National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 236 out of 5,069

Result pages: prev   137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335   next


VAERS ID: 1392087 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026C21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Deep vein thrombosis, Erythema, Influenza like illness, Pain in extremity, Peripheral swelling, Skin discolouration
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol 0.5MG Tablets 1 a day
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: After vaccine the following day Friday 5/28 I had COVID flu like symptoms and right arm very sore for 24 plus hours until Wednesday 6/2 stopped. Than woke up Friday 6/4 early AM with swollen right arm, purple and reddish in color.. Continued on through Sunday morning 6/6 went to ER at 9 am. treated for deep vein thrombosis, blood clot found in right arm and given an injection of Eliquis to the stomach to last 24 hours until Eliquis tablets starter pack. My arm is still swollen and bruised now at vaccine spot, today Friday 6/11 scheduled to see a Hematologist Dr. MD 6/14 I am very concerned and don''t understand.


VAERS ID: 1392096 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Heart rate irregular, Immunoglobulin therapy, Inflammatory marker increased, Intensive care, Nausea, Palpitations, Troponin increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procysbi, Aleve, Cystadrops Eyedrops omeperazole Lexapro
Current Illness: None
Preexisting Conditions: Cystinosis, Anxiety depression
Allergies: NKA
Diagnostic Lab Data: 6/5/2021 ER EKG ST segment abnormalities, irregular heart rate, elevated troponin 12.5, inflammatory markers elevated. Given NS 1L. ECHO normal Transferred to PCICU by ambulance, troponin 30 given morphine IV, Toradol IV, IVIG, solumedrol Discharged home 6/8
CDC Split Type:

Write-up: 2 days after 2nd Pfizer dose sudden severe chest pain with SOB, nausea, palpations. Unrelieved by OTC IB or rest.


VAERS ID: 1392125 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation delayed, Muscle spasms, Scar
SMQs:, Dystonia (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: Multiple
Current Illness: High blood pressure, diabetes,overactive bladder,arthritis, carpal tunnel, back issues.
Preexisting Conditions: Obesity, back issues
Allergies: Lactose intolerance
Diagnostic Lab Data:
CDC Split Type:

Write-up: Scars on left arm, cramps, late period.


VAERS ID: 1392128 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: Type 2 diabetes Hypertriglyceridemia
Preexisting Conditions: n/a
Allergies: No Known Allergies
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt received 2nd dose of COVID vaccine at 21 days after 1st dose instead of 28 days.


VAERS ID: 1392409 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Wrong technique in product usage process
SMQs:, Medication errors (narrow)

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

Write-up: Patient presented to clinic to receive 2nd dose of Pfizer COVID vaccine. NP SD cleaned arm with alcohol swab, grabbed a syringe and inserted needle in arm, attempted to push but no vaccine in clean, sterile syringe/needle. Less than 0.1mL air bolus administered. Provider then had to administer a second needle this time with the vaccine.


VAERS ID: 1392482 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Tinnitus
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Took Tylenol 5 hours after second shot of Pfizer COVID vaccine
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Allergy to dust, Panadol and majority of shampoo & conditioner
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 1st shot on 05/13/2021: in the next 24 hours, taste changed. It eventually went away 2nd shot on 06/03/2021: in the next 48 hours, ear whooshing sound and nosebleed. It eventually went away


VAERS ID: 1392487 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-0580-15 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Palpitations, Sleep disorder
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins: d, B. C, Zinc, Magnesium, CoQ10
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resting heart rate increased from 58 to 77 over the course of 7 days. racing heart rate, not correlated with activity, tired, fatigued, unable to sleep, loss of appetite, headache


VAERS ID: 1392514 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-25
Onset:2021-06-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Constipation, Dysuria, Gait inability, Magnetic resonance imaging spinal abnormal, Myelitis transverse, Paraesthesia, Spinal cord infarction
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Recent spider bite to left ribcage; patient did not seek treatment per report Substance Abuse
Preexisting Conditions: Remote history of cardiac disease
Allergies: No known Allergies
Diagnostic Lab Data: Thoracic MRI: Signs of transverse myelitis vs. spinal cord infarction
CDC Split Type:

Write-up: Presents to our facility today with complaints of progressive weakness, inability to ambulate, abdominal pain, left thoracic wall paresthesias, inability to move bowels, and urinary difficulties. Reports he was also bitten by a spider on his left side recently and did not seek treatment, but decided to seek treatment when he developed same symptoms in his right side. Reports he has been experiencing symptoms for 1 week or more.


VAERS ID: 1392539 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / UNK - / IM

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

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

Write-up: Patient was 11 years and 9 months years old at time of vaccination. Must be 12+ for Pfizer


VAERS ID: 1392755 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-06-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Paranasal sinus discomfort, Respiratory tract congestion, SARS-CoV-2 test positive, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diffuse large B cell lymphoma- in remission
Allergies: NKA
Diagnostic Lab Data: SARS-COV-2 Rapid: SARS-COV-2 detected (6/4/2021)
CDC Split Type:

Write-up: 62 YO female presents to the ED on 6/4 with complaints of non productive cough, chest congestion, post-nasal drip, nasal congestion, chills, SOB, sinus pressure, and sore throat. Denies fever. COVID rapid test results back negative the same day. Vitals were stable and pt was discharged with COVID-19 diagnosis. She is s/p J&J vaccination on 5/11.


VAERS ID: 1392758 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-15
Onset:2021-06-04
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1508015 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Cough, Decreased appetite, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: symptom onset 05/25- cough , SOB, headache, poor appetite, abdominal discomfort.


VAERS ID: 1392849 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: moderate pain at injection site for 2 days with no immobility issues.
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: none. no doctor
CDC Split Type:

Write-up: Severe pain at injection site, muscles of outer upper right arm. Immobility of right arm. By 06/07/2021 , little change. Range of possible motion only 30% of normal. Severe pain and (arm "not working") outside of 30% range of motion.


VAERS ID: 1392878 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-01
Onset:2021-06-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril effexor
Current Illness: none
Preexisting Conditions: hypertension depression tinnitus sensoneural hearing loss
Allergies: none
Diagnostic Lab Data: troponin 6/08 cardiac catheterization
CDC Split Type:

Write-up: myocarditis. chest pain, elevated troponin


VAERS ID: 1392882 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: body fatigue everyday. nausea, headache even after a week


VAERS ID: 1392914 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: ADMINISTERED VACCINE THAT HAD BEEN OXPOSED TO A TEMPERATURE BREACH. REQUIRED RE-VACCINATION


VAERS ID: 1392924 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: PATIENT RECIEVED INCORRECTLY STORED VACCINE; REQUIRES RE-ADMINISTRATION


VAERS ID: 1392977 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Immediate post-injection reaction, Nausea, Taste disorder
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)

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

Write-up: STRONG Metallic taste in mouth within seconds of injection lasting 48 hours initially, then off & on throughout the day for 48 additional hours. Nausea and adverse taste made it hard to eat food, affected taste buds.


VAERS ID: 1392992 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-06-04
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amniorrhoea, Blood test, Epidural injection, Exposure during pregnancy, Induced labour, Laboratory test abnormal, Premature delivery, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: I was taking prenatal vitamins, clindamycin and a topical betamethasone.
Current Illness: I did not have any other illnesses.
Preexisting Conditions: I do not have any chronic or long-standing health conditions.
Allergies: I do not have any allergies.
Diagnostic Lab Data: I had blood work drawn and my amniotic fluid checked. I had an epidural and everything else that comes along with giving birth.
CDC Split Type: vsafe

Write-up: On 06/04 I woke up and I had a lot of water leakage and I let it go throughout the day a little longer. I called the OBGYN and I went in and had it checked around 4:00PM. There were several tests that were run. I was leaking amniotic fluid. I had to go into labor that day. The pregnancy was considered pre-term because I wasn''t due until 07/15. On 06/05, my baby was born at 5lb, 5oz. After I was told I had to go into labor, I was induced. I received a cervix softener and than I was given Pitocin. I was induced at 10PM on 06/04 and I delivered at 12PM on 06/05. I was in labor for 14 hours. Right now my baby is in the NICU and she will hopefully be coming home 06/13. If she does come home on 06/13, she will have been in the NICU for 8 days. I was given penicillin and betamethasone, which is supposed to help with the development of the babies lungs. All of her tests have come back normal. The only issue was with her bilirubin levels.


VAERS ID: 1393000 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ecchymosis, Induration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: Crescent shaped ecchymoses and induration oinferior to external lower lip, abuts vermillion border. No other ski changes or rash, no oral/airway angioedema.


VAERS ID: 1393226 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia, Flatulence
SMQs:, Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily at bedtime: Rosuvastatin Tabs 20 mg Lisinopril Tabs 5 mg
Current Illness: none
Preexisting Conditions: high blood pressure high cholesterol
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: constant gas, acid indigestion, and heartburn


VAERS ID: 1393246 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0R8736 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 0R8736 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen Protonix Vitamin D Magnesium Melatonin Glucosamine chondroitin Biotin
Current Illness: None
Preexisting Conditions: Acid reflux
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 4 o?clock the day of my shot I became extremely exhausted. I have been through chemo and it was that type of exhaustion. Then the headache and nausea started. I woke up Saturday morning running a low-grade fever, by lunch it was 102.7. Around that time diarrhea started. Friday night until 915 Sunday morning, I would be awake for an hour and a half or two hours, then sleep for the same around the clock. I had every symptom on the nonemergency list except for injection site problems and vomiting. The fever broke Sunday afternoon, but I still felt terrible. I barely made it through work on Monday. I started feeling a little better throughout the week. But a week later I still have nausea and diarrhea no matter what I eat. Also still more tired than usual. I had Covid back in November, and I heard that the vaccine side effects could be worse, but I sure wasn?t expecting all of this!


VAERS ID: 1394032 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-06-04
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Migraine, Thrombosis
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), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XARELTO
Current Illness: Antiphospholipid syndrome; Migraine
Preexisting Conditions: Medical History/Concurrent Conditions: Vertigo (She has a history of vertigo and went to the hospital about 18 months ago.); Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210617520

Write-up: THROMBOSIS OF THE CLOT; INCREASED FREQUENCY OF MIGRAINES/VERTIGO; STROKE; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included vertigo, and concurrent conditions included lupus antiphospholipid syndrome, and migraine. The patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on APR-2021, 1 total dose for prophylactic vaccination. Concomitant medications included Xarelto (rivaroxaban) for lupus antiphospholipid syndrome. On APR-2021, the patient developed thrombosis of the clot and increased frequency of migraines/vertigo (over the past month or two). On 04-JUN-2021 (3 night ago), she was diagnosed with stroke. Later, she underwent procedure for thrombosis of the clot and she was stable. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from stroke, and thrombosis of the clot, and the outcome of increased frequency of migraines/vertigo was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210617520-covid-19 vaccine ad26.cov2.s-Stroke, Thrombosis Of The Clot. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1394072 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025C21A / 1 LA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Seizure immediately after the dose was given; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (Seizure immediately after the dose was given) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025C21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Jun-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Jun-2021, the patient experienced SEIZURE (Seizure immediately after the dose was given) (seriousness criterion medically significant). On 04-Jun-2021, SEIZURE (Seizure immediately after the dose was given) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No Concomitant medications were reported. No treatment information was reported.; Sender''s Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.


VAERS ID: 1394142 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Atrial fibrillation, Atrial flutter, Cardiac failure congestive, Chest pain, Condition aggravated, Diarrhoea, Dyspnoea, Fatigue, Fear of death, Headache, Heart rate increased, Nausea, Pruritus, Rash
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: COUMADIN
Current Illness: Atrial fibrillation; Chest pain; Congestive heart failure; Flutter atrial; Heartbeats increased; Shortness of breath
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021665319

Write-up: congestive heart failure exacerbated; Atrial Fibrillation; however these symptoms were exacerbated after having the 1st dose; The patient stated that she know that if she got a covid vaccine she may die because of her heart and lungs.; flutter; shortness of breath exacerbated; chest pain/ chest pain exacerbated; racing heartbeat at times exacerbated; abdominal pain/ cramping in abdomen/ belly pain; diarrhea; tired; headache; stomach was queasy; rash; itching; This is a spontaneous report received from a contactable consumer via medical information team. A 73-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: Unknown), via unspecified route of administration in the right arm, on 04Jun2021 (at the age of 72-year-old), as a single dose for COVID-19 immunisation. Medical history included ongoing congestive heart failure, ongoing atrial fibrillation, ongoing flutter and does experience shortness of breath (ongoing), ongoing chest pain, and racing heartbeat at times (ongoing). Concomitant medications included Warfarin sodium (COUMADIN). On 04Jun2021 after vaccination, when the patient by reaching to home experienced itching and rash that initially was on her left arm and knuckles and moved to her right arm where she got the vaccine. Those symptoms have since resolved with no further concerns. A couple hours after the administration of the vaccine, the patient experienced severe pain in her chest. It was reported that the pain was an 11 on a scale of 1 to 10, and her heart was really racing. The patient had shortness of breath, which she had with her problems, but it was a little more. The patient stated that she has a history of congestive heart failure, with Atrial Fibrillation and flutter and does experience shortness of breath, chest pain, and racing heartbeat at times however these symptoms were exacerbated after having the 1st dose administered. The patient stated her symptoms almost put her in the Emergency Room but she held off on going and chose to wait her symptoms out. It calmed down so the patient did not go to the emergency room. Later, on the patient had a chest pain but not as severe. It was reported that in the morning and over the weekend it was minor. The patient started cramping in her abdomen and had diarrhea at night and had it again on Saturday and she had some yesterday (06Jun2021). This morning (07Jun2021) the patient had it and then around 2:00 she started having belly pain/abdominal pain and diarrhea. The patient wanted to know if there were any contraindications with receiving the Pfizer COVID19 vaccine in conjunction with Coumadin use. Response was provided for the same as: When vaccinating Persons with Increased Bleeding Risk, providers often avoid giving intramuscular injections (not just this vaccine) or choose alternative routes because of the risk for hematoma formation after injections. The Pfizer-BioNTech COVID-19 Vaccine should only be administered as an intramuscular injection. Also reported that there was no contraindication listed upon the package insert for patients receiving blood thinners and getting the COVID19 vaccine as well as provided information regarding use with blood thinners. It was reported that one provider advised her to not get the vaccine, however her cardiologist recommended her to get the vaccine due to risks vs benefits. However, the patient was waiting call back from her Cardiologist regarding her chest pain and racing heart symptoms at that time. The patient wants to make sure the physician doesn''t want to see her. The patient was overall not felt well and was fatigued as well and she wanted to know if those symptoms are commonly seen or have they been reported. She also stated that she gets tired easily due to heart congestion but she was feeling more tired than usual. Patient does not usually get headaches and also got a headache on Friday after getting her COVID19 vaccine. The patient wanted to know how long her side effects may last because already she was scheduled dental procedure tomorrow (08Jun2021) wants to make sure everything was okay, and also she wanted to know more information regarding the reported cases of Myocarditis. The patient was more concerned and worried about getting the second dose because with the first dose she experienced events and she stated that her second dose was scheduled on the 25Jun2021. It was reported that when the patient''s husband visited for vaccination, they asked whether he was on blood thinner. But the patient was mentioning that she (his wife) was on blood thinner coumadin, however they did not ask her regarding the blood thinners. Even the patient had not informed about the blood thinners to them. The patient queried about whether they give a different type of vaccine for blood thinners or its okay to take normal vaccine. The patient stated that she know that if she got a covid vaccine she may die because of her heart and lungs. It was reported that her stomach was queasy. The events congestive heart failure exacerbated, Atrial Fibrillation, however these symptoms were exacerbated after having the 1st dose were assessed as medically significant. The outcome of the events was unknown. Follow-up attempts are needed; Information on the lot/batch number has been requested.


VAERS ID: 1394226 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dyskinesia, Feeling cold, Headache, Hyperhidrosis, Hypersomnia, Influenza like illness, Mobility decreased, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 60MG Daily Humira 40mg/0.4ml bi-weekly Avastin eye injection every 10 weeks Eylea eye injection every 10 weeks
Current Illness: None
Preexisting Conditions: Fibromyalgia Retinal issues
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My injection was Friday June 4th around 930am. After returning home Friday after my 2nd Moderna Covid-19 vaccination I went to sleep. I woke up a little while later EXTREMELY cold and shaking very bad. My head was pounding and hurting so bad and I felt like I had the worst flu ever. I could not hardly move my left arm and it hurt really bad. The rest of my body felt shaky and weak. I covered up with multiple blankets and turned my A/C off using an app on my phone. I needed to pee but i felt so bad I couldn''t bring myself to get up and walk to the bathroom. I wanted to go to the hospital but I was home by myself. I fell back asleep and woke up later still feeling the same only now I was sweating so much I no longer needed to pee. I fell back asleep and didn''t wake up until around 6 am when my husband got home from work. I was so tired I just wanted to sleep. He gave me some ibuprofen and I went back to sleep. I woke up around noon feeling a bit better. I laid in bed watching TV and napping. Eventually I felt better that Saturday afternoon/evening. I had a bad headache every day after that until around Wednesday that I got rid of using ibprophen. On that Monday night following my injection I was driving and I got a sudden extremely sharp pain in my heart and my left leg and arm jerked hard and my left side of my face contorted. I felt fine immediately after no lingering pain. Then yesterday I had an aching pain in my left chest but then it went away


VAERS ID: 1394245 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0173 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain lower, Appendicitis, Computerised tomogram abdomen abnormal, Monocyte count increased, Neutrophil count increased, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, penicillin
Diagnostic Lab Data: 6/4/2021: abdominal pain right lower quadrant in stomach 6/5/2021: went to urgent care for pain. CT scan showed acute appendicitis Labwork: monocytes "High" 1.04x10(9)/L ANC Auto: "high" 12.92x10(9)/L WBC: "high" 16.05x10(9)/L
CDC Split Type:

Write-up: Acute Appendicitis


VAERS ID: 1394281 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cellulitis
SMQs:

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: Cellulitis


VAERS ID: 1394296 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

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

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

Write-up: Error: Booster Given Too Early


VAERS ID: 1394329 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Headache, Mental impairment, Pain, Pyrexia, Speech disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Mobic & 5 mg melatonin (at night)
Current Illness: None
Preexisting Conditions: Chronic back pain from 2 herniated/bulging discs
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 6 hours, I developed a fever, all over body aches (from neck to toes), headache, inability to think clearly, difficulty speaking. This lasted for approximately 48 hours until the fever broke. Fogginess and headache lasted for another 48 hours.


VAERS ID: 1394332 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Nausea, Nodule, Pain, Pain in extremity, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown, nothing listed at pharmacy
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKDA
Diagnostic Lab Data: None, recommended the patient follow-up with her provider or acute provider if needed however, reports improvement in symptoms.
CDC Split Type:

Write-up: reports 2 days following her 1st Covid 19 vaccine she had left leg ache and small nodule/lump on her left leg, reports she "massaged it out", denies redness or swelling but states leg feels sore. Also reports palpitations beginning on 6/4, full body pain, fever, nausea. She presented to the pharmacy today and appeared in no acute distress and arrived with her husband to report the event.


VAERS ID: 1394371 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-05-20
Onset:2021-06-04
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Headache, Hypoaesthesia, Muscle spasms, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Headache, body numbness ,muscle cramp,tingling all over the body, extreme pain, not able to walk As of today, june 12 2021, he still in pediatrics department, since June 7 2021.


VAERS ID: 1394429 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394431 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394436 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394439 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394442 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394446 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394447 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect product formulation administered, Product storage error, Product use issue
SMQs:, Medication errors (narrow)

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

Write-up: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394453 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394456 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: It was discovered the pfizer vaccine was not removed from the freezer to the refrigerator after 14 days in the freezer. After contacting Pfizer, the vaccine was not viable after 17 days. The vaccine was administered to the patient after the 17 day timeframe.


VAERS ID: 1394459 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 RA / IM

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

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

Write-up: vaccine was outdated unknown adverse effects


VAERS ID: 1394465 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was expired no adverse effects known


VAERS ID: 1394470 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394473 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 RA / IM

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

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

Write-up: vaccine was outdated no known adverse effected


VAERS ID: 1394474 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394481 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394489 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

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

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

Write-up: vaccine was outdated unknown adverse effects


VAERS ID: 1394490 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 RA / IM

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

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

Write-up: vaccine was out of date no adverse effects known


VAERS ID: 1394495 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394500 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 1 LA / IM

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

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

Write-up: vaccine was outdated no adverse effects known


VAERS ID: 1394709 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-24
Onset:2021-06-04
   Days after vaccination:72
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Arthropod sting, Bronchospasm, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)

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

Write-up: I had an acute anaphylactic reaction to a yellow jacket sting. Within 20 minutes of the sting, my whole body was swollen and airways began to constrict. I received epinephrine, type 1 and 2 antihistamines, and steroids, and the symptoms resolved. I am reporting this because I was stung by a yellow jacket in the same location a year earlier (pre-vaccine) and had no reaction. I had never had an anaphylactic reaction. Clearly, other factors could have caused the new response to what appears to be the same stimulus, but receiving an MRNA vaccine designed to stimulate immune response seems like a suspect worth investigating.


VAERS ID: 1394833 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACYLEFT PFIZER VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE OUT DOSES FROM THESES VIALS RENDERINGTHEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1394848 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

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

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

Write-up: PHARMACY LEFT PFIZER VIALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE DONES OUT OF THESE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE


VAERS ID: 1394877 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Incorrect dose administered, Incorrect product formulation 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PHARMACY LEFT PFIZER VALS IN THE FREEZER FOR LONGER THAN 2 WEEKS AT THE TEMPERATURE (-25 AND -15 DEGREES C). WE GAVE OUT DOSES FROM THE VIALS, RENDERING THEM POSSIBLY LESS EFFECTIVE.


VAERS ID: 1394982 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (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: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After 1 week of first dose of moderna vaccine, patient experienced breakthrough bleeding and on and off spotting through out until she received the 2nd dose 28 days after.


VAERS ID: 1395003 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Oligomenorrhoea
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Longer than an 8 day menstrual cycle. At first I didn?t think this was weird but it turns out that many of my women friends are experiencing longer periods, and friends who went through menopause a long time ago are having hot flashes like menopause again. I know of about 6 people now. So that?s when I thought my daughters extra long menstrual cycle could be an adverse event.


VAERS ID: 1395022 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dyspnoea, Electrocardiogram, Enzyme level test, Fatigue, Myocarditis, Pyrexia, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: 24 hours: Acute Myopericarditis, Difficulty breathing, Heavy chest Within hours: Fever, Severe Chills, extreme fatigue


VAERS ID: 1395035 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Induration, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red patch on my arm. Arm pain for a few days but now it is just red and feels hard


VAERS ID: 1395061 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain
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:
CDC Split Type:

Write-up: Rolling body aches and pain throughout body, subsiding after two days.


VAERS ID: 1395096 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Rash, Rash erythematous, Rash papular, Rash pruritic, 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: faint feeling, fever
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: seasonal allergies
Diagnostic Lab Data: none yet.
CDC Split Type:

Write-up: Within two hours of receiving the vaccine, the patient developed a rash on his chest and abdomen. It moved to his back. This rash was small raised bumps and were itchy. 24 hours later, it looks more like hives on his abdomen. The bumpy rash stayed consistent, and the hives went away until a few days later a very red and inflamed rash developed on his neck, eyes, chin, cheeks, forehead. this has stayed consistent and the hives-like rash is back on his abdomen.


VAERS ID: 1395129 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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

Write-up: Mother indicated that patient was 12 years of age. The patient was actually 11 years and 11 months. She was 6 days shy of her 12th birthday, so not a recommended product as of yet. The patient did not experience any adverse effects to our knowledge and is scheduled for the second dose in the series as recommended. There was no answer when the pharmacy tried to reach the mother.


VAERS ID: 1395153 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Blood pressure decreased, Dizziness, Gait disturbance, Heart rate decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), 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), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, D and Zinc only
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Lightheaded, low heart rate, low blood pressure, blacking out with no vision the first hour of the vaccine. Could not walk without being held.


VAERS ID: 1395222 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Diarrhoea, Dyspepsia, Fatigue, Feeling abnormal, Headache, Injection site erythema, Vaccination site induration, Vaccination site rash, Vaccination site swelling
SMQs:, Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: 1. Fatigue, foggy-brain, and slight headache for 2 days following the vaccination, starting a couple hours after the vaccination, worsening the following day, and then slowly receding the second day after the vaccine. 2. A red raised rash with hardening of the underlying tissue just below the site of vaccination on the left upper arm. Approximately 2??x 3??, and it started 6 days after the vaccination. Rim darker than the inside. 3. Digestive griping and diarrhoea 5-6 days after vaccination.


VAERS ID: 1395388 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-21
Onset:2021-06-04
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 111111 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoacusis
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Ability to hear is affected, sounds like under water or muffled-Mild, Additional Details: Patient did not receive the first vaccine here, and I did not have all the information.


VAERS ID: 1395389 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-08
Onset:2021-06-04
   Days after vaccination:116
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, COVID-19, Encephalopathy, Lacunar infarction, Mental status changes, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Chronic kidney disease (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet ALPRAZolam (XANAX) 0.25 MG tablet aspirin 325 MG tablet busPIRone (BUSPAR) 10 MG tablet cyanocobalamin (VITAMIN B-12) 1000 MCG tablet loratadine (CLARITIN) 10 MG tablet losartan (COZAAR) 25 MG tablet ma
Current Illness: None known
Preexisting Conditions: Carcinoma in situ in rectal polyp Dyslipidemia Cerebral infarction (HCC) Aphasia GI bleed HTN (hypertension) Hyperlipidemia Tubulovillous adenoma GAD (generalized anxiety disorder) Stroke-like symptoms Hyponatremia Solar keratosis IFG (impaired fasting glucose) Bilateral carotid artery stenosis Personal history of rectal cancer TIA (transient ischemic attack)
Allergies: Acesulfame Potassium (Swelling), Aspartame (Swelling), Codeine (Hives), Lisinopril (Coughing), Plavix [Clopidogrel] (GI Bleed ), Saccharin (Swelling), Sorbitol( Swelling), Sucralose (Swelling)
Diagnostic Lab Data: COVID-19 test positive on 6/4/2021.
CDC Split Type:

Write-up: Patient presented to emergency department on 6/4/21 with altered mental status. During workup patient was found to be COVID-19 positive. Patient had fever at time of admission which was believed to be caused by COVID-19 infection. She was admitted for lacunar infarct and acute encephalopathy. She was started on dexamethasone for COVID-19 management, but was stopped as there was no major change in disposition with treatment. During the course of the hospital stay, she was deemed asymptomatic for COVID-19 and her symptoms were more likely to be attributed to other causes.


VAERS ID: 1395451 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: dizziness


VAERS ID: 1395720 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-17
Onset:2021-06-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Blood test, Computerised tomogram abdomen abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fish oil & immunity vitamine, vitamin D, & dutasteride
Current Illness: none
Preexisting Conditions: none
Allergies: Penicillin as a child
Diagnostic Lab Data: CT scan, blood drawn
CDC Split Type:

Write-up: On or around 6/4/2021, I started feeling mild/moderate abdominal pain. It would come and go. The abdominal pain increased in duration & intensity over the next few days. It became severe by 6/9/2021. I saw my primary care physician the morning of 6/9/2021. He sent me home with pain meds and made an appointment for an ultrasound the next day. The pain became so severe later that day that I went to the local ER, around 3:30 pm on 6/9/2021. Around 10:30 pm on 6/9/2021, I was diagnosed with appendicitis. I had an emergency appendectomy on the morning of 6/10/2021.


VAERS ID: 1395784 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009C21A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Fall, Feeling abnormal, Headache, Impaired work ability, Laboratory test, Loss of consciousness, Skin laceration
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None mentioned
Preexisting Conditions: Unsure
Allergies: Unknown
Diagnostic Lab Data: "Tests to rule out a concussion".
CDC Split Type:

Write-up: Patient received his shot at 7 AM. He went home (works evening shift), and "felt slight headache around 1:00 PM." He went to work at 3:00 PM and around 8 PM "felt lightheaded and passed out and hit his forehead". A coworker called EMS and they tended to his forehead wound and transported him by ambulance to Hospital. He said that "they started an IV because they thought he was dehydrated?" At the hospital, he said they did "full testing to make sure he didn''t have a concussion". He was released and got home around 10 PM and took Ibuprofen. He said he "felt bad all day Sat. and laid around and rehydrated. He "felt OK by Sunday."


VAERS ID: 1395797 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0023C210 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Headache, Ophthalmological examination, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (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: Phenobarbital 129.6 mg morning Phenobarbital 129.6 night Vimpat 50 mg 2x day Lamictal 250 mg 2x day Levothyroxine 150 mcg daily Fish oil 2000 mg daily my Calcium 1200 mg daily Magnesium 500 mg daily Vitamin D3 125 mcg daily Vitamin B12 5000
Current Illness: None
Preexisting Conditions: Epilepsy, hypothyroidism, pcod
Allergies: Penicillin, sulfa, latex, oranges
Diagnostic Lab Data: Visit to urgent care to have visual exam and verification of Bell''s palsy
CDC Split Type:

Write-up: Bell''s palsy right side from June 4 and continuing. Beaver of 102.1 June 4 for approximately 12 hours, headache continuing from June 3,


VAERS ID: 1395936 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-02-07
Onset:2021-06-04
   Days after vaccination:117
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arteriogram coronary normal, Back pain, Chest pain, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Myocarditis, Pain in extremity, Palpitations, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamins, Omega 3s, Turmeric, probiotics, collagen
Current Illness: none
Preexisting Conditions: none
Allergies: B12 injections
Diagnostic Lab Data: 6/4 - negative EKG, Troponins 6/6 - EKG positive for ST elevation, positive troponin 6/6 Repeat EKG, troponins - still irregular 6/7 Angio gram - ruled out heart attack/blockages 6/7 discharged home with Colchicine.
CDC Split Type:

Write-up: Left arm, back, chest pain, heart palpitations starting on Friday, June 4th. ED visit and testing showed normal EKG, labs. Discharged home. Returned to ER on Sunday, June 6th. EKG showed ST elevation. Transferred to ED. Positive troponin, admitted to hospital with suspected perimyocardits with intent to rule out heart attack.


VAERS ID: 1395994 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-24
Onset:2021-06-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Computerised tomogram abnormal, Dyspnoea, Portal vein thrombosis, Renal pain, Scan with contrast abnormal, Thrombosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
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: 100mcg Fentenal patch, Levothyroxine,
Current Illness: No
Preexisting Conditions: Hashimoto''s,
Allergies: Penicillin, Aluminum,
Diagnostic Lab Data: CAT scan with Contrast Blood work
CDC Split Type:

Write-up: I had no regular symptoms, but a few days later I sat down in my chair and it felt like someone shot me in the stomach, I took oxycodone, it kept getting worse and I dealt with it for a week. I started getting pain in my kidney and went to the ER because of the pain and the pain level on a scale of 1-10 was a 8-9 at all times. I couldn''t'' breathe and was rushed to the hospital. I have portal vein thrombosis and have three blood clots in my stomach. I tried to figure out what to do to relieve the pain, I couldn''t eat or during and was on IV''s. I was in so much pain to even eat a cracker, they kept me at the hospital. While in the hospital they did a CAT scan to see if it was diverticulitis and found out that I had 3 blood clots, they also did the dye or contrast. I spent days in the hospital and was transferred to the hospitals skilled nursing facility so that they can watch me because of the clots. I was told that the blood clots could burst in the vein.


VAERS ID: 1396044 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-08
Onset:2021-06-04
   Days after vaccination:88
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient was admitted to Hospital on 6/4. Per internal reported event by pharmacist: Patient received the Pfizer vaccine (second shot 3/8) Test positive for COVID - 6/2/21 Received REGEN-COV on 6/4/21 - was then admitted due to O2 stats. Does this need to be reported as MAB related? Admitted to ICU post infusion Patient name


VAERS ID: 1396302 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: convulsive shivering/chills fever up to 102 F Excellerated heart rate, typically resting heart rate approx 75 bpm, during reaction BPM approx. 140, peaking at 190bpm. soreness body aches.


VAERS ID: 1396310 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood sodium decreased, Blood test, Confusional state, Discomfort, Electroencephalogram, Encephalitis, Headache, Intensive care, Lumbar puncture, Magnetic resonance imaging head abnormal, Magnetic resonance imaging heart, Myocarditis, Neurological examination, Pain in extremity, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: Flovent, Amoxycillin
Current Illness: Had bullseye rash that was diagnosed as Lyme disease but had no other symptoms
Preexisting Conditions: Mild Asthma
Allergies: Peanuts
Diagnostic Lab Data: Brain MRI - June 5; Lumbar Puncture - June 5; Blood work - June 5-10; Heart MRI - June 9; EEG - June 5-6; EKG, Neurological exams
CDC Split Type:

Write-up: Had 2nd Pfizer vaccine at 5:15pm Thursday June 3. Felt fine that evening, just complained arm was starting to hurt when he went to bed around 11pm. Threw up twice on Friday June 4 at 9:30am & 1:30 pm. Very uncomfortable, bad headache, no energy. Mostly slept from 6pm Friday June 4 to 5am Saturday June 5. Immediately threw up when he woke up Friday. Threw up again about 30 min. later and 4 more times during the day. Still having bad head pain. Started to become confused and say things that didn''t make sense. Went to ER around 4:30pm Saturday June 5. Blood work showed his sodium level was dangerously low. He was immediately given sodium and transported to Hospital ICU. Had brain MRI, lumbar puncture and lots of blood work done. Brain MRI showed signs of encephalitis. Also had myocarditis. Was in hospital until Thur. June 10. Encephalitis and myocarditis seemed to resolve quickly and he was just treated with rest and fluids along with antibiotics in case there was any viral/infectious cause of symptoms. All such tests have been negative to date


VAERS ID: 1396312 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-01
Onset:2021-06-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Facial pain, Headache, Hypoaesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (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: Vitamin D, Vitamin C, Ashwagandha, Magnesium, Ginger, Turmeric, Blood pressure medication (unknown name) 10mg once per day, Advair Diskus Inhaler once per day, Albuterol inhaler as needed, Tylenol Arthritis Pain?1300 mg twice a day as neede
Current Illness: None
Preexisting Conditions: Fibromyalgia, Arthritis, Migraines , Hypertension, "Problems with left sciatic nerve"
Allergies: No known allergies
Diagnostic Lab Data: N/A - no medical tests or laboratory results completed at time of submission Patient states that she has a doctor''s office visit scheduled for 6/14/21 at 4:00 p.m. Encouraged patient to complete VAERS report with PCP if any medical tests or laboratory results are obtained.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine 13 days after receiving her Covid vaccine, the patient stated ?I have been experiencing bad headaches that makes the right side of my face numb and/or painful to the touch. Although I have had headaches in the past, these feel different.? Patient stated that she started noticing these headaches late in the week that followed that administration of the vaccine (beginning on or around 6/4/21) Patient also stated that she began developing stomach aches approximately one week following the vaccine administration (beginning on or around 6/6/21)


VAERS ID: 1396401 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Patient started to feel dizzy and nauseous 30 minutes after vaccination. Had left sided chest pain. Was taken to ER by EMS.


VAERS ID: 1396422 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Injection site erythema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cancer
Preexisting Conditions:
Allergies: cephalosporins/ macrolides/ meperidine/ morphine/ oxycodone/ PCN/ quinolones/ sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported chest tightness after the vaccine into the night which resolved itself the next morning. Patient reported hives the next morning lasting 5 days. Redness at the site of injection presented itself after 7 days of the vaccine and was still there on 06/13/21


VAERS ID: 1396549 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Fatigue, Feeling abnormal, Haemoptysis, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Infective pneumonia (broad)

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

Write-up: As per patient an hour later after she got the shot, she started feeling really tired and went to bed. She was not able to get up till 12pm to 1pm next afternoon. When she woke up she felt chalky feeling in her mouth and spat up blood couple of times. When patient called pharmacy was advised to call PCP. On the follow up call patient informed that doctor advised her to go in if she had those symptoms again. As per patient she didn''t have those symptoms again so didn''t need to go in. Apart from this, patient had more expected side-effects such as backache, local site pain, and tiredness. On the follow up call patient mentioned that she''s feeling lot better and doesn''t have any side-effects at the moment.


VAERS ID: 1396637 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-03-20
Onset:2021-06-04
   Days after vaccination:76
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Positive COVID-19 PCR test on 6/4/2021 after being fully vaccinated.
CDC Split Type: 2106060022

Write-up: This individual is a COVID-19 vaccine breakthrough case. Individual was symptomatic. Not hospitalized.


VAERS ID: 1396685 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-19
Onset:2021-06-04
   Days after vaccination:77
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6204 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Anti-cyclic citrullinated peptide antibody negative, Antinuclear antibody negative, Arthralgia, Arthropathy, Differential white blood cell count normal, Episcleritis, Full blood count normal, Limb mass, Mobility decreased, Nodule, Pain, Pain in extremity, Red blood cell sedimentation rate normal, Rheumatoid factor negative
SMQs:, Parkinson-like events (broad), Scleral disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza vaccines not tolerated
Other Medications:
Current Illness:
Preexisting Conditions: Allergies, Allergic asthma, Insomnia
Allergies: Gluten, Soy, Eggs, Dairy, Salmon, Green beans, Tree nuts
Diagnostic Lab Data: June 11: CBC w Diff, Antinuclear Antibiodies, Sed Rate, CCP and anti-CCP, RF, --all normal
CDC Split Type:

Write-up: Episcleritis in left eye in May. Hard nodules formed on multiple finger joints on both hands after sleeping over the course of a week (June 4-11); aching in hands, wrists, shoulders, hips, knees and feet. Lump forming on left wrist (June 13). Joints popping when moving. Unable to move without pain.


VAERS ID: 1396764 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient reported swelling of left clavicle, possibly swollen lymph node.


VAERS ID: 1396767 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: When questioned patient denied receiving a COVID vaccination. Patient even completed two consent form and signed, patient even checked had not received another COVID vaccination. Upon entering vaccine information found patient had completed the Moderna vaccination in April 2020 in another state. Patient not responsive to phone call, unsure why patient thought she needed the Pfizer vaccine as well as the Moderna.


VAERS ID: 1396797 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Malaise, Pain, Pain in extremity, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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: Get very sick from flu shots
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: I do have sensitivities to preservatives on foods and in the flu vaccine.
Diagnostic Lab Data: None but if it continues I will go to a doctor.
CDC Split Type:

Write-up: The day after the second vaccine I got bodyaches and a headache. The next day I had pain in my hands and feet and they felt like they were swollen, but I had no swelling. Over the next week the sensation of swelling continued in my hands and feet and I have severe joint pain and mild swelling in my lower extremities. I have not felt well since.


VAERS ID: 1396808 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Diarrhoea, Dyspnoea, Fatigue, Heart rate increased, Injection site rash, Injection site swelling, Palpitations, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid 30mg/twice daily Levothyroxine 62.5mcg daily, Diamox 375mg/ 2X daily Hydrocortisone 7.5mg/2Xdaily Advair 230/22 two puffs twice daily Fluticasone Spray Xyzal 2.5mg daily
Current Illness:
Preexisting Conditions: Asthma Cortisol Deficiency GERD Hypothyroidism Pseudotumor Cerebri
Allergies: Augmentin Season Allergies
Diagnostic Lab Data: Blood Work Chest X-Ray PCP
CDC Split Type: vsafe

Write-up: Fifteen hours after the vaccine my son woke up and his respiratory rate was high. It was over 140. I woke him up and he had chills and diarrhea. Because of his Cortisol Deficiency I called his doctor. I was advised to give him 30mg Hydrocortisone and lots of water. His Respiratory and heart rate were high. He was feeling a little short of breath and he had heart palpitations. We went to the ER and they did lots of testing. He had a fever and Sepsis testing. All results were normal and they gave him a Liter of fluids. He was discharged after two hours and his pulse was still high at 105-110. We monitored him and his heart rate was slowing and he started to feel better. His Endocrinologist had him take a double dose of Hydrocortisone the next day. His improvement progressed and by the fourth day the symptoms were gone. He was able to do his normal activities but tired and worn out from the ordeal. One week later he had a slightly elevated heart rate but it resolved quickly. He had had a local reaction in his arm with swelling and a rash after the first vaccine.


VAERS ID: 1397016 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nausea, headache, body ache, fever


VAERS ID: 1397061 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pyrexia, Tachycardia
SMQs:, Anaphylactic reaction (broad), 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: We did not take her to the ER. Temperatures were 99-102.8 throughout the second day, Heart rate 110-130 just walking to bathroom, Heart rate 90-100 at rest.
CDC Split Type:

Write-up: Starting early morning after vaccine, approximately 15 hours after vaccine, patient developed severe chest pain, shortness of breath, and tachycardia. Her fever was high throughout the day (often 102.8 even after Tylenol and Ibuprofen). I am a physician and my husband is as well, we monitored her heart rate, oxygenation, temperature, and symptoms at home. We called her doctor and asked whether this could be myocarditis and whether we should go to the ER. She felt that we should just have her rest and monitor her vitals. I dosed her with two large doses of Ibuprofen (600 mg twice during the day), and by 6 pm on 6/4 her chest pain started to improve and her fever broke. The severe crushing chest pain lasted about 12 hours.


VAERS ID: 1397224 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac dysfunction, Chest pain, Echocardiogram abnormal, Magnetic resonance imaging heart, Troponin increased
SMQs:, Cardiac failure (broad), Myocardial infarction (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? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cardiac MRI Echocardiogram
CDC Split Type:

Write-up: Chest pain, elevated troponin levels, decreased cardiac function


VAERS ID: 1398515 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: moderate to severe fainting spell; tingling in legs and hands; profuse sweating; chills; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (moderate to severe fainting spell) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Jun-2021 at 2:10 PM, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Jun-2021, the patient experienced PARAESTHESIA (tingling in legs and hands), HYPERHIDROSIS (profuse sweating) and CHILLS (chills). On 04-Jun-2021 at 12:15 PM, the patient experienced SYNCOPE (moderate to severe fainting spell) (seriousness criterion medically significant). On 04-Jun-2021, SYNCOPE (moderate to severe fainting spell), HYPERHIDROSIS (profuse sweating) and CHILLS (chills) had resolved. At the time of the report, PARAESTHESIA (tingling in legs and hands) outcome was unknown. It was reported the patient did not go to ER but did consider calling an ambulance if the initial part of the spell did not pass within another 30 minutes. No treatment and concomitant medication information reported. Company Comment : Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1398579 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-05-01
Onset:2021-06-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dizziness, Fatigue, SARS-CoV-2 test positive, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: INFLUENZA, Start Date Format: 602, Start Date: 2019, Comment: Went back in 2019, last year in January, they said she had influenza and sent her home.
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: Test for Covid 19; Result Unstructured Data: Test Result:Positive; Comments: positive for Covid-19
CDC Split Type: USPFIZER INC2021670857

Write-up: Light-headed/Dizzy; Fatigue; tested positive for Covid-19; tested positive for Covid-19; This is a spontaneous report from a contactable consumer or other non hcp. A 58-year-old female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE solution for injection, Batch/Lot Number: EW0172, Expiry date: unknown), via an unspecified route of administration on 01May2021 as 2nd dose, single dose for covid-19 immunisation. Patient historical vaccine included received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE solution for injection, Batch/Lot Number: ER8731), via left upper arm in the muscle on 10Apr2021 as 1st dose, single dose for covid-19 immunisation. Patient medical history included influenza from 2019 to an unknown date went back in 2019, last year in January, they said she had influenza and sent her home and the patient''s concomitant medications were not reported. The patient experienced tested positive for covid-19 on 04Jun2021, light-headed on an unspecified date, dizzy on an unspecified date, fatigue on an unspecified date. The patient underwent lab tests and procedures which included sars-cov-2 test it was positive on 04Jun2021 positive for Covid-19. Outcome of the event was unknown. Follow-up attempts are needed. Further information is requested.


VAERS ID: 1398756 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal X-ray, Abdominal pain, Blood test, Electrocardiogram, Ultrasound abdomen, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins Omegas Probiotics Vitamin D3 Digestive enzymes
Current Illness: None
Preexisting Conditions: Was 7 weeks postpartum at time of vaccine and breastfeeding so still recovering from childbirth
Allergies: None
Diagnostic Lab Data: 6/10/21-6/11/21 ER visit for severe abdominal pain. ER did EKG, bloodwork, abdominal x ray, abdominal ultrasound, could not find any explanation to the pain
CDC Split Type:

Write-up: Started heavy vaginal bleeding and severe abdominal pain within 6 hours of receiving vaccine. Bleeding continued for 6 days. Abdominal pain at time of report has not fully resolved.


VAERS ID: 1398788 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-23
Onset:2021-06-04
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 1 UN / IM

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

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

Write-up: Breakthrough COVID-19 (symptomatic) diagnosed on June 4/2021


VAERS ID: 1398926 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Heart rate increased, Palpitations, Restlessness, Scan, X-ray
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron supplements B6/b12/multivitamin
Current Illness: No
Preexisting Conditions: Gastric bypass One kidney -born that way no issues Sinus surgery-sinus issues
Allergies: Septra
Diagnostic Lab Data: X rays/ blood tests and some other scans
CDC Split Type:

Write-up: 15 minutes in I felt something shoot across my chest and my heart started racing. Drove home and heart felt like it was going to explode and couldn?t relax, felt like someone sitting on my chest. Went to the ER around 6:30-7pm same day as shot heart rate was in the 130s and climbing and blood pressure was 178/100. Given a few different meds to bring down. Prescribed medication and to see a cardiologist.


VAERS ID: 1399012 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-18
Onset:2021-06-04
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

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

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

Write-up: Prolonged and heavier menses: My menstrual cycle started June 4, 2021. Normally, it is of light flow and lasts almost seven days or less. This time my flow was moderate progressing to heavy compared to my normal flow and it lasted 11 days. This had never happened to me. I did not have any additional stressors, life changing events or health issues that would affect my cycle. I don?t use any form of oral contraceptives. I did experience a headache for two days mid cycle but it?s not uncommon for me to have a headache sometimes during menses. I took Advil 200mg for it one time.


VAERS ID: 1399051 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EW0178 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Chest X-ray, Chest discomfort, Chest pain, Electrocardiogram
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 04 June 2021: ECG, pulse oximeter, blood pressure, Chest X-ray, blood work
CDC Split Type:

Write-up: Around 1am the morning following the initial vaccine dose, patient woke with chest pain. Patient took Advil and the pain had subsided by 3am. Patient called primary care physician morning of 04 June 2021 and primary care physician recommended patient visit local ER so he did. Day of 04 June 2021, patient continued to have pressure in the chest area but no pain. Feeling of chest pressure resolved by 05 June 2021.


VAERS ID: 1399087 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-10
Onset:2021-06-04
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Eczema, Full blood count abnormal, Inflammation, Neutrophil count increased, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (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: alendronate clopidogrel lisinopril tolterodine donepezil meloxicam
Current Illness: none
Preexisting Conditions: chronic back and knee pain, HTN, mild cognitive impairment
Allergies: None
Diagnostic Lab Data: Biopsy done 6/8/21 showed "Spongiotic dermatitis with mixed inflammation: The degree of neutrophilic inflammation is somewhat unusual, but the overall findings are most suggestive of either an eczematous dermatitis or possibly an irritant or allergic contact dermatitis." Her CBC showed elevated neutrophils.
CDC Split Type:

Write-up: Erythrodermic rash of the torso and extremities. Not responsive to prednisone and hydroxyzine after a week of high dose burst.


VAERS ID: 1399106 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal sensation in eye, Injection site discolouration, Injection site erythema, Injection site pain, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: Severe pain at site of injection. Large red area formed and is now purple. Eye sight seems to have gotten worse. Feels like glue is on my eyes.


VAERS ID: 1399383 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW019H / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Adverse Effect: Guest had an episode of dizziness and passing out per report. Treatment: Guest lowered the floor, ice pack applied to back of the neck: EMS assessed - juice offered accepted. VSS. Outcomes: Guest provided 45 monitoring time, mother with guest. Guest stable and released by EMS to mother''s Care.


VAERS ID: 1399451 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-06-02
Onset:2021-06-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia
SMQs:, Taste and smell disorders (narrow)

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

Write-up: i lost my sense of taste for 5 days after the vaccine


VAERS ID: 1400287 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: DIZZINESS, LIGHTHEADED, PALE, ICE PACK, WATER


VAERS ID: 1400328 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-28
Onset:2021-06-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Costochondritis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine, Zoloft, Lactaid
Current Illness:
Preexisting Conditions: Asthma, Costochondritis
Allergies: Augmentin, Lactose intolerant
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms consistent with pericarditis. Sharp pressure exclusively at the breast bone that increases with deep breathing. Sensation of wearing clothing that is too tight. Symptoms occur sporadically but can last anywhere from 30 min-2hrs. Although there is a history of Costochondritis, pain associated with Costochondritis is isolated to the left side of the upper abdomen.


Result pages: prev   137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=236&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


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