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From the 11/12/2021 release of VAERS data:

Found 875,292 cases where Vaccine is COVID19 and Patient Did Not Die

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Onset Date)

This is page 24 out of 8,753

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VAERS ID: 1848791 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Myalgia, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin Calcium, Losartan Potassium
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Initial onset - Chills, Fever 102 degrees, Muscle Aches Treated with Tylenol, symptoms diminished over the next 24 hours.


VAERS ID: 1848793 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New York  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Dyspnoea, Gait disturbance, Headache, Insomnia, Mobility decreased, Muscular weakness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: only daily vitamin, occasional aspirin
Current Illness: none
Preexisting Conditions: vericose veins, mitral valve prolapse
Allergies: tree pollen, bactrim
Diagnostic Lab Data: none
CDC Split Type:

Write-up: all=over pounding headache, all-over body- musle & joint aches, fever 100.1,extrememweaknes, instability waalking , getting up & down,no sleeping, mild pains stomach area,labored breathing.


VAERS ID: 1848794 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Passed out, profuse sweating


VAERS ID: 1848797 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Injection site pain, Pain, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: adderall, citalopram
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Body aches, fever, pain at injection site all over night. Intense dizziness and fainted once in morning


VAERS ID: 1848804 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Viibryd 40mg 1qd, Gabapentin 300mg 1 TID, Buspirone 10mg 1 BID PRN, Metoprolol ER 100mg 1qd, Triamterene/hctz 37.5/25 1qd, Trulicity 0.75 1qw, Dicyclomine 20mg tab, Tramadol 50mg , 1q12h
Current Illness: Nothing
Preexisting Conditions: Pre- Diabetes, HTN, Depression and anxiety
Allergies: KNDA
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Patient said that starting early evening of 11/4 (date of vaccination administration) she felt flu like, aches and fever. She said that starting early morning 11/5 she started to also have dizziness and it has not gone away like the flu like symptoms have. She said it''s mostly when she changes position. I recommended trying otc meclizine and see if that helps improve anything.


VAERS ID: 1848816 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tiredness for a day after second Moderna dose in February
Other Medications: Synthroid, amalodepine
Current Illness: None
Preexisting Conditions: High blood pressure (controlled)
Allergies: Pennicillan
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea/vomiting for 30 minutes, 12 hours after vaccination; severe chills but no fever starting 12 hours after vaccination lasting 10 hours, This was a booster shot. Original doses were Moderna on 01/20/2021 and 02/17/2021


VAERS ID: 1848832 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling abnormal, Hallucination, Lethargy, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 12 hours after recieving 2nd dose of COVID-19 vaccine, symptoms began to appear. I began to feel feverish and lethargic. By 30 hours after, I had a very high fever and began hallucinating. I felt as though I was leaving my body. I had taken Ibuprofen earlier and then took Tylenol along with meclizine to alleviate the vertigo and dizziness. I awoke this morning at 9am 11/6/21 feeling much better with no further side effects.


VAERS ID: 1848835 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 213021A / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: erythromycin approx 30 years ago, penicillin approx 40+ years ago
Other Medications: bystolic 10mg, bystolic 5mg, D3, B12, calcium citrate & D3, methyl boost, alpha lipoic acid, factor 1 - probiotic, factor 4 - probiotic
Current Illness: hypertension - in an allergic reaction my heart rate increases, gluten sensitive, lactose intolerant
Preexisting Conditions: hypertension - in an allergic reaction my heart rate increases, gluten sensitive, lactose intolerant
Allergies: preservatives, chemicals, erythromycin, penicillin, food allergies, medication allergies, PEG,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Later in the day on 11-05-2021 day of shot I became very tired. I felt very cold all over and started to shake with very bad headache. I started feeling hot all over. In the middle of the night I woke to being very hot, headache. I put cold wash clothes on my head and on my arms and legs throughout the evening and morning. Running fever at 100.3. This morning feel very tired, headache temperature 97.3. Feel tired, weak and headache.


VAERS ID: 1848836 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Patient denies. SO of patient says patient has sensitive skin.
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Symptoms: Left arm erythema, urticarial, hives, no SOB, no CP, no N/V, no dizziness, VSS Pt kept in treatment area for 30 minutes and was dc home. Treatment: Received 1 dose Benadryl 25mg PO per order. MD ordered for pt to take a total of 3 doses of Benadryl 25mg PO every 6 hours (including the first dose) Per pt, symptoms improving but redness, hives remained present. Instructed pt to call 911 or go to ER if symptoms or addtl symptoms (CP, SOB) start or worsen.


VAERS ID: 1848837 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-11-01
Onset:2021-11-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DayQuil
Current Illness: Sore throat
Preexisting Conditions: None
Allergies: Amoxicillin Cyclopentolate Clindamycin Tropicamide Keflex? Doxycycline?
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Fever, Chills, Aches, Diarrhea, Cough. I currently still have all symptoms the next day at 9:45am after the vaccine.


VAERS ID: 1848839 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-01
Onset:2021-11-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006021A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Gaze palsy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ocular motility disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, body aches, head ache


VAERS ID: 1848856 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Swelling of side of face and throat.


VAERS ID: 1848858 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Fatigue, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tiredness and mild fever after second Pfizer Covid vaccine on 4/28, 35 years old
Other Medications: Gabapentin, Concerta, Biotin, Fish oil, Vitamin D
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on right arm (same side as flu shot), weakness, fever, exhaustion, labored breathing


VAERS ID: 1848877 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue, Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Full body muscle aches, including stomach cramps and headache. Fatigue, chills and low grade fever


VAERS ID: 1848889 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8839 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Nausea, Vomiting
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out, woke up minutes later and conscious. Emergency number called, and patient taken to hospital. Nauseous and vomited.


VAERS ID: 1848911 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039F21A / 2 LA / IM

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

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

Write-up: Patient was given Moderna booster (0.25 ml) instead of full 2nd dose (0.5 ml). Mistake was realized after patient left the pharmacy and he returned the following day for the other 0.25 ml


VAERS ID: 1848912 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna COVID-19 Vaccine EUA Skull sensitive to touch, fever, chills , ache all over and sharp shooting pains in head.


VAERS ID: 1848915 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-26
Onset:2021-11-05
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 2 LA / IM

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 11AM and the vaccine was administered around 207PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement.


VAERS ID: 1848919 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Injection site erythema, Injection site mass, Injection site pruritus
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: The patient had extreme tiredness for 2 days post vaccination and her arm around the injection site became red and itching with a large white lump at injection site that is still present as of today (3 days post vaccine).


VAERS ID: 1848920 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-26
Onset:2021-11-05
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 2 LA / -

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 11AM and the vaccine was administered around 246PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement.


VAERS ID: 1848927 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-01
Onset:2021-11-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Nasopharyngitis, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

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

Write-up: Sore throat, body weakness, severe cold


VAERS ID: 1848928 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-28
Onset:2021-11-05
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 1 LA / IM

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 1235AM and the vaccine was administered around 3PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement.


VAERS ID: 1848941 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:1957-08-16
Onset:2021-11-05
   Days after vaccination:23457
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 3 LA / IM

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 11AM and the vaccine was administered around 2PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement. The patient''s first 2 doses were Pfizer.


VAERS ID: 1848946 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-30
Onset:2021-11-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 2 RA / IM

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 1115AM and the vaccine was administered around 245PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement.


VAERS ID: 1848951 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1855194 / 1 LA / IM

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

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

Write-up: This vaccine was stored at room temperature outside of 2 hours. The vial was opened around 3PM and the vaccine was administered around 530PM. I did not realize this was incorrect until 11/5/21. I have contacted my managers and the manufacturer who did not have stability data past 2 hours and advised to use clinical judgement.


VAERS ID: 1848956 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Mobility decreased, Nausea, Syncope
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 (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 112 mcg; Zyrtec (OTC); multivitamin,; vitamin D3; vitamin B12; vitamin C; probiotic; lutein. Imitrex only as needed and not taken on day of vaccination.
Current Illness: None
Preexisting Conditions: Hashimoto?s thyroiditis; migraines; Raynaud?s
Allergies: No allergies per se. However, intolerance to sulfa due to Raynaud?s.
Diagnostic Lab Data: None at present
CDC Split Type:

Write-up: Fainted and lost consciousness in bathroom overnight. Had felt slight dizziness from 6:30 pm onward on date of injection. Subsequent to incident, continued to feel severe nausea / dizziness and could not make it back to bed from floor initially. Unsure of duration of state of unconsciousness. However, made it back to bed at 4:47 am.


VAERS ID: 1848961 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Back pain, Chills, Eye irritation, Fatigue, Headache, Heart rate increased, Insomnia, Lymphadenopathy, Nausea, Neck pain, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Arthritis (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:
Other Medications: Vyvanse, daily multivitamin, B6, Plaquenil
Current Illness: None
Preexisting Conditions: Undiagnosed autoimmune connective tissue
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Consistent fever of 102 or more; severe chills and body aches; nausea; throbbing headache; back and neck pain; racing heartbeat 111 bpm; burning eyes; swollen lymph nodes/glands; fatigue/weakness. All started about 10 pm on the night of vaccine. Progressed throughout the night. I have been taking Tylenol and ibuprofen to lessen the symptoms but it''s not doing much. Difficult to sleep yet exhausted. Still experiencing all symptoms at 4 pm next day.


VAERS ID: 1848972 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA E33F21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Extra dose administered, Hangover, Neck pain, Scratch
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Arthritis (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? No
Hospitalized? No
Previous Vaccinations: moderna: 2/6/21 & 3/6/21 in bed for 2 days after 3/6
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I AM HOME
CDC Split Type:

Write-up: BRUISING ON MY RIGHT SIDE. I NOTICED FIRST BECAUSE MY NECK HURT. LOOKED IN THE MIRROR-BIG BRUISE THERE SIZE OF MY FINGERS. ABOVE THAT IS A SCRATCH! I HAVE A BRUISE ON MY RIGHT BREAST! AS I STAYED IN BED THE WHOLE ENTIRE DAY AFTER THE SHOT FEELING LIKE I HAD A HORRIBLE HANGOVER! I HAVE A DOG SO HAD TO TAKE HER OUT A FEW TIME ONLY TO GET BACK INTO BED AND DRINK WATER WHICH IS ALL I HAD THE DAY AFTER THE BOOSTER. SHOT ON THURS. IN BED FRIDAY. TODAY I WENT TO THE PHARMACY AND TOLD THEM WHAT MY EFFECTS ARE. HE TOLD ME TO KEEP A LOOK OUT ON MY LEGS FOR THROMBOSIS!!! MY HEALTH HAS BEEN PERFECT.


VAERS ID: 1848988 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Fatigue, Injected limb mobility decreased, Insomnia, Lymphadenitis, Pain, Pyrexia, Vaccination site erythema, Vaccination site inflammation, Vaccination site pain, Vaccination site rash, Vaccination site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid 19 Pfizer dose 2
Other Medications: Armour Thyroid(45mg) Unithroid(50 mg) Isibloom(.15mg/.03mg) Adderall XR(20 mg)
Current Illness: N/A
Preexisting Conditions: Hashimotos & ADHD
Allergies: Augmentin and erythromycin (hive reaction)
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Fever 100.8F Fatigue Sore arm Red, swollen, extremely enflamed rash at vaccine site Painful swollen armpit Difficulty moving or using arm due to pain Inability to sleep due to pain


VAERS ID: 1848999 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Erythema, Fatigue, Headache, Pain, Pain in extremity, Pruritus, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: SEVER BODY AND JOINT ACHE [ONGOING] HEADACHE - INTERMITTEN SHARP PAINS [ONGOING] PAINFUL SORENESS IN ARM - REDNESS, ITCHING, SWEELING [ONGOING] MILD FEVER 100.8 FATIGUE TIRENESS AND LIGHTHEADED [ONGOING]


VAERS ID: 1849000 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Rash, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Diarrhea, rash, vaginal bleeding


VAERS ID: 1849014 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 330268D / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Lymphadenitis, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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: Multi vitamin Magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Inflammation and swelling in left armpit


VAERS ID: 1849023 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 - / SYR

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

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

Write-up: At around 1 pm he complained of stomach pain and nausea. He was in so much pain, he couldn?t talk.


VAERS ID: 1849028 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Anxiety, Blood potassium decreased, Dizziness, Feeling abnormal, Hypersensitivity, Laboratory test, Pallor, Paraesthesia, Thirst
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ER verified his potassium was low, but I cannot validate what labs/tests were ran.
CDC Split Type:

Write-up: Patient received 1st dose Pfizer. No history of allergies to food/meds. Received vaccine at 11:27 am and started feeling "funny" while waiting post vaccine. We immediately brought him back into the IMZ room. His anxiety escalated and he felt dizzy like he was going to pass out. We gave him an ice pack for his head. No nausea. He lost all color in his skin. Then his legs began to tingle. BP: 179/83. Pulse: 92. He asked that we call 911. He started to regain color and feel a little better and then it hit him again (another wave of symptoms). Emergency arrived around 11:47 am and took him to the hospital. After speaking with him last evening he said he has been very thirsty all day. His KCl was a little low at the hospital and they gave him an IV. The ER could not determine exactly what happened. They are classifying it as an allergic reaction because some of the symptoms. It could have been the start of anaphylaxis; although no issues with breathing/swelling.


VAERS ID: 1849038 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822811 / 1 - / IM

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

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

Write-up: The patient is underage to have received J&J no adverse effects


VAERS ID: 1849040 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Chills, Electrocardiogram, Sensitive skin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Baby aspirin, ranolazune, isosorbide monnitrate, atorvastatin
Current Illness: Angina
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: EKG at Dr office
CDC Split Type:

Write-up: Chest pain, chills, sensitive skin


VAERS ID: 1849048 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), 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)

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: Same as above but not as bad as this time
Other Medications: Lisinopril Warfarin Lasix Aldactone Metoprolol Lexapro
Current Illness: None
Preexisting Conditions: A Fib, Depression, Scoliosis, Arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, vomiting, diareaha, dizziness, chills, low grade fever


VAERS ID: 1849056 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-10-26
Onset:2021-11-05
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose increased, Chest X-ray normal, Computerised tomogram head, Dizziness, Ear discomfort, Extra dose administered, Full blood count normal, Laboratory test, Magnetic resonance imaging normal, Metabolic function test, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allergy shots (Day before). ASA 81 mg, Atorvastatin 10 mg, Vitamin D orally 20,000 units
Current Illness: none
Preexisting Conditions: Post-stroke (temporary memory only NO motor function was 9.10.2021) so meds changed around a couple times prior to my Moderna BOOSTER (1/2 dose). Otherwise, Osteoarthritis Left knee.
Allergies: Sulfa-Hives. No foods.
Diagnostic Lab Data: 11.5.2021 CBC, CMP, Chest Xray, CT Brain, MRI--basically all negative for a stroke. Glucose was elevated only on admission to the ED.
CDC Split Type:

Write-up: Acute onset of dizziness, nausea, later vomiting. Started 0730 upon arising. Last vomiting was about 12:45 (5 hours of duration) with residual nausea. Went to the Emergency Department to rule out early signs of a stroke. Tests (lab, chest xray, CT Brain, MRI Brain) were all negative. I was discharged. Perhaps this series of symptoms started from irritation in nerves in ears (problem I had in 2015). I had my first stroke (Lucunar pin point in Left hippocampus) that resulted in amnesia (inability to form new memories for a few hours). THere were NO motor function changes and the only thing positive was the MRI. This stroke was 5.5 months after second Moderna.


VAERS ID: 1849057 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Facial paralysis, Hypoaesthesia, Magnetic resonance imaging, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 16 hours after second phizer shot, I experienced right facial numbness, swelling and drooping.


VAERS ID: 1849067 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 076C21A / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site erythema, Injection site pain, Musculoskeletal stiffness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Had fatigue, fever, body aches, headache, soreness and redness at injection site, stiffness of neck.


VAERS ID: 1849079 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

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

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

Write-up: Noted to have significant vaccine leakage on skin when I looked back at the video that I took. The nurse wiped off the fluid from skin. We were not notified at the time and now cannot determine how much vaccine patient received. Best guess is 75% (maybe)


VAERS ID: 1849080 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pain of skin
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Skin painful to touch approximately 12 hours after receiving acclimation. This reaction last approximately 18 hours


VAERS ID: 1849100 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Nausea, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Vital signs taken at 1500 ? BP 94/45, HR 69, SpO2 97% 1505? BP 100/92, HR 96, SpO2 99% 1510? BP 96/65, HR96, SpO2 99% 1516- BP 108/68, HR 98, SPO2 99%
CDC Split Type:

Write-up: At 1500 pt developed nausea, pallor, dizziness. EMS was called and vitals were periodically taken. PT was layed supine on foam matt. At 1503 pt vomited about 100mL of stomach contents. At 1510 pt sat up. At 1513 pt. stood up and denied dizziness. At 1516 pt sat on a chair and claimed she felt okay.


VAERS ID: 1849109 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 071F21A / UNK LA / IM

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

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

Write-up: rash, redness, and swelling


VAERS ID: 1849112 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sore arm w/ Pfizer 1st dose Covid vaccine
Other Medications: Prozac Wellbutrin Estrace Prenatal vitamin
Current Illness: None
Preexisting Conditions: Sleep Apnea Depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes in both armpits


VAERS ID: 1849116 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Woke up in the middle of the night shivering uncontrollably. I have a fever of 101.5 Could not sleep the rest of the night and kept shivering uncontrollably. In the morning I had a throbbing headache and very achy all over.. I felt that way the rest of the day. The fever lasted all day as well. Today (11/6/21) I am feeling a bit better but still a little bit of a headache It was a very horrible experience. I never felt that sick in my life.


VAERS ID: 1849138 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8030 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Headache, Palpitations, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (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: unk
Current Illness: unk
Preexisting Conditions: asthma, diabetes
Allergies: nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called with swollen arm from neck to hand, states it started this morning after receiving Pfizer Covid-19 booster in his right arm yesterday. Yesterday he had chest pain, heart pounding and headache that went away then he woke up this morning with arm swelling. I recommended he call his MD office and go to urgent care for further assessment.


VAERS ID: 1849149 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Injection site pain, Lymph node pain, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: On the same evening I received a flu shot in my right arm and the Pfizer booster in my left. I had already completed 2 rounds of pfizer vaccination in April of 2021. On Friday night I began having some tightness in my chest, and the injection site from the booster was extremely painful. When waking up ok Saturday morning I was still in a lot of pain and noticed the lymph nodes in my left armpit were severely swollen. The lymph nodes in the left side of my throat were also a bit swollen. The pain in my arm, chest, and lymph nodes has subsided a bit throughout Saturday, though I still have a significant lump under my arm.


VAERS ID: 1849164 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram ST segment depression, Electrocardiogram ST segment elevation, Myocardial injury, Pain in extremity, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Critical elevation of Troponin 1.092 and abnormal ECG with major ST segment elevations in leads II, III, aVF, and V2, V3, V4, V5 and V6; ST depression in aVR. Severe Myocardial Injury documented in ED on 11/6/21. Patient required emergency transfer by aircraft hospital.
CDC Split Type:

Write-up: severe chest pain radiating to the left arm, shortness of breath starting 0900 on 11/5; presenting to the ED at 0600 on 11/6.


VAERS ID: 1849165 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5618 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bradykinesia, Dizziness, Fatigue, Hyperhidrosis, Injection site pain, Loss of consciousness, Pallor, Posture abnormal
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), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient received the vaccine and then walked approximately 50 feet to the post-vaccination observation area, where we were directed to a seating area. She sat down, told me (her mother) that she was tired and a little dizzy, and then her head rolled to the right side and her body went slack?she passed out. I immediately started saying her name and tapping her shoulder and face to wake her up, while also signaling to the clinic staff that she needed help. She twitched a few times while passed out but didn?t wake up for about 15-20 seconds. Then, she abruptly opened her eyes and was alert though really tired. She said she was okay, but she was sweaty, pale and slow to move. She was able to transfer herself to a wheelchair and was taken to a separate observation area where she was allowed to lay down while a nurse checked her vitals. She was given some water followed by some grape juice. We waited another 15 minutes in this area until patient was feeling well enough to get up and move around. She was cleared to leave and we left around 1:35 p.m. She was tired for the rest of the day and had a sore arm near the injection site, but had no additional symptoms after this incident.


VAERS ID: 1849166 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Rash erythematous, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red rash- larger every day Hot to the touch Rash feels hard/like a bump


VAERS ID: 1849171 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymphadenopathy, Pain, Vomiting
SMQs:, Acute pancreatitis (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: Fainting
Other Medications:
Current Illness:
Preexisting Conditions: Obesity, IBS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe body aches, vomiting, swollen arm pit on arm of vaccine site.


VAERS ID: 1849178 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chest discomfort, Dyspnoea, Fatigue, Lymph node pain, Lymphadenopathy, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer COVID Vaccine dose 2 in February 2021. 27 y/o fevers, muscle and joint pain, fatigue.
Other Medications: Escitalopram 10mg
Current Illness: Sinus infection
Preexisting Conditions: Asthma
Allergies: Sunflower Seeds
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12-30 hours after injection: fevers, muscle pain, joint pain, nausea, vomiting, fatigue 30 hours after injection to current: chest tightness, shortness of breath, left axillary lymph node swelling and pain, muscle pain


VAERS ID: 1849183 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Lethargy, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

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: Allegra Flonase Hydrocortisone
Current Illness: None
Preexisting Conditions: Seasonal allergies Eczema
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lethargy Vomiting Diarrhea


VAERS ID: 1849206 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Nausea, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme nausea and convulsive vomiting


VAERS ID: 1849207 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-10-14
Onset:2021-11-05
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 212A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neuropathy peripheral, Paraesthesia, Sciatica
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Physical exam on date of onset and performed daily to monitor progress.
CDC Split Type:

Write-up: Unexplained, nontraumatic severe peripheral neuropathy primarily of sciatic nerve and branches with accompanying non-related dermatomal patterns of RLE and paresthesia. No assoc weakness noted as yet. Started dexamethasone oral, ibuprofen at onset of symptoms with minimal improvement noted (day 2-3). Raising dexamethasone dosage and adding antihistamine and pepcid to treatment. Will continue to treat and monitor.


VAERS ID: 1849208 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 RL / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pyrexia, Vomiting
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: Claritin Fluoride
Current Illness: Environmental Allergies
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low fever on Friday 11/5, fever of 101 - 102 on Saturday 11/6, vomiting on Saturday 11/6 at 6:30 pm. Gave him Tylenol for fever and Zofran for vomiting.


VAERS ID: 1849219 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA COVID-19 VACCIN / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Headache, Injection site pain, Nasal congestion, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Zetia, Hormone Replacement Therapy. Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: seasonal hayfever
Diagnostic Lab Data:
CDC Split Type:

Write-up: I also had the flu vaccine at the same time, but shot into the right arm. Left arm became very sore and I experienced mild headaches. By about 10pm, I begin running a fever which peaked at 101.7. Although the fever has decreased, I continue to have a low grade fever at the writing of this document--on Nov. 7. I remain very achy, have sore joints, and mild congestion. It is important to note that I had no side effects with the first two doses of Pfizer that I had.


VAERS ID: 1849225 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Syncope, Throat tightness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (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: TdAP- body aches and fainting
Other Medications: multivitamin and Cetirizine
Current Illness: none
Preexisting Conditions: normally healthy
Allergies: Anaphylactic reactions to Clindamycin and Keflex. Allergies to scents in lotions and UV lights used in nail salons
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fainting, Headache, joint pain, Throat tightness and extreme fatigue


VAERS ID: 1849237 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032F21A / 1 LA / SYR

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

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

Write-up: Error: Patient Too Young for Vaccine Administered-


VAERS ID: 1849242 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Joint injury, Limb injury, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1849252 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 3 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site erythema, 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: Iron Pills Olly Vitamins
Current Illness: None
Preexisting Conditions: Low Iron / Anemia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection was placed in my upper left arm. Around the injection site my arm is hot, red, the skin is raised in the red area, and the skin in this area is very itchy. This area is about the size of my palm. It started 2 days after the injection and has not gone away yes (5 days later).


VAERS ID: 1849253 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Diarrhea-Medium, Additional Details: Patient''s wife reported patient has diarrhea that is darker than normal. She also told me he''s on iron supplements.


VAERS ID: 1849262 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8028 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site inflammation, Injection site swelling, Injection site vesicles, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Swelling at Injection Site-Severe, Systemic: Fever-Medium, Additional Details: Site of injection looks like a burn. It has gotten hot and inflammed and is blistering. Some of the blisters have burst others are oozing.


VAERS ID: 1849270 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Contusion, Epistaxis, Headache, Injection site pain, Injection site urticaria, Loss of personal independence in daily activities, Nasal dryness, Nausea, Pain, Pain in extremity, Seizure
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra seizure medication
Current Illness: Seizure, dry bloody nose, pain in left arm down to finger, nausea, headache on left side of head only, hives around injection, brusing on hands, injected arm feels like its burning when moving. While waiting the 15 minutes after second Moderna Dosage, my seizure was triggered and staff had to help assist me and my husband. Nurses said it had nothing to do with the vaccine but I never experienced these symptoms my first dosage.
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Seizure, dry bloody nose, burning sensation while moving left arm, pain from injection all the way to my fingers, brusing on hands While waiting the 15 minutes of the second dosage, my seizure was triggered. I felt my seizure at 11:18am and was fully conscious by 11:47am


VAERS ID: 1849273 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Breast pain, Chest discomfort, Dysgeusia, Fatigue, Headache, Injection site pain, Lip swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Taste and smell disorders (narrow), Extravasation events (injections, infusions and implants) (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamin that morning and Zyrtec the evening before as always
Current Illness: No
Preexisting Conditions: No
Allergies: Sensitive to Miralax, PCN and Bactrim
Diagnostic Lab Data: No
CDC Split Type:

Write-up: I had a metal taste about 20 minutes after my shot similar to what I had back in March 2020. This lasted a couple hours. The nurse said she has seen this in patients who had previous infection. Note- I took a Binax rapid test the night before my test and it was negative. I also had a sensation of chest tightness and lip swelling and a headache. The headache continued Saturday and my lip still has a slight sensation today Sunday morning and I am still tired. I did have soreness in my chest under my right breast and soreness where I got the shot -- right arm. It is believed I was previously infected back in March 2020 when they were not testing and was home from work for 14 days. I am O Positive blood type. Do I really need a second shot? I do not think I need one.


VAERS ID: 1849277 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Headache, Injection site erythema, Injection site pain, Injection site swelling, Nausea, Pain, Pyrexia, Seizure
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (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: COVID vaccine (42) weak, body ache, fever, arm sore,
Other Medications: Eatradiol 2mg Prozac 40mg Wellbutrin Trazadone Stelara
Current Illness: None
Preexisting Conditions: Psoriatic and rheumatoid arthritis
Allergies: Allergic to Vicadon
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, fever, nausea, body aches, injection site swelling and red, sore arm, difficulty breathing and 2 possible seizures


VAERS ID: 1849279 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site induration
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: Redness and firm at injection site


VAERS ID: 1849280 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same adverse effect Moderna #2. Fever, headache and chills following shingrix
Other Medications: Bupropion, Levothyroxine, Vitamin D, Benazapril, Lipitor, 81 mg aspirin
Current Illness: None
Preexisting Conditions: History stroke, HTN, CKD3, depression/anxiety, PFO, hypothyroid, Vitamin D deficiency
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever/Chills lasted for 2 hours. Headache lasted for 24 hours


VAERS ID: 1849286 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8020 / 3 LA / SYR

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

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

Write-up: Aches, headache, swelling of lips


VAERS ID: 1849290 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-11-01
Onset:2021-11-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 938804 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Lymphadenopathy, Myalgia, 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: Second dose of Pfizer COVID vaccine 01/04/2021
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None so far
CDC Split Type:

Write-up: Lymphadenopathy, severe headache, fever of 103, diffuse myalgia for 48 hours and still going


VAERS ID: 1849291 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 077C21B / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Injection site nodule, Injection site pain, Injection site swelling
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I still have a egg size swollen knot and is still sore to the touch next to my injection site. Worried if this could be a clot. Should I see a health care professional?


VAERS ID: 1849294 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 065F21A / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Breast pain, Erythema, Limb mass, Myalgia, Oedema peripheral, Pain in extremity, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Lipodystrophy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Arm has a huge lump red itchy scratch under armpit is swollen enlarged pain down in side of arm to breast muscles


VAERS ID: 1849296 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / -

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: Amlodipine, Levothyroxine, vitamin D
Current Illness: None
Preexisting Conditions: Hypothyroidism, treated
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache. Similar to dehydration headaches.


VAERS ID: 1849300 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 58yr, covid 19 vaccine, had high fever and chills for 24hrs then was fine
Other Medications: Atenolol, Cymbalta, vit d, vit e, flaxseed caps, probiotic, Otc allergy meds
Current Illness: Allergies are bad right now
Preexisting Conditions: Copd, diabetes, HTN, asthma
Allergies: Promethazine (Phenergan), ?? Cipro,
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had more of a cough and a low grade temp and general malaise. I took ibuprofen and Tylenol alternately.


VAERS ID: 1849301 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LL / SYR

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

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

Write-up: Diarrhea 24 hours later.


VAERS ID: 1849302 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Sick to my stomach it happened about 20 mins after vaccine was administered


VAERS ID: 1849318 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Patient passed out approximately 2 minutes after shot administration due to vaso-vagal reaction


VAERS ID: 1849337 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fear, Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Chills (24 hours), fever (24 hours), headache (over 24 hours), injection site pain (over 24 hours), nausea (after 24 hours)


VAERS ID: 1849341 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg Total 30 mg/day Venlafaxine 150 mg 1/day Motrin 800 mg up to 3/day Estradiol 1 mg/day Trazadone 100 mg 1/day Cyclobenzaprine 5 mg 1/day Cinnamon Magnesium
Current Illness: Multiple Sclerosis
Preexisting Conditions: Multiple Sclerosis
Allergies: Sulfa drugs
Diagnostic Lab Data: None as yet
CDC Split Type:

Write-up: Fever up and down as high as 102 - Tylenol - still up and down Muscle pain -Tylenol and Motrin - helps some Joint pain Injection site swelling -wait it out Headache Uncontrollable shivering Fatigue


VAERS ID: 1849345 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 061E21A / 3 LA / IM

Administered by: Public       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: Lanreotide, Creon, Bupropion HCl, Dicyclomine, Tamsulosin, Ferrocite, multi-vitamin, Vit. B6, B12, D3, Claritin, Chlortabs, Trazodone, Oxycodone HCl
Current Illness:
Preexisting Conditions: Pancreatic Neuroendrocrine Tumors
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Head Ache


VAERS ID: 1849359 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CW0170 / 3 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram normal, Dysarthria, Electrocardiogram normal, Heart rate increased, Hemiplegia, Nausea, Pyrexia, Urine analysis normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Blood clot.
Other Medications: Aubagio 14mg, Amantadine 100mg, Prozac 20mg, Nifedipine 60mg, Carvedilol 3.125mg, Rosuvastatin 10mg, Tolterodine 4mg, Protonix 40mg, Aspirin 81mg, Vitamin D3 & Liquid B-Complex
Current Illness: MS
Preexisting Conditions: MS
Allergies: Penicillin and Sulfa
Diagnostic Lab Data: ER.
CDC Split Type:

Write-up: Loss of use of entire left-side of body, nausea, low-grade temperature, slurred speech and rapid pulse. Went to ER. CAT scan, EKG, blood and urine tests and chest x-ray. All results came back negative. ER doctor diagnosed as possible reaction to third dose of Pfizer vaccine. Patient had a hemorrhagic stroke on 08/25/2020 with entire left-side paralysis. Therapy for a year and regained back to 75% of normalcy. Patient received the first dose of Pfizer vaccine on 02/12/2021 with no side effects at all. On 03/05/2021 received second dose of Pfizer vaccine.


VAERS ID: 1849361 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Liothyronine 25mcg 1x day. Amethyst birth control 1x day.
Current Illness: None
Preexisting Conditions: Hashimoto?s Thyroiditis. Obesity.
Allergies: Allergic to: peaches and bleach
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph nodes in left armpit for 3 days so far


VAERS ID: 1849362 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Exposure during pregnancy, Extra dose administered, Injection site mass, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), 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: Bupropion 150mg Fluoxetine 40mg Bonjesta 20mg Fish oil Prenatal vitamins
Current Illness:
Preexisting Conditions: Depression Pregnancy
Allergies: Penicillin (rash)
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Currently pregnant. Estimated delivery date: 1/17/2022. First baby. On the night after receiving booster shot, a lump formed at shot site. The lump is about 2 in diameter and extremely itchy. Tried Benadryl cream( does not help), calamine lotion( relief s a bit), ice pack on shoulder( helps a lot). The symptom continues and don?t know when will it recover.


VAERS ID: 1849366 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: calcium citrate, mvi, naproxen psyllium husk
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: redness swelling below left axillae ina 4x4 cm area


VAERS ID: 1849370 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Petechiae, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: pt had fever and chills the day after the shot. Then Friday (2 days post) she developed petechiae on her legs and feet. She has had it before but usually only on her feet when her shoes/socks are too tight. Today is Sunday. She still is experiencing this. She has a cardiologist appt tomorrow and will have him look at it.


VAERS ID: 1849376 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Feeling abnormal, Headache, Insomnia, Nasopharyngitis, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Dementia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd dose Maderna
Other Medications: Blood Pressure medication (irbesartan 150 mg)
Current Illness: none
Preexisting Conditions: HBP
Allergies: Alcohol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Friday 11/5/21 is date I received shot around 9:15-9:20 am. I was fine all day until 7pm. I started feeling like I was getting a cold with a headache....I decided to take 2 tylenol and go to bed.....I was unable to sleep all night.....headache continued along with body aches followed by diahrea and some vomiting..this continued throughout the night into the morning - felt bad all day yesterday 11/6/2021. Headache continued...took tylenol and went to bed...felt better this morning. Drank gatorade and wanter yesterday and a few saltines...today had scrambled eggs and toast with more gatorade.


VAERS ID: 1849377 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Administration site pain, Cheilitis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (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: UNKNOWN
Current Illness: N/A
Preexisting Conditions: UNKNOWN
Allergies: SHELL FISH
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported waking up the morning of 11/05/21 with a inflamed portion of her upper lip. Patient reported that her lip did not itch and she never experienced any difficulty breathing. She only reported having soreness at the site of administration.


VAERS ID: 1849381 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA NA / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Myalgia, Pain, 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: amlodapine/benazapril, synthroid
Current Illness: none
Preexisting Conditions: hypertension, hypothyroid
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: extreme chills, fever 102 degrees, soreness, muscle aches, which have lasted over 24 hours, except for the fever. I was thinking about calling 911 but I didn''t.


VAERS ID: 1849382 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / -

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

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

Write-up: Adenopathy to left axillary area


VAERS ID: 1849388 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Insomnia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (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: Effexor, gabapentin, seroquel, lisinopril, estradiol
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Insomnia, brain zaps, tinnitus


VAERS ID: 1849414 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066F21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Typical side effects on first and second Moderna vaccine
Other Medications: No medications taken at the time of vaccination. I take cholesterol meds 5 mg Rosuvastatin every other day. I take baby aspirin nightly. I take Vitamin B, C, D3, E. I take Fish Oil, Co-Q-10, Vitamin K2, Lutein, Zeaxanthin
Current Illness: None
Preexisting Conditions: Crohn''s Disease has been in remission for many years. I have high calcium levels in my arteries and high cholesterol.
Allergies: Allergic to nickel and latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Typical side effects including fever, chills, headache, etc. I also had a non typical response which included uncontrollable shaking of my hands and forearms. All of this subsided within a day or two.


VAERS ID: 1849415 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-01
Onset:2021-11-05
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Respiratory disorder, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (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: Afib, hx of PE/DVT, HTN, dementia, depression, hypothyroidism, gout, sarcoidosis, IBS, HLD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 11/5 for worsening resp status, COVID+


VAERS ID: 1849424 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Lymphadenopathy, Pain
SMQs:, 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: Body aches, chills, swollen lymph nodes injection side axillary area


VAERS ID: 1849425 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FH8027 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), 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: Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Additional Details: advised patient to try benadryl


VAERS ID: 1849430 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-11-04
Onset:2021-11-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30135BA / 3 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Irbesartan 150 mg, omeprazole, aller-tec, B12, calcium/magnesium with vitamin d, one a day woman?s vitamins, culturelle. Flovent, albuteral if needed.
Current Illness: None
Preexisting Conditions: Htn, asthma, allergies, GERD
Allergies: Cats,dogs.
Diagnostic Lab Data: I did not seek medical treatment. Will email my Doctor if mild swelling and redness does not go down.
CDC Split Type:

Write-up: About 24 hours laterI had a red welt about the size is a half dollar mild swelling. That evening, Friday, I felt achy, very tired. This continues through it the whole day on Saturday. The red area grew to about 3 times the size of what it was on Friday. I was still very tired. I was on the couch resting for about 1.5 days. Felt a little better on Sunday, arm looks the same.


VAERS ID: 1849454 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Bandaemia, Blood bilirubin increased, Blood creatinine increased, Blood lactic acid increased, Computerised tomogram abdomen abnormal, Condition aggravated, Dehydration, Diverticulitis, Hypotension, Nausea, Tachycardia, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan Naproxen PRN
Current Illness: none
Preexisting Conditions: HTN intermittent diverticulitis
Allergies: none
Diagnostic Lab Data: Lactate 3.8 WBC 12.8 with 28% bandemia Bilirubin 4.1 Creatinine 2.66 CT with microperforation of diverticulitis
CDC Split Type:

Write-up: nausea and vomiting starting 2 days later with abdominal pain. Presented 4 days later to the ER, for nausea, vomiting, dehydration. He was found to be hypotensive, tachycardic.


VAERS ID: 1849455 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Fatigue, Nausea, Pyrexia, Somnolence
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Alfusion
Current Illness: None
Preexisting Conditions: None
Allergies: Dust, cats, penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea- 2-3 days Fever above 100? for 2 and 1/2 days (note: highest 103? Chills Tight chest General blahs Tired Sleeping


VAERS ID: 1849463 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-11-03
Onset:2021-11-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Blood test, Chest X-ray, Condition aggravated, Cough
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? Yes
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: Verapamil, levothyroxine, omeprazole, loratadine Flonase, montelukast
Current Illness: Hypertension, Hyperthyroidism, Gerd, Asthma, Sinus polyps, osteopenia, Esophageal spasms
Preexisting Conditions: Same as #11
Allergies: Aspirin, Nsaids
Diagnostic Lab Data: I was administered 4 doses of albuterol all at one time, also iv injection of prednisone. I had a chest xray and bloodwork. Followed with another treatment of asthma meds hours later all done on 11/5/2021.
CDC Split Type:

Write-up: I ended up in the emergency room on 11/5 with a severe asthma attack and cough which hasn''t happened to me in over 5 years. I have been in remission from any attacks.


VAERS ID: 1849464 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026D21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Hyperhidrosis, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Uncontrollable shivering, sweating, dizziness upon standing 10:30pm - 4:30am. 24 hours after injection - exhaustion, headache, b
Other Medications: Nothing that day. Evening med = generic lipitor; OTC = multivitamin, calcium + D, biotin
Current Illness: None
Preexisting Conditions: Asthma, arthritis
Allergies: Tetracycline
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Uncontrollable shivering, sweating, dizziness upon standing 10:30pm - 4:30am. 24 hours after injection - exhaustion, headache, body ache, left arm and left breast itching; Day 3 - still tired, arm itches a little, but much better. NOTE: I reacted the same way but worse and longer with my second dose of Moderna.


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