National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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



Case Details (Reverse Sorted by Onset Date)

This is page 237 out of 8,010

Result pages: prev   138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336   next


VAERS ID: 1685224 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 AR / IM

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

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

Write-up: Developed rash on both forearms and c/o of headache. 25mg of PO Benadryl given. Observed for 30 minutes, rash improving , stated felt better.


VAERS ID: 1685227 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-20
Onset:2021-09-08
   Days after vaccination:111
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abscess drainage, Abscess limb, Blood culture positive, SARS-CoV-2 test
SMQs:, Sepsis (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolol, enoxaparin, acetaminophen hydrocodone, furosemide, mupirocin topical, spironolactone, pepcid
Current Illness: obesity, cirrhosis, chronic pressure ulcer, chronic anticoagulation, UTI, ETOH, ESBL, Hyponatremia, anxiety, gastroparesis
Preexisting Conditions: obesity, cirrhosis, chronic pressure ulcer, chronic anticoagulation, UTI, ETOH, ESBL, Hyponatremia, anxiety, gastroparesis
Allergies: NKA
Diagnostic Lab Data: Rapid test covid
CDC Split Type:

Write-up: gluteal abscess drainage and positive blood culture results


VAERS ID: 1685231 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hypersensitivity
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 is a 74 y.o. female who presented for a COVID-19 vaccine. Patient began experiencing Allergic Reactions to Covid-19 Vaccine: dizziness15 minutes after the administration of Covid Vaccine Manufacturer: Pfizer COVID-19 vaccine. Patient was given the medication specified above 1 minutes after the reaction began. The adverse effects worsened after receiving rescue medication. Patient was released to emergency room with significant other.


VAERS ID: 1685234 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Contusion, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Peniccilin
Diagnostic Lab Data: Blood work, Iv, Medical exam
CDC Split Type:

Write-up: Head contusion, Fainting or Siezure


VAERS ID: 1685244 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dry mouth, Dyspnoea, Dysstasia, Fatigue, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: sickle cell disease
Allergies: shelfish
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was giving a second dose of moderna at about 3:45 pm and at 3:51pm patient started to develop fatigue and weakness sysmptoms. Suddenly patient started complaining about dry mouth and dizziness and he was not able to stand on his feet. He tried to stand up and he faint on the chair. I layed him down flat on a table and squeezed his legs allowing the blood flow towards his head (brain). Patient started to feel better but, suddenly started having shortness of breath. At that moment, I called for emergency help. patient was awake and concious all the time.


VAERS ID: 1685248 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Fatigue, Headache, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Most annual flu shots
Other Medications: Hydrochlorothiazide (diuretic)
Current Illness:
Preexisting Conditions: High Blood Pressure
Allergies: mollusks
Diagnostic Lab Data:
CDC Split Type:

Write-up: 101.5 degree fever at 2:30am on 9/8, coupled with chills, severe body aches and fatigue, headache, chest pains and 110 bpm heart rate. Took 600mg ibuprofen. Fever went down but peaked again to 101 around 3pm the next day. Chills were intermittent but severe body aches and fatigue continued. Heart rate dropped to 90 bpm at 3 pm. Took another 600mg ibuprofen. 9/9 at 10am fever is gone, no chills, heart rate is 75 bpm (normal), lingering fatigue.


VAERS ID: 1685268 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a dose of expired Moderna Covid vaccine. No adverse reaction noted or reported.


VAERS ID: 1685290 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a dose of expired Moderna Covid vaccine. No adverse reaction noted or reported.


VAERS ID: 1685293 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted 5 to 6 minutes after vaccination


VAERS ID: 1685302 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-13
Onset:2021-09-08
   Days after vaccination:118
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: She had Pfizer vaccines on 4/22/21 and 5/13/21. She was diagnosed with COVID at an outpatient lab on 8/30/21. She was seen by her PCP and given steroids. However, SOB, cough, and wheezing got worse, so she came to ED and admitted at Hospital on 9/8/21. Hosptal day 2.


VAERS ID: 1685310 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Glossodynia, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No known
Current Illness: no known
Preexisting Conditions: diabetic
Allergies: pneumonia vaccine (arm swelling)
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: Patient reported tongue soreness and swelling of face. Her pulse was first checked about 15 minutes after administration and was 76 beats per minute. Her blood pressure was checked and found to be 162/86 with pulse of 87 at that time. Repeat blood pressure was 168/72 with pulse of 74. She says she was tingly and dizzy. She was checked by EMT and was allowed to leave after checking out ok.


VAERS ID: 1685311 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Dysphagia, Throat irritation
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

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: buspirone 15 mg BID, propranolol 40 mg BID, paroxetine 20 mg daily, pregabalin 75 mg daily
Current Illness: No
Preexisting Conditions: none reported
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Approximately 10 minutes post-vaccination the patient described her throat being itchy and some difficulty swallowing. She was immediately given diphenhydramine 25 mg x 1 dose and then monitored for the next 4 hours. Her symptoms resolved quickly and had no more complaints. She did report a previous food allergy and carries an Epi-Pen for this issue. She did not report the specific food.


VAERS ID: 1685317 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Dizziness, Fatigue, Feeling cold, Grip strength decreased, Hyperhidrosis, Malaise, Mobility decreased, Nausea, Pain, Pain in extremity, Paraesthesia, Presyncope, Sensory disturbance, Sleep disorder
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unkown
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: Penicillin
Diagnostic Lab Data: The paramedics took her vitals
CDC Split Type:

Write-up: Ten minutes after the vaccination the patient called out that she didn''t feel well. I went to talk with her and she was experiencing dizziness and light headed to the point she felt she was going to pass out. She also had severe stomach discomfort to the point she thought she was going to have both diarrhea and vomiting. We laid the patient down on a bench with her head supported and then called the paramedics. She was cold and sweating. She said that both arms were tingling with an uncomfortable sensation and the left arm was also painful with pain radiating down from shoulder to hand. She also said she couldn''t move her hands very well and had a hard time gripping things. The paramedics came after about another 10 minutes and checked out the patient. All her vitals were ok, and the patients symptoms were improving. She was still weak but she had someone there to take her home. The following day we called her and she said she didn''t sleep and still felt sick (nausea, aches and pains, fatigue)


VAERS ID: 1685318 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate 200mg - 1 tab QHS
Current Illness: siezures, heart, blood pressure, cholesterol
Preexisting Conditions: siezures, heart, blood pressure, cholesterol
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states that her seizures were controlled. Had not had any seizures in months. Since the vaccine, she experienced 3 seizures on 9/8/2021 and 1 seizure on 9/9/2021.


VAERS ID: 1685327 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / UNK RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Chills, Condition aggravated, Headache, Pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: moderna 1st dose , fever and chills 01/20/2021
Other Medications: Tylenol, Lozartan Potassium, omeprazole
Current Illness: none
Preexisting Conditions: History of cancer
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: headache, body ache , chills, slight fever, runny nose,


VAERS ID: 1685342 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received a dose of expired Moderna Covid vaccine. No adverse reaction noted or reported.


VAERS ID: 1685345 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Cardiac disorder, Chills, Condition aggravated, Pyrexia, Respiratory disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Chills from fever-like/ Respiratory or heart muscle irregularity (excessive Caffein -like to the heart)
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: In progress
CDC Split Type:

Write-up: Chills from fever-like Heart muscle tighten (excessive caffeine effects) , difficult breathing


VAERS ID: 1685350 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-17
Onset:2021-09-08
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Hypoxia, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Acute cystitis, Hydronephrosis, Hyperlipidemia, HTN, Prostate Ca, Diabetes
Allergies: No Known
Diagnostic Lab Data: Covid + 09/08/2021
CDC Split Type:

Write-up: Breakthrough Covid-19 First Dose 01/27/2021 79-year-old male who presents to the ER for shortness of breath, cough and fever. He was a bit hypoxic on arrival.


VAERS ID: 1685361 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 3 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Flu like symptoms, Injection site swelling, redness, warm to the touch


VAERS ID: 1685395 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045C21A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Decreased appetite, Extra dose administered, Feeling cold, Headache, Hot flush, Influenza like illness, Interchange of vaccine products, Malaise, Pain
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: I was 30yrs old when I received my second dose of Pfizer COVID-19 vaccine on 1/29/21. I had hot/ cold flashes, body aches, nause
Other Medications: Acyclovir
Current Illness: None
Preexisting Conditions: Scoliosis
Allergies: Sensitive to gluten, dairy, and latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hot/ cold flashes, headache, body aches, not hungry. I felt like I had the 24hr flu after my second dose of Pfizer, but this booster dose of Moderna has been way worse. Still sick and unsure how long this will last.


VAERS ID: 1685409 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Inappropriate schedule of product administration
SMQs:, Anaphylactic reaction (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Call center received call from pt on 9/8/21 at 8:36pm. Pt states she received first dose of moderna vaccine on 7/30/21 (Lot#088D; Left deltoid) and 2nd dose on 9/4/21 at pharmacy (outside) and felt chest tightness since 9/5/21 and did not go away. Advised pt to go to the nearest ED to get evaluated and pt verbalized understanding.


VAERS ID: 1685443 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 LA / IM

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

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

Write-up: The pharmacist who gave me my vaccine flicked the syringe that contained my covid vaccine three times to expel air. This flicking risks inactivating the vaccine or degrading the quality.


VAERS ID: 1685453 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
SMQs:, Medication errors (narrow)

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

Write-up: At intake and on consent form, patient did not disclose any prior COVID19 vaccine doses, and she indicated she was presenting for her first dose. Moderna was administered as the presumed first dose. When entering her dose information into the Immunization Registry, staff discovered that the patient had received a dose of Pfizer COVID19 vaccine in April 2021 at a different site. Patient was contacted and upon questioning she then disclosed that she had received Pfizer as stated above. When asked why she did not disclose this at the time of vaccination on 9/8/21 , she stated that she thought because the Pfizer dose was given 6 months ago she did not need to disclose that. She has not reported any adverse effects to us at this point. This was identified as a "mixed dose" error and is being reported to VAERS as such.


VAERS ID: 1685461 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-01
Onset:2021-09-08
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: unknown specifics of vaccine info such as dates of administration and lot numbers. patient admitted with diagnosis of covid breakthrough


VAERS ID: 1685476 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

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

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

Write-up: No adverse reactions, Phone call to check on client today by Clinic Manager, Client states he has no problems


VAERS ID: 1685486 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-27
Onset:2021-09-08
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 RA / IM

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

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

Write-up: Pt received Pfizer x2 vaccine in April 2021. Pt became COVID + on 9/8/2021. Needed 2L O2. Admitted to the hospital on 9/8/2021 and receiving remdesivir and dexamethasone.


VAERS ID: 1685495 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: none


VAERS ID: 1685517 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported.


VAERS ID: 1685519 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: unknown


VAERS ID: 1685520 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Blood urine present, Rash
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood in urine was abnormal, blood work came back normal
CDC Split Type:

Write-up: The next day after the shot when I woke up I started peeing blood and I now have a body rash


VAERS ID: 1685521 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-20
Onset:2021-09-08
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: unknown lot numbers for vaccine. patient hospitalized and diagnosed with Covid breakthrough case


VAERS ID: 1685529 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported


VAERS ID: 1685536 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Hyperhidrosis, Myalgia, Pain, Pyrexia, Sluggishness
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Injection at 8am. At 4:45pm came an onsite of mild chills and general sluggish feeling At 5:38pm, body aches, muscle aches, joint pain at 6:30 pm, worsening feeling and with fever 7pm, profuse sweating with chills, body aches, fever 11:35pm-began to come out of it 10am next day, mostly finished and able to remain working.


VAERS ID: 1685540 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

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

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

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA, Moderna COVID-19 Vaccine EUA: Mixed Series Patient received Pfizer vaccine on 8/7/2021 for the first doe, and received Moderna vaccine on 9/8/2021 for the second dose.


VAERS ID: 1685545 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported


VAERS ID: 1685558 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-02-25
Onset:2021-09-08
   Days after vaccination:195
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aldactone, Carafate, Cardizem, Miralax, ASA, B12
Current Illness:
Preexisting Conditions: CAD, HTN, GERD
Allergies: Amoxil, Bactrim, Cipro, tylenol
Diagnostic Lab Data: COBAS SARS COV2 PCR
CDC Split Type:

Write-up: Breakthrough COVID19 infection


VAERS ID: 1685559 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported


VAERS ID: 1685575 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported


VAERS ID: 1685579 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Diarrhea, fever, sweats and chills, extreme body ache and headaches, light headed ness, feels like I?m not getting a full breath while breathing in. Felt as though I was going to pass out multiple times. I took Tylenol for my fever but it didn?t help. This has been going on for almost 2 days


VAERS ID: 1685586 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Pain, Pyrexia, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Flu Shot, last year, anaphylaxis; Pneuomnia shot, l2 years ago, anaphylaxis.
Other Medications: Lisinopril; Protonix; Celexa; Singulair
Current Illness: None
Preexisting Conditions: Asthma; High Blood Pressure; Psedo-tumor cerebri
Allergies: Flu shot; pneumonia shot; restoril; Cefzil; Augmentin; Iodine; Eggs; Mushrooms; Truffles; Dates; Sulfa; Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: difficulty breathing, fever, aching all over, swelling of tongue and lips within 15 minutes of administration


VAERS ID: 1685587 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-09-08
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fatigue, Myalgia, Pyrexia, SARS-CoV-2 test positive, Upper respiratory tract infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID PCR test ran and was positive on 9/8/2021.
CDC Split Type:

Write-up: Patient presented to hospital with URI symptoms, fever, myalgia, fatigue, and diarrhea.


VAERS ID: 1685588 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported


VAERS ID: 1685611 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK LA / IM

Administered by: Other       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received an expired Moderna covid vaccine on 9/8/21. No adverse reaction reported or noted.


VAERS ID: 1685634 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Private       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: Covid-19 Pfizer vaccines
Current Illness: none
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine was mixed on 9/7/21 at 1650. This patient received this dose on 9/8 at 1015, The vial was "expired" past its 6-hour mix window. Patient was monitored for 15 minutes per protocol, but error was not realized until after patient was home. We attempted to contact patient to notify of event but have not been able to reach them. we will try again.


VAERS ID: 1685654 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F03184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Pain, Pain in extremity, Pyrexia, Sensitive skin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: Lisinopril 10mg/day
Current Illness: None
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, body aches, sensitive skin, fatigue, sore arm


VAERS ID: 1685656 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-01
Onset:2021-09-08
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: BREAKTHROUGH CASE : Covid + 09/08/2021


VAERS ID: 1685658 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Axillary pain, Chills, Dizziness, Dry eye, Fatigue, Headache, Pain in extremity, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 50mg, Prilosec OTC, Calcium/Magnesium/Zinc, B-6, D-3.
Current Illness: None
Preexisting Conditions: Nuerocardiogenic Syndrome, Vertigo, Seasonal Allergies. TMJ - bilaterally displaced discs.
Allergies: Penicillin, Tetracyline, Erythromycin, Sulfa drugs, Ceclor Pulvule, Avelox, Lomotil, Tequin, Ryanatan, Transderm Scop, Flomas, Entex LA, Anaprox, Sudafed, Allegra. Detrol LA, Nitrofuratin.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, arm pain at site, dry eyes. Fever, chills, vomiting, fatigue, shakes, weak, dizzy. Stabbing pain in left arm pit.


VAERS ID: 1685676 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / SYR

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

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

Write-up: diarrhea and abdominal pain, ongoing for 24 hours so far, not severe enough for treatment at this point


VAERS ID: 1685799 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breast mass, Extra dose administered
SMQs:, Medication errors (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: NONE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Client received 3rd dose on 09/07/2021 and saw a lump on left side of the chest on 09/08/2021. Client was seen in Urgent Care and a biopsy was recommended. Client came to notify us in case issues with vaccine. Client schedule to see primary MD next week.


VAERS ID: 1685975 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: even a day after receiving the vaccine experiencing burning pain in arm of injection and fingers in hand going numb randomly


VAERS ID: 1685978 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-09-08
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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: No
Current Illness: No
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Platelets count 09/04/2021 - 106 02/27/2021 - 201 10/03/2020 - 220 03/13/2020 - 246 11/02/2019 - 204 06/29/2019 - 158 11/24/2018 - 214 05/19/2018 - 246
CDC Split Type:

Write-up: Platelets dropped drastically for the first time in my life. It was 201 in my February 2021 report. The blood report dated 09/04/2021 shows a drastic drop to 106. My PCP has done another test and I am seeing him 09/15/2021. Please advice if there is anything I should do about it. Please also inform him about anything that he needs to look in to. Thanks


VAERS ID: 1686001 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Fatigue, Loss of consciousness, Muscle rigidity, Nausea, Pallor, Staring, Tremor, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient received vaccine within a minute of sitting down she became pale and had a blank stare. Her arms and legs became extremely rigid and she became to shake. This lasted for 15 seconds, patient regained consciousness she had voided herself, she complained of being tired and dizzy. She laid down and drank water for 20 minutes, she tried to stand up and quickly felt she needed to vomit. Patient stated she had not eaten or drank that morning. I used my professional judgement and at this time I called an ambulance. Student with the assistance of her boyfriend walked outside the clinic and refused to go into the ambulance. She stated she felt better as soon as he stepped outside. Patient was contact today 09/09/21 by the medical assistant and ensured she was feeling well without any other adverse reaction.


VAERS ID: 1686196 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-25
Onset:2021-09-08
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 (?) / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CBD/THC (mmj), Lemon balm, Passion flower
Current Illness: Previous chest pain. Blood pressure always normal
Preexisting Conditions: Obesity
Allergies: N/a
Diagnostic Lab Data: Too much to write. I?ll mail them if you want. The blood pressure is the only thing out of the ordinary besides hypokalemia which I had pre-vax.
CDC Split Type:

Write-up: Chest pain on multiple occasions. High blood pressure on 9/1 (first ER visit) . Didn?t think much of it. It was higher on 9/9. Pre-vax Blood pressure was about 140/70. 9/1: 160/high 70s. 9/8: 172/low 80s. Not exact #?s, since it seems they only recorded my blood pressure after giving me metropolol(blood pressure med).


VAERS ID: 1686232 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Electrocardiogram, Hypoaesthesia oral, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (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: Acetomenophen, hydrocodone. ibuprofen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received 1st dose J&J COVID vaccine right deltoid @ 1413. Around 1428, pt c/o chest tightness, lips feeling numb, tachypneic, and dizziness post vaccination. V/S: 102/85, HR 108, SPO2 95% RA, RR 26. EKG done in clinic. SPO2 93% noted, started on 2 LPM via nasal cannula. RRT notified. RN-to-MD report given to Dr. Pt transferred to UC via wheelchair via 2-person assist @ 1453.


VAERS ID: 1686237 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Eye movement disorder, Loss of consciousness, Muscle twitching, Speech disorder, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify 5 mg, Sertraline 100 mg, Probiotic (HMF Forte)
Current Illness: Hives (2 days, in the morning)
Preexisting Conditions: OCD, GAD, asthma
Allergies: Peanuts, cashews, grass (seasonal)
Diagnostic Lab Data: In the ER, I was seen by an on-duty doctor and diagnosed with vasovagal syncope. A nurse performed a series of blood pressure checks lying, sitting and standing. Those results were normal (this was done approx. 3 hours after the vaccination). I was then discharged.
CDC Split Type:

Write-up: First thing I noticed was that the index finger on my right hand was twitching. Then I started feeling extremely dizzy and I blacked out. When I came to, the first thing I registered was that my father and the pharmacist were waking me up and trying to talk to me. Then they laid me on the floor on my side and the pharmacist started to take my blood pressure while calling emergency services. On waking up, at first I almost couldn''t talk, but later I was able to talk better. The paramedics came and took me to the hospital. My father''s account: about 5 minutes after the shot, I heavily leaned to the left side in my chair, with my arms and legs stretched and trembling. My eyes were rolled up. When he and the pharmacist woke me up, I was extremely confused and could hardly talk. The pharmacist was continuously checking my blood pressure. It was about 90/70.


VAERS ID: 1686239 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Muscle spasms, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

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

Write-up: 12 hours after her 2nd shot, patient complained of pain in her right arm near where she received the vaccine. 15 minutes later she woke up violently shaking. They appeared to be seizures but have since been identified by doctors as severe muscle spasms. These have continued for 2 days. She has been admitted to the hospital. The episodes seem to occurs 1-2 times per hour and remain fairly significant even after being administered Ativan.


VAERS ID: 1686244 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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: active treatment for rectal cancer
Allergies: codiene
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving the covid vaccine PT stated "I am feeling light headed and heart palpitations." I asked to take PT vitals, she declined for me to do so but wanted her pulse to be taken. After taking her pulse a couple of times PT stated "I am not feeling any better" so I immediately called RRT. They responded immediately and took her down to urgent for further assessment. Received RRT call from Covid vaccine clinic regarding pt feeling dizzy after Covid vaccine. Went to assess pt at the Covid vaccine clinic. Pt A&Ox 4. Pt stated has been feeling dizzy since yesterday. Pt stated in between chemotherapy. Pt was recommended by staff to move RA after the vaccine. Pt was pacing in the room and moving RA. Pt felt lightheaded. VS was 122/77 P 83


VAERS ID: 1686426 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Lymphadenopathy, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 10 mg
Current Illness: No
Preexisting Conditions: Autoimmune-ulcerative colitis Factor V with Leiden Hx of Rheumatic Fever
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheaded, dizzy, nausea, severe body aches, headache, swollen lymph nodes on left side of neck, extreme fatigue


VAERS ID: 1686447 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-27
Onset:2021-09-08
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 1 RA / IM

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

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient developed cellulitis.


VAERS ID: 1686452 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-18
Onset:2021-09-08
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: robitussin AC, colchicine, prednisone, norco, allopurinol, lipitor
Current Illness: NA
Preexisting Conditions: HLD, GERD< ahteroclserosis, prediabetes, gout, acuoustic neuroma, tinnitus, obesity
Allergies: NKDA
Diagnostic Lab Data: 9/4 covid pcr +
CDC Split Type:

Write-up: admitted for covid-19


VAERS ID: 1686614 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-15
Onset:2021-09-08
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, clopidogrel, folic acid, Lantus pen, metformin, metoprolol succinate ER, rivaroxiban, Stiolto Respimat inh, Incruse Ellipta inh,
Current Illness:
Preexisting Conditions: History of coronary artery disease status post CABG and most recent stent February 2021, DM 2 insulin-dependent, ILD (bronchiectasis), restrictive lung disease, bronchiectasis, hypertension, hyperlipidemia, history of recurrent pulmonary embolism, and history of tobacco abuse
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 9/8/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 3/25/21 and 4/15/21. On 9/8/21, patient admitted to our facility for COVID-19 pneumonia with acute shortness of breath. Patient was discharged to home on 9/9/21.


VAERS ID: 1686716 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acoustic stimulation tests abnormal, Deafness, Deafness unilateral
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever, joint pain 73
Other Medications: Novolog, Basgalar, Cardeverol, Allipurinol, Lipitor, Eliquis, Lisinopril
Current Illness: None
Preexisting Conditions: Type 2 Diabetes, CKD, treated for prostate cancer, hypertension
Allergies: Latex
Diagnostic Lab Data: Hearing tests at Clinic 09/09/21
CDC Split Type:

Write-up: Total loss of hearing in right ear


VAERS ID: 1686740 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Fatigue, Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VYVANSE, ADDERALL, METFORMIN, LEVOTHYROXINE, VITAMIN, COLESTIPOL, WELLBUTRIN, PROSTIQ
Current Illness:
Preexisting Conditions: PCOS, depression, obesity, add/adhd
Allergies: Sulfa, aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, muscle pains, feeling fatigued, wore out, ran down, HEADACHE, nose bleed (unsure if related)


VAERS ID: 1686743 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Skin warm, Sunburn
SMQs:, Peripheral neuropathy (broad), Accidents and injuries (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: Pravastatin, aspirin, methotrexate, emgality
Current Illness: Arthritis
Preexisting Conditions: Arthritis
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Burning sensation (like sunburn), entire back ( shoulders to belt line ) , and to the back of the arms. Warm to touch. No visible rash.


VAERS ID: 1688660 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza - had flair up in eyes - Uveitis- increased inflammation (allergic to eggs) - mandatory unless anaphylactic reaction f
Other Medications: Multivitamin, Citracal, probiotics, immune support, Cinnamon
Current Illness: Osteoporosis, cataracts, Uveitis, Sarcoidosis, Asthma
Preexisting Conditions: Osteoporosis, cataracts, Uveitis, Sarcoidosis, Asthma
Allergies: Tetracycline, Topamax, severely allergic to all items on Rast test
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness/Pain at insertion site much less after 48 hours ....I felt numbness to face (like when you take pain pills and that aura type feeling to face) ...lasted about 30minutes


VAERS ID: 1688831 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, 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: Nexium, Pepcid, Zyrtec, Flonase and MVI
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 12 hours after vaccine my arm pit was hurting and that evening I noticed swelling in my axillary area and extended into my upper chest and neck area and chest wall. I have monitored the area and will seek further medical care if it persistent.


VAERS ID: 1688838 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

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

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

Write-up: Headache, fever, chills, shaking, hot flashes. Duration: 12 hours.


VAERS ID: 1688840 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: SOB, "like throat tightening" and dizzy


VAERS ID: 1688863 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Chills, Fever, Fatigue


VAERS ID: 1688912 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 3 LA / IM

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

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

Write-up: Redness, itching, big hard lump, pain when touched, warm to touched


VAERS ID: 1688913 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: Developed itching, hives, dizziness, and flushing 30 minutes after receiving vaccine. Received Benadryl 25mg and solumedrol IM injection.


VAERS ID: 1688929 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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: Birth control
Current Illness:
Preexisting Conditions:
Allergies: Minocilin
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1688951 (history)  
Form: Version 2.0  
Age: 97.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin EC 81 mg. qd Atorvastatin 20mg qd Levemir 15 units at bedtime Novolog 9 units before meals Metoprolol 25 mg. 1/2 tab q d Miralax powder 17gm q d Omeprazole DR 20mg qd Easivent one spacer inhale by m outh every hours PRN Levothyro
Current Illness: Nothing acute
Preexisting Conditions: Acute respiratory failure Personal history of Covid 19 Type 2 diabetes Dysphagia Degenerative disease of nervous system Athsclerotic heart disease Bradycardia Hypertensive Chronic Kidney Disease Chronic Kidney Disease, stage 3B Mild cognitive impairment Personal Hisotry of Pneumonia GERD Dyskinesia Benign prostatic hyperplasia Obstructive and Reflux uropathy Personal history of pneumonia GERD Dyskinesia BPH Obstructive and Reflux uropathy Personal history of urinary tract infections.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Resident given a vaccine (Maderna) on 9-8-2021 that was opened on 9-1-2021


VAERS ID: 1688986 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

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

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

Write-up: fever all day, lump under left arm


VAERS ID: 1688990 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, 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? 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: Injection site soreness, unable to lift left arm very high. Headache worsening on day 3 after shot.


VAERS ID: 1689013 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Foaming at mouth, Muscle rigidity, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: NONE REPORTED
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PATIENT RECEIVED FIRST DOSE OF PFIZER. AFTER APPROXIMATELY 10 MINUTES, PATIENT STARTED SEIZURING,FOAMING AT MOUTH AND WAS VERY RIGID. PARAMEDICS WERE CALLED IN AND HE WAS ASSESSED. HE REPORTED THAT THIS OCCASIONALLY HAPPENS WHEN HE GETS BLOOD DRAWS. HE RECOVERED AND WAS ABLE TO GO HOME.


VAERS ID: 1689022 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-09-08
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Current Illness: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Preexisting Conditions: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Allergies: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
Diagnostic Lab Data: Patient swabbed at our offsite testing center. No primary care provider listed on file for them.
CDC Split Type:

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


VAERS ID: 1689026 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-05
Onset:2021-09-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

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

Write-up: Twitching coming from the muscle the shot was given. It started three days after the shot and has been going on for two days.


VAERS ID: 1689027 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-21
Onset:2021-09-08
   Days after vaccination:110
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

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

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

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


VAERS ID: 1689028 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: PT REPORTS LOCALIZED RASH THAT RESOLVED IN A DAY FOLLOWING FIRST DOSE OF THE VACCINE.


VAERS ID: 1689047 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-11
Onset:2021-09-08
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, COVID-19, Chest pain, Cough, Dyspnoea, Fall, Musculoskeletal chest pain, Pleuritic pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: significant PMH of CAD, paroxysmal atrial fibrillation, HTN, HLD, s/p TAVR, bladder cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented with SOB, cough and was admitted for COVID-19 viral infection. He has been coughing with progressive dyspnea and pleuritic chest pain component x1 day with chest wall pain since fall couple weeks ago. No fevers chills rigors loss of taste or smell nausea vomiting abdominal pain or diarrhea. No dysuria or hematuria. He received full dose aspirin, azithromycin, Decadron in the ED. He was continued on zinc, vitamin D3, decadron, famotidine and monitored overnight with no need for oxygen. He was found safe for discharge with continued supplements and decadron.


VAERS ID: 1689051 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308 A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adnexa uteri pain, Bone pain, Chills, Fatigue, Injection site pain, Muscle spasms, Ovulation pain, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (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: Effexor XR 37.5 mg daily Adderall IR 5mg 2X daily
Current Illness: None
Preexisting Conditions: Anxiety, PTSD, Panic disorder, Depression
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I awoke the following day with ovulating type pain that has maintained since. I also began spotting and now am spotting heavier with the cramping and ovulating pain. September 1st was the first day of my last period so I should not be having any of these symptoms for at least another 10 days. Other symptoms included injection site pain, aching bones, chills, and fatigue.


VAERS ID: 1689087 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Low hg due to prior miscarriage in July, was told by provider would return to normal by October
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt experienced a headache 5 minutes after injection of first COVID vaccine which lasted approxiamtely 10 minutes. She stated it was located around the right of her temple and moved towards the center of her head. We gave her water and asked her to remove he mask to help with breathing. She rested for an additional 30 minutes. She reported she was then ok and left. When contacted later in the afternoon she reported she was fine.


VAERS ID: 1689088 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: body aches, chills, fever, headaches, muscle pains in arms,


VAERS ID: 1689153 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-08-13
Onset:2021-09-08
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Hyperglycaemia, Hypomagnesaemia, Hypoxia, Laboratory test abnormal, Lactic acidosis, Nausea, Oxygen saturation decreased, Palpitations, Pneumonia, SARS-CoV-2 test positive, Sepsis, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (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), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, chronic hypoxic respiratory failure on home O2 at 3 L, atrial fibrillation, insulin-dependent diabetes, carotid COPD, chronic hypoxic respiratory failure on home O2 at 3 L, atrial fibrillation, insulin-dependent diabetes, carotid artery disease, HTN, OSA, HLD
Allergies: dilTIAZem
Diagnostic Lab Data:
CDC Split Type:

Write-up: 62-year-old male with PMH of COPD, chronic hypoxic respiratory failure on home O2 at 3 L, atrial fibrillation, insulin-dependent diabetes, carotid artery disease, HTN, OSA, HLD and morbid obesity presented to the hospital today after having increased work of breathing, hypoxia with minimal exertion, right-sided chest pain and palpitations. Patient has been suffering with positive at home coronavirus testing since August 7th. Patient has been managing at home with oxygen and oral steroid treatment per his primary care doctor. Over the last 3-4 days his work of breathing has increased. Patient states that his oxygen saturation is as low as 84% when ambulating short distance. Tested positive on 9/8/2021 62-year-old male with PMH of COPD, chronic hypoxic respiratory failure on home O2 at 3 L, atrial fibrillation, insulin-dependent diabetes, carotid artery disease, HTN, OSA, HLD and morbid obesity presented to the hospital today after having increased work of breathing, hypoxia with minimal exertion, right-sided chest pain and palpitations. Patient has been suffering with positive at home coronavirus testing since August 7th. Patient has been managing at home with oxygen and oral steroid treatment per his primary care doctor. Over the last 3-4 days his work of breathing has increased. Patient states that his oxygen saturation is as low as 84% when ambulating short distance. He usually does not have to wear his oxygen all the time, only at night but over the last month he has required 3 L continuously. He has required 4 L over the last 4 days to maintain O2 sat greater than 90. Patient has had a few episodes of nausea vomiting several days ago, denies diarrhea. Laboratory evaluation is significant for lactic acidosis, hyperglycemia, hypo magnesemia. COVID swab is positive. Chest CT was obtained which revealed multifocal pneumonia, No evidence of central pulmonary emboli. Sepsis is present on admission, weight based IV fluid resuscitation and antibiotics were initiated. Otherwise, patient denies any recent fevers/chills/sweats/nausea/vomiting/productive cough/chest pain/chest pressure/palpitations/abdominal pain/diarrhea/constipation/frequency/urgency/dysuria/hematuria/hematemesis/melena.


VAERS ID: 1689155 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-05
Onset:2021-09-08
   Days after vaccination:156
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036B21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Blood creatinine increased, COVID-19, Chest pain, Computerised tomogram thorax abnormal, Diarrhoea, Dyspnoea, Hyperglycaemia, Hypomagnesaemia, Hypoxia, Laboratory test abnormal, Lactic acidosis, Nausea, Oxygen saturation decreased, Palpitations, Pneumonia, SARS-CoV-2 test positive, Sepsis, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: MRSA Patient Angina Patient MRSA Patient Angina Patient Appendectomy Patient Bradycardia Patient CAD (coronary artery disease). Patient COPD Patient Cardiac catheterization Patient Cataract Patient Chronic kidney disease stage 4 Patient Circumcision Patient Dyspnea on exertion Patient Ex-cigarette smoker Patient Hernia Patient Hernia repair Patient Hypercholesterolemia Patient Hyperparathyroidism Patient Hypertension Patient Murmur Patient Stent placement Patient
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 75 Y/O male fully vaccinated against COVID came to ER approx 10 days ago and tested + for covid. He was discharged home with symptomatic treatment. He returned to ER with C/O weakness, Diarrhea, and SOB, He was noted to have AKI with creatinine 3.4, Patient seen by ID and started on IV decadron and remdesvir. Tested positive on 9/8/2021 62-year-old male with PMH of COPD, chronic hypoxic respiratory failure on home O2 at 3 L, atrial fibrillation, insulin-dependent diabetes, carotid artery disease, HTN, OSA, HLD and morbid obesity presented to the hospital today after having increased work of breathing, hypoxia with minimal exertion, right-sided chest pain and palpitations. Patient has been suffering with positive at home coronavirus testing since August 7th. Patient has been managing at home with oxygen and oral steroid treatment per his primary care doctor. Over the last 3-4 days his work of breathing has increased. Patient states that his oxygen saturation is as low as 84% when ambulating short distance. He usually does not have to wear his oxygen all the time, only at night but over the last month he has required 3 L continuously. He has required 4 L over the last 4 days to maintain O2 sat greater than 90. Patient has had a few episodes of nausea vomiting several days ago, denies diarrhea. Laboratory evaluation is significant for lactic acidosis, hyperglycemia, hypo magnesemia. COVID swab is positive. Chest CT was obtained which revealed multifocal pneumonia, No evidence of central pulmonary emboli. Sepsis is present on admission, weight based IV fluid resuscitation and antibiotics were initiated. Otherwise, patient denies any recent fevers/chills/sweats/nausea/vomiting/productive cough/chest pain/chest pressure/palpitations/abdominal pain/diarrhea/constipation/frequency/urgency/dysuria/hematuria/hematemesis/melena.


VAERS ID: 1689173 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-06
Onset:2021-09-08
   Days after vaccination:125
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1070 / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Nobe6
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke up with slight facial paralysis issues in the left side of my face. It got worse over 24 hours. I went to the emergency room and they confirmed it was a case of bells palsy. They prescribed me prednisone. Outcome unknown, treatment will be for the next 7 days from September 9th


VAERS ID: 1689185 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER FC3181 / UNK LA / SYR

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

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

Write-up: Local reaction, swelling, itching and redness


VAERS ID: 1689197 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Heart rate increased, Hypoaesthesia oral, Palpitations, Skin warm, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (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: None
Current Illness: None
Preexisting Conditions: Exercise induced asthma
Allergies: None
Diagnostic Lab Data: None yet. But I will seek medical Attention if it continues.
CDC Split Type:

Write-up: I am experiencing numbness to my lips and tongue, increased heart-rate, pounding heartbeat, shakiness, facial flushing/warmth. This started the day after vaccination 9/8/21 and continues into today 9/10/21 with no lessening of symptoms.


VAERS ID: 1689223 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-08
Onset:2021-09-08
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 LA / IM

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

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

Write-up: Hospitalized Remdesivir, dexamethasone


VAERS ID: 1689236 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-09-08
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Hospitalized dexamethasone, remdesivir


VAERS ID: 1689239 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-01
Onset:2021-09-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Nausea, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C
Current Illness: None
Preexisting Conditions: None
Allergies: Fragrance and Beef
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, severe chills for hours, severe headaches and nausea


VAERS ID: 1689240 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-08-06
Onset:2021-09-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Hospitalization due to COVID 19 on 9/8/2021. Reported per Janssen vaccine EUA.


VAERS ID: 1689244 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-11
Onset:2021-09-08
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Hospitalization


VAERS ID: 1689272 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-22
Onset:2021-09-08
   Days after vaccination:198
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Hospitalization


VAERS ID: 1689293 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid arm- large, hard, hot to touch swollen circle on arm about 2 inches just diameter. Getting worse 2 days later. Itchy at injection site.


VAERS ID: 1689295 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Electromyogram, Heart rate increased, Hypoaesthesia, Palpitations, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Back surgery and nerves. Had surgery years prior on lower back.
Allergies: Cast dye in epidural injection, Moderna Vaccine
Diagnostic Lab Data: Possible Nerve damage as this is side effect described by pharmacist of Moderna on CDC website. Called pharmacist and primary doctor. They prescribed EMG for nerve damage and heart rate is elevated.
CDC Split Type:

Write-up: Burning and tingling in hands, as well as Numbness in limbs. Severe fevers for three days and heart palpitation.


VAERS ID: 1689302 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Endotracheal intubation, Erythema, Extubation, Intensive care, Positive airway pressure therapy, Pruritus, Respiratory distress, Stridor, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: has had local reaction to pneumovax and flu vaccine, unknown dates including erythema/itching/rash but limited to arm
Other Medications: prednisone, benadryl, combivent, pulmicort, adderall, melatonin
Current Illness: None
Preexisting Conditions: ADHD, hx cricopharyngeal spasm, laryngomalacia, left thyroid nodule, migraine headaches, obesity, PCOS, severe persistent asthma, vocal cord dysfunction
Allergies: acetaminophen, celecoxib, cephalosporins, latex, macrolides and ketolides, morphine, neomycin, NSAIDs, penicillins, propofol, quinolones, sulfa antibiotics, vinylpyrrolidinone-vinyl acetate polymer, avocado, banana, kiwi, macrodantin, melon, tomato
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: From chart review: 15 minutes post injection VSS with no patient complaints. 45 minutes post injection patient developed whole body itching with erythematous skin. PIV started an normal saline administered. Given 125 mg IV solumedrol, pt started wheezing and took 2 puffs of inhaler (presume albuterol) without relief. Respiratory code called and transferred to ER. From ER note: "Found in respiratory distress, tripoding, mentating appropriately. Sats 100%. Lungs clear. Given epi 0.3mg- unfortunately this was given IV not IM. She developed emesis, improved after zofran and suctioning, was able to protect her airway through this episode. No benefit from the epi, and on reeval she had developed stridor. Next given racemicepi with BiPAP, benadryl 50mg IV, ativan 1mg and another epi 0.3mg now IM. Work of breathing worsened and lungs now severely diminished. Sats still 100%. Decision made to intubate, which was done successfully as below, after which she was admitted to the ICU." Extubated 9/9 per chart review but remains in hospital.


VAERS ID: 1689308 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-21
Onset:2021-09-08
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pfizer on 2/28 and 3/21. Positive on 9/8


VAERS ID: 1689312 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-09-08
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: Hospitalization


Result pages: prev   138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=237&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No

Government Disclaimer on use of this data


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