as it sounds like injection was quite high as well. This is the only issue remaining.


VAERS ID: 1750218 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC4184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Patient bled at the time of the injection and stated at her second immunization that she continued to bleed for 7 hours after vaccination and went through 7 band aids before it ultimately quit bleeding.


VAERS ID: 1750622 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-05
Onset:2021-09-09
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is the 2nd report I am filing. I was put on the following medication to stop the reaction methylprednisolone, fexofenadine and triamcinolone. on 9/1/2021. Today 9/302021 my symptoms have returned. I have welts and itching on my neck, face, hairline, eyelashes, chest and in my ears.


VAERS ID: 1751895 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-11
Onset:2021-09-09
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 056D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Alopecia, Back pain, Chills, Decreased appetite, Headache, Lethargy, Pyrexia, SARS-CoV-2 test, Vaccination site pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 PCR test positive
Allergies:
Diagnostic Lab Data: Test Date: 20200802; Test Name: COVID-19 virus test; Test Result: Positive; Result Unstructured Data: PCR test.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Hair loss; Fever; Chills; Headache; Pain at injection site; Lethargy; Back pain; no apettite; This spontaneous case was reported by a consumer and describes the occurrence of LETHARGY, BACK PAIN, DECREASED APPETITE, ALOPECIA, and PYREXIA in a 27-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 055E21A and 056D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 PCR test positive on 02-Aug-2020. On 11-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced LETHARGY, BACK PAIN, DECREASED APPETITE, PYREXIA, CHILLS, HEADACHE, and VACCINATION SITE PAIN. On 10-Sep-2021, the patient experienced ALOPECIA. On 12-Sep-2021, LETHARGY, BACK PAIN, DECREASED APPETITE, PYREXIA, CHILLS, HEADACHE, and VACCINATION SITE PAIN had resolved. At the time of the report, ALOPECIA outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available) on 02-Aug-2020, SARS-CoV-2 test positive PCR test. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1751914 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USMODERNATX, INC.MOD20213

Write-up: Expired vaccine was given to 10 patients; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine was given to 10 patients) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011A21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine was given to 10 patients). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine was given to 10 patients) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment medication was reported. No concomitant medication was reported. Initially, other Health Care professional reported AE patients who received second dose, and Consent for Safety to follow up: Provided Further, query was updated from Safety in follow-up, regarding the incident which was occurred in a jail, where all patients are male, and where they administered expired vaccine in three different instances to 10 patients each time: 2 of these instances were first doses, while the third instance (described in case MOD21-146004) were second doses. Most recent FOLLOW-UP information incorporated above includes: On 22-Sep-2021: Follow-up was received on 22-Sep-2021 which included no new information


VAERS ID: 1752037 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eye haemorrhage, Maternal exposure during pregnancy, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101219410

Write-up: popped blood vessels in eyes from intensity of vomiting; vomiting for several days; Patient is pregnant; This is a spontaneous report from a contactable consumer. A 45-year-old pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 09Sep2021 (Batch/Lot number was not reported) (at the age of 45 years old) as single dose for Covid-19 immunisation. The patient medical history was not reported. It was unknown if patient had other vaccine in four weeks, and unknown if patient had other medications in two weeks. The first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) was administered via intramuscular in Aug2021 for Covid-19 immunisation. The patient''s concomitant medications were not reported. The patient was pregnant when she received the vaccine on 09Sep2021, she was 25 weeks pregnant. The patient reported that on 10Sep2021, she was vomiting for several days and popped blood vessels in eyes from intensity of vomiting. It was unknown if she received any treatment. Outcome of the events was recovering. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.


VAERS ID: 1752039 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Acid reflux (oesophageal); Allergy; Blood pressure high
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101219427

Write-up: Inflammation in left hip area; This is a spontaneous report from a contactable consumer (patient). A 51-year-old non-pregnant female patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 09Sep2021 20:00, at the age of 51-years-old, (Lot Number: Ff2588) as DOSE 1, SINGLE for covid-19 immunisation. Medical history included High blood pressure, acid reflux, and allergy. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. On 09Sep2021 20:00, the patient experienced inflammation in left hip area. The event involved Emergency room/department or urgent care. The event was assessed as medically significant. The outcome of the event was unknown. Since the vaccination, the patient has not been tested for COVID-19. Therapeutic measures were taken as a result of the event (Pain med and inflammatory med).


VAERS ID: 1752124 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-09-09
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / OT
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, 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:
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: Covid-19 virus test; Test Result: Positive
CDC Split Type: USPFIZER INC202101233168

Write-up: COVID-19; COVID-19; FACILITATED COLLECT This is a solicited report based on the information received by Pfizer from AbbVie Pharmacovigilance (Manufacturer Control No: 21K-163-4077839-00) from a contactable male consumer reported for himself. A 66-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 intramuscular on 25Mar2021, at the age of 66-years-old (Batch/Lot number was not reported) as single dose for covid-19 immunisation and adalimumab (HUMIRA), subcutaneous from an unspecified date (Batch/Lot number was not reported) to an unspecified date, for psoriatic arthritis. The patient had received the first dose of bnt162b2 on 02Mar2021 at the age of 66-year-old. The patient medical history and the patient''s concomitant medications were not reported. On 09Sep2021, the patient had a SARS-CoV-2 test positive. The outcome of the event was recovering. The reporter''s causality for the event of COVID with HUMIRA (ADALIMUMAB) was a reasonable possibility. The reporter''s assessment of the causal relationship of the event with bnt162b2 was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Based on plausible dose -event relationship post vaccination and no other alternate explanation the causal role of BNT162B2 cannot be excluded for the reported LOE events


VAERS ID: 1752852 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Neuralgia, Pain
SMQs:, Peripheral neuropathy (narrow), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches and numbness, nerve pain and jolts.


VAERS ID: 1753246 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-06-07
Onset:2021-09-09
   Days after vaccination:94
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: Bell''s palsy


VAERS ID: 1753348 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Condition aggravated, Dizziness, Dyspnoea, Fatigue, Hypersensitivity, Pain in extremity, Pyrexia, Spirometry abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Seasonal allergies
Allergies: Seasonal allergies
Diagnostic Lab Data: Spirometry - Poor quality when completed by an experienced technician resulting in FVC of 73% and FEV1 76% but poor flow curves.
CDC Split Type:

Write-up: After his shot about 2.5 hours he noted significant fatigue, arm felt like "i was slugged by a baseball super sore'', allergies flared up, fever on/off then "shortness of breath was terrible". "Going to the refrigerator was to the point I was getting lightheaded forcing myself to breath." Primatene mist used for mowing grass. He bought more to use. Today his lungs are ok (9/20/21). Yesterday he used the primatene within the first hour of waking. Fatigue today is fine and has worn off as of 3 days ago. Started Flovent on 9/20/21 with albuterol prn, zyrtec daily with follow up in one week to recheck lung function and shortness of breath on exertion.


VAERS ID: 1753538 (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: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic shock, Angiogram cerebral, Arteriogram carotid, Bell's palsy, C-reactive protein, Chest X-ray, Chest discomfort, Computerised tomogram, Differential white blood cell count, Dysphagia, Electrocardiogram, Facial pain, Full blood count, Hyperacusis, Hypoaesthesia, Magnetic resonance imaging, Metabolic function test, Photophobia, Pruritus, Trigeminal neuralgia, Troponin
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Demyelination (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: as a result of vaccine significant nerve issues specifically trigeminal neuralgia
Allergies: Ergotamines, triptans and adhesive
Diagnostic Lab Data: MRI:9/29 CAT ANGIOGRAM BRAIN AND NECK : 9/28 EKG: 9/9, 9/28 CHEST XRAY 9/30 CBC 9/27,93 BASIC METABOLIC :9/27,9/30 WBC DIFFERENTIAL : 9/27,09/30 C-REACTIVE PROTEIN 9/30 TROPONIN 9/30
CDC Split Type:

Write-up: Anaphylactic shock : 2 dose benadryl, 2 doses of epipen, compazine, milk of magnesia, prednisone, albuterol inhaler on 9/9 9/9 started Prednisone taper high doses of benadryl, Zyrtec, and famotidine. itching, numbness in face and chest tightness, difficulty swallowing. 9/14 diagnosed with Bells Palsy. hen on9/21 first diagnosis of trigeminal neuralgia. 4 er visits, ct scans, mri chest xrays. Significant nerve pain in the face sensitive to light and sounds, continued difficulty swallowing. I have to keep ice packs on face and top right side of my head and now taking gabapentin. I have a detailed written record of all medications and symptoms. I am happy to share from the last 22 days


VAERS ID: 1753671 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Motion sickness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline,gabapentin, Norco
Current Illness: None
Preexisting Conditions: Migraines and back pain
Allergies: Penicillin
Diagnostic Lab Data: Blood Work- to look for inflammation-9/14
CDC Split Type:

Write-up: Dizziness, nausea, motion sick


VAERS ID: 1753805 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-03-05
Onset:2021-09-09
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd doss of Phizer 03/05/2021, chills and soreness lasting 3 days
Other Medications: Aspirin, Metaphorim, Atorvastatin, Ometprosal, Genovia, Lisinopril, Ezetimide, Ampalodapine, Toparol, Laradien, Hydrochlorothiazide, Glipazide, Melatonin, Fish Oil
Current Illness: N/A
Preexisting Conditions: Diabetes, Heart Failure
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: BREAKTHROUGH CASE : Covid + 09/09/2021


VAERS ID: 1753854 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-07
Onset:2021-09-09
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Polymerase chain reaction
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: History of COPD, HTN
Allergies:
Diagnostic Lab Data: Cycle threshold 16.6 on admission
CDC Split Type:

Write-up: Patient admitted to the hospital for COVID 19. Reporting per Moderna COVID vaccine EUA.


VAERS ID: 1753937 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-26
Onset:2021-09-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Received 2nd dose 1 week early


VAERS ID: 1754033 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Antinuclear antibody positive, Asthenia, Blood cholesterol increased, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood thyroid stimulating hormone normal, Blood triglycerides increased, Cardiovascular function test, Chest pain, Cough, Drug screen negative, Dyspnoea, Fatigue, Gastrooesophageal reflux disease, Globulins increased, Glycosylated haemoglobin normal, Haemoglobin normal, Hepatitis viral test negative, High density lipoprotein normal, Low density lipoprotein increased, Metabolic function test, Monocyte count normal, Pain, Platelet count normal, Protein urine present, Rash, Red blood cell count normal, Red blood cell sedimentation rate normal, Red blood cells urine positive, Red cell distribution width increased, Urine abnormality, Urine analysis abnormal, Vitamin D decreased, White blood cell count normal, White blood cells urine negative
SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg daily Lisinopril 40 mg daily Allopurinol 300 mg daily Epinephrine only for emergencies.
Current Illness: Bilateral foot pain
Preexisting Conditions: Hypertension, Tibialis posterior tendinitis, gout, bunion, ankle pain
Allergies: Iodine, Shellfish
Diagnostic Lab Data: Cardiac workup ER multiple dates ----Clinic workup---- 9/20/21 RBC 5.93, RDW 14.7, Monocyte 4.3%, Hgb 17.4, WBC 7.2, Platelets 230. Glucose 109, ALT 54.0, HgbA1C 5.9, globulin 3.5, CMP otherwise normal with creatinine 1.0, total cholesterol 237.0, HDL 46.0, LDL 143, Triglycerides 242 Urinalysis trace lysed blood with 100 protein, 0-3 RBCs no WBCs, trace mucous Vitamin D 14.6 --- 9/24 TSH 3.49, drug toxicology negative, CK total 98, 100 protein in urinalysis,0-4 WBC in urine, 0-3 RBCs, ANA Ab Pattern 2 speckless, ANA Ab pattern homogenous, AnA Ab screen positive, ANA Ab titer 1 and 2 positive (High), Hepatitis A /B/C and HIV negative ESR 9/30/21 is 2.
CDC Split Type:

Write-up: ER visit 9/10/21 Left chest soreness started 2 days after vaccine progressively worsening, significant fatigue, body aches, shortness of breath,. ER visit 9/13/2021 Primary care visit 9/13/21 Primary care visit 9/14/21 Primary care visit 9/24/21 Low vitamin D, proteinuria - weakness, fatigue, chest pain intermittently, difficulty breathing, cough, acid reflux. About 2 weeks after vaccine bilateral cheek rash Primary caare 9/30/21 10/1/21 Today Persistent fatigue, body aches


VAERS ID: 1754334 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-09-09
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation
SMQs:, Supraventricular tachyarrhythmias (narrow)

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

Write-up: New Afib.


VAERS ID: 1754966 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor 75 mg daily Vitamin C, and Zinc
Current Illness: none
Preexisting Conditions: Osteoporosis
Allergies: none
Diagnostic Lab Data: Took rapid COVID test---negative.
CDC Split Type:

Write-up: Chills, fever, and headache. This lasted 2 days. Ten days later, fever and headache returned for one day. Took rapid COVID test---negative.


VAERS ID: 1755835 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: Inappropriate schedule of vaccine administered; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a pharmacist and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 21-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 09-Sep-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered). On 21-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant medications was reported. Treatment information was not provided. Patient was claiming that he was not given a vaccine so another pharmacist gave another dose.


VAERS ID: 1756058 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Exposure to SARS-CoV-2, Fatigue, Immunisation, Malaise, Off label use, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: USPFIZER INC202101227817

Write-up: Covid exposure; Runny nose, after booster shot; Caller started sneezing, after booster shot; Felt out of sorts, after booster shot; felt tired; Booster; off label use; This is a spontaneous report from a contactable consumer or other non hcp. A 74-years-old female patient received bnt162b2 (BNT162B2), dose 3 via an unspecified route of administration on 09Sep2021 (Batch/Lot number was not reported) as DOSE 3, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient previously received first dose bnt162b2 (BNT162B2, Solution for injection, Batch/Lot Number: not reported) via unspecified route of administration unspecified date as DOSE 1, SINGLE for covid-19 immunisation. Patient previously received second dose bnt162b2 (BNT162B2, Solution for injection, Batch/Lot Number: not reported) via unspecified route of administration on unspecified date as DOSE 2, SINGLE for covid-19 immunisation. The patient experienced covid exposure on an unspecified date, runny nose, after booster shot on an unspecified date, caller started sneezing, after booster shot on an unspecified date, felt out of sorts, after booster shot on an unspecified date, felt tired on an unspecified date, booster on 09Sep2021, off label use on 09Sep2021. Caller stated that she was exposed from her friend, and she just wanted to relay her experience to support the booster dose. The outcome of the events exposure to sars-cov-2, rhinorrhoea, sneezing, malaise, fatigue was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow-up.


VAERS ID: 1756407 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-06
Onset:2021-09-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049EZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Depression, Dizziness, Electrocardiogram normal, Fibrin D dimer normal, Headache, Hypoaesthesia, Limb discomfort, Palpitations, Panic reaction, Paraesthesia, Peripheral coldness, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 2000iu.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Amoxycillin.
Diagnostic Lab Data: EKG, D-dimer and bloodwork for myocarditis were all completed on September 13th and negative.
CDC Split Type:

Write-up: Leg heaviness, cold legs and feet, right side facial numbness, tingling across back, full body shakes began 3 days post vaccination and continued for approximately 24 hours. Dizziness/lightheadedness, headaches and heart palpitations also began during that time frame. Dizziness subsided within 1 week. Heart palpitations and headaches have continued for 3 plus weeks. Feelings of panic and depressive lows began for the first time in patient''s life during this time frame and have continued to this point.


VAERS ID: 1756693 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 088D21A / 2 RA / IM

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

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

Write-up: Patient states pain in arm started after receiving shot and he can no longer lift right arm over parallel without extreme pain.


VAERS ID: 1756814 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Dyspnoea exertional, Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pneumonia
Other Medications: clonidine, prozac, vitamins
Current Illness: htn
Preexisting Conditions: htn, depression,anxiety
Allergies: cymbalta, effexor, ambien, celebrex,imetrex, diovan,lisinoprol, norvasc,topamax
Diagnostic Lab Data: called dr. muscle relaxer ordered. magnisum ordered. still sob
CDC Split Type:

Write-up: dizziness. muscle spasms and pain not relieved with rest/tylenol or ibprophen. short of breath on exertion.


VAERS ID: 1757023 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), 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: Macrodantin, as a prophylactic
Current Illness: None
Preexisting Conditions: IBS
Allergies: None known
Diagnostic Lab Data: None reported at this time.
CDC Split Type:

Write-up: Menstrual cycle started on 9.7.21; 1 week early for an otherwise normal cycle. Previous cycle was 8.16.21. Menstrual cycle started again 10.1.21, only 3 weeks after previous cycle start date. Again, this is an abnormality that did not exist prior to 2nd vaccine. October 2021 cycle is also abnormally heavy and consisting of clots.


VAERS ID: 1757125 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820096 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zertec, multi vitamin.
Current Illness: None
Preexisting Conditions: Migraines about 4-5 times a year.
Allergies: Latex, deet.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Symptoms start 12 hour after injection with fever 101f lasting 12 hours. With muscle pain in left arm lasting 5 days. And mild shortness of breath lasting duration of fever. With general fatigue lasting 4 days.


VAERS ID: 1757196 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Public       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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clonidine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Have not sought out medical advice.
CDC Split Type:

Write-up: Severe headache, light headedness and increased blood pressure. Continued arm and shoulder pain 3 weeks after injection. 2nd shot taken on 10/1/2021, development of rash in bilateral antecubical areas.


VAERS ID: 1758703 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-05-07
Onset:2021-09-09
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1759352 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-24
Onset:2021-09-09
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus test, Angiogram pulmonary abnormal, Anion gap, Asthenia, Atrioventricular block first degree, Blood bicarbonate, Blood chloride decreased, Blood glucose increased, Blood lactic acid, Blood pH normal, Blood potassium normal, Blood sodium decreased, Bordetella test negative, Bradycardia, COVID-19 pneumonia, Chest X-ray abnormal, Chlamydia test negative, Computerised tomogram thorax abnormal, Contusion, Diabetic ketoacidosis, Dyspnoea, Dysuria, Electrocardiogram abnormal, Enterovirus test negative, Fibrin D dimer, Full blood count abnormal, Haemoglobin normal, Head injury, Headache, Hepatic steatosis, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Metabolic function test, PCO2 decreased, Respiratory syncytial virus test, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Syncope, Troponin, Troponin increased, Urine analysis abnormal, X-ray limb abnormal, pH body fluid
SMQs:, Torsade de pointes/QT prolongation (broad), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (broad), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Sepsis (narrow), 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? Yes
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg tablet albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler allopurinoL (ZYLOPRIM) 100 mg tablet aspirin 81 mg tablet azelastine (ASTELIN) 137 mcg (0.1 %) nasal spray colesevelam (WELCHOL) 625 mg t
Current Illness:
Preexisting Conditions: Nervous Chronic bilateral low back pain without sciatica Cervical radiculopathy Hearing loss Respiratory Obstructive sleep apnea of adult Allergic rhinitis Acute respiratory failure with hypoxia (CMS/HCC) Circulatory Essential hypertension Digestive Gastroesophageal reflux disease Genitourinary Prostate cancer (CMS/HCC) Left ureteral stone Musculoskeletal Osteoarthritis, multiple sites Endocrine/Metabolic Type 2 diabetes mellitus without complication (CMS/HCC) Hypercholesterolemia Pure hypercholesterolemia Diabetic ketoacidosis without coma associated with type 2 diabetes mellitus (CMS/HCC) Infectious/Inflammatory COVID-19 virus infection Other Obesity (BMI 30.0-34.9) History of brachytherapy Asbestos exposure Ambulatory dysfunction
Allergies: Ace InhibitorsAngioedema / Facial Swelling AtorvastatinMyalgia / Muscle Pain LisinoprilAngioedema / Facial Swelling LovastatinMyalgia / Muscle Pain RosuvastatinMyalgia / Muscle Pain CholestyramineConstipation HydrochlorothiazideOther (document details in comments) Nsaids (Non-steroidal Anti-inflammatory Drug)Other (document details in comments) OtherConstipation PiroxicamOther (document details in comments)
Diagnostic Lab Data: 09/13/21 1916 Respiratory virus detection panel Collected: 09/13/21 1705 | 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 Detected Critical 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 09/13/21 1403 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/13/21 1233 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 09/13/21 1403 COVID-19 PCR - Communal Living / SNF Placement (Asymptomatic) Collected: 09/13/21 1233 | Final result | Specimen: Swab from Nasopharynx Procedure Component Value Ref Range Date/Time CT chest without contrast [3302586241] Resulted: 09/14/21 1409 Order Status: Completed Updated: 09/14/21 1409 Narrative: CT CHEST WO CONTRAST IMPRESSION: New subtle peripheral right lower lobe airspace disease concerning for possible development of early COVID-19 pneumonia. Persistent bilateral calcified and noncalcified pleural plaques related to changes of prior asbestos exposure. Fatty liver disease. END OF IMPRESSION: INDICATION: COVID-19 positive with increasing oxygen requirement. TECHNIQUE: Helical CT scan of the chest without contrast was performed from the lung apices to below the diaphragm with 3 mm axial reconstruction. MPR coronal and sagittal images were created. CONTRAST: No contrast was administered. COMPARISON: September 9, 2021. FINDINGS: Allowing for the limitations of this unenhanced technique, there is no pathologic adenopathy appreciated. No pleural or pericardial effusions are noted. There is scattered coronary artery calcification. Regional soft tissues are grossly intact. Limited evaluation of the upper abdomen demonstrates fatty liver disease. There are stable calcified and noncalcified pleural plaques identified related to prior asbestos exposure. Slight right lower lobe airspace disease concerning for changes of developing COVID-19 pneumonia. Central airways are patent without evidence for endobronchial lesions. Minimal bibasilar dependent changes are noted. Osseous structures are grossly intact. Mild scattered degenerative changes noted. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray foot right 3+ views [3302455217] Resulted: 09/11/21 1811 Order Status: Completed Updated: 09/11/21 1811 Narrative: XR FOOT 3 OR MORE VW RIGHT IMPRESSION: No significant findings. END OF IMPRESSION: INDICATION: unexplain bruising, suspect neuropathic injury. TECHNIQUE: AP, lateral and oblique projections of the right foot were obtained. COMPARISON: None available. FINDINGS: Normal bony mineralization. No definite evidence of fracture or dislocation is seen. The surrounding soft tissues are grossly unremarkable. The joint spaces are within normal limits. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view - Portable [3301992052] Resulted: 09/09/21 0715 Order Status: Completed Updated: 09/09/21 0716 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Somewhat low lung volumes limit assessment. 2. Mild cardiomegaly changes. 3. Otherwise no acute cardiopulmonary process. 4. Cannot exclude minimal left basilar atelectasis or infiltrates. END OF IMPRESSION: INDICATION: Sepsis. TECHNIQUE: Single AP projection of the chest is acquired. COMPARISON: Chest radiograph dated December 24, 2016. FINDINGS: Cardiomegaly changes are reidentified. No consolidation, effusion or pneumothorax is identified. Osseous structures are intact. Somewhat low lung volumes limit assessment. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT angiogram chest pulmonary embolism with and without contrast [3302001480] (Abnormal) Resulted: 09/09/21 0450 Order Status: Completed Updated: 09/09/21 0450 Narrative: PROCEDURE INFORMATION: Exam: CTA Chest Without And With Contrast Exam date and time: 9/9/2021 2:53 AM Age: 73 years old Clinical indication: Other: Na; Additional info: Hypoxia, +dimer, SOB. Hypoxia, +dimer, SOB TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest without and with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNI 350; Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: DX XR CHEST 1 VW 9/8/2021 11:41 PM FINDINGS: Pulmonary arteries: Normal. No pulmonary emboli. Aorta: Unremarkable. No aortic aneurysm. No aortic dissection. Lungs: Unremarkable. No consolidation. No masses. Pleural spaces: Multifocal pleural nodularity with calcification scattered throughout the bilateral thorax most consistent with asbestos exposure with calcific plaque along the right hemidiaphragm. Heart: Unremarkable. No cardiomegaly. No pericardial effusion. Lymph nodes: Unremarkable. No enlarged lymph nodes. Liver: Diffuse fatty infiltration of the liver.There are moderate degenerative changes present. Gallbladder and bile ducts: There has been a cholecystectomy. Bones/joints: Unremarkable. No acute fracture. Soft tissues: Unremarkable. Other findings: . IMPRESSION: 1. Findings of asbestos exposure. 2. Hepatic steatosis. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/8/2021 - 9/22/2021 (14 days) Last attending ? Treatment team Acute respiratory failure with hypoxia Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath Hypoxia Elevated troponin DKA, type 2, not at goal Hospital Course Patient presented to the hospital on 9/9 with weakness, ambulatory dysfunction and shortness of breath. Patient was found to have new onset oxygen requirement and lab work was concerning for increased glucose, anion gap and beta hydroxybutyrate. Ultimately, it was believed patient was in euglycemic DKA secondary to SGL 2 inhibitor use and he was admitted to the hospital for further management. Euglycemic DKA Believed to be in the setting of SGLT2 inhibitor use. With initiation of insulin and IV fluids patient''s gap closed and beta hydroxybutyrate returned to normal. Patient was maintained in the hospital to initiate insulin in order to optimize home insulin regimen. His insulin requirement for mealtime was increased due to initiation of steroids and treatment of Covid pneumonia. At the time of discharge she was well managed on 35 units Lantus nightly and lispro 23 units 3 times daily. He will need continued titration of insulin in the outpatient setting as he has completed his dexamethasone course. Anticipate lessening mealtime coverage required. COVID pneumonia & OSA Patient did have weakness and shortness of breath with a new oxygen requirement on the hospital. Initial respiratory viral panel, chest x-ray and CT scan showed no evidence of Covid pneumonia. CT scan did show signs of asbestos exposure. Patient was in the process of being placed secondary to amatory dysfunction and had asymptomatic Covid swab performed which was positive. Repeat CT scan showed that patient was now showing signs of Covid pneumonia. With his hypoxia and new oxygen requirement he met criteria to receive inpatient treatment for Covid pneumonia. He was initiated on dexamethasone x10 days, remdesivir x5 and received convalescent plasma x1. He was discharged after receiving the full course of all these agents on 2 L NC. The 10-day quarantine timeframe from time of positive test is 9/13-9/23. Throughout his hospital stay he did receive CPAP at nighttime as he has OSA. This is an aerosolizing procedure which the facilities were not comfortable with during his Covid positive timeframe. Options were to send him with oxygen alone versus await 10-day mark when he could go with CPAP. To ensure this was a safe discharge with oxygen alone to get him to rehab sooner a nocturnal oximetry was performed which showed overnight on oxygen alone nocturnal oximetry shows patient spent 98% of the night above 90% SpO2 on 3 L NC. He was found to be appropriate for discharge to rehab with transition back to CPAP on 9/24. Asymptomatic bradycardia Patient was on metoprolol tartrate 50 mg once daily upon admission. He had a profound bradycardia to the 40-50s. His metoprolol was reduced to 25 mg and subsequently was held altogether. This did not alter his heart rate and it remained in the 40s to 50s. An EKG was performed which did show a profound first-degree AV block with PR interval of 280. No history of Lyme disease but has had tick exposure. This was not further investigated as patient was asymptomatic throughout. Brachytherapy & side effects Patient noticed he had started being incontinent of stool during his admission status post brachytherapy placement on 9/7. This is likely proctitis related to radiation which can be ongoing. We recommended he reach out to his radiation oncologist for further information regarding the time course of this. He has mild abdominal pain which is improving daily. Ambulatory dysfunction Patient was noted to have falls at home prior to admission. This was believed to be in the setting of above illness but patient was unsafe to return home where he lives by himself. Social work was able to find placement at encompass. a 73 y.o. male presenting with generalized weakness and shortness of breath. Admitted from the ED with lab findings consistent with diabetic ketoacidosis, which has improved with fluids, as well as new oxygen requirement of uncertain etiology. Plans Principal Problem: Shortness of breath #. Metabolic acidosis likely secondary to ketoacidosis #. Type 2 diabetes Possibly related to diabetic ketoacidosis given that patient has elevated beta hydroxybutyrate and UA positive for ketones as well as blood sugar of 286. This may also be contributing to his generalized weakness. ?Repeat BMP pending. Repeat VBG within normal limits. ?Blood glucose checks every 2 hours ?Start low-dose sliding scale as patient is not on insulin at home. ?IV fluids: Normal saline 100 mL/h #. Hypoxia with new O2 requirement Patient states that he has been short of breath for the last 2 days. CT the of the lungs did show evidence of exposure to asbestos, but this would be unlikely to cause acute hypoxia. Given chest x-ray and CT findings, low suspicion for pneumonia. Though it sounds as if patient may be wheezing when listening to him breathe without the stethoscope, on auscultation lungs are clear bilaterally with no wheezing patient has not received any breathing treatments since arriving at the hospital. ?Continue supplemental O2 as needed, wean as tolerated ?Continuous pulse ox ?Albuterol nebulizer or DuoNeb every 2 hours as needed per respiratory therapy protocol. #. Prostate cancer #. S/p brachytherapy seed placement 9/7 Some concern for possible side effects due to onset of symptoms shortly following brachytherapy seed placement. ?Consult to radiation oncology. #. Urinary frequency UA was positive for nitrites, blood, glucose, and ketones. ?Urine culture pending. #. Hyperlipidemia ?Continue home colesevelam 625 mg daily ?Continue ezetimibe 10 mg daily #. Hypertension ?Continue home losartan 100 mg nightly ?Continue home metoprolol tartrate 50 mg daily ?Continue home felodipine 10 mg daily #. Chronic back pain ?Continue home gabapentin 300 mg twice daily ?Continue home duloxetine 30 mg daily #. Gout ?Continue home allopurinol 100 mg daily Diet: Consistent carb DVT Prophylaxis: Lovenox Disposition: Pending clinical improvement CODE STATUS (LOI): Prior Patient was discussed who is in agreement with the plan. Subjective Chief Complaint Shortness of Breath and Fatigue History of Present Illness a 73 y.o. male with PMH of prostate cancer status post placement of brachytherapy seeds 2 days ago, type 2 diabetes, hypercholesterolemia, HTN, OSA on CPAP, GERD, history of kidney stone who presents with 1 day of generalized weakness and 2 days of shortness of breath.. Patient states that he presented to the hospital because he was getting out of bed at noon yesterday and when he went to stand up he collapsed because he felt that his legs could not support him. He tried to get back up and was unable to do so. He crawled to the bathroom. He said that when he fell he did hit the back of his head, but he did not lose consciousness and remembers the entire event. He does have a bit of a headache still, but says he has not had any confusion or vision changes since the fall. His primary complaint is this generalized weakness. During encounter, patient is on 2 L nasal cannula and clearly short of breath with increased work of breathing. When asked about his shortness of breath, he says that it started 2 days ago since his procedure for brachytherapy seed placement. He denies fevers, chills, increased cough, chest pain, palpitations. Further denies lightheadedness, dizziness. Says that when he stands up he falls backwards, but that this is related to weakness in his body rather than a feeling like he is going to pass out. Since his brachytherapy procedure, he has been having urinary frequency which he says was not an issue for him so much before. States that he needs to urinate every hour. He was initially having dysuria, but was given a medication for this (most likely Pyridium) which turned his urine orange but caused the dysuria to resolve. He is unable to see if there is blood in his urine due to urine coloration. Denies issues with incomplete voiding. Patient denies smoking, alcohol, illicit drug use. Ambulates without any assistive devices at home. Has never needed supplemental oxygen before. He currently lives alone and is retired, but formerly worked as a plumber. His primary contact and POA if he were to become unable to make decisions as his brother. ED Course: Patient brought in by EMS. Per ED report, patient had a temperature of 100.6 per EMS, but was afebrile on arrival in the ED. Also on arrival had heart rate 103, respirations 20, blood pressure 162/83, satting 93% on 2 L nasal cannula. Per ED report, he was satting in the high 80s on room air prior to this. Since initial arrival heart rate has been in the 80s to 90s. CBC showed no leukocytosis and normal hemoglobin. BMP significant for blood glucose of 282, sodium 131 corrected to 134, potassium 3.9, chloride 96, bicarb 19, anion gap 16. Lactate 1.2. UA positive for nitrites, moderate blood, glucose, and ketones. Blood culture and urine culture pending. I-STAT showed pH 7.39, PCO2 34. Troponin 0.03. EKG negative for ischemia but suggestive of first-degree heart block with prolonged PR interval and some regularity in heart rate with possible PAC noted. D-dimer 5.91, but CT scan negative for PE. CXR showed no acute cardiopulmonary process. In the ED patient has received 1 L bolus of NS, but no other medications thus far. Family medicine consulted for admission of patient with new O2 requirement and generalized weakness.


VAERS ID: 1760238 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Contusion, HIV test false positive, Laboratory test normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (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: oral antihistamine
Current Illness: none
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported large bruise of groin with no trauma. labs completed and normal. bruise improved with time. she also was found with a false positive HIV antibody screen on 9/9/2021. unclear if related to vaccine.


VAERS ID: 1760452 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-06
Onset:2021-09-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dermatitis acneiform, Injection site reaction
SMQs:, Hypersensitivity (narrow)

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

Write-up: Patient reported little "pimple like bumps" on arm where he received the injection 4-5 days post injection. He said it was not itchy or painful, but the bumps "kept growing"


VAERS ID: 1761218 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-10
Onset:2021-09-09
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1761556 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-02
Onset:2021-09-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Culture wound positive, Incisional drainage, Staphylococcal bacteraemia, Staphylococcus test positive, Vaccination site abscess
SMQs:, Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fioricet fluticasone hydrochlorothiazide levothyroxine losartan methocarbamol metoprolol nambumetone nortriptyline potassium chloride semaglutide
Current Illness: unknown
Preexisting Conditions: HTN Hypothyroidism morbid obesity Eczema Prediabetes
Allergies: NKDA
Diagnostic Lab Data: 9/27/21 Abscess Culture: + MSSA 9/28/21 Blood Culture: + MSSA
CDC Split Type:

Write-up: Patient developed an abscess at the vaccination site, ultimately requiring hospitalization and surgical I&D. Abscess subsequently grew out MSSA, and patient had MSSA bacteremia requiring outpatient antibiotic therapy. Of interest, her husband reports receiving the vaccination at the same time from the same vial, and did not have any negative sequelae.


VAERS ID: 1761928 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Decreased appetite, Dizziness, Hyperhidrosis, Immunoglobulin therapy, Lethargy, Myalgia, Pain, Paraesthesia, Pyrexia, SARS-CoV-2 test negative, Upper-airway cough syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlopidine, 5 mg Losartan, 100 mg Glipizide, 2/day @ 10 mg 81 mg Aspirin Bone-Up 1,000 mg D3, 2,000
Current Illness: Chronic Lymphocytic Leukemia (CLL) on Calquence 2x day, Aug 2019-June 2021 High Blood Pressure Borderline Diabetes GERD (occasional Tums only)
Preexisting Conditions: Chronic Lymphocytic Leukemia (CLL) on Calquence 2x day, Aug 2019-June 2021 High Blood Pressure
Allergies: None
Diagnostic Lab Data: NOTE: I was on chemo (Calquence) at the time of my two shots and 4 months after had NO antibodies (per labs from Leukemia Society in "Covid vaccine study". 9/11/21 - Called pharmacy & confirmed that delayed symptoms could be reaction. 9/13 - To Chiropractor (neck & back alignment for tingling & body aches) 9/15 - Called Oncology nurse; called Urgent Care & Primary dr. 9/15 - Tested NEGATIVE for Covid 9/15 - 9/20 - fever, in bed 9/20 - to Primary care Nurse Practitioner; slight cough (from post nasal drip). 9/22 - feeling much better - to Oncologist for pre-IVIG appt.
CDC Split Type:

Write-up: 9/9 - 4P - Muscle sore and tingling in upper arm where shot was administered; 9/10 - 2p - Tingling radiated over and down arm; thought it was neurology acting up; took Gabapentin but did not help. 9/10 - 9/14 - Blood pressure 171/101 - thought from IVIG treatment for CLL; chills, sweats, achey, lethargy, lightheaded, went to bed. 9/14 - 9/21- Temp 100.-102 during night 4p to 4a ; seemed better during day. Didn''t eat for three days.


VAERS ID: 1762380 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Fatigue, Headache, Hypoaesthesia, Immediate post-injection reaction, Pyrexia, Rhinorrhoea
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Pain in top of head immediately. Numbness in both hands and dizziness immediately. The next day, extremely tired, confused, weak, runny nose, feverish. It lasted 10 days. The confusion lasted a few days longer.


VAERS ID: 1762387 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Injection site inflammation, Muscle spasms
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flexeril, meloxicam, multivitamin, probiotic, vitamin d3
Current Illness: None
Preexisting Conditions: None
Allergies: Codine, hydrocodone, oxycodone, latex, adhesive
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Intramuscular inflammation, burning joints, muscular spasm s. Now 10/5/21, still occurring since 9/9/21 (two days after vaccine). Taking meloxicam, flexiril, massage and chiropractic care per recommendation of orthopedic and trying trigger point injections in the near future.


VAERS ID: 1764105 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USMODERNATX, INC.MOD20213

Write-up: Expired vaccine used; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) in a 54-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006C21A) for COVID-19 vaccination. No Medical History information was reported. On 09-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine used). On 09-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The Patient took Vaccine after 15 days the vial was first thawed and punctured. No concomitant information was reported. No treatment information was reported. Most recent FOLLOW-UP information incorporated above includes: On 28-Sep-2021: Follow up received on contain no significant information.


VAERS ID: 1764998 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 RA / IM

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

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

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


VAERS ID: 1765041 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Heart rate increased, Hypoaesthesia, Vertigo, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypoglycaemia (broad), Dehydration (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: None
Diagnostic Lab Data: Several dizziness/vertigo episodes following vaccine dose. Numbness in both hands has been ongoing
CDC Split Type:

Write-up: Within 1 minute of receiving the shot, rapid heart rate, extreme dizziness, confusion, change in vision, numbness in right hand.


VAERS ID: 1765457 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-09-09
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Cerebrovascular accident, Computerised tomogram head, Facial paralysis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin ( 1xday 10mg ) Amlodipine ( 5mg 1xday )
Current Illness: NA
Preexisting Conditions: High BP High Cholesterol
Allergies: Lisinopril
Diagnostic Lab Data: CT Scan Bloodwork
CDC Split Type: vsafe

Write-up: I woke up one morning and I couldn''t move the right side of my face I thought I was having a stroke. I went to the ER for treatment where I was diagnosed with Bell''s Palsy. I had a CT Scan of my head and brain and I also had bloodwork done. I experienced paralysis on my face.


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