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

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



Case Details (Reverse Sorted by Onset Date)

This is page 249 out of 8,010

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VAERS ID: 1696493 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Confusional state, Fatigue, Migraine, Nausea, Pain, Pregnancy test negative, Pruritus, Pyrexia, Skin burning sensation, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control- Yaz
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: pregnancy test- 9/12/13 - negative
CDC Split Type:

Write-up: 9/7/21: 12:00pm- extreme nausea 12:30pm- continued nausea, feeling overheated 1:00pm- continued nausea, feeling overheated, began getting confused (I was filling out paperwork and couldn''t spell my middle or last name) 1:15pm- continued nausea, feeling overheated, still confused- threw up symptoms continued 4:00pm- continued nausea, extreme chills to the point of shaking 4:30pm- continued nausea, painful body aches, violent shaking from cold chills (was wearing 2 pairs of pants, long socks, shirt/hoodie, sock cap, covered in heavy blanket and sitting outside in 85 degree weather) symptoms continued 5:00pm- all symptoms above present, took temperature- 101.4 6:00pm - all symptoms above present, took temperature- 102.3 7:00pm- all symptoms above present, took temperature- 102.9 symptoms continued 9:00pm-continued nausea, painful body aches, feeling overheated and sweating everywhere, skin extremely hot to touch symptoms continued. extreme fatigue all day 9/8/21 8:00am- fever broke, nausea continued, extreme body aches continued symptoms continued all day and night extreme fatigue all day (10 hours of sleep) 9/9/21 6:00am- horrible migraine, extreme nausea 6:30am- skin began burning and itching after shower 7:00am- threw up 7:30am- took Benadryl and burning and itching stopped nausea and migraine continued all day extreme fatigue all day (8 hours of sleep) 9/10/21 6:00am- horrible migraine, extreme nausea, extreme fatigue 6:30am- skin began burning and itching after shower 6:40am- threw up nausea and migraine continued all day extreme fatigue all day (9 hours of sleep) 9/11/21 8:00am- horrible migraine, extreme nausea, extreme fatigue 9:00am- skin began burning and itching after shower 11:40am- threw up 1:00pm- threw up 9:00pm- threw up nausea and migraine continued all day extreme fatigue all day (8 hours of sleep) 9/12/13 8:00am- horrible migraine, extreme nausea, extreme fatigue 8:30am- skin began burning and itching after shower remained nauseous all day, did not throw up fell asleep by 5:00pm 9/13/21 5:30am- horrible migraine, extreme nausea, extreme fatigue 6:00am- skin began burning and itching after shower 9:00am- threw up nausea and migraine continued all day extreme fatigue all day (12 hours of sleep)


VAERS ID: 1696650 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dizziness, Flushing, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Client presented for vaccination at county jail and was vaccinated with J &J Covid vaccine at 11:00 am without incident. At 11:05 am client appeared flushed and diaphoretic. C/O nausea and dizziness. BP 165/121; HR 121. Client repositioned, offered cool water and cloth and removed mask. MD on site assessed lungs and heart. 8 mg Zofran administered subq at 11:15. Client continued to complain of nausea and at 11:20 am complained of chest pain 3-4/10 with no change with repositioning. Jail staff called for ambulance to take client to ED for further assessment. Client was transported at 11:50 am.


VAERS ID: 1696732 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-28
Onset:2021-09-07
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxycodone, hctz, diltiazem
Current Illness:
Preexisting Conditions: Back pain, high blood pressure
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm was sore after injection until the pain got so bad I had to go to the ER. Ibuprofen and oxycodone where given in the ER


VAERS ID: 1696748 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-16
Onset:2021-09-07
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Victoza, Microzide, Cozaar, Metformin, Amaryl, Pravachol, Lamisil, aspirin, multi vit, Omega 3
Current Illness:
Preexisting Conditions:
Allergies: No know allergies
Diagnostic Lab Data: COVID-19 09/09/2021
CDC Split Type:

Write-up: Patient received 2nd Pfizer on 02/16/2021. Patient developed symptoms related to COVID-19 on 09/07/2021. Patient received positive results on 09/13/2021.


VAERS ID: 1696775 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-02-14
Onset:2021-09-07
   Days after vaccination:205
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abnormal weight gain, Asthenia, COVID-19, Chills, Cough, Dyspnoea, Dyspnoea exertional, Fall, Fibrin D dimer increased, Hypervolaemia, Limb injury, Musculoskeletal chest pain, Oxygen saturation decreased, Pain, Pain in extremity, Painful respiration, Peripheral swelling, Pleuritic pain, SARS-CoV-2 test positive
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chief Complaint Increased SOA x3 days, COVID positive today. Reports low spO2 on clinic monitor. 92% on RA on arrival to the ED. History of Present Illness 50-year-old female with past medical history significant for asthma, type 2 diabetes, and obesity (BMI 86.6), presented to LMH with 3-day history of shortness of breath and recent Covid positive test. Patient reports being in her baseline state of health until 6 days prior to admission. She received Covid vaccination series in February 2021. On September 4, patient went out with friends to a bar, fell and injured her left leg while climbing up on the stage. Since that time, she has felt more weak, has had pain in her left leg, and some increase


VAERS ID: 1696792 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 RA / IM

Administered by: Private       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: myopia OU w/astigmatism
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient was inappropriately given a first dose of Pfizer when he is not yet 12 years of age


VAERS ID: 1696837 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-23
Onset:2021-09-07
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin d, gabapentin, lisinopril, metformin, norco, pravastatin, tramadol, valsartan, vesicare
Current Illness: DM type 2, CAD, osteoarthritis,
Preexisting Conditions: DM type 2, CAD, osteoarthitis,hyperlipidemia, HTN
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, CXR, COVID positive
CDC Split Type:

Write-up: SOB, high flow N/C, CBC,CXR, CMP,


VAERS ID: 1696894 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-09-07
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, COVID-19, Chest X-ray, Echocardiogram, Fall, Full blood count, Metabolic function test, Respiratory viral panel, SARS-CoV-2 test positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine,triamterine, ramipril
Current Illness:
Preexisting Conditions: Hypothyroidism, HTN,
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, Cardiac Profile ,CXR, Echocardiogram, Respiratory panel
CDC Split Type:

Write-up: syncope, fall, COVID positive


VAERS ID: 1696900 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-14
Onset:2021-09-07
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac telemetry, Condition aggravated, Dyspnoea, Fibrin D dimer, Hypoxia, Positive airway pressure therapy, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Sleep apnoea syndrome
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, Breo inhaler, hydrochlorthiazide, Singulair, Spiriva, Fluticasone propionate nasal spray, Vitamin D
Current Illness:
Preexisting Conditions: Bronchiectasis, Choelecystitis (chole 02/08), Interstitial lung disease, Hypertension, Osteoporosis, Obstructive sleep apnea,
Allergies: none
Diagnostic Lab Data: 9/10/21 Covid Rapid Molecular positive, 9/11/2021 Covid Anti-Spike IgG positive, 9/11/21 D-Dimer 3,766
CDC Split Type:

Write-up: 67 yo male hx of bronchietctasis, ILD, presents to ED for shortness of breath, found to have COVID PNA with hypoxia requiring 15L NRB mask changed to 15L HFNC O2. Admitted to telemetry unit. Started on decadron and remdesivir 9/10/2021. Possible bacterial pneumonia. Started on cefepime and levofloxacin, bronchodilators, BiPAP at night for sleep apnea.


VAERS ID: 1696913 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

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

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

Write-up: Patient requested a booster (third) dose of Covid-19 vaccine, the pharmacy did not provide his first dose. The pharmacy administered a Pfizer dose a. It is our understanding that the patient received Moderna series, however, we only were aware of this after the patient received the vaccination. Ultimately the patient received a Moderna series and a Pfizer third dose due to self-attesting he was immune compromised.


VAERS ID: 1697210 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle tightness, Speech disorder, Tongue discomfort
SMQs:, Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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: grade 3 reaction to first dose of Shingrix vaccine 4 months prior
Other Medications: Vitamin B, Vitamin C, Magnesium
Current Illness: none
Preexisting Conditions: none
Allergies: none known before this one
Diagnostic Lab Data: none
CDC Split Type:

Write-up: About 10 minutes post injection, started feeling a tickle in my tongue and tightness in the neck. Difficulty speaking but was able to breathe unobstructed. feeling of hand gripping neck lasted about 45 minutes and subsided on its own with rest.


VAERS ID: 1697569 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Consciousness fluctuating, Fall, Fatigue, Joint injury, Mobility decreased, Pain, Pain in extremity, Pyrexia, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), 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? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin 10mg/ 3x week CoQ10
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: X-ray of left knee on Thursday, September 9th, 2021 MRI scheduled for Thursday, September 16th, 2021
CDC Split Type:

Write-up: I experienced all the common side effects: sore arm, fatigue, fever, chills, body aches within the first 12 hours of receiving my second dose of the Moderna shot. I passed in and out of consciousness 4 times during the early hours of Wednesday morning, September 8th resulting in a fall in my bathroom onto the tile floor. I have severely injured my left knee. I cannot bend my knee and have constant pain in it. I have had a x-ray and will have a MRI to see if the meniscus or MCL is torn. If my husband hadn?t caught me I passed out when he did I would have further injured myself and likely hit my head.


VAERS ID: 1697759 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alopecia, Arthralgia, Migraine, Muscle twitching, Pain in extremity, Tinnitus, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had my second Covid shot on September 2 and have an appointment with the neurologist on September 25 and an ENT on October 14th.
CDC Split Type:

Write-up: Approximately four days after the second vaccine was given I had terrible Ringing/ Pulsatile Tinnitus in both my ears that sounds like a heartbeat. Extreme intense migraines for several days, hair started falling out after the first Moderna shot and getting worse.I?ve also had weird muscle twitches /tremors, pain in my calves and joints and feeling very weak. My constant ringing has not let up and I had bouts of dizziness, ears also feel full.


VAERS ID: 1697767 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1820095 / 1 LA / IM

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

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

Write-up: PATIENT GOT LIGHT HEADACHE AFTER VACCINE


VAERS ID: 1697942 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-30
Onset:2021-09-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Asthenia, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone gel Levothyroxine Hydrocortisone
Current Illness:
Preexisting Conditions: Hyperthyroidism High blood pressure
Allergies: Cranberries Isoboide
Diagnostic Lab Data: Suggestions was to get a covid test result were negative
CDC Split Type:

Write-up: Loss if smell and taste Felt feverish Body aches and headaches Weaknesses and tired


VAERS ID: 1700106 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-11
Onset:2021-09-07
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 AR / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Acute respiratory failure, Asthenia, C-reactive protein, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Differential white blood cell count, Dry eye, Dyspnoea, Eye disorder, Fatigue, Fibrin D dimer, Full blood count, Hypoxia, Laboratory test, Metabolic function test, Ocular hyperaemia, Pyrexia, SARS-CoV-2 test positive, Sepsis, Systemic inflammatory response syndrome, White blood cell count normal
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hospital Medications L1 acetaminophen (TYLENOL) tablet 1,000 mg L1 acetaminophen (TYLENOL) tablet 500 mg albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 90 mcg inhaler (60 dose canister) amiodarone (PACERONE) tablet 200 mg apixaban
Current Illness: Presented to PCP office 9.7.21 - acute respiratory distress, fever, shortness of breath - COVID-19 positive 9.7.21
Preexisting Conditions: Hospital Controlled type 2 diabetes mellitus without complication, without long-term current use of insulin History of prostate cancer Persistent atrial fibrillation Acute respiratory disease due to COVID-19 virus Non-Hospital Hypertension associated with diabetes Hyperlipidemia associated with type 2 diabetes mellitus Cardiomyopathy Aortic root dilatation Class 2 severe obesity due to excess calories with serious comorbidity and body mass index (BMI) of 38.0 to 38.9 in adult
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized (9.7.21 - still admitted); COVID-19 positive; fully vaccinated HISTORY OF PRESENT ILLNESS: Patient is a 78 y.o. male with a history of permanent atrial fibrillation and type 2 diabetes who presents today as directed by his PCP due to fever and hypoxia. Patient has COVID-19 infection. He states he has had symptoms for at least 2 weeks. It initially started with a dry cough and generalized fatigue and weakness. He also states that he has been having issues with his eyes. He says that they are dry and sometimes red. He has great concern about his eyes in fact stating that he has a disease in their some kind, he is sure of it. He denies vomiting or diarrhea. He had not noted any fevers at home. On arrival, he was hypoxemic and required supplemental oxygen which he does not use at baseline. He was noted to have a low-grade fever. His lab work and vitals were otherwise largely unremarkable. He had radiographic evidence of COVID pneumonia. On exam, he is lying on his side in no acute distress. He does still require supplemental oxygen. His biggest concern is about his eyes at this time. Despite his elevated level of concern, he does struggle to be able to elaborate as to exactly what is wrong with them. He states he received his 2nd dose of the Moderna COVID-19 vaccine in March of 2021. Plans are discussed for admission and he is agreeable. He wishes to be listed as full code status. ASSESSMENT / PLAN: * Acute respiratory disease due to COVID-19 virus Assessment & Plan Admit to medicine-hypoxia secondary to COVID pneumonia Patient has noted symptoms for at least 2 weeks, outside therapeutic window for remdesivir Will initiate daily Decadron 6 mg, oxygen therapy, wean as able, does not use at baseline Will trend daily complete blood count, CMP, CRP, D-dimer, continuous pulse oximetry Encourage incentive spirometry and pronation COVID 19 Pneumonia Acute Hypoxic Respiratory Failure - improving Sepsis - improving Presenting symptoms: Hypoxia, Febrile, Cough SIRS criteria met 2: HR 76, RR 24, TEMP 38.1, WBC 8.64 COVID 19 detected by PCR: 9/7. Symptomatic day: 14 plus Removed from Covid isolation 9/8. CXR with findings of Covid Pneumonia Received Decadron and acetaminophen in ED. Not a Remdesivir candidate because 14 days symptomatic. Current oxygen saturation 97%, oxygen requirement increasing daily from 2L admission $g 4L $g 9L $g 11L $g 15L $g 13L with oxymizer on 9/11. CRP improving 13L Intermediate NC on 9/13 Given 80mg lasix IV x1 9/14 - Give another 80mg IV lasix now - Dexamethasone 6 mg oral daily - 8 of 10 days, but can prolong this course per pulmonology consult - Daily labs CBC with differential, CMP, D-dimer - Continuous pulse oximetry and telemetry - Mucinex 600mg BID


VAERS ID: 1700107 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-20
Onset:2021-09-07
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Dyspnoea, Electrocardiogram, Full blood count, Metabolic function test, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril, metformin
Current Illness:
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, COVID, CXR, EKG
CDC Split Type:

Write-up: SOB, COVID positive


VAERS ID: 1700256 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK AR / IM

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

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

Write-up: The adverse event was that an expired Janssen COVID-19 Vaccine has been administered to the patient. There were no adverse event, symptoms or any health related issues regarding the patient. Only that the vaccine has been given after the expiration date, nothing else.


VAERS ID: 1700282 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK AR / IM

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

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

Write-up: The adverse event was that an expired Janssen COVID-19 Vaccine has been administered to the patient. There were no adverse event, symptoms or any health related issues regarding the patient after the vaccine dose was given. Only that the vaccine has been given after the expiration date, nothing else.


VAERS ID: 1700286 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-20
Onset:2021-09-07
   Days after vaccination:171
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood glucose increased, C-reactive protein abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Decreased appetite, Fall, Fatigue, Fibrin D dimer increased, Full blood count normal, Hypoxia, Lung infiltration, Mobility decreased, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Upper respiratory tract congestion, White blood cell count normal
SMQs:, Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet ALPHA-LIPOIC ACID PO atorvastatin (LIPITOR) 10 MG tablet benzonatate (TESSALON) 100 MG capsule dexamethasone (DECADRON) 6 MG tablet Donepezil HCl 23 MG tablet finasteride (PROSCAR) 5 MG tablet guaiFENes
Current Illness: Fall 9.7.21 COVID-19 positive 9.7.21
Preexisting Conditions: Diabetes Allergic rhinitis Glaucoma Essential hypertension Hyperlipidemia Palpitations Traumatic subdural hematoma with loss of consciousness of 30 minutes or less Paroxysmal atrial fibrillation Urinary frequency BPH associated with nocturia Kidney stone Nonrheumatic aortic valve stenosis Major depressive disorder with single episode, in full remission Early onset Alzheimer''s dementia without behavioral disturbance History of subarachnoid hemorrhage Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin LBBB (left bundle branch block) Spinal enthesopathy, cervical region Pneumonia due to COVID-19 virus Atherosclerotic heart disease of native coronary artery without angina pectoris Cardiomyopathy, unspecified Gastroesophageal reflux disease Long term (current) use of insulin Low-tension glaucoma, right eye, moderate stage Occlusion and stenosis of bilateral carotid arteries Hypoxia
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalization; COVID-19 positive (9.7.21); fully vaccinated Admission Date: 9/7/2021 Discharge Date: 9/9/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus detected Pneumonia due to COVID-19 virus HOSPITAL COURSE: Patient is a 86 y.o. male with a history diabetes mellitus type 2 on metformin and Lantus as well as hypertension, mild dementia, depression, BPH, aortic stenosis, paroxysmal atrial fibrillation and glaucoma, who presented with upper respiratory congestion and fatigue. Patient did have his 1st Moderna vaccination in February and received a 2nd vaccination on 03/20. Patient reports that he had been doing well, until this past weekend when he had developed upper respiratory congestion with a sore throat. He also reported fatigue and decreased appetite. Patient had mechanical falls at home an due to weakness and inability to get up independently EMS was called. In the ED patient was hypoxic requiring 2L NC and febrile. Complete blood count showed normal white count, with chest x-ray showing bilateral infiltrates. COVID swab was positive. Patient was started on decadron and remdesivir. He was weaned off oxygen and remained on room air for 24 hours. Fevers resolved and he was afebrile for 24 hours. CRP and Ddimer trended down. Patients glucose was elevated due to steroids. Discussed with patient and he adjusts his qhs lantus dose based on glucose at night. Discussed with patient to continue this and metformin. Discussed with patient to call PCP if glucose $g 300. PT / OT recommended home with home healthcare. Will discharge patient home to continue another 6 days of decadron. Discussed with patient quarantine due to COVID positive status. Patient discharged home in stable condition with follow up with his PCP on 9/16. Patient was feeling well and eager to discharge home.


VAERS ID: 1700345 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient observed sitting in waiting area sweating profusely. Patient alert and oriented x4, he states "I feel like I''m going to faint". Patient explains "since being a child I''ll get this way after getting a vaccine". Vital signs assessed BP 86/52 HR 58, O2 97%, RR 16. Patient was instructed to lay supine and elevated legs onto chair. Ice packed applied, reassessed VS, BP 115/71, HR 59, O2 98%. Patient verbalized that he was beginning to feel better. Patient states he feels better, no sweating observed at this time. No emergency medication administered.


VAERS ID: 1700380 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-09-07
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, COVID-19, Cough, Diarrhoea, Headache, Nausea, Pyrexia, SARS-CoV-2 test positive, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair inhaler, Albuterol inhaler, Lipitor, Tessalon (prn), OSCAL-D, Vitamin D, Vitamin B-12, Flexeril, Colace, FLONASE nasal spray, Gabapentin, Glimepiride, Ibuprofen, Synthroid, METANX, Losartan, Antivert, Singulair, Fish oil, Protonix,
Current Illness:
Preexisting Conditions: Patient is a 63 y.o. female who has a past medical history of Acid reflux, Acute pain of both knees (10/28/2020), Acute right-sided low back pain without sciatica (8/27/2018), Allergic rhinitis, Arthritis, Asthma, Bleeding, Blood transfusion, Chronic pain of both knees (1/15/2021), Chronic right-sided low back pain without sciatica (8/27/2020), Colon polyps, Depression, Diabetes mellitus type II, Diverticulosis, Encounter for blood transfusion, Fibromyalgia (10/5/2006), History of colonoscopy (2/2/2003), History of endoscopy (4/8/11), Hyperlipidemia, Hypertension, Iron deficiency anemia, NAFLD (nonalcoholic fatty liver disease), Pain of left hip joint (3/6/2019), PONV (postoperative nausea and vomiting), Seasonal allergies, Shoulder pain, right (7/8/2020), and Thyroid disease.
Allergies: Tessalon, Ceclor
Diagnostic Lab Data: 9/14/2021 COVID-19 Rapid Molecular Positive,
CDC Split Type:

Write-up: HPI: Patient is a 63-year-old female with multiple medical problems who presents to the emergency department chief complaint of cough, abdominal pain, diarrhea, nausea, headache, back pain, and fevers. Patient states that she has had her symptoms for approximately 9 days. She was tested on 9/9 for COVID-19 and was negative. Patient states that she has been having some diarrhea and vomiting but it temporarily improved


VAERS ID: 1700413 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Cough, Decreased appetite, Ear pain, Nausea, Pain, Respiratory symptom, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: obesity
Allergies: none
Diagnostic Lab Data: covid testing 09/15/2021
CDC Split Type:

Write-up: URI symptoms (cough, runny nose, congestion), body aches, gi upset (nasueas, abdominal pain), decrease appetites, ear pain


VAERS ID: 1700423 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-09-07
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Dyspnoea exertional, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Anoro Slipta, Dorzolamide-Timolol, Eliquis, Lantanoprost, Levothyroxine, Midodrine, Sotalol
Current Illness: Unknown
Preexisting Conditions: HTN, Hyperlipidemia, COPD, Sleep apnea, Thyroid disease, Macular degeneration
Allergies: PCN
Diagnostic Lab Data: Not yet repeated
CDC Split Type:

Write-up: 09/07/2021 The patient presents with shortness of breath. Pt with hx of COPD not on oxygen at home. Pt states he was discharged from the hospital on x5 days ago, he was COVID-19 positive. States since then he has felt increasingly short of breath. Pt was given a pulse oximeter, states PTA his O2 saturation dropped below 90% so he called EMS. The onset was 5 days ago. The course/duration of symptoms is worsening. Degree at onset mild. Degree at present moderate. The Exacerbating factors is exertion. The Relieving factors is sitting upright. Prior episodes: multiple ED visits.


VAERS ID: 1700464 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-18
Onset:2021-09-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP 28-day cycle
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: 9/7/2021 medical facility, Dr., Diagnosis
CDC Split Type:

Write-up: Developed Bell''s Palsey- facial paralysis of cranial nerve VII


VAERS ID: 1700590 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-11
Onset:2021-09-07
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bacterial test negative, Bordetella test negative, COVID-19, Chlamydia test negative, Coronavirus test negative, Enterovirus test negative, Influenza virus test negative, Mycoplasma test negative, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Viral test negative
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cholecalciferol, vitamin D3, 50 mcg (2,000 unit) tablet tablet cyanocobalamin, vitamin B-12, 1,000 mcg tablet divalproex sprinkle (DEPAKOTE SPRINKLE) 125 mg capsule folic acid (FOLVITE) 1 mg tablet levothyroxine (SYNTHROID) 25 mcg table
Current Illness:
Preexisting Conditions: Acute hyperactive alcohol withdrawal delirium (CMS/HCC) Wernicke-Korsakoff syndrome (alcoholic) (CMS/HCC) Alcohol use disorder, severe, in sustained remission (CMS/HCC) Alcohol withdrawal seizure with delirium (CMS/HCC) Bacteremia Delirium tremens (CMS/HCC) Eyelid laceration, right Foot fracture, left Muscle strain of foot, left, subsequent encounter Nasal septal abscess Peroneal tendinitis of left lower extremity Plantar fasciitis of left foot Positive D dimer At risk for falls Transaminitis Impulsiveness Abnormal TSH Generalized anxiety disorder Hypothyroidism Memory impairment Adjustment disorder with depressed mood Anxiety Neurocognitive deficits Prediabetes Mental disorder Aphasia Major neurocognitive disorder, due to another medical condition, with behavioral disturbance, severe (CMS/HCC) Seizure disorder (CMS/HCC) Vitamin D deficiency
Allergies: NKA
Diagnostic Lab Data: 09/07/21 2325 Respiratory virus detection panel Collected: 09/07/21 1924 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 09/07/21 2046 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/07/21 1924 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical
CDC Split Type:

Write-up: UNKNOWN


VAERS ID: 1700604 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-01-27
Onset:2021-09-07
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Aortic arteriosclerosis, Arteriosclerosis, Arteriosclerosis coronary artery, Asthenia, Atelectasis, Bronchiectasis, COVID-19, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Constipation, Diverticulum intestinal, Flank pain, Headache, Hepatic cyst, Hepatic steatosis, Lung infiltration, Lung opacity, Nausea, Nephrolithiasis, Pneumonitis, Prostatomegaly, Pulmonary embolism, Pyrexia, Renal cyst, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Spinal osteoarthritis
SMQs:, Liver neoplasms, benign (incl cysts and polyps) (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Other ischaemic heart disease (narrow), Hypersensitivity (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Outpatient Medications amLODIPine (NORVASC) 10 mg tablet finasteride (PROSCAR) 5 mg tablet
Current Illness:
Preexisting Conditions: Non-Hospital Kidney stone Erectile dysfunction of organic origin
Allergies: LevofloxacinHives / Urticaria Ciprofloxacin
Diagnostic Lab Data: 09/09/21 2323 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/09/21 2223 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast [3302391282] Resulted: 09/15/21 0957 Order Status: Completed Updated: 09/15/21 0957 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: Negative for PE. Bilateral groundglass infiltrates compatible with pneumonitis. The left basal infiltrate is worse than seen on 9/9/2021. END OF IMPRESSION: INDICATION: covid r/o pe. TECHNIQUE: CT Angiographic imaging utilizing transverse helical scans are obtained through the chest after the injection of intravenous contrast material. Multiplanar 2D reformations obtained from raw data. 3D-MIP volume-rendered reformatted images generated on an independent workstation under physician review to obtain angiographic images. One or more of the following dose reduction techniques were used: automated exposure control, adjustment of the mA and/or kV according to patient size, use of iterative reconstruction technique. CONTRAST: 100mL of IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Up-to-date CT equipment and radiation dose reduction techniques were employed. CTDIvol: 5.9 - 129.8 mGy. DLP: 404 mGy-cm. COMPARISON: No relevant studies available. FINDINGS: Diagnostic quality: Adequate. Pulmonary artery: Homogeneous enhancement with no evidence of filling defects consistent with pulmonary emboli. Thoracic Aorta: Normal caliber and homogeneous enhancement. No aneurysm or dissection. Mild atheromatous plaque. Lungs: There is worsening of left basal infiltrate and associated atelectatic change. There is associated mild bronchiectasis. A new groundglass infiltrate is seen involving the right lower lobe. Additional groundglass infiltrates are seen in both upper lobes. These findings are compatible with clinical history of Covid 19 infection. Airways: Unremarkable. Adenopathy: No mediastinal or hilar adenopathy. Coronary arteries: Mild significant coronary artery calcification. Heart and pericardium: The heart, pericardium are unremarkable. Pleura: No significant pleural abnormality. Upper Abdomen: Upper abdominal organs unremarkable. Hepatic hypodensities are again seen, unchanged, appearance compatible with cysts. No significant bony abnormality. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3302189096] Resulted: 09/10/21 0725 Order Status: Completed Updated: 09/10/21 0725 Narrative: XR CHEST 1 VW IMPRESSION: Left lower lobe developing infiltrate. END OF IMPRESSION: INDICATION: Suspected sepsis Suspected sepsis. 72 years TECHNIQUE: AP chest COMPARISON: 2/27/2020 FINDINGS: The heart is normal in size. In the left lower lobe, there is hazy opacity, new from prior. There is no pleural effusion. There is no pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT abdomen pelvis with contrast [3302189115] (Abnormal) Resulted: 09/09/21 2237 Order Status: Completed Updated: 09/09/21 2237 Narrative: PROCEDURE INFORMATION: Exam: CT Abdomen And Pelvis With Contrast Exam date and time: 9/9/2021 9:54 PM Age: 72 years old Clinical indication: Abdominal pain; Flank; Right; Additional info: Right flank pain and fever TECHNIQUE: Imaging protocol: Computed tomography of the abdomen and pelvis with contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNPAQUE 350; Contrast volume: 100 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CT ABD PEL WO STONE 4/20/2020 1:01 PM FINDINGS: Lungs: Left basilar patchy airspace disease. Liver: Mild diffuse hepatic steatosis with multiple 5 mm to 2 cm simple appearing hepatic cyst. Gallbladder and bile ducts: Normal. No calcified stones. No ductal dilation. Pancreas: Normal. No ductal dilation. Spleen: Normal. No splenomegaly. Adrenal glands: Normal. No mass. Kidneys and ureters: Bilateral 1 cm to 4 cm simple renal cyst. Punctate 1 mm nonobstructing left renal stone. Stomach and bowel: Generalized colonic diverticulosis with constipation. Stomach and small bowel shows no acute abnormality. Appendix: Appendix is not well seen. Intraperitoneal space: Unremarkable. No free air. No significant fluid collection. Vasculature: Mild atherosclerotic changes within the abdominal aorta. Mild atherosclerotic changes within the abdominal aorta. Lymph nodes: Unremarkable. No enlarged lymph nodes. Urinary bladder: Unremarkable as visualized. Reproductive: Enlarged prostate gland. Bones/joints: Degenerative changes within the lumbar spine. Soft tissues: Unremarkable. IMPRESSION: Left basilar patchy airspace disease. Simple appearing hepatic and bilateral renal cyst. 1 mm nonobstructing right renal stone. Markedly enlarged prostate gland. COMMENTS: Consistent with the American College of Radiology''s Incidental Findings Committee white paper: Any incidental renal lesion less than 1 cm or classified as too small to characterize, or any incidental cystic renal lesion characterized as simple-appearing, is likely benign. No follow-up imaging is recommended for these lesions per consensus recommendations based on imaging criteria.
CDC Split Type:

Write-up: ED to Hosp-Admission Current 9/9/2021 - present (6 days) Hospital Patient presents with ? Fever ? Flank Pain Patient is an 72 y.o. gentleman with history of BPH, hypertension who came with history of fever and right flank pain for the last 2 days. Patient also states he has some mild headache. Denied cough, shortness of breath, sore throat, nausea, vomiting, diarrhea. Patient was taking Tylenol and ibuprofen but he stopped it because he was afraid he cannot damage his liver and kidney. Patient states he seen his little Bronkaid pro infection from the school. Patient got his two dose of COVID-19 vaccine in February ( Moderna ). Review of Systems Constitutional: Positive for fever. HENT: Negative. Eyes: Negative. Respiratory: Negative. Negative for cough and shortness of breath. Cardiovascular: Negative. Gastrointestinal: Positive for nausea. Genitourinary: Negative. Musculoskeletal: Negative. Skin: Negative. Neurological: Positive for weakness. Hematological: Negative. Psychiatric/Behavioral: Negative.


VAERS ID: 1700632 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-17
Onset:2021-09-07
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (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: Regular multi vitamins, nothing else
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: After I got my first vaccine dose I noticed a few heart palpitations. They weren''t too bad so I only mentioned it to the pharmacist before I got my second dose. I asked her if she has had any other patient say they had heart palpitations after getting the shot. She said she hadn''t heard of it and asked if I still wanted to get it. I told her yes because she didn''t seem too worried. After getting my second dose I noticed that same day LOTS of heart flutters and palpitations! I ended up calling the after hours nurse that night because I was worried about it. The nurse told me that if I am not having chest pain or shortness of breath to probably not worry about it. For the next 5 after getting the shot I had major heart flutters and palpitations almost constantly. I made an appointment with a doctor but the soonest they had was the following week. After the 5 day I noticed my heart calming down. SInce then I don''t feel my heart has been the same. I don''t have the flutters nearly as much but I notice it beating harder and just "off". I don''t feel that if I went to the doctor they would be able to do anything for me because it''s not bad enough. I am still grateful to have gotten the vaccine but I am so so so sad that I have had this reaction and pray my hear will heal to how it was before. I don''t feel safe to get any boosters or further vaccines though.


VAERS ID: 1700743 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

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

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

Write-up: Pfizer lot EW0178 given to client. Vaccine was beyond the use by date.


VAERS ID: 1700854 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-16
Onset:2021-09-07
   Days after vaccination:234
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: PATIENT HAD COVID VACCINE PFIZER, ON Dose 1 date: 01/16/2021, Dose 2 date: 01/16/2021, AND TESTED POSITIVE TO COVID


VAERS ID: 1700881 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site swelling, Lethargy, Lymph node pain, Lymphadenopathy, Myalgia, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (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: Protonix Metformin Lisinopril My Kind Organincs Womens 40+ multi vitamin
Current Illness: Seasonal allergy issues due to high pollen counts - cough, runny nose, etc.
Preexisting Conditions: Asthma and allergies
Allergies: Codeine Salmederol Multi food and environmental allergies (tree nuts, coconut, soy, melon, etc.)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Other than lethargy, a headache, mildly achy muscles and swelling (large knot) at the injection site, the primary problem was with a lymph node at center of left collar bone. It became very swollen and painful and was warm to the touch. The pain has gone away and the swelling is far less than in the first several days, but is still present. I did not seek medical attention as I read this could be a side effect. I am concerned that the lymph node has not returned to normal over a week since injection. I will be seeing my primary care physician as soon as I can get an appointment.


VAERS ID: 1700949 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-23
Onset:2021-09-07
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Cough, Diarrhoea, Headache, Oropharyngeal pain, Pain
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sickle cell
Allergies: None
Diagnostic Lab Data: Went to hospital from chest pains.
CDC Split Type: vsafe

Write-up: Bad chest pain all over, next day pain continued to get worse, diarrhea, headaches, sore throat, slight cough.


VAERS ID: 1701336 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Cardiac flutter, Feeling hot, Heart rate irregular, Oral pruritus, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Within a minute of getting vaccine, warm sensation all over my body. I broke out in hives, throat and mouth were itchy, irregular heartbeat, elevated BP, felt flutters in my chest. I went to emergency room. I was given Benadryl and steroids


VAERS ID: 1703528 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: COVID-19 rapid POC test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210918333

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a consumer via a company representative concerned a 24 year old male of unspecified race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: Unknown, expiry: unknown) dose was not reported, 1 total administered on APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 07-SEP-2021, the patient underwent rapid test for Covid-19 and it was tested positive (Suspected clinical vaccination failure and Suspected covid-19 infection). At the time of this report the patient felt very ill and closed to be hospitalized. On 08-SEP-2021, the patient reported that he was feeling much better. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from suspected covid-19 infection, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with product quality complaint: 90000192895.; Sender''s Comments: V0:20210918333-Covid-19 vaccine ad26.cov2.s- Suspected clinical vaccine failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1703544 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthropod bite, Lymph node pain, Pain, 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: USJNJFOC20210920505

Write-up: LYMPH NODES ON BOTH ARMS; SORT OF TWO MOSQUITO BITES ON HER LEFT UPPER THIGH; MOSQUITO BITES ARE ITCHY, ROUND AND SIZE OF A DIME; GENERAL ACHINESS; This spontaneous report received from a patient concerned a 52 year old female. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1821286, and expiry: UNKNOWN) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-SEP-2021, the patient experienced general achiness. On 10-SEP-2021, the patient experienced lymph nodes on both arms. On 10-SEP-2021, the patient experienced sort of two mosquito bites on her left upper thigh. On 10-SEP-2021, the patient experienced mosquito bites are itchy, round and size of a dime. The action taken with covid-19 vaccine was not applicable. The patient was recovering from general achiness, had not recovered from lymph nodes on both arms, and sort of two mosquito bites on her left upper thigh, and the outcome of mosquito bites are itchy, round and size of a dime was not reported. This report was non-serious.


VAERS ID: 1703889 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-09-07
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Decreased appetite, Dyspnoea, Fatigue, Headache, Lung opacity, SARS-CoV-2 test positive, Total lung capacity decreased, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Interstitial lung disease (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, ASA, atorvastatin, cyclobenzaprine, gabapentin, ipratropium, lisinopril, melatonin, metoprolol, ranolazine, ropinirole, tramadol, zolpidem
Current Illness: no
Preexisting Conditions: afib, chronic back pain, CAD, headaches, GERD, CABG, HTN, MI, OSA, unstable angina
Allergies: nka
Diagnostic Lab Data: PCR + 9.14/2021 CXR: Low lung volumes with patchy bilateral airspace opacities, consistent with the patient''s known COVID-19 pneumonia.
CDC Split Type:

Write-up: breakthrough covid case w/ Shortness of breath, fatigue, headache, loss of appetite


VAERS ID: 1703931 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-12
Onset:2021-09-07
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: + COVID19 9/7/21
CDC Split Type:

Write-up: Patient received Moderna vaccination on 2/8/21 and 3/12/21 to become fully vaccinated. Patient tested positive for COVID19 on 9/7/21 and was admitted 9/15/21. Patient is still currently admitted for treatment.


VAERS ID: 1703952 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-29
Onset:2021-09-07
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

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

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

Write-up: Positive COVID test


VAERS ID: 1703973 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-09-07
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID positive test 9/7/21
CDC Split Type:

Write-up: COVID vaccine breakthrough case


VAERS ID: 1704142 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Aphthous ulcer
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix 40 mg, Cardizem 120, Azo, multi Vitamin, Vitamin C, D, citracal and D3, instaflex, B6, B complex, probiotic, boswellia, red yeast rice,
Current Illness: none
Preexisting Conditions: asthma, prediabetic, tachycardia, Gerd, post operative hypothyroidism, sleep apnea
Allergies: Reglan, ephedrine,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5-6 after vaccination, my mouth broke out in canker sores. all of mouth and tongue. I had added nothing new - no meds etc. It still hurts on 9-16 (a week after it started). Doctor told me to report it since vaccination/boosters after effects are still unknown.


VAERS ID: 1704177 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-07
Onset:2021-09-07
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

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

Write-up: hospitalization


VAERS ID: 1704246 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood glucose, Computerised tomogram, Electrocardiogram, Full blood count, Headache, Laboratory test normal, Muscular weakness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamoxifen
Current Illness: patient refers not having any illness at time of vaccination
Preexisting Conditions: breast cancer patient in remission since last year
Allergies: NONE
Diagnostic Lab Data: Patient went to emergency room. They did CT, EKG, Glucose, CBC, and chemicals. She does not have any alterations in the laboratories.
CDC Split Type:

Write-up: Patient refers approximately 3 hours after administrating first dose of Pfizer, started to experience stomach pain, leg weakness, and headache. Symptoms lasted approximately 36 hours. Patient refers Thursday the 9th she fainted at 5am while bathing, after the faint she had a headache


VAERS ID: 1704288 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Oropharyngeal pain, Periorbital irritation, Periorbital oedema, Pharyngeal swelling, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: HA, fever/chills, throat pain/swelling, periorbital edema/irritation


VAERS ID: 1704370 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 3 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Rash pruritic, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: thyroid meds
Current Illness:
Preexisting Conditions:
Allergies: bee sting, steroid injection
Diagnostic Lab Data:
CDC Split Type:

Write-up: first night: vomiting chills diarrhea dizziness, rash developed with profound itchiness, steroid cream didnt work, similar to moderna arm


VAERS ID: 1704384 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphagia, Feeling hot, Hyperhidrosis, Peripheral swelling, Rash, Rash erythematous, Throat irritation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient received Janssen COVID-19 vaccination at 1013. At 1035 patient reported difficulty swallowing and a mild red rash was noted to patient''s neck. Vital signs stable. Patient denied dyspnea, N/V, dizziness and itch. MD notified. BP 133/86, HR 75, RR 18, SpO2 97%. *** *** At 1057 patient reported feeling hot, scant sweating noted to back, itch to throat continued, scant swelling noted to both hands and patient reported "shoes feeling tighter". Rash no longer noted to patient''s neck. Dyspnea denied. *** *** At 1115 MD ordered 25mg IM diphenhydramine one time as needed for throat itch. Administered to left deltoid. MD ordered for patient to be observed for an additional 30 minutes. *** *** At 1120 patient stated relief from throat itch and difficulty swallowing. *** *** Patient left clinic in stable condition at 1148. BP 121/83, HR 75, RR 18, SpO2 98% RA. Denied dyspnea, N/V, itch, rash, swelling, dizziness upon leaving. ***


VAERS ID: 1704388 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-07
Onset:2021-09-07
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/10/21 2nd dose02/07/21 Diagnosed covid positive:09/08/21 Symptom onset:09/07/21 Exposure:community Symptoms:fever, cough,fatigue,muscle aches,loss of smell/taste,sore throat,nausea,chills,runny nose HA.


VAERS ID: 1704391 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-07
Onset:2021-09-07
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/10/21 2nd dose02/07/21 Diagnosed covid positive:09/08/21 Symptom onset:09/07/21 Exposure:community Symptoms:fever, cough,fatigue,muscle aches,loss of smell/taste,sore throat,nausea,chills,runny nose HA.


VAERS ID: 1704397 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-18
Onset:2021-09-07
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose03/18/21 2nd dose Diagnosed covid positive:09/09/21 Symptom onset:09/0721 Exposure: Symptoms:fever, HA


VAERS ID: 1704494 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Menstrual disorder
SMQs:

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

Write-up: Started cycle on 9/6/2021 and cycle was completely gone 9/07/2021. Still had menstrual cramps but nothing more.


VAERS ID: 1704569 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-31
Onset:2021-09-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Antibody test, Antinuclear antibody, Asthenia, Blood creatine phosphokinase normal, C-reactive protein normal, Extrasystoles, Fatigue, Full blood count normal, Headache, Hypoaesthesia, Immunoglobulin therapy, Laboratory test normal, Magnetic resonance imaging neck, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging thoracic abnormal, Motor dysfunction, Paraesthesia, Procalcitonin normal, Pyrexia, Spinal disorder, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Hypokalaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No home medications
Current Illness: None
Preexisting Conditions: No chronic health conditions
Allergies: No known allergies
Diagnostic Lab Data: MRI lumbar non-contrast unremarkable (9/13/2021). MRI cervical/thoracic shows segment of nonenhancing T2 hyperintensity at the level of C3-C4 (9/15/2021). CBC, CRP, PCT within normal limits. CK 153 normal. ANA, Lyme unremarkable. Respiratory multiplex negative. MRI brain and LP (cell count, glucose, protein, oligoclonal bands, ME PCR, cytology) scheduled for 9/16/2021. Blood collected and sent to clinic for Anti-MOG antibodies and anti-NMO antibodies, results pending.
CDC Split Type:

Write-up: 13 Years old Female with no PMH presenting with numbness/tingling in all extremities generalized weakness x 1 week (since 9/7). Started with bilateral lower extremity paraesthesias ("tingling pins and needles like when my leg falls asleep") from mid-thigh to toes while lying in bed at night. Sensation exacerbated by movement. Has persisted for the past 7 days. The next day, she began to have a similar sensation in her hands bilaterally (all four fingers, wrist to fingertips). Hand paraesthesias also persisted since they began. Also had intermittent abdominal paraesthesias which have since resolved. 24 hours ago developed poor grasp and tremor. Increased fatigue and general weakness. One fever (100.9 orally) on 9/10. Went to pediatrician who sent her to the ED on 9/10. Left before being seen by attending. Felt one skipped beat last night. Frontal bilateral dull headache last night while lying down, self resolved after one hour. Has had about 5 nighttime headaches in the past month. No headaches during the day. No visual changes. Second dose of Pfizer was done on Aug 31st. No history of known or suspected covid infection. No dizziness, n/v, chest pain, sob, recent unintended weight loss, chills, cough, throat pain, odynophagia, change in appetite, tick bites, dysuria, heavy periods, medication use/ vitamin use, abdominal pain, recent travel, sick contacts, rash, diarrhea, constipation, urinary symptoms, hematochezia, fall, or pain anywhere. Admitted to Medical Center on 9/13. Treatment with 40g IVIG started 9/15/2021 and second dose 9/16/2021 40 g. Patient is currently hospitalized at the time of submitting this report.


VAERS ID: 1705275 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-08-31
Onset:2021-09-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / SYR

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

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

Write-up: Small bumps/ hives all over face.


VAERS ID: 1705890 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Medication errors (narrow), Sexual dysfunction (broad)

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

Write-up: Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient received 3rd dose and 3 hours after patients right arm, right side of face, and right arm became numb and it has continued. Patient called today (48 hours later) and I advised patient to go to emergency room/urgent care. Patient does not have PCP.


VAERS ID: 1705896 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-08-10
Onset:2021-09-07
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 066D21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Injection site pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Site: Pain at Injection Site-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient reported pain and tingling in immunization arm one month after shot - another healthcare provider called it ''covid arm''


VAERS ID: 1706459 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Adnexa uteri pain, Arthralgia, Back pain, Chest discomfort, Decreased appetite, Dizziness, Dysphagia, Dyspnoea, Ear discomfort, Electric shock sensation, Electrocardiogram abnormal, Erythema, Eye pain, Facial pain, Fatigue, Headache, Loss of personal independence in daily activities, Neck pain, Neuralgia, Pain, Paraesthesia, Pharyngeal swelling, Rash macular, Respiratory tract congestion, Sinus tachycardia, Swelling, Uterine pain
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), 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: Xyzal, vitamin c, folate, biotin, vitamin d3
Current Illness: None
Preexisting Conditions: Endometriosis L total hip replacement Seasonal allergies Irritable bowel syndrome Polycystic ovarian syndrome Premenopausal dyspeptic disorder ADHD Seborrheic dermatitis Anxiety Depression
Allergies: Tamiflu, morphine, amoxicillin
Diagnostic Lab Data: 9/14/21- Ekg showed sinus tachycardia
CDC Split Type:

Write-up: Vaccine at 4pm. At 5pm started having a sharp, shooting, electrical shock sensation under Left side of tongue. Around 7:30 I had localized redness and swelling under the left side of my tongue and a weird tingling sensation throughout my body. The next day the swelling increased with difficulty eating and drinking that lasted through 9/14/21. The following day 9/9/21 I had swelling of my left tonsil and left side of throat, bilateral nasal turbinate swelling, bilateral ear pressure and 99.5.F temp. The following day, 9/10/21, I had red blotches in my throat and on my tonsils, my swallowing felt different/weird/a little more difficult, my throat and tonsil swelling worsened, the nasal turbinate swelling worsened where I could barely breath through nose, I had nerve pain and sensitivity behind My left ear that radiates down my neck and to My left shoulder, I had midline upper back pain/pressure, and at 3pm had sharp stabbing pain to my right lower quadrant of abdomen/uterus/ovary (this resolved after an hour). All symptoms have continued through 9/14/21. 9/13/21 I felt very fatigued, unable to do much of anything, barely ate much due to fatigue. I woke up at 1pm on 9/14/21 with A heart rate of 148 just standing and 125 resting which continued for the past 8-9 hrs. Chest discomfort toward the 7 hour mark, slightly winded with some dizziness and HA. My nerve pain behind my left ear had moved up into my l face, forehead, and behind my left eye. Had ekg that showed just tachycardia. All other Vital signs were normal. My nasal turbinate, throat and tonsil swelling was beginning to improve but not resolved and the tongue swelling and pain had resolved. I had fluids to help with the heart rate. And Sudafed and Afrin to try to help with the nasal turbinate swelling. Continue to nave some nasal turbinate swelling and congestion, left tonsil swelling with blotches in the throat and ear pressure as well as fatigue.


VAERS ID: 1706471 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 264A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiac disorder, Cardiac function test, Chest X-ray, Chest discomfort, Feeding disorder, Insomnia, Loss of consciousness, Malaise, Nausea, Pain, Pulmonary oedema, Somnolence, Throat tightness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DIPHENHYDRAMINE HYDROCHLORIDE; CLARITINE; EPINEPHRINE
Current Illness: Allergy; Environmental allergy; Food allergy
Preexisting Conditions: Comments: The patient was very healthy before getting vaccinated, all her lab test was normal and did not have a history of the same medical condition.
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: Blood test; Result Unstructured Data: No result; Test Date: 20210907; Test Name: Chest X-ray; Result Unstructured Data: No result; Test Date: 20210908; Test Name: Blood test; Result Unstructured Data: No result; Test Date: 20210908; Test Name: Chest X-ray; Result Unstructured Data: No result; Test Date: 20210909; Test Name: Blood test; Result Unstructured Data: No result; Test Date: 20210909; Test Name: Cardiac function test; Result Unstructured Data: cardiac lab change and she has a cardiac damaged and retaining
CDC Split Type: USJNJFOC20210920683

Write-up: CARDIAC DAMAGED; UNABLE TO SLEEP; PAIN ALL OVER HER BODY; FEELING UNWELL; NAUSEA; VOMITTING; EDEMA ON BOTH LUNG; FEELING VERY SLEEPY; UNABLE TO EAT AND DRINK; SHE PASSED OUT; CHEST TIGHTENING; THROAT TIGHTENING; This spontaneous report received from a patient concerned a 35 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: allergy to eggs, mustard and avocado, allergy and environmental allergens and the patient''s pre-existing medical conditions included: The patient was very healthy before getting vaccinated, all her lab test was normal and did not have a history of the same medical condition. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 264A21A) dose was not reported, 1 total, administered on 07-SEP-2021 on right deltoid for prophylactic vaccination. Concomitant medications included diphenhydramine hydrochloride for allergy, epinephrine for allergy, loratadine for allergy, and corticosteroids for allergy. On 07-SEP-2021, few minutes post vaccination, the patient was unable to breath, her chest and throat was tightening. The patient used epi (epinephrine) pen to alleviate the allergic reaction and passed out on the pharmacy floor. On the same day, once the patient gained her strength and went to hospital and had series of blood works and Chest X-ray. The patient was given IV fluids. On 08-SEP-2021, the patient felt unwell, unable to get up all day, felt very sleepy, tiredness, nausea, vomiting, unable to eat and drink without throwing up. At the evening, she went to the ER again, did a series of blood works, chest x-ray and was given IV fluids, anti-nausea and anti-inflammatory. On 09-SEP-2021, the patient experienced chest pain which was worsening and experienced pain all over her body and the patient was unable to sleep. Therefore, patient went to ER again, gave her another IV fluids and performed a Pulmonary Embolism protocol and another blood works. The attending physician informed her that her cardiac lab change so much and she has a cardiac damaged and retaining too much fluids. She was referred to a cardiologist for echo and stress test. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from she passed out on 07-SEP-2021, was recovering from throat tightening, had not recovered from chest tightening, feeling unwell, feeling very sleepy, unable to eat and drink, nausea, vomiting, unable to sleep, pain all over her body, edema on both lung and the outcome of cardiac damaged was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210920683-covid-19 vaccine ad26.cov2.s-Pulmonary oedema,Loss of consciousness.This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1706587 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Diarrhoea, Muscle spasms, Pain
SMQs:, Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Crohn''s disease; Ulcerative colitis
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210926661

Write-up: Condition aggravated; Pain; Cramps; Stools watery; This spontaneous report received from a patient concerned a 63 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: moderate to severe adult Crohn''s disease, and moderate to severe ulcerative colitis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot number. Non-company suspect drugs included: adalimumab (form of admin unknown, subcutaneous, batch number was not reported) dose, frequency, and therapy dates were not reported, and dose, frequency, and therapy dates were not reported for moderate to severe adult crohn''s disease, and moderate to severe ulcerative colitis. No concomitant medications were reported. On 07-SEP-2021, the patient experienced condition aggravated. On 07-SEP-2021, the patient experienced pain. On 07-SEP-2021, the patient experienced cramps. On 07-SEP-2021, the patient experienced stools watery. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the condition aggravated, pain, stools watery and cramps was not reported. This report was non-serious.


VAERS ID: 1706612 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Poor quality product administered
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210930407

Write-up: ADMINISTRATION OF EXPIRED DOSE OF THE JANSSEN COVID-19 VACCINE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, and expiry: UNKNOWN) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-SEP-2021, the patient experienced administration of expired dose of the janssen covid-19 vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of administration of expired dose of the janssen covid-19 vaccine was not reported. This report was non-serious.


VAERS ID: 1706910 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Infection, Injection site erythema, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Error: Infection / Cellulitis (diagnosed by MD)-


VAERS ID: 1706918 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

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

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

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


VAERS ID: 1707297 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site warmth
SMQs:

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

Write-up: Left arm injection site is warm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Left arm injection site is warm) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. unknown) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, the patient experienced VACCINATION SITE WARMTH (Left arm injection site is warm). At the time of the report, VACCINATION SITE WARMTH (Left arm injection site is warm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not provided. Treatment information was not provided.


VAERS ID: 1707330 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 03321A / 1 - / OT

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

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

Write-up: Diarrhea; Puked; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea) and VOMITING (Puked) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 03321A) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, the patient experienced DIARRHOEA (Diarrhea) and VOMITING (Puked). At the time of the report, DIARRHOEA (Diarrhea) and VOMITING (Puked) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment medication was not provided by the reporter.


VAERS ID: 1707343 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-02-23
Onset:2021-09-07
   Days after vaccination:196
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Arm is still real tender; Hurting all over; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PAIN (Arm is still real tender) and MYALGIA (Hurting all over) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 23-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 24-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 05-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced MYALGIA (Hurting all over). On an unknown date, the patient experienced VACCINATION SITE PAIN (Arm is still real tender). On 07-Sep-2021, MYALGIA (Hurting all over) had resolved. At the time of the report, VACCINATION SITE PAIN (Arm is still real tender) had not resolved. Concomitant medication were not reported Treatment medication were not reported


VAERS ID: 1707349 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A / 2 - / OT

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

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

Write-up: Received expired vaccine; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received expired vaccine) in a 52-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039A21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received expired vaccine). On 07-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were reported. Treatment information was not provided. The patient had no symptoms after administration. No temperature excursion episodes, vial was stored correctly. This case was linked to MOD-2021-311017 (Patient Link).


VAERS ID: 1707356 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21A. / 2 - / OT

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

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

Write-up: This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Received expired vaccine) in a 45-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039A21A.) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Received expired vaccine). On 07-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Received expired vaccine) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medication was reported. No treatment medications were reported This case was linked to MOD-2021-310991 (Patient Link).


VAERS ID: 1707458 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Fatigue, Headache
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: USMODERNATX, INC.MOD20213

Write-up: stomach is off; fatigue; headache; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL DISCOMFORT (stomach is off), FATIGUE (fatigue) and HEADACHE (headache) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced ABDOMINAL DISCOMFORT (stomach is off), FATIGUE (fatigue) and HEADACHE (headache). At the time of the report, ABDOMINAL DISCOMFORT (stomach is off), FATIGUE (fatigue) and HEADACHE (headache) outcome was unknown. No Concomitant information was reported. No treatment information was reported.


VAERS ID: 1707473 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-11
Onset:2021-09-07
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Fall, Inappropriate schedule of product administration
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: she lost her balance and fell down; Fell down; More than 35 days after the first dose (11May2021) without receiving the second dose (7-Sep-2021); This spontaneous case was reported by a consumer and describes the occurrence of BALANCE DISORDER (she lost her balance and fell down), FALL (Fell down) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days after the first dose (11May2021) without receiving the second dose (7-Sep-2021)) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 11-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced BALANCE DISORDER (she lost her balance and fell down), FALL (Fell down) and INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days after the first dose (11May2021) without receiving the second dose (7-Sep-2021)). On 07-Sep-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (More than 35 days after the first dose (11May2021) without receiving the second dose (7-Sep-2021)) had resolved. At the time of the report, BALANCE DISORDER (she lost her balance and fell down) and FALL (Fell down) outcome was unknown. No concomitant medications were provided. No treatment medications were provided.


VAERS ID: 1707499 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Blood pressure is very low
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: blood pressure is very low/82 over 35; This spontaneous case was reported by a consumer and describes the occurrence of HYPOTENSION (blood pressure is very low/82 over 35) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced HYPOTENSION (blood pressure is very low/82 over 35). At the time of the report, HYPOTENSION (blood pressure is very low/82 over 35) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: 82/35 (Low) Blood pressure is very low. Concomitant product use was not provided. Treatment product information was not provided.


VAERS ID: 1707509 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-06
Onset:2021-09-07
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939893 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Burning sensation, Dizziness, Feeling abnormal, Feeling cold, Feeling hot, Headache, Heart rate, Nausea, Pain, Syncope, Vaccination site pain
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210908; Test Name: Blood test; Result Unstructured Data: normal; Test Date: 20210908; Test Name: heart; Result Unstructured Data: normal
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Had a hot and cold feeling; Had a hot and cold feeling; Left arm was throbbing; Feeling was scary/Feels like she was hit by a truck; Fainted; Room became dizzy; left arm was throbbing; Experienced burning in the chest; Headache; Nauseousness; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (Fainted) in a 45-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A and 939893) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced BURNING SENSATION (Experienced burning in the chest), HEADACHE (Headache) and NAUSEA (Nauseousness). On 08-Sep-2021, the patient experienced SYNCOPE (Fainted) (seriousness criterion medically significant), DIZZINESS (Room became dizzy), FEELING HOT (Had a hot and cold feeling), FEELING COLD (Had a hot and cold feeling), PAIN (Left arm was throbbing), FEELING ABNORMAL (Feeling was scary/Feels like she was hit by a truck) and VACCINATION SITE PAIN (left arm was throbbing). At the time of the report, SYNCOPE (Fainted), DIZZINESS (Room became dizzy), BURNING SENSATION (Experienced burning in the chest), FEELING HOT (Had a hot and cold feeling), FEELING COLD (Had a hot and cold feeling), PAIN (Left arm was throbbing), FEELING ABNORMAL (Feeling was scary/Feels like she was hit by a truck), HEADACHE (Headache), NAUSEA (Nauseousness) and VACCINATION SITE PAIN (left arm was throbbing) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Sep-2021, Blood test: normal (normal) normal. On 08-Sep-2021, Heart rate: normal (normal) normal. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Lab investigation includes tests, heart monitoring and took blood and test results came back normal. On 08-Sep-2021 patient had an annual mammogram scheduled at local hospital and she fainted during mammogram. No concomitant medication was provided by the reporter. No treatment information was provided by the reporter. This case concerns a 45-year-old, male patient with no relevant medical history. The patient experience burning sensation, headache and nausea 1 month 2 days and, syncope, dizziness, pain in extremity ,feeling hot , feeling cold , pain , and feeling abnormal 1 month 3 days after the second dose of mRNA-1273 (Moderna COVID-19 Vaccine). The rechallenge was unknown since no information about the first dose was disclosed. The reporter assessment was not. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) in not affected by this report. This case was linked to MOD-2021-312925 (Patient Link).; Sender''s Comments: This case concerns a 45-year-old, male patient with no relevant medical history. The patient experience burning sensation, headache and nausea 1 month 2 days and, syncope, dizziness, pain in extremity ,feeling hot , feeling cold , pain , and feeling abnormal 1 month 3 days after the second dose of mRNA-1273 (Moderna COVID-19 Vaccine). The rechallenge was unknown since no information about the first dose was disclosed. The reporter assessment was not. The benefit-risk relationship of mRNA-1273 (Moderna COVID-19 Vaccine) in not affected by this report.


VAERS ID: 1707513 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Fatigue, Illness, Lymphadenopathy, Myalgia, Oropharyngeal pain, Palpitations, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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

Write-up: Extremely sick; Heart racing; Very bad sore throat; Very bad cough; Lymph nodes are swollen; Very fatigued; Sore arm; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Extremely sick), PALPITATIONS (Heart racing), OROPHARYNGEAL PAIN (Very bad sore throat), COUGH (Very bad cough) and LYMPHADENOPATHY (Lymph nodes are swollen) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced ILLNESS (Extremely sick), PALPITATIONS (Heart racing), OROPHARYNGEAL PAIN (Very bad sore throat), COUGH (Very bad cough), LYMPHADENOPATHY (Lymph nodes are swollen), FATIGUE (Very fatigued) and MYALGIA (Sore arm). At the time of the report, ILLNESS (Extremely sick), PALPITATIONS (Heart racing), OROPHARYNGEAL PAIN (Very bad sore throat), COUGH (Very bad cough), LYMPHADENOPATHY (Lymph nodes are swollen), FATIGUE (Very fatigued) and MYALGIA (Sore arm) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) NEGATIVE. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided. No treatment medications were provided.


VAERS ID: 1707514 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, 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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 09/07/2021; Test Name: Body temperature; Result Unstructured Data: Body temperature 101.2?F.
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case reported by a consumer, describes the occurrence of pyrexia (fever 101.2?F) and myalgia (muscle pain) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 vaccine, batch/lot# 002F21A) for COVID-19 immunization. No medical history reported. On Aug 8, 2021, patient received the first dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Sep 7, 2021, patient received the second dose of mRNA-1273 (Moderna COVID-19 vaccine), intramuscular; 1 dosage form. On Sep 7, 2021, patient experienced pyrexia (fever 101.2?F) and myalgia (muscle pain). At the time of the report, pyrexia (fever 101.2?F) and myalgia (muscle pain) outcome unknown. Diagnostic results: On Sep 7, 2021: Body temperature 101.2?F (high). The patient''s concomitant medications included multivitamins. No treatment medications provided.


VAERS ID: 1707526 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Feeling abnormal, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Memory loss/Ask her a question, she does not remember the answer; Feels like a headache is coming but it is not but she does not have a headache; Sore Arm; This spontaneous case was reported by a consumer and describes the occurrence of AMNESIA (Memory loss/Ask her a question, she does not remember the answer ), FEELING ABNORMAL (Feels like a headache is coming but it is not but she does not have a headache) and MYALGIA (Sore Arm) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040C21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced AMNESIA (Memory loss/Ask her a question, she does not remember the answer ), FEELING ABNORMAL (Feels like a headache is coming but it is not but she does not have a headache) and MYALGIA (Sore Arm). At the time of the report, AMNESIA (Memory loss/Ask her a question, she does not remember the answer ), FEELING ABNORMAL (Feels like a headache is coming but it is not but she does not have a headache) and MYALGIA (Sore Arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Reportedly, patient did not feel tired or fatigued. Patient''s consent to follow-up was affirmative. Concomitant product use was not provided. Treatment product information was not provided.


VAERS ID: 1707555 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

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

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

Write-up: arm is really sore; extremely exhausted; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (arm is really sore) and FATIGUE (extremely exhausted) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced PAIN IN EXTREMITY (arm is really sore) and FATIGUE (extremely exhausted). At the time of the report, PAIN IN EXTREMITY (arm is really sore) and FATIGUE (extremely exhausted) had not resolved. no concomitant medications are provided. treatment to the events not reported.


VAERS ID: 1707561 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050C21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Asthenia, Bone pain, Dizziness, Feeling abnormal, Headache, Illness, Insomnia, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Back pain; Thyroid disorder NOS
Preexisting Conditions: Medical History/Concurrent Conditions: Ankle reconstruction (Reconstructive surgeries on ankle and knee)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Feels kind of hung over/ feels like he''s getting over the flu; All his broken bones hurt like hell now/bone aches; Lightheaded; Left arm is really sore more than the first time; Headache; Body aches / lower back has been really achy; Horribly sick/really sic/feeling sick; Sick to his stomach/still feel poopy; Low energy/still in bed; Couldn''t sleep last night; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Horribly sick/really sic/feeling sick), ABDOMINAL DISCOMFORT (Sick to his stomach/still feel poopy), ASTHENIA (Low energy/still in bed), INSOMNIA (Couldn''t sleep last night) and FEELING ABNORMAL (Feels kind of hung over/ feels like he''s getting over the flu) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 050C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Ankle reconstruction (Reconstructive surgeries on ankle and knee). Concurrent medical conditions included Thyroid disorder NOS and Back pain. On 07-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, the patient experienced ILLNESS (Horribly sick/really sic/feeling sick), ABDOMINAL DISCOMFORT (Sick to his stomach/still feel poopy), BONE PAIN (All his broken bones hurt like hell now/bone aches), DIZZINESS (Lightheaded), HEADACHE (Headache) and MYALGIA (Body aches / lower back has been really achy). 07-Sep-2021, the patient experienced ASTHENIA (Low energy/still in bed), INSOMNIA (Couldn''t sleep last night) and PAIN IN EXTREMITY (Left arm is really sore more than the first time). On 08-Sep-2021, the patient experienced FEELING ABNORMAL (Feels kind of hung over/ feels like he''s getting over the flu). The patient was treated with NAPROXEN SODIUM (ALEVE) for Adverse event, at an unspecified dose and frequency and TRAMADOL ongoing since an unknown date for Adverse event, at a dose of 1 dosage form. At the time of the report, ILLNESS (Horribly sick/really sic/feeling sick), ABDOMINAL DISCOMFORT (Sick to his stomach/still feel poopy), ASTHENIA (Low energy/still in bed), INSOMNIA (Couldn''t sleep last night), FEELING ABNORMAL (Feels kind of hung over/ feels like he''s getting over the flu), BONE PAIN (All his broken bones hurt like hell now/bone aches), DIZZINESS (Lightheaded), PAIN IN EXTREMITY (Left arm is really sore more than the first time), HEADACHE (Headache) and MYALGIA (Body aches / lower back has been really achy) outcome was unknown. Concomitant medication provided include thyroid medication and tramadol for mild narcotic for pain in back. Patient took half of a marihuana brownie for his symptoms. This case was linked to MOD-2021-313212 (Patient Link). Most recent FOLLOW-UP information incorporated above includes: On 09-Sep-2021: Follow-up was received on 9-SEP-2021 and Updated relevant medical history, added treatment medication, added event; lightheaded, updated event verbatim.


VAERS ID: 1707570 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Musculoskeletal discomfort, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), 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: USMODERNATX, INC.MOD20213

Write-up: this week my neck rings from time to time; neck pain/my left side woke up sore; This spontaneous case was reported by a patient and describes the occurrence of NECK PAIN (neck pain/my left side woke up sore) and MUSCULOSKELETAL DISCOMFORT (this week my neck rings from time to time) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 07-Sep-2021, the patient experienced NECK PAIN (neck pain/my left side woke up sore). On an unknown date, the patient experienced MUSCULOSKELETAL DISCOMFORT (this week my neck rings from time to time). At the time of the report, NECK PAIN (neck pain/my left side woke up sore) and MUSCULOSKELETAL DISCOMFORT (this week my neck rings from time to time) outcome was unknown. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. No treatment medication was reported.


VAERS ID: 1708023 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-10
Onset:2021-09-07
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Syncope, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (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: Flu shot
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown However, patient stated that she got similar side effects when she received a flu shot vaccine however with Pfizer vaccine it was severe.
Allergies: Unknown
Diagnostic Lab Data: Her physician is ordering lab work and an MRI
CDC Split Type:

Write-up: Patient states she gradually became partial blindness and weakness . She states that she collapsed a few times In addition to that she stated that she had a similar reaction when she received a flu shot but with Pfizer it was severe. Thank


VAERS ID: 1708048 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cognitive disorder, Cough, Ear pain, Fatigue, Headache, Lymphadenopathy, Myalgia, Oropharyngeal pain, Sputum increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Erythromycin, sulfa, penicillin
Diagnostic Lab Data: Not everyone has health insurance or can afford health insurance.
CDC Split Type:

Write-up: Night of shot: Extreme fatigue, muscle aches left side of chest, back, and neck Day 2: Extreme fatigue, muscle aches, joint ache, headache, felt similar to a flu/hangover Day 3&4: Extreme fatigue, muscle aches, joint ache, headache, felt similar to a flu/hangover, ear ache, lymphnodepathy front neck lympthnodes. Hurt to put on deodorant left arm Day 5:Extreme fatigue, muscle aches, joint ache, severe headache, felt similar to a flu/hangover Day 6 &7: fatigue, headache, inner ear pain, increased mucosa production Day 8, 9, 10: increased mucosa production, sore throat resulting in cough and painful to ingest fluids or solids. Failed all exams during this period due to impaired cognitive abilities.


VAERS ID: 1708234 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-02
Onset:2021-09-07
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 - / -

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

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

Write-up: Positive COVID test


VAERS ID: 1708331 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Headache, Hypoaesthesia, Injection site pain, Musculoskeletal stiffness, Rash, Swelling, Urticaria, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Influenza, injectable, quadrivalent, preservative-free, Sanofi Pasteur. In 2020 received this vaccine and had rash and mild swe
Other Medications: Allegra-D, Montelukast
Current Illness: seasonal allergies
Preexisting Conditions: seasonal allergies
Allergies: Captain Morgan, Menthol, Codeine, erythromycin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 30 minutes after receiving the vaccine she developed a rash and then hives as well as swelling, stiffness and numbness in her right arm. She also developed a headache behind her eyes. Was transported to ER and received prednisone and benadryl. Symptoms improved and she was prescribed oral prednisone for 4 more days along with famotidine for 10 days. Symptoms of swelling and rash improved after a few hours. She continues to have R arm paresthesia/numbness, pain at the injection site and in her R shoulder, intermittent headaches with blurry vision and decreased strength in her R arm as of today, 9/17.


VAERS ID: 1708423 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2589 / 1 RA / IM

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

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

Write-up: The patient came in to our ED department for a complaint other than Covid. While the patient was her the provider ordered a Covid vaccine to be given before he left. It was found after the patient was discharged that the wrong diluent was used to reconstitute the pfizer vaccine. Sterile water was used instead of the recommended Normal Saline. Pfizer and the CDC was contacted. Due to the lack of data the CDC recommended that we revaccinate in the opposite arm. The patient has been initially contacted via voicemail and we are waiting a response. We will continue to contact the patient until we have a conversation with him if possible.


VAERS ID: 1708473 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Chest pain, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Full blood count normal, Headache, Immediate post-injection reaction, Metabolic function test normal, Nausea, Non-cardiac chest pain, Syncope, Troponin normal, Urine analysis normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pt states she received a flu shot at age 24 in 2010 and then experienced heart palpitation, nausea, weakness. Unknown vaccinatio
Other Medications: Propranolol and Losartan/HCTZ
Current Illness: none
Preexisting Conditions: psuedotumor, HTN, hyperthyroidism, migraines
Allergies: beans and guacamole
Diagnostic Lab Data: on 9/11 in ER CBC, CMP, POC troponin, u/a. were done and within normal limited . EKG showed normal sinus rhythm. Pt was given Toradol, Morphine, and Zofran for her symptoms and discharged home with dx of non-cardiac chest pain.
CDC Split Type:

Write-up: fainting per patient, immediately after receiving the vaccination . Pt then started having symptoms of weakness, fatigue, dizziness.. That evening she started to feel week and had little energy . Symptoms were progressive and then on 9/11, she started having weakness with sob and chest pain, and fatigue. she was taken to ER and patient states doctor was concerned about myocarditis and advised her not to take second vaccine. on 9/13 she was seen at the clinic with sx of mild headache, full frontal region, mild nausea, and fatigue. She was no longer having chest pain, sob and states she feels a little better today compared to yesterday. She had another f/u on 9/17 at the clinic and felt normal all symptoms had resolved.


VAERS ID: 1708527 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-18
Onset:2021-09-07
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / IM

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

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

Write-up: Hospitalized due to COVID illness


VAERS ID: 1708531 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: I started my period 4 days early, finished my period 5 days later, and spotted for an additional 6 days. This is HIGHLY unusual for me. My cycles are normally 27-29 days each month and I never have spotting. I have never been more than 2 days early or 2 days late.


VAERS ID: 1708542 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-02-11
Onset:2021-09-07
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: SARS-CoV-2 test
SMQs:, COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SARS-CoV-2 Antigen specimen collected on 9/7/21
CDC Split Type:

Write-up: hospitalized


VAERS ID: 1708725 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dyspnoea, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol, clopidogrel, lipitor, pantoprazole, aspirin, lorsartan
Current Illness: no
Preexisting Conditions: heart condition
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: vomiting for 2 days, diarrhea for 2 days, shortness of breath, quizziness in stomach


VAERS ID: 1708893 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 1 UN / IM

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

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

Write-up: PATIENT FULLY VACCINATED TESTED POSITIVE FOR COVID 9/7/2021 AND HOSPITALIZED 9/7/2021


VAERS ID: 1708929 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-30
Onset:2021-09-07
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Pain, Respiratory distress, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Coronary artery disease Chronic obstructive pulmonary disease
Allergies:
Diagnostic Lab Data: POISITIVE COVID TEST 9/7/21
CDC Split Type:

Write-up: RESPIRATORY COMPLAINTS, SHORTNESS OF BREATH, COUGH BODY ACHES, LOSS OF TASTE AND SMELL


VAERS ID: 1708942 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-26
Onset:2021-09-07
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205921A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinal Venlafaxine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan - two blood clots in my lung.
CDC Split Type:

Write-up: About 8 days later, after covid agot started having a hard time breathing doing normal things such as talking or even going on a walk. Also had light chest pain. I normally run 3 to 4 times per week so this was not normal. The following day after the shot I felt like I had bad covid again (dec 2020) but I recovers after 48 hours.


VAERS ID: 1709039 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 1 RA / IM

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

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

Write-up: Moderna was received from deep freezer on 8/6/21. Was placed in refrigerator on 8/6/21. 30 day expiration date was 9/5/21. Moderna was left in refrigerator and used until 9/13/21. On 9/14/21 we realized we were beyond the 30 days and immediately notified the Pharmacy for direction. The Pharmacists are in communication with Moderna to see if the doses are considered valid or invalid. Risk Management is involved to decide on the best course of action and if we notify the patient before we hear back from Moderna.


VAERS ID: 1709049 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-01
Onset:2021-09-07
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetic High Blood Pressure Anemic Rheumatoid Arthritis
Allergies:
Diagnostic Lab Data: Bloodwork for diabetes Cholesterol
CDC Split Type: vsafe

Write-up: I didn''t have any immediate reactions after receiving the vaccine because everything was fine. I didn''t start to have any effect from the vaccine until September 2021 when I developed dizziness from vertigo that usually last a couple of hours, but now it has been going on for well over a week. I have had low energy since but I am also anemic so it was a hard recovery due to always being tired. My dizziness and energy levels is getting better.


VAERS ID: 1709089 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-04
Onset:2021-09-07
   Days after vaccination:215
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia
SMQs:, Guillain-Barre syndrome (broad)

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

Write-up: Weakness.


VAERS ID: 1709438 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Device connection issue
SMQs:, Medication errors (broad)

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

Write-up: WHEN THE TECHNICIAN GAVE THE PATIENT THE VACCINE AND PRESSED DOWN ON THE PLUNGER THE SYRINGE DETACHED FROM THE NEEDLE AND VACCINE LIQUID CAME OUT AND NEVER MADE IT INTO PATIENT ARMS. THE PHARMACIST READMINSTERED THE VACCINE BUT ONLY 0.4MLS JUST IN CASE THE PATIENT RECEIVED A SMALL AMOUNT OF VACCINE.


VAERS ID: 1709639 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC184 / 2 LA / IM

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

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

Write-up: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient


VAERS ID: 1709641 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient


VAERS ID: 1709643 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient


VAERS ID: 1709647 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient


VAERS ID: 1710206 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Headache
SMQs:

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: NONE
Current Illness: FATTY LIVER DISEASE
Preexisting Conditions: FATTY LIVER DISEASE
Allergies: NONE
Diagnostic Lab Data: ENT CONSULT AFTER URGENT CARE VISIT; HEAD CT ON 09/17/2021
CDC Split Type:

Write-up: ONSET OF HEADACHES X7 DAYS AFTER VACCINE, HEADACHES PERSIST ON (09/17/2021)


VAERS ID: 1710984 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Connecticut  
Vaccinated:2021-01-01
Onset:2021-09-07
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product dose omission issue
SMQs:, Medication errors (broad)

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

Write-up: 1st dose in Jan2021 and no 2nd dose; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of PRODUCT DOSE OMISSION ISSUE (1st dose in Jan2021 and no 2nd dose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced PRODUCT DOSE OMISSION ISSUE (1st dose in Jan2021 and no 2nd dose). On 07-Sep-2021, PRODUCT DOSE OMISSION ISSUE (1st dose in Jan2021 and no 2nd dose) had resolved. No concomitant product information was provided. Treatment information was not provided.


VAERS ID: 1711014 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 1 - / OT

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

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

Write-up: Hives which look like raised looking bug bites; Itchiness in her lower back; This spontaneous case was reported by a consumer and describes the occurrence of URTICARIA (Hives which look like raised looking bug bites) and PRURITUS (Itchiness in her lower back) in a 19-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 003C21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, the patient experienced URTICARIA (Hives which look like raised looking bug bites) and PRURITUS (Itchiness in her lower back). At the time of the report, URTICARIA (Hives which look like raised looking bug bites) and PRURITUS (Itchiness in her lower back) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. No treatment medications were reported.


VAERS ID: 1711051 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-05
Onset:2021-09-07
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 RA / OT

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, 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: ZINC
Current Illness: Blood pressure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Fever; Chills; She''s been throwing up; This spontaneous case was reported by a consumer and describes the occurrence of PYREXIA (Fever), CHILLS (Chills) and VOMITING (She''s been throwing up) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037F21A and 006D21A) for COVID-19 vaccination. Concurrent medical conditions included Blood pressure. Concomitant products included ZINC for an unknown indication. On 05-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced PYREXIA (Fever), CHILLS (Chills) and VOMITING (She''s been throwing up). At the time of the report, PYREXIA (Fever), CHILLS (Chills) and VOMITING (She''s been throwing up) outcome was unknown. Concomitant medications include Blood pressure medicines. Treatment information was not provided by reporter.


VAERS ID: 1711053 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / UNK - / OT

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

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

Write-up: administered expired doses to some patients; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered expired doses to some patients) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047A21A) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (administered expired doses to some patients). On 08-Sep-2021, EXPIRED PRODUCT ADMINISTERED (administered expired doses to some patients) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided. Treatment product information was not provided.


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