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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 250 out of 8,010

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VAERS ID: 1711093 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Tennessee  
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 020F21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Chest discomfort, Fatigue, Feeling abnormal, Myalgia, Paraesthesia, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (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), 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: SINGULAIR
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: my right arm is sore; pressure in my chest; tingly feeling in my head; felt a little bit funny/ feel a little bit off; heat in my stomach/ my stomach was so hot; Weird side effects; very tired; This spontaneous case was reported by a consumer and describes the occurrence of CHEST DISCOMFORT (pressure in my chest), PARAESTHESIA (tingly feeling in my head), FEELING ABNORMAL (felt a little bit funny/ feel a little bit off), ABDOMINAL DISCOMFORT (heat in my stomach/ my stomach was so hot) and VACCINATION COMPLICATION (Weird side effects) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma. Concomitant products included MONTELUKAST SODIUM (SINGULAIR) for an unknown indication. 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 CHEST DISCOMFORT (pressure in my chest), PARAESTHESIA (tingly feeling in my head), FEELING ABNORMAL (felt a little bit funny/ feel a little bit off), ABDOMINAL DISCOMFORT (heat in my stomach/ my stomach was so hot), VACCINATION COMPLICATION (Weird side effects) and FATIGUE (very tired). On an unknown date, the patient experienced MYALGIA (my right arm is sore). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, CHEST DISCOMFORT (pressure in my chest), PARAESTHESIA (tingly feeling in my head), FEELING ABNORMAL (felt a little bit funny/ feel a little bit off), ABDOMINAL DISCOMFORT (heat in my stomach/ my stomach was so hot), VACCINATION COMPLICATION (Weird side effects), FATIGUE (very tired) and MYALGIA (my right arm is sore) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication includes citrocine two a day (Regularly but not everyday)


VAERS ID: 1711121 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-09
Onset:2021-09-07
   Days after vaccination:29
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: Erythema, Formication, Paraesthesia, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: feels the tingling, prickly sensation; her legs are somehow red; Something is crawling beneath my skin; itchy skin more whenever she is on bed already; rashes on her arm; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (feels the tingling, prickly sensation), ERYTHEMA (her legs are somehow red), FORMICATION (Something is crawling beneath my skin), PRURITUS (itchy skin more whenever she is on bed already) and RASH (rashes on her arm) in a 67-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 09-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) (Intramuscular) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced PARAESTHESIA (feels the tingling, prickly sensation), ERYTHEMA (her legs are somehow red), FORMICATION (Something is crawling beneath my skin), PRURITUS (itchy skin more whenever she is on bed already) and RASH (rashes on her arm). At the time of the report, PARAESTHESIA (feels the tingling, prickly sensation), ERYTHEMA (her legs are somehow red), FORMICATION (Something is crawling beneath my skin), PRURITUS (itchy skin more whenever she is on bed already) and RASH (rashes on her arm) outcome was unknown. No concomitant and treatment information was reported. Patient did not have any side effects with first dose of vaccine.


VAERS ID: 1711162 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Louisiana  
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 062E21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bedridden
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: She was in bed/ not doing so hot/ knocked down in bed for two days; This spontaneous case was reported by a consumer and describes the occurrence of BEDRIDDEN (She was in bed/ not doing so hot/ knocked down in bed for two days) in a 53-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 062E21A) 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 BEDRIDDEN (She was in bed/ not doing so hot/ knocked down in bed for two days). At the time of the report, BEDRIDDEN (She was in bed/ not doing so hot/ knocked down in bed for two days) outcome was unknown. No concomitant was reported. No treatment was reported. This case was linked to MOD-2021-314558 (Patient Link).


VAERS ID: 1711824 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Headache, Lymphadenopathy, Nausea, Pain, Pyrexia, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL; IBUPROFEN; ZYRTEC [CETIRIZINE HYDROCHLORIDE]; VITAMIN D [COLECALCIFEROL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Fibromyalgia; Postural orthostatic tachycardia syndrome
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101167626

Write-up: Severe headache; fever; body aches; severe anxiety; nausea; dizziness; swollen glands; This is a spontaneous report received from a contactable consumer(patient). A 38-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number was unknown and expiry date was not reported) via an unspecified route of administration, on 04Sep2021 13:00, at the Left arm, at the age of 38-year-old, at dose 2, single for covid-19 immunisation in a pharmacy or drug store. The patient''s medical history includes fibromyalgia, postural orthostatic tachycardia syndrome, and anxiety. Concomitant medications in two weeks include diphenhydramine hydrochloride (BENADRYL), ibuprofen, cetirizine hydrochloride (ZYRTEC), colecalciferol (VITAMIN D), and multivitamin (unspecified). The patient previously took cymbalta, phenergan and oxycodone hydrochloride, paracetamol (PERCOCET) and experienced allergies. The patient did not receive other vaccines in two weeks. The patient is not pregnant at the time of vaccination. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number and expiry date were not reported) via an unspecified route of administration, on 14Aug2021 12:30 at the right arm, at dose 1, single, for covid-19 immunisation. The patient did not have prior COVID vaccination. On 07Sep2021, the patient experienced severe headache, fever, body aches, severe anxiety, nausea, dizziness, swollen gland resulted in Emergency room/department or urgent care. The patient underwent nasal swab post vaccination in Sep2021 but the result was unknown. The patient received treatment in response to the events which included fluids, anti-nausea medication, pain reliever. The outcome of the events was not recovered. The lot number for BNT162B2, was not provided and will be requested during follow up.


VAERS ID: 1711826 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Lip swelling
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: Medical History/Concurrent Conditions: Lip swelling (after taking a pill and eating Kiwi fruit)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101167845

Write-up: upper lip swelling; This is a spontaneous report from a contactable consumer (patient). A 74-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: FC3184), via an unspecified route of administration on 04Sep2021, as dose 1, single for COVID-19 immunization. The patient''s medical history included upper lip swelling after taking a pill and eating Kiwi fruit. Concomitant medications were not reported. On 07Sep2021, 3 days after first dose of vaccine, the patient had reaction and her upper lip was swollen. The clinical outcome of the event was unknown.


VAERS ID: 1711833 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC318Z / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL TARTRATE; ASPIRIN (E.C.); ESTROVEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high; COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101168744

Write-up: Noticed a swollen lymph node that is tender in the lower curve of my neck today that is tender.; Noticed a swollen lymph node that is tender in the lower curve of my neck today that is tender.; It''s on my neck, arms and legs. Red, raised, itchy bumps.; Measles type rash started this morning; This is a spontaneous report from a contactable Consumer. This consumer(patient) reported that, A 49-years-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Left on 02Sep2021 19:30 (Batch/Lot Number: FC318Z) as DOSE 2, SINGLE for covid-19 immunisation (age at vaccination 49-years-old). The patient historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 via an unspecified route of administration, administered in Arm Right On 26Jul2021(07:00 PM) (Batch/Lot Number: FA7484) as DOSE 1, SINGLE for covid-19 immunisation (age at vaccination 49-years-old) and not received any other vaccine within 4 weeks. Medical history included Controlled high blood pressure and if covid prior vaccination: Yes, from an unknown date and unknown if ongoing. Concomitant medication included metoprolol tartrate (METOPROLOL XL) 25mg, acetylsalicylic acid (ASPIRIN (E.C.)) and boron, calcium, cimicifuga racemosa extract, folic acid, glycine max extract, magnolia officinalis, nicotinic acid, pyridoxine hydrochloride, riboflavin, selenium, thiamine, tocopherol, vitamin b12 nos (ESTROVEN) taken within 2 weeks of vaccination. Patient was not pregnant at time of vaccination. The patient Noticed a swollen lymph node that is tender in the lower curve of my neck today that is tender on 07Sep2021(10:00 AM) and Measles type rash started this morning and has progressively gotten worse today. It''s on my neck, arms, and legs. Red, raised, itchy bumps on 07Sep2021(06:00 AM). For treatment, she did not take nothing and not been tested covid post vaccination. Outcome of the events was not recovered.


VAERS ID: 1711891 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-09-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101176586

Write-up: Blood clots both lungs; This is a spontaneous report from a contactable other health professional (patient). A non-pregnant 54-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose, via an unspecified route of administration, administered in arm left in Aug2021 at the age of 54 years old, as single dose for covid-19 immunisation. The patient medical history was not reported. No known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. There were no concomitant medications. The patient experienced blood clots both lungs on 07Sep2021 19:30. AE resulted in: Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event). The patient was hospitalized for blood clots both lungs for 3 days. AE treatment was Blood thinners, pain medication. The outcome of the event was not recovered. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender''s Comments: Based on the available information and the strong drug event temporal association, a possible contributory role of suspect product BNT162B2 to development of event Pulmonary thrombosis cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1711901 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-01
Onset:2021-09-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101176809

Write-up: feeling nauseous; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE: Solution for injection; Batch/Lot number was not reported), dose 1 via an unspecified route of administration on as DOSE 1, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 07Sep2021 caller had the first dose of the Pfizer COVID-19 vaccine in August and she is due for the second shot on Friday. She said that she had been feeling pretty good but yesterday and today, she is feeling nauseous. She said that that is her only symptom. She wanted to know if she should be concerned having the adverse event weeks after getting the vaccine. She wanted to know if something bad is starting to happen to her. The outcome of the event was unknown. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1711922 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Parosmia
SMQs:, Taste and smell disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101181755

Write-up: Smelling like somebody smoking cigarettes around me all the time and nobody is smoking around me; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received bnt162b2 (BNT162B2) formulation solution for injection, dose 1 (Lot number and expiry date was not reported) via an unspecified route of administration on 03Sep2021 as a single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 07Sep2021 the patient experienced smelling like somebody smoking cigarettes around reporter all the time and nobody was smoking around reporter. When asked permission for further probing, consumer stated, No, you are fine now. just call them in the morning you are fine. When probed for any further assistance, consumer stated, No, you are fine. LOT# and Expiration Date: Consumer stated, reporter have like card here. Reporter don''t have the expiration on the doses that reporter got. No, patient don''t have anything on here that patient understand. As consumer was unwilling to complete the report. Further probing could not be done. Hence, limited information available over the call. Outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1711943 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea
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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101182833

Write-up: Feeling stomach cramps; Constant diarrhea; This is a spontaneous report from a contactable consumer, the patient. A 31-year-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 07Sep2021 at 12:30 (at the age of 31-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history reported. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient did not receive any concomitant medications. On 07Sep2021 at 18:00, the patient felt stomach cramps and constant diarrhea. It was reported that after 48 hours, the patient still felt stomach cramps and constant diarrhea. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events feeling stomach cramps and constant diarrhea were not recovered at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow-up.


VAERS ID: 1712021 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Georgia  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VITAMIN D3; ACETYLSALICYLIC ACID; TURMERIC [CURCUMA LONGA RHIZOME]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hyperlipidemia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192457

Write-up: Just not feeling well; Nausea; fluttering in stomach (butterflies instomach feeling); This is a spontaneous report from a non-contactable consumer, the patient. A 48-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FE3592) via an unspecified route of administration in the left arm on 07Sep2021 at 18:45 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. Medical history included hyperlipidemia. The patient did not have any known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Concomitant medications included colecalciferol (VITAMIN D3), acetylsalicylic acid (ASPIRIN), curcuma longa rhizome (TURMERIC) and unspecified multivitamin; all from an unknown date for an unknown indication and unknown if ongoing. On 07Sep2021 at 18:45, the patient was not feeling well, nausea and fluttering in stomach (butterflies in stomach feeling). The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were not taken as a result of the events. The clinical outcome of the events just not feeling well, nausea and fluttering in stomach (butterflies in stomach feeling) was not resolved at the time of report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1712117 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Dizziness postural, Fatigue, Headache, Memory impairment, Nausea, Pain, Pain in extremity, Palpitations, Paraesthesia oral, Scar pain, Sciatica, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety (Anti anxiety meds); Injury NOS (literally anywhere that have injured has sharp stabbing pain/not just joint pain but any injury site/scar under eye hurts)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101210223

Write-up: Extremely fatigued; Headache; Leg and knee, sciatica pain/not justjoint pain but any injury site; Scar under eye hurts; Leg and knee, sciatica pain; Not just joint pain but any injury site/literally anywhere that have injured has sharp stabbing pain; Sciatica pain; Leg and knee, sciatica pain, back; Nausea; Blurred vision; Memory fog.; Tongue tingles; Heart races for no reason; Dizzy when stand up; This is a spontaneous report from a contactable consumer, the patient. A 47-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the right arm on 07Sep2021 at 14:00 (at the age of 47-years-old) as a single dose for COVID-19 immunisation. Medical history included anxiety and unspecified injury. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medication included unspecified anti anxiety medications from an unknown date and unknown if ongoing. On 07Sep2021 at 14:00, the patient felt extremely fatigued, headache, not just joint pain but any injury site, scar under eye was hurting, leg and knee, sciatica pain, back, literally anywhere the patient was injured had sharp stabbing pain, nausea when she ate, blurred vision, memory fog, tongue tingled, heart raced for no reason and got dizzy when she stood up. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events extremely fatigued, headache, not just joint pain but any injury site, scar under eye was hurting, leg and knee, sciatica pain, back, literally anywhere that she had injured, had sharp stabbing pain, nausea, blurred vision, memory fog, tongue tingles, heart races for no reason, dizzy when stand up was not resolved at the time of this report.


VAERS ID: 1712135 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The same day of vaccination, high fever 39 and the next day reaction on the face (swelling and intense itching) 10 days two days of fever 39, 3 and greater reaction on the face.


VAERS ID: 1713213 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-19
Onset:2021-09-07
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Intermenstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: I am 9 days late on my period. I had my period after the first dose, but have yet to get it again after the 2nd dose. I also had some spotting 2 days after the second dose.


VAERS ID: 1713360 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-09-07
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Fatigue, Nausea, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, omeprazole, bisoprolol fumarate, Xanax,
Current Illness: None
Preexisting Conditions: No
Allergies: Amox-clav
Diagnostic Lab Data: covid-19 viral testing antigen
CDC Split Type:

Write-up: Fever, loss taste and smell, congestion, fatigue, nausea


VAERS ID: 1713449 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-09-07
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Muscle spasms, Pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ointment nifedipine/dilated an/lidocaine
Current Illness: Anal fissure
Preexisting Conditions: IBS and migraine
Allergies: Iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cramps in feet and hands, burning and shooting pain in arms, legs and back.


VAERS ID: 1713505 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

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

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

Write-up: Vaccinated with expired vaccine by 7 days. No adverse reaction


VAERS ID: 1713512 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM

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

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

Write-up: Vaccinated with expired vaccine by 7 days. No adverse reaction


VAERS ID: 1713520 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM

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

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

Write-up: Vaccinated with expired vaccine by 7 days. No adverse reaction.


VAERS ID: 1713557 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-07-30
Onset:2021-09-07
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0181 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Gait disturbance, Neuralgia, X-ray
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Severe nerve pain in sole of right foot out of the blue with no injury or other warning or prior pain or injury. Nerve pain spread up right leg to thigh. Unable to walk or put any weight on foot/leg.. X-ray was unremarkable.


VAERS ID: 1713561 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM

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

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

Write-up: Vaccinated with expired vaccine. No adverse reaction.


VAERS ID: 1713586 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Georgia  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Headache, Lacrimation increased, Neck pain, Oropharyngeal pain, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Lacrimal disorders (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins B12, Biotin, collagen, D3, multivitamin, calcium, vitamin C
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore throat, neck pain, headache, watery eyes, soreness.


VAERS ID: 1713606 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 LA / SC

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

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

Write-up: Vaccinated with expired vaccine times 7 days. No adverse reaction.


VAERS ID: 1713615 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 UN / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 RA / -
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 LA / SC

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

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

Write-up: vaccinated with expired vaccine by 7 days. No adverse reaction.


VAERS ID: 1713846 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hemiparesis, Hypoaesthesia, Hypoaesthesia eye, Intranasal hypoaesthesia, Joint noise, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Corneal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Arthritis (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: Vitamin D & K, Vitamin B12 & Iron
Current Illness: None
Preexisting Conditions: None
Allergies: Allergy to Sulfas & Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate pulsating and numbness in the left nostril that migrated to the left eye over the next few days and down the left side of the body. Almost two weeks later and there is still numbness on the left side of the face. Overall weakness on the left side. Joints cracking every - movement and every joint is effected. Arms, legs, feet, neck, crack even with the slight lest movement. (Never cracked prior to vaccine) This started a week after the vaccination.


VAERS ID: 1713978 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Burning sensation, Ear discomfort, Fatigue, Headache, Hypoaesthesia, Laboratory test, Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Post-natal vitamin, iron supplement, probiotic, magnesium/calcium supplement, birth control
Current Illness: Seasonal allergies
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pending lab tests.
CDC Split Type:

Write-up: 3 days post vaccine fatigue started. 4 days post vaccine my legs started getting tingling/burning and some numbness in lower legs and feet. I also started getting constant muscle twitches in legs and sometimes in arms. Headaches also started after one week. Ear pressure also began 9 days post vaccine. I spoke to my primary doctor 12 days post vaccine and she suggested taking in electrolytes in the form of gatorade or Liquid IV packets. She ordered lab work which was drawn on 9/16/21 and she ordered a B12 shot. I will follow up with her on Monday 9/20/21. I continue to have muscle twitches in legs and arms, headaches on and off, fatigue, low energy, numbness and tingling in legs and feet.


VAERS ID: 1714329 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-05-01
Onset:2021-09-07
   Days after vaccination:129
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8738/EW0168 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Diplopia, Eye movement disorder, Magnetic resonance imaging, Migraine
SMQs:, Ocular motility disorders (narrow), Hypoglycaemia (broad)

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

Write-up: Double vision, problem moving my eye , migraine


VAERS ID: 1714516 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Loss of personal independence in daily activities, Mobility decreased, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: body aches / fever of 101.5 for 48 hours / tired / headache / unable to move from bed without help / chills / nausea / loss of appetite received the vaccine on a Tuesday (9-7-21) - went to bed the evening after the vaccine at 6:00 pm - missed school the two next days - stayed in bed until Friday morning and was able to go to school but didn''t feel fully recovered until Saturday. Gave Tylenol and Advil alternating every 4-8 hours to help with symptoms -


VAERS ID: 1714632 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: sweating; fever; leg fatigue or tired; This spontaneous case was reported by a consumer and describes the occurrence of HYPERHIDROSIS (sweating), PYREXIA (fever) and FATIGUE (leg fatigue or tired) in a male 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 dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, the patient experienced HYPERHIDROSIS (sweating), PYREXIA (fever) and FATIGUE (leg fatigue or tired). At the time of the report, HYPERHIDROSIS (sweating), PYREXIA (fever) and FATIGUE (leg fatigue or tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment and concomitant medications were provided. Reporter did not allow further contact


VAERS ID: 1714680 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012E21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling
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: MULTIVITAMINS [VITAMINS NOS]; LISINOPRIL
Current Illness: Drug allergy; Sulfonamide allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Itchiness; Big red well; Swelling; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE ERYTHEMA (Big red well) and VACCINATION SITE SWELLING (Swelling) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012E21A) for COVID-19 vaccination. Concurrent medical conditions included Sulfonamide allergy and Drug allergy. Concomitant products included MULTIVITAMINS [VITAMINS NOS] and LISINOPRIL for an unknown indication. 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 PRURITUS (Itchiness), VACCINATION SITE ERYTHEMA (Big red well) and VACCINATION SITE SWELLING (Swelling). The patient was treated with PARACETAMOL (TYLENOL) for Symptomatic treatment, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE PRURITUS (Itchiness), VACCINATION SITE ERYTHEMA (Big red well) and VACCINATION SITE SWELLING (Swelling) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.


VAERS ID: 1714989 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-09-07
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, COVID-19, Cough, Dyspnoea, Fatigue, Malaise, Pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Lung disease, diabetes mellitus, unspecified disability (neurological, neurodevelopmental, intellectual, physical, vision or hearing impairment)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and hospitalized due to Covid. Patient started feeling sick on 9/4/21 with fatigue, shortness of breath, cough, congestion, body aches and loss of smell. Patient was in the hospital for 4 days, she was not in ICU or on a ventilator.


VAERS ID: 1714995 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-13
Onset:2021-09-07
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Asymptomatic COVID-19, COVID-19, Device leakage, Dysstasia, Gait inability, SARS-CoV-2 test positive
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet ferrous sulfate (FEOSOL, 65 FE,) 325 (65 FE) MG tablet HYDROcodone-acetaminophen (NORCO) 7.5-325 MG tablet lidocaine-prilocaine (EMLA) 2.5-2.5 % topical cream LORazepam (ATIVAN) 0.5 MG tablet Methoxy PE
Current Illness: None known
Preexisting Conditions: Urethral stricture Renovascular hypertension Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris Hyperlipidemia Acute deep vein thrombosis (DVT) of proximal vein of both lower extremities ESRD (end stage renal disease) on dialysis End stage renal disease Acute encephalopathy ESRD on dialysis Chronic systolic (congestive) heart failure Secondary hyperparathyroidism of renal origin Coagulation defect, unspecified Anemia in chronic kidney disease Gastro-esophageal reflux disease without esophagitis Glaucoma Iron deficiency anemia, unspecified Ureteral stricture PVD (peripheral vascular disease) Type 2 diabetes mellitus with complications Generalized weakness Anemia, unspecified type Chronic kidney disease, unspecified CKD stage Former smoker
Allergies: Sulfa drugs (itching)
Diagnostic Lab Data: COVID-19 test positive on 9/7/2021
CDC Split Type:

Write-up: Patient presented to emergency department on 8/26/2021 with weakness and leaking for urinary catheter. Patient was discharged on the same day from skilled nursing facility and son reported patient was very weak and could not stand or walk. Upon screening for discharge to facility, patient was found to be COVID-19 positive. Patient remained asymptomatic with COVID-19 infection during admission. He was discharged on home hospice on 9/17/2021.


VAERS ID: 1715023 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-10
Onset:2021-09-07
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/17/21 COVID+ test
CDC Split Type:

Write-up: COVID vaccine breakthrough case


VAERS ID: 1715130 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-31
Onset:2021-09-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sept 7, starting itching/tingling on my face, midday, not bad or consistent. Colored my hair that night, using same product I''ve used for 15-20 years. When washing off my face near hairline and neck was red and tiny bumps, it itches all night. Wednesday the 8, I could hear my heartbeat in my left ear, usually happens with headache in both ears, but no headache and only in left ear. All day Wednesday, Thursday, Friday I scratched uncontrollably til I bled, on my neck, face, arms and legs. Hydrocortisone cream didn''t help, my only relief was from hand sanitizer wipes. That weekend I took some Benadryl but could only take at night, by Monday I tried otc allergy pills while at work but the made me super drowsy, even tho they were non drowsy meds. Some, very few of the itchy patches I had have went away, like on my nose and ear love have went away, all other spots are trying to heal but when one starts itching it''s like a domino effect, they all do, do I without knowing scratch off the scabs. Now a large itchy rash has developed on my back as well. I''m currently using Benadryl topical cream but it wears off sooner than it should. I haven''t had any major physicals symptoms that are ER worthy, it''s just super irritating with no end in sight


VAERS ID: 1715220 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure abnormal, Dizziness, Dyspnoea exertional, Feeling abnormal, Headache, Heart rate increased, Menstruation irregular, Palpitations, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Fertility disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medication take day of vaccine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I have annual blood work on file with Dr. (she''s my primary). Since my reactions started I haven''t been able to get an appointment with my primary or any other doctor in the office. I have an appointment with a cardiologist on Thursday 9/23 to hopefully get some answers.
CDC Split Type:

Write-up: I have difficulty catching my breath from simple tasks such as vacuuming and cleaning. I first noticed it when I walked up my attic stairs to put something in storage and my heart felt like it was beating out of my chest. My heart rate was over 150 bpm from walking up 5 stairs. My resting heart rate is around 60 and now when I stand it shoots to over 100 and my blood pressure drops. My blood pressure is all over the place throughout the day. I am light headed when standing, dizzy, blurry vision, constant headaches, my arms get tingly feeling- especially when laying down and brain fog. My period started 10 days early and only lasted for 1 day. I have been monitoring by side effects and keeping a journal so when I can speak to my primary we can review in detail.


VAERS ID: 1715603 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-23
Onset:2021-09-07
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Diarrhoea, Headache, Nausea, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Zoloft, Konopin, Lyothyrinine
Current Illness:
Preexisting Conditions: residual palsy, Rt eye blindness from Ramsey Hunt Syndrome, shingles of the 9th and 10th cranial nerve, ADD, Panic disorder, Hashimotos Thyroiditis ?
Allergies:
Diagnostic Lab Data: positive Covid 19 test 09/09/2021
CDC Split Type:

Write-up: Joint pain, headache, nausea, diarrhea. Symptom onset day was 09/07/2021.


VAERS ID: 1715611 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039BZ1A / 2 - / IM

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

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

Write-up: 2nd dose was given early.


VAERS ID: 1715647 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA2588 / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Cough, Dyspnoea, Lung disorder, Pyrexia, Respiratory symptom
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: celecoxib, lisinopril., nifedipine, pantoprazole,pravastatin, tamsuolin, zolpidem
Current Illness:
Preexisting Conditions: dermatologic disorders, disease of mouth/teeth,jaw,pharynx, genitourinary disease, hypertension, pain or migraine, respiratory system disorder, upper respiratory system symptoms
Allergies: amoxicillin, bacitracin, gleevec, triple antibiotic,penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient came 9/19 to report symptoms after receiving 3rd dose of Pfizer. Symptoms: aching joints, chills, fever 101 for 3 days, low grade fever 2 days (99), Per pt, after symptoms gone (5 days), cant breathe without coughing and acting lungs.


VAERS ID: 1715689 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-02-02
Onset:2021-09-07
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, Hypoxia, Oxygen saturation decreased, SARS-CoV-2 test positive
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 (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: Abatacept, tylenol, fosamax, prozac, lasix, norco, lisinopril, mothotrexate, toprol XL, multivitamin, zanaflex.
Current Illness:
Preexisting Conditions: HTN, rheumatoid arthritis, dyslipidemia, benign familial tremor, depression, diet controlled diabetes mellitus, chronic diastolic heart failure.
Allergies: Claritin (dizziness), gabapentin (sedation/confusion), lipitor (muscle symptoms), Penicillins (rash), sulfas (rash)
Diagnostic Lab Data: "Detected" COVID swab reported to the BCHD on 08/19/2021.
CDC Split Type:

Write-up: Patient fully vaccinated for COVID admitted inpatient with original COVID positive test on 08/19/21. Patient with hypoxia (80''s) and shortness of breath on 09/07/21 and presented to ED, she admitted to receive remdesivir, O2, dexamethasone. Respiratory needs maintained in mid to high 90''s on 1L O2. Discharged home on 09/09/2021 with Homecare support and O2 at 1L/NC.


VAERS ID: 1715732 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-30
Onset:2021-09-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Intermenstrual bleeding, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Tylenol and ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received first dose on August 30 2021, expected menstrual cycle began September 1 2021. Cycle stopped the 6th of September, but continued to spot through out September 15 2021. Started another ?period? on September 16 2021, lasted 5 days. As of September 20th I have spotting again.


VAERS ID: 1715787 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Delirium, Dizziness, Fatigue, Headache, Nausea, Pain, Pyrexia, Tremor, Vaccination site pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Headache and dizziness started at 9:00PM and 400mg of ibuprofen was taken (13 hours after vaccination). Chills and body aches began shortly after at 9:30PM. By 10:00PM all symptoms drastically worsened with a pounding headache, extreme dizziness and nausea, severe chills and aching with uncontrollable shaking, fever of 103?F, and delirium that continued until 1:00AM. At 1:00AM chills, aching, and delirium were gone but 101.5?F fever remained with headache and dizziness. The day after the vaccination, low grade fever of 100?F, headache, dizziness, and exhaustion persisted all day long from 7:00AM until sleep at 11:00PM. There was also minor pain at the vaccination site in right arm. By the third day, headache and dizziness were gone but still feeling tired and pain at vaccination site. On the fourth day almost entirely back to normal.


VAERS ID: 1715834 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043AZ1Z / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Blood test, Bone pain, Chest X-ray, Chills, Computerised tomogram, Dyspnoea, Headache, Infusion, Muscle spasms, Myalgia, Nausea, Pain in extremity, Pneumonia, Pyrexia, Scan with contrast, Skin discolouration, Transfusion, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Thalassemia
Allergies: Penicillin
Diagnostic Lab Data: CT Scans with & without contrast x 2 on 09/18/2021 Blood work every day of hospitalization Chest x-ray on 09/18 Shots for anti-blood-clotting Steroid to open up lungs Blood transfusion and iron infusion
CDC Split Type:

Write-up: Started with a fever of 101 F and a severe headache (4 days). The next day had blurry vision, the fever increased to 102 F and it would not break, also started to experience muscle and joint pain as well as back spasms (9 days). Started to also experience chills. Had a fever for 9 days along with abdominal pain and shortness of breath. Skin turned an orangish color on the 5th day and lasted for 4 days. Also experienced extreme leg pain (in the bones). Then she started to experience nausea. Eventually, by day 10 she had extreme shortness of breath and this is when we took her to the ER. She was diagnosed with pneumonia and was hospitalized where she is today.


VAERS ID: 1715846 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-09-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Began menstruation on September 7th (AM) after having already had a full menstrual period as expected that went from August 29th through September 3rd. The first period from 8/29 - 9/3 was expected and typical. There was no menstruation between 9/4 and 9/6. The second period went from 9/7 through 9/13.


VAERS ID: 1716097 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-26
Onset:2021-09-07
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A201A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Bladder catheterisation, COVID-19, COVID-19 pneumonia, Chemotherapy, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Culture urine positive, Lung opacity, Respiratory symptom, SARS-CoV-2 test positive, Urinary retention
SMQs:, Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin, probiotic, acetaminophen, cephalexin, lotrisone cream, vitamin b12, ondansetrone, miralax PRN, prochlorperazine PRN
Current Illness:
Preexisting Conditions: B12 deficiency, C. difficile colitis (2012), Carcinoma metastatic to bone with unknown primary site (HCC) (05/20/2021), Cervical carcinoma (HCC), Diverticulosis, History of COVID-19 (Dec 2020/Jan 2021), History of ITP, Hyperlipidemia, Hypertension, Lymphoma (HCC) (03/31/2021), Non-ST elevated myocardial infarction (non-STEMI) (HCC) (06/28/2018), Recurrent infections, Retroperitoneal mass, and TIA (transient ischemic attack)
Allergies: Aspirin, ciprofloxacin, penicillins, clopidogrel, sulfa, vytorin, bactrim
Diagnostic Lab Data: 9/7/21 COVID19: positive 9/15/21 chest xray: Bilateral pulmonary opacities likely representing COVID-19 pneumonia. 9/15/21 CT abdomen: Bilateral ground-glass pulmonary opacities consistent with COVID-19 pneumonia.
CDC Split Type:

Write-up: Approximately a week ago on 9/7/21 patient tested positive for COVID-19 back then she was having URI like symptoms which patient reports are getting better. Patient has been undergoing chemotherapy for lymphoma and did receive her last chemotherapy on 9/3/21. For past few months patient has been having recurrent urinary retention. Currently on chronic foley, last urine culture was positive for Pseudomonas outpatient treatment with Keflex. Patient has some symptoms of abdominal discomfort. Patient reports at baseline she is able to stand using walker and ambulated. She has history of chronic compression fractures of vertebra. She has metastasis of lymphoma to her vertebrae. She denies fevers chills. Denies vomiting. Denies any focal neurological deficit. Denies breathing discomfort chest pain palpitation. Denies abdominal pain constipation. Patient reports improving symptoms, no difficulty in breathing, on room air. Admitted on 9/15/21. Radiological finding could be lagging clinical resolution or improvement. At the same time patient might get worse we need to observe. We will not start patient on steroids remdesivir. Continue to monitor clinically. Incentive spirometry. Discharged 9/20/2021


VAERS ID: 1716104 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cardiac telemetry, Chest X-ray, Chest pain, Cold sweat, Cyanosis, Electrocardiogram abnormal, Intensive care, Myocarditis, Nausea, Pallor, Troponin increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: none
Preexisting Conditions: asthma
Allergies: Penicillin, peanuts, tree nuts
Diagnostic Lab Data: high troponin levels
CDC Split Type:

Write-up: Woke up with severe chest pains, pale , blue lips, nausea, clammy. Brought him to Medical Center emergency room. Bloodwork, chest xray and EKG done. Bloodwork showed high lveles of troponin. Transported via ambulance to a d Medical Center pediatric intensive care unit. During stay at hospiatl he had telemetry monitoring, ekg, and regular bloodwork to check troponin levels. Diagnosed with Myopericarditis


VAERS ID: 1716373 (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: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 03A21A / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood culture negative, Blood glucose increased, C-reactive protein abnormal, COVID-19, Cardiomegaly, Cerebral small vessel ischaemic disease, Chest X-ray abnormal, Computerised tomogram head abnormal, Computerised tomogram spine, Decreased appetite, Facet joint syndrome, Fall, Fatigue, Fibrin D dimer increased, Full blood count normal, Hypoxia, Inspiratory capacity decreased, Lung infiltration, Mucosal hypertrophy, Oropharyngeal pain, Paranasal sinus inflammation, Pneumonia, Pulmonary congestion, Pyrexia, SARS-CoV-2 test positive, Spondylolisthesis, Total lung capacity decreased, Upper respiratory tract congestion, Vertebral foraminal stenosis, White blood cell count normal
SMQs:, Cardiac failure (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), 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), Arthritis (narrow), Respiratory failure (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet ALPHA-LIPOIC ACID PO atorvastatin (LIPITOR) 10 MG tablet Donepezil HCl 23 MG tablet finasteride (PROSCAR) 5 MG tablet guaiFENesin 100 MG/5ML syrup hydrocortisone rectal (ANUSOL HC) 2.5 % cream insulin g
Current Illness:
Preexisting Conditions: Respiratory Allergic rhinitis Pneumonia due to COVID-19 virus Hypoxia Circulatory Essential hypertension Palpitations Paroxysmal atrial fibrillation (HCC) Nonrheumatic aortic valve stenosis LBBB (left bundle branch block) Atherosclerotic heart disease of native coronary artery without angina pectoris Cardiomyopathy, unspecified (HCC) Occlusion and stenosis of bilateral carotid arteries Digestive Gastroesophageal reflux disease Nervous Glaucoma Traumatic subdural hematoma with loss of consciousness of 30 minutes or less (HCC) Early onset Alzheimer''s dementia without behavioral disturbance (HCC) Low-tension glaucoma, right eye, moderate stage Genitourinary Urinary frequency BPH associated with nocturia Kidney stone Endocrine/Metabolic Diabetes (HCC) Hyperlipidemia Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin (HCC) Other Major depressive disorder with single episode, in full remission (HCC) History of subarachnoid hemorrhage Spinal enthesopathy, cervical region (HCC) Long term (current) use of insulin (HCC)
Allergies: No Known Allergies
Diagnostic Lab Data: Procedure Component Value Ref Range Date/Time DR CHEST SINGLE VIEW Resulted: 09/07/21 2210 Order Status: Completed Updated: 09/07/21 2212 Narrative: EXAMINATION: Single View Chest EXAM DATE: 9/7/2021 9:47 PM TECHNIQUE: Single view chest INDICATION: 86-year-old male presents with weakness. Evaluate for infiltrate. The patient is COVID 19 positive. COMPARISON: Chest radiographs performed May 12, 2021 and May 22, 2020. ENCOUNTER: Not applicable. _________________________ FINDINGS: There are low lung volumes and the chest was somewhat underpenetrated. There are hazy infiltrates along the periphery of the right mid lung zone and in the right lower lung zone. Suspect there may be subtle infiltrate in the left lung base as well. There is no sizable pleural effusion. There is no pneumothorax. Heart size is probably borderline enlarged when allowing for low inspiratory portable technique. The pulmonary vasculature is slightly congested. No overt congestive heart failure. The thoracic spine is poorly seen. The bony thorax otherwise appears to be within normal limits. _________________________ Impression: 1. There is hazy infiltrate along the periphery of the right midlung zone and in the right lower lung zone. Also suspect infiltrate the left lung base. Probable bilateral pneumonia. COVID 19 pneumonia could have this appearance. CT SPINE CERVICAL WITHOUT CONTRAST Resulted: 09/07/21 2154 Order Status: Completed Updated: 09/07/21 2156 Narrative: EXAMINATION: CT cervical spine without contrast EXAM DATE: 9/7/2021 9:07 PM TECHNIQUE: Standard protocol cervical spine CT was performed without contrast. Reconstructed coronal and sagittal images are provided. INDICATION: Neck trauma (Age $g= 65y). COMPARISON: 8/31/2018 ENCOUNTER: Not applicable _________________________ FINDINGS: No acute cervical spine fracture is identified. Vertebral heights are normal. AP alignment is stable and appears preserved other than for trace anterolisthesis of C7 due to degenerative facet disease. No occipital condylar fracture. Normal alignment at the craniocervical junction. Chronic bilateral upper rib fractures are noted with some interval healing of those on the left. Considerable neural foraminal stenosis is present on the right at C4-5 and bilaterally at C5-6. Limited evaluation of spinal canal contents on CT though there is no gross evidence of critical canal stenosis. Ligamentous injury is not assessed. No identified hematoma. ___________________________ Impression: No acute cervical spine fracture or suspicious malalignment. CT HEAD WITHOUT IV CONTRAST Resulted: 09/07/21 2149 Order Status: Completed Updated: 09/07/21 2152 Narrative: EXAMINATION: CT head without contrast EXAM DATE: 9/7/2021 9:07 PM TECHNIQUE: Standard protocol CT images of the head were obtained without intravenous contrast. Coronal and sagittal reconstructed images were created. INDICATION: Head trauma, minor (Age $g= 65y) COMPARISON: 11/20/2018 HAND DOMINANCE: Right. ENCOUNTER: Not applicable _________________________ FINDINGS: There is no acute intracranial hemorrhage. The ventricular and sulcal spaces are age appropriate. No midline shift or other significant mass effect. No definite residual of the previous left subdural collection. Gray-white differentiation is maintained without encephalomalacia or evidence of acute infarction. White matter low attenuation is similar to before and likely represents chronic small vessel ischemic change. The calvarium and skull base are intact. No acute orbital trauma. Mucosal thickening in the paranasal sinuses without evidence of hemorrhage. Clear mastoid cells. _________________________ Impression: No acute intracranial abnormality. Procedure Component Value Ref Range Date/Time Peripheral Blood Culture Collected: 09/07/21 2047 Order Status: Completed Specimen: Blood, Venous Updated: 09/13/21 0002 Cult Blood Peripheral No bacteria or yeast isolated Peripheral Blood Culture Collected: 09/07/21 2047 Order Status: Completed Specimen: Blood, Venous Updated: 09/13/21 0002 Cult Blood Peripheral No bacteria or yeast isolated COVID-19 PCR, Rapid (Abnormal) Collected: 09/07/21 2031 Order Status: Completed Specimen: Swabbed Collection from Nasopharynx Updated: 09/07/21 2104 COVID-19 PCR Detected Abnormal Not Detected Comment: COVID-19 (SARS-CoV-2) test is positive. Clinical correlation with patient history and other diagnostic information is necessary to determine infection status. This test has received Emergency Use Authorization (EUA) by the FDA, but performance has not been evaluated for asymptomatic patients. Testing was performed using a nucleic acid amplification method. The specimen source may have been changed from the original order per patient situation or symptoms. Covid 19 Result Comment See Comment Comment: COVID-19 results reported as "detected" means COVID-19 positive. Positive patients should self-isolate for 10 days or 24 hours after fever resolves and other symptoms are improving, whichever is longer: - Stay home except to get medical care and wear a facemask if you must leave - Separate yourself from other people in your home, known as home isolation - Cover your coughs and sneezes - Wash your hands often - Avoid sharing household items - Clean high-touch surfaces everyday - If you have a medical emergency and need to call 911, notify dispatch personnel that you may have COVID-19 and put on a facemask before emergency medical services arrive.
CDC Split Type:

Write-up: 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: 1717687 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Decreased appetite, Dizziness, Dyspnoea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: High fever body aches shortness breath lost appetite dizziness; High fever body aches shortness breath lost appetite dizziness; High fever body aches shortness breath lost appetite dizziness; High fever body aches shortness breath lost appetite dizziness; High fever body aches shortness breath lost appetite dizziness; This spontaneous case was reported by a consumer and describes the occurrence of PAIN (High fever body aches shortness breath lost appetite dizziness), DYSPNOEA (High fever body aches shortness breath lost appetite dizziness), DIZZINESS (High fever body aches shortness breath lost appetite dizziness), DECREASED APPETITE (High fever body aches shortness breath lost appetite dizziness) and PYREXIA (High fever body aches shortness breath lost appetite dizziness) 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 07-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 dosage form. On 07-Sep-2021, the patient experienced PAIN (High fever body aches shortness breath lost appetite dizziness), DYSPNOEA (High fever body aches shortness breath lost appetite dizziness), DIZZINESS (High fever body aches shortness breath lost appetite dizziness), DECREASED APPETITE (High fever body aches shortness breath lost appetite dizziness) and PYREXIA (High fever body aches shortness breath lost appetite dizziness). On 09-Sep-2021, PAIN (High fever body aches shortness breath lost appetite dizziness), DYSPNOEA (High fever body aches shortness breath lost appetite dizziness), DIZZINESS (High fever body aches shortness breath lost appetite dizziness), DECREASED APPETITE (High fever body aches shortness breath lost appetite dizziness) and PYREXIA (High fever body aches shortness breath lost appetite dizziness) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No Concomitant Medications were provided by the reporter No Treatment Information were provided by the reporter


VAERS ID: 1717859 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Hyperhidrosis, Insomnia, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Comments: The patient has been working outdoor for many year, he was not one of those people that sweat that much, he never experienced such events before vaccination.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210935118

Write-up: BODY ACHES; SHORTNESS OF BREATH; TIREDNESS; SWEATY AROUND HIS NECK AREA, PERSPIRING FROM BACK AND SHOULDER AREA, FELT WATER COMING THROUGH THE BACK; WAKING UP IN THE MORNING; This spontaneous report received from a consumer concerned a 43 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included: The patient has been working outdoor for many year, he was not one of those people that sweat that much, he never experienced such events before vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 20-AUG-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 experienced sweaty around his neck area, perspiring from back and shoulder area, felt water coming through the back. On 07-SEP-2021, the patient experienced waking up in the morning. On an unspecified date, the patient experienced body aches, shortness of breath, and tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, shortness of breath, and tiredness, and had not recovered from sweaty around his neck area, perspiring from back and shoulder area, felt water coming through the back, and waking up in the morning. This report was non-serious.


VAERS ID: 1717925 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 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: 2nd dose administered on day after the manufacturer expiration date; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (2nd dose administered on day after the manufacturer expiration date) in a 41-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 001B21A) 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 (2nd dose administered on day after the manufacturer expiration date). At the time of the report, EXPIRED PRODUCT ADMINISTERED (2nd dose administered on day after the manufacturer expiration date) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant drugs were reported. No Treatment information were reported.


VAERS ID: 1718003 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 - / OT

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

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

Write-up: administered past the 30 day refrigeration time; This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) 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 EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time). On 07-Sep-2021, EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. The date refrigeration was reported as 20-Apr-2021 and the temperature changes (in F) was 40. Earlier this week we realized that some doses of the Moderna COVID Vaccine had been administered past the 30 day refrigeration time. No treatment information was reported.


VAERS ID: 1718063 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 - / OT

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

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

Write-up: administered past the 30 day refrigeration time; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) 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 EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time). At the time of the report, EXPIRED PRODUCT ADMINISTERED (administered past the 30 day refrigeration time) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication information not provided by the reporter. Date refrigerated: 20-Apr-2021. Temperature changes (in F): 40. Treatment information not provided by the reporter.


VAERS ID: 1718133 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-09-07
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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: Hypertension
Preexisting Conditions: Medical History/Concurrent Conditions: Overweight; Smoker (former smoker)
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: COVID-19 virtus test; Test Result: Positive ; Result Unstructured Data: positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Tested positive for COVID-19; Tested positive for COVID-19 on September 7th; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Tested positive for COVID-19) and DRUG INEFFECTIVE (Tested positive for COVID-19 on September 7th) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Overweight and Smoker (former smoker). Concurrent medical conditions included Hypertension. On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced COVID-19 (Tested positive for COVID-19) and DRUG INEFFECTIVE (Tested positive for COVID-19 on September 7th). At the time of the report, COVID-19 (Tested positive for COVID-19) had not resolved and DRUG INEFFECTIVE (Tested positive for COVID-19 on September 7th) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 07-Sep-2021, SARS-CoV-2 test: positive (Positive) positive. Concomitant medication of the patient was not reported. No treatment information was provided by the reporter.; Sender''s Comments: This case concerns a 55-year-old female patient, former smoker, overweight and hypertensive, who experienced the unexpected event of COVID-19, vaccination failure was considered as an additional event. The event occurred approximately 4 months after the second dose of Spikevax. The event was considered related to the product per the reporter''s assessment. The rechallenge was not applicable. The benefit-risk relationship of Spikevax in not affected by this report.


VAERS ID: 1718143 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: tiredness; headaches; having a lot of fever; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of PYREXIA (having a lot of fever), HEADACHE (headaches) and FATIGUE (tiredness) in a 19-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 03-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 PYREXIA (having a lot of fever), HEADACHE (headaches) and FATIGUE (tiredness). On 08-Sep-2021, PYREXIA (having a lot of fever), HEADACHE (headaches) and FATIGUE (tiredness) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided by the reporter. No treatment information was provided by the reporter.


VAERS ID: 1718157 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-29
Onset:2021-09-07
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026520-2A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Nephrolithiasis, SARS-CoV-2 antibody test, SARS-CoV-2 test
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: SARS-CoV-2 antibody test; Result Unstructured Data: High; Test Date: 20210904; Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210907; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Kidney stone; Lack of drug effect; Covid 19 antibody test was positive /She currently feels very weak, sick, kind of like out of breath/ she can''t really smell anything /coughing; This spontaneous case was reported by an other health care professional and describes the occurrence of NEPHROLITHIASIS (Kidney stone) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 043L20A and 026520-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 29-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 26-Jan-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 07-Sep-2021, the patient experienced DRUG INEFFECTIVE (Lack of drug effect) and COVID-19 (Covid 19 antibody test was positive /She currently feels very weak, sick, kind of like out of breath/ she can''t really smell anything /coughing). On an unknown date, the patient experienced NEPHROLITHIASIS (Kidney stone) (seriousness criterion medically significant). The patient was treated with PARACETAMOL (TYLENOL) ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, NEPHROLITHIASIS (Kidney stone), DRUG INEFFECTIVE (Lack of drug effect) and COVID-19 (Covid 19 antibody test was positive /She currently feels very weak, sick, kind of like out of breath/ she can''t really smell anything /coughing) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Sep-2021, SARS-CoV-2 test: negative (Negative) Negative. On 07-Sep-2021, SARS-CoV-2 antibody test: 4.05 (High) High. On 07-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No relevant concomitant medications were reported. The patient has received 2 doses of the Moderna covid-19 vaccine by intramuscular injection on 29DEC2020 (lot number 026520-2A, expiration date unknown), and 26JAN2021 (lot number 043L20A, expiration date unknown). She has been fine throughout most the pandemic. She went to the hospital on 23AUG2021 for a lithotripsy for a kidney stone. This was an outpatient procedure and she felt like she never recovered. She was staying at her daughter''s house after the procedure. 1 week later, on 31AUG2021, her son in lawand 9 months pregnant daughter, both in their 30s, tested positive for covid-19. Because she continued to not feel right, like she had a little bit of a cold, she was tested for covid-19 on 4SEP2021 which was negative. She went for another swab and antibody test on 7SEP2021 which was positive and the antibody test showed a result of 4.05. She currently feels very weak, sick, kind of like out of breath, and like she basically can''t do anything. She has been a little nauseous, finds it very hard to eat something, she can''t really smell anything and everything tastes like dust or something. She also feels very dizzy, weak, disoriented, and like she was on another planet. Last night she started coughing a lot, with a dry cough that won''t stop once you start coughing. She has been taking Tylenol for her symptoms. She has also talked to her nephrologist who said the shot probably saved her life. Company Comment: This case concerns a 56-year-old, female patient with no relevant medical history, who experienced the unexpected events of nephrolithiasis and COVID 19. Additional event of drug ineffective was also considered. The events occurred approximately 7 months after the second dose of Spikevax. The rechallenge was not applicable. The benefit-risk relationship of Spikevax is not affected by this report.; Sender''s Comments: This case concerns a 56-year-old, female patient with no relevant medical history, who experienced the unexpected events of nephrolithiasis and COVID 19. Additional event of drug ineffective was also considered. The events occurred approximately 7 months after the second dose of Spikevax. The rechallenge was not applicable. The benefit-risk relationship of Spikevax is not affected by this report.


VAERS ID: 1718238 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-19
Onset:2021-09-07
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Mastication disorder, Pain in jaw
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Osteonecrosis (broad)

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

Write-up: Trouble chewing, swallowing, pain in jaw


VAERS ID: 1718280 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Extra dose administered, Off label use, SARS-CoV-2 antibody test
SMQs:, Lack of efficacy/effect (narrow), Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic kidney disease; Kidney transplant
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: covid test; Test Result: Positive ; Comments: Nasal swab
CDC Split Type: USPFIZER INC202101169394

Write-up: Patient had third Pfizer/BioNtech vaccine within the past 2 weeks.; Patient had third Pfizer/BioNtech vaccine within the past 2 weeks.; Tested positive for COVID; Tested positive for COVID; This is a spontaneous report from a contactable consumer. A 72-year-old male patient received three doses of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on an unspecified date, at the age of 72-years-old, (Batchs/Lot numbers was not reported) as single dose for covid-19 immunisation. Medical history included chronic kidney disease and renal transplant from an unknown date. The patient received other unspecified medications. The patient tested positive for covid via Nasal Swab on 07Sep2021. The patient received Monoclonal Antibody Infusion as treatment for the event. No covid prior vaccination and no covid tested post vaccination. The outcome of the event was not recovered. The lot number for the vaccine, bnt162b2 was not provided and will be requested during follow up.


VAERS ID: 1718281 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-02-01
Onset:2021-09-07
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes (Other medical history: Diabetes)
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC202101169396

Write-up: Patient received both doses of Pfizer/BioNtech vaccine in February 2021 and now tested positive for COVID 19; Patient received both doses of Pfizer/BioNtech vaccine in February 2021 and now tested positive for COVID 19; This is a spontaneous report from a contactable consumer. A 73-years-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration on Feb2021 (Batch/Lot number was not reported) and dose 1 via an unspecified route of administration on Feb2021 (Batch/Lot number was not reported) both as single dose for covid-19 immunisation (Age at vaccination 73 years) . Medical history included diabetes mellitus. Concomitant medications were not reported. The patient was not pregnant at the time of vaccination. The patient received both doses of pfizer/biontech vaccine in February 2021 and now tested positive for covid 19 (medically significant) on 07Sep2021 with outcome of not recovered. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 07Sep2021 . Therapeutic measures were taken as a result of the reported events including Monoclonal Antibody Infusion. The patient visited a Physician office as a result of the events. Information about Lot number has been requested.


VAERS ID: 1718525 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Feeling jittery, Hypertension, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine Lamtrogine Clonazepam Meloxicam VitaminC, zinc, magnesium, calcium, coq10
Current Illness: None
Preexisting Conditions:
Allergies: Mucinex [guaifenesin] Coconut Methocarbamol Oxcarbazepine Tree Nuts Imitrex [sumatriptan Succinate] Zoloft [sertraline]
Diagnostic Lab Data: None At home blood pressure log
CDC Split Type:

Write-up: Plantations x 4 days Jitters x 4 days Chest pain x4 days High blood pressure


VAERS ID: 1718711 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-27
Onset:2021-09-07
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Heavy menstrual bleeding, Menstruation delayed, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Heather .35 mg, Zyrtec and Tylenol
Current Illness: Migraines with ora
Preexisting Conditions: Migraines with ora, ovarian cysts
Allergies: Aspirin
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Menstrual cycle was delayed. Once menstruation started, it has been ongoing and not stopped. Today is 14 days, 2 weeks of continued bleeding. I previously had issues with regualrity with menstruation but this has been remedied for a few years with the birth control I take.


VAERS ID: 1718794 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-30
Onset:2021-09-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Infusion on 9/4/21: CARBOplatin, Dexamethasone, Docetaxel, Fosaprepitant, Ondansetron, Ambien, Famotidine, Xanax, Crestor, Soma, Ditropan, Celebrex
Current Illness: Chemo infusion as noted above
Preexisting Conditions: Metastatic prostate cancer Venous insufficiency SVT Atrial flutter Psoriasis Hyperlipidemia Anxiety
Allergies: Sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: No immediate reaction, developed dermatomal distribution rash with vesicles of left hemiflank on 9/7, consistent with zoster (shingles), responded well to treatment with valacyclovir.


VAERS ID: 1718876 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-08-20
Onset:2021-09-07
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Condition aggravated, Dysmenorrhoea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: My period has become full of clots. It was incredibly humiliating as I was standing at a gas pump when I felt a pop and clumps of blood started pouring down my legs. I have always had a very healthy period but after the first vaccine dose, I had clumps of blood and major cramping. After the second dose, I again experienced major cramp and incredible bloating. But the extreme clumping and clots of blood pouring down my legs at a gas pump in front of other patrons was aweful, humiliating, and it is a disgrace to think we can promote this to people!


VAERS ID: 1718929 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-01-22
Onset:2021-09-07
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anti-thyroid antibody increased, Anti-thyroid antibody positive, Blood thyroid stimulating hormone, Thyroxine normal
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad), Immune-mediated/autoimmune disorders (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: chlorthalidone, Aspirin, Crestor, Ezitamide, Norvasc
Current Illness: none
Preexisting Conditions: coronary artery disease, hypertension, familial lipid disorder
Allergies: none
Diagnostic Lab Data: 09/07/2021 labs: TSH 7.5 (norm 0.3 to 4.2 mIU/L), TPO (thyroperoxidase antibodies 35.3 (norm <9.0 IU/mL), T4 0.9 (norm 0.9 to 1.7 ng/dL). All thyroid related tests were normal from 2013 to summer 2020.
CDC Split Type:

Write-up: On routine exam in September 2021, after receiving Pfizer vaccine booster in August 2021, patient noted to have thyroid antibodies, elevated TSH and low T4. He was Rx''d levothyroxine 75 micrograms a day with follow-up in three months. Patient had normal THS and T4 in 2020 and for the preceeding seven years.


VAERS ID: 1719062 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-27
Onset:2021-09-07
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Respiratory disorder, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: buPROPion (WELLBUTRIN XL) 300 MG 24 hr tablet clonazePAM (KLONOPIN) 1 MG tablet docusate sodium (COLACE) 100 MG capsule fluticasone (FLONASE) 50 MCG/ACT nasal spray ibuprofen (MOTRIN) 800 MG tablet levothyroxine (SYNTHROID) 75 MCG tablet lo
Current Illness:
Preexisting Conditions: Endocrine Acquired hypothyroidism Musculoskeletal and Integument Closed fracture of base of fifth metatarsal bone with routine healing, right Genitourinary Menses painful Dysmenorrhea Uterine leiomyoma Other Heavy menses Hx of tubal ligation S/P endometrial ablation BMI 35.0-35.9,adult Obesity (BMI 30.0-34.9) Tobacco abuse Vitamin D deficiency RhD negative History of robot-assisted laparoscopic hysterectomy
Allergies: NKA
Diagnostic Lab Data: COVID-19 RESULT:Detected
CDC Split Type:

Write-up: HPI patient is a 43-year-old female who presents for evaluation. Patient is having mild upper respiratory tract type symptoms with cough nonproductive she has lost her taste and smell. Patient been going on for last 3 to 4 days. As noted her husband is quite sick with regard to GI complaints associated possibly with COVID-19 as well. Patient denies any other significant problems at this point. GI or GU complaints no other cardiac or pulmonary complaints medications were reviewed with the patient as were her drug allergies


VAERS ID: 1719182 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-28
Onset:2021-09-07
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6206 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Fatigue, Pulmonary congestion, Respiratory disorder, SARS-CoV-2 test
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Infective pneumonia (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: albuterol HFA (PROAIR HFA) 108 (90 Base) MCG/ACT inhaler cetirizine (ZYRTEC) 10 MG tablet ENBREL SURECLICK 50 MG/ML injection folic acid (FOLVITE) 1 MG tablet methotrexate 2.5 MG tablet Multiple Vitamins-Minerals (MULTIVITAMIN ADULT PO) vit
Current Illness:
Preexisting Conditions: Respiratory CAP (community acquired pneumonia) Acute hypoxemic respiratory failure (CMS/HCC) COPD (chronic obstructive pulmonary disease) (CMS/HCC) Nervous and Auditory Cubital tunnel syndrome on right Carpal tunnel syndrome on right Carpal tunnel syndrome, right Other Leukocytosis/Bandemia Tobacco abuse Sinus tachycardia Morbid obesity with BMI of 45.0-49.9, adult (CMS/HCC) Pleuritic chest pain Numbness and tingling in both hands Acute pain of right shoulder Menopausal symptoms Bilateral hand pain
Allergies: NKA
Diagnostic Lab Data: SARS-CoV-2 PCR - IPOC Detected
CDC Split Type:

Write-up: 52-year-old female with a significant smoking history here with a 4-day history of upper respiratory symptoms. Started with a cough, chest congestion and fatigue. Had diarrhea a few days ago. Son who is 32 is also sick. No sick contacts at work. Patient states that she just came back from vacation. She was around her parents who are also symptomatic. She has a significant smoking history but has never been fully diagnosed with COPD. (Approximately 32 pack years) She has tried Nothing, which has not helped. In general, the problem is worse compared to when it started. COVID-19 contacts? No Loss of taste/smell? No COVID Vaccinated? Yes


VAERS ID: 1719402 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014F21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Nausea, Slow response to stimuli, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SHORT OF BREATH, CHEST TIGHTNESS, NAUSEA/VOMITING, THEN SLOW TO RESPOND. 911 CALLED, BENADRYL & EPINEPHRINE ADMINISTERED. PATIENT TAKEN TO HOSPITAL BY AMBULANCE BUT RELEASED SAME DAY


VAERS ID: 1719440 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-24
Onset:2021-09-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 2 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bell's palsy, Extra dose administered
SMQs:, Hearing impairment (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: unknown
Current Illness: unknown
Preexisting Conditions: States he is a cancer patient
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient began having bells palsy like symptoms on 9/7/2021, was diagnosed on 9/9 by Dr. Patient states was given antivirals/corticosteroids. Symptoms resolved after 2 weeks. Unsure if Dr. office has already completed a vaers report.


VAERS ID: 1719558 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-17
Onset:2021-09-07
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7483 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3593 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation delayed, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medicines. Vitamin C 1000mg daily
Current Illness: None. I''m healthy.
Preexisting Conditions: None. I''m healthy.
Allergies: None
Diagnostic Lab Data: I will see a doctor on September 24th.
CDC Split Type:

Write-up: My menstrual cycle should have begun August 23-26th. No period happened in August. I then began menstruating on Sept. 7th. Bleeding has been HEAVY! Bleeding through tampons within 20 minutes. Clumps of blood the size of golf balls coming out EVERY DAY. I''m sTILL bleeding. Today is Sept. 21st. 2 weeks of a heavy period. This is not normal. My periods have been regular since I was 11 years old. I''m seeing a doctor this Friday (my day off) to address this issue.


VAERS ID: 1719605 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dyspnoea, Heart rate increased, Impaired driving ability, Oxygen saturation decreased, Palpitations, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (broad), Dehydration (broad)

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

Write-up: Approximately 30 minutes after receiving the vaccine, I experienced shortness of breath, dizziness, tingling of my arms and fingers and could feel my heart racing. I called 911 and an ambulance came to a parking area just a short drive from the pharmacy where I received my vaccine. I was checked out by the paramedics. My blood pressure was elevated, my heart rate was elevated. My oxygen saturation was only 92. I chose not to be taken to the hospital because my symptoms began to improve after some time had passed. I attempted to drive home shortly after and had to pull over and call a family member to come get me as the dizziness had returned.


VAERS ID: 1720696 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: TDAP; hives; 1988
Other Medications: Zyrtec, omeprazole, Flonase, Adderall IR, Adderall XR, Naprosyn, Prozac
Current Illness: None
Preexisting Conditions: Bertilotti''s Syndrome, arthritis, GERD, ADHD, GAD, PTSD, Sciatica, bulging L4 vertebrae, vitiligo
Allergies: Pertussis Vaccine, TB test, Penicillin, cockroach, pecan tree pollen.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria and rash to trunk within 2 hours of receiving injection. Rash continued to spread throughout trunk and to extremities over the following 3 days; even with continued use of regular daily antihistamines and added oral diphenhydramine and topic hydrocortisone 1%.


VAERS ID: 1721548 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Headache, Myalgia, Nasal congestion, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Taste and smell disorders (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Test Date: 20210904; Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative; Test Date: 20210907; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Tested positive for COVID; Cough; Nasal congestion; Loss of taste; Loss of smell; Chills; Muscle ache; Headache; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Tested positive for COVID), COUGH (Cough), NASAL CONGESTION (Nasal congestion), AGEUSIA (Loss of taste) and ANOSMIA (Loss of smell) in a 26-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced COVID-19 (Tested positive for COVID), COUGH (Cough), NASAL CONGESTION (Nasal congestion), AGEUSIA (Loss of taste), ANOSMIA (Loss of smell), CHILLS (Chills), MYALGIA (Muscle ache) and HEADACHE (Headache). The patient was treated with IBUPROFEN ongoing from 07-Sep-2021 for SARS-CoV-2 infection, at an unspecified dose and frequency. At the time of the report, COVID-19 (Tested positive for COVID), COUGH (Cough), NASAL CONGESTION (Nasal congestion), ANOSMIA (Loss of smell), CHILLS (Chills) and HEADACHE (Headache) had not resolved and AGEUSIA (Loss of taste) and MYALGIA (Muscle ache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Sep-2021, SARS-CoV-2 test: negative (Negative) Negative. On 07-Sep-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications reported Treatment medications for SARS-CoV-2 infection included:Musinex All in One Cold/Flu-20 ML: Mornings from 08-SEP-2021 to till date. Musinex Nightshift Cold/Flu-20 ML: Evenings from 08-SEP-2021 to till date. Goodie Powder from 07-SEP-2021 to till date. Nose spray 2 times a day from 08-SEP-2021 to till date Most recent FOLLOW-UP information incorporated above includes: On 12-Sep-2021: Follow up received and it contains no new information On 12-Sep-2021: Follow up received: Patient initials, gender, age, events event outcome and treatment medications added.


VAERS ID: 1721557 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / UNK - / OT

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

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

Write-up: administered expired doses; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (administered expired doses) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 032M20A) 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). On 07-Sep-2021, EXPIRED PRODUCT ADMINISTERED (administered expired doses) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications were not provided by reporter. Treatment information was not provided by reporter. This case was linked to MOD-2021-314573, MOD-2021-314570. Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Start date of drug, event and batch number were updated. On 15-Sep-2021: Possible NNI.


VAERS ID: 1721596 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Feeling abnormal, Feeling cold, Headache, Hyperhidrosis, Mobility decreased, Myalgia, Pyrexia, SARS-CoV-2 test, Vaccination site discolouration, Vaccination site swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Could not lift his hand over his head; Sweat and Sweating without doing anything; Woke up one hour freezing; Injection site turned black and blue; Dizzy; Lightheaded; Did not feel good. He could not get out of bed until the next day at 3 pm; Arm was really sore/Sore all over; Fever; Injection site was swollen; Headache / Head was pounding and Slight headache; Chills; Really tired; This spontaneous case was reported by a consumer and describes the occurrence of MOBILITY DECREASED (Could not lift his hand over his head), HYPERHIDROSIS (Sweat and Sweating without doing anything), FEELING COLD (Woke up one hour freezing), VACCINATION SITE DISCOLOURATION (Injection site turned black and blue) and DIZZINESS (Dizzy) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 939906) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in January 2021. 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 MOBILITY DECREASED (Could not lift his hand over his head), HYPERHIDROSIS (Sweat and Sweating without doing anything), FEELING COLD (Woke up one hour freezing), VACCINATION SITE DISCOLOURATION (Injection site turned black and blue), DIZZINESS (Dizzy), DIZZINESS (Lightheaded), FEELING ABNORMAL (Did not feel good. He could not get out of bed until the next day at 3 pm), MYALGIA (Arm was really sore/Sore all over), PYREXIA (Fever), VACCINATION SITE SWELLING (Injection site was swollen), HEADACHE (Headache / Head was pounding and Slight headache), CHILLS (Chills) and FATIGUE (Really tired). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, MOBILITY DECREASED (Could not lift his hand over his head), HYPERHIDROSIS (Sweat and Sweating without doing anything), FEELING COLD (Woke up one hour freezing), VACCINATION SITE DISCOLOURATION (Injection site turned black and blue), DIZZINESS (Dizzy), DIZZINESS (Lightheaded), FEELING ABNORMAL (Did not feel good. He could not get out of bed until the next day at 3 pm), MYALGIA (Arm was really sore/Sore all over), PYREXIA (Fever), VACCINATION SITE SWELLING (Injection site was swollen), HEADACHE (Headache / Head was pounding and Slight headache), CHILLS (Chills) and FATIGUE (Really tired) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In January 2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported . Patient reported that he still did not feel good. He took Tylenol at about 1 or 2 pm in the morning, it did not do anything for him. On 11-SEPT-2021 is the 1st day he is feeling good since Tuesday night. He could not do anything on Tuesday night, Wednesday or Thursday. He had a slight headache on Thursday. He could not make his doctor appointment the next day because of his side effects, however he has an appointment on Monday 13SEPT2021. He only took it because he travels a lot.


VAERS ID: 1721612 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Oropharyngeal pain, Product administered to patient of inappropriate age, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Medication errors (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: Sore throat; Fever; 17-year-old received the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of OROPHARYNGEAL PAIN (Sore throat), PYREXIA (Fever) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old received the Moderna vaccine) in a 17-year-old male patient 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 first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced OROPHARYNGEAL PAIN (Sore throat), PYREXIA (Fever) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old received the Moderna vaccine). On 07-Sep-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (17-year-old received the Moderna vaccine) had resolved. At the time of the report, OROPHARYNGEAL PAIN (Sore throat) and PYREXIA (Fever) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Follow up received on 10-SEP-2021 and does not contain any new information On 13-Sep-2021: Follow up received on 13-SEP-2021 and does not contain any new information


VAERS ID: 1721795 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-09
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: Body temperature; Result Unstructured Data: fever of 102 Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Fever of 102F after 3rd dose; This spontaneous case was reported by a nurse and describes the occurrence of PYREXIA (Fever of 102F after 3rd dose) 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 09-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 PYREXIA (Fever of 102F after 3rd dose). On 09-Sep-2021, PYREXIA (Fever of 102F after 3rd dose) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 07-Sep-2021, Body temperature: 102 (High) High. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications were provided by the reporter. No treatment medications were provided by the reporter. This case was linked to MOD-2021-319554, MOD-2021-319548 (Patient Link).


VAERS ID: 1721910 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypercholesterolemia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101169616

Write-up: Enlarged lymph node, axillary, ipsilateral to vaccine administration site. 10.5 cm (4.0+ inches). Tender. Mobile.; This is a spontaneous report from a contactable physician. A 53-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 05Sep2021 12:45 (Lot Number: FE3592) as dose number unknown, single (at the age of 53 years old) for COVID-19 immunisation. Medical history included hypercholesterolaemia, no allergies. Concomitant medications were not reported. On 07Sep2021 02:00, the patient experienced enlarged lymph node, axillary, ipsilateral to vaccine administration site. 10.5 cm (4.0+ inches). Tender. Mobile. The outcome of the events was not recovered. No treatment required. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19.; Sender''s Comments: The event lymphadenopathy was considered related to suspect drug based on temporal association and known safety profile of the drug. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate


VAERS ID: 1722245 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DC178 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1722248 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH DC178 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1722250 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 2LC3P / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-


VAERS ID: 1722529 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Confusional state, Cough, Dizziness, Fatigue, Headache, Injection site pain, Lymphadenopathy, Nasal congestion, Oropharyngeal pain, Pain, Pain in extremity, Paranasal sinus discomfort, Rhinorrhoea, Sinus pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily: Lisinopril, Amitriptyline, CoQ10, and Daily Multivitiman. As needed: Sumatriptan & Flonase
Current Illness: None
Preexisting Conditions: High blood pressure (treated) and migraines (treated)
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: I expected some of these side effects for a day or so, but it has been 2 weeks as of yesterday and they are getting worse instead of better. Everything below started with the second dose and has not ended yet. Continued pain in left shoulder (injection site); swollen lymph nodes in both armpits; swollen glands in throat; sore throat; cough; nasal congestion; runny nose; headaches; pain in almost all joints; shooting pains in arms, legs, and abdomen; pain/pressure in sinus cavities; tiredness/fatigue; dizziness; confusion. For reference, I am that person that normally just sucks it up and moves on, which is why I haven''t reported until now. I expected some side effects and I don''t just lay down and give in, but this seems a bit excessive after 2 weeks.


VAERS ID: 1722547 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, C-reactive protein normal, Chest X-ray abnormal, Chest pain, Cough, Dyspnoea, Electrocardiogram abnormal, Fatigue, Full blood count, Influenza virus test negative, Lymphocyte percentage increased, Metabolic function test normal, Monocyte percentage, Neutropenia, Neutrophil percentage decreased, Pain, Pneumonia, Pyrexia, SARS-CoV-2 test, SARS-CoV-2 test negative, Sinus arrhythmia, Sinus bradycardia, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: nkda
Preexisting Conditions: obesity, depression
Allergies:
Diagnostic Lab Data: (9/9/21) COVID/Flu Ag negative (9/14/21) CXR: LLL pneumonia (9/21/21) CXR: LLL pneumonia (9/21/21) EKG: sinus bradycardia and sinus arrhythmia (9/21/21) CBC: neutropenic WBC 3.6 (47% segs, 43% lymph, 7% mono), CMP: normal, CRP 0.8. COVID PCR pending.
CDC Split Type:

Write-up: Exp 11/3/2021 59267-1000-1 Pfizer COVID-19 Vaccine Had first Pfizer COVID vaccine 2 weeks ago (9/7/21). Developed high fevers starting that night and continued for 10 days. Felt dyspnea, chest pain, weak, fatigued, and body aches. Went to ER 2 nights later, tested negative COVID/Flu. 2 days later (9/10/21) started coughing with continued fevers so went to ER 9/14/21 where found to have LLL pneumonia and started on amoxicillin twice a day for 10 days and azithromycin x 5 days. Fever broke 4 days go (9/17/21). Chest pain, fatigue x 1 week, Fever/Cough x 10 day


VAERS ID: 1722614 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 058448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Fatigue, Headache, Influenza like illness, Laboratory test normal, Myalgia, Pain, Vomiting, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: I started having flu likes symptoms, I had a headache, a fever of 101, I started throwing up. As I got better I developed pain in my left chest and upper left abdomen, extreme fatigue, muscle pain, soreness. It got worse after a day or two. It has been the same for the past week and a half. When I started throwing up and having the chest pain I went to the doctor they said it could be myocarditis because of the vaccine. They prescribed ibuprofen and another medication. I took that for a week but the symptoms will not go away. Yesterday I went to the ER and they did tests and an x-ray but they did not find anything out of the ordinary. They prescribed Tylenol for the pain.


VAERS ID: 1722705 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-09-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Bad nose bleed from right side of nose. Reoccured badly 3-4 times within the first time on September 7th. This has continued to be an issue through today''s date, with a moderate nose bleed every other day / daily. No history of recurrent nose bleeds or ever having a nose bleed to this degree.


VAERS ID: 1722719 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-18
Onset:2021-09-07
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Poor quality sleep, Restlessness, Sleep disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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: Extreme fatigue and poor sleep quality. I am not feeling rested even when getting 8 hours of sleep it is not good quality, many disturbances, and not waking feeling restored. Wanting to take naps in the middle of the day and feeling more fatigued in workouts. Nothing has changed about diet or other habits.


VAERS ID: 1722761 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-07-20
Onset:2021-09-07
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Cholecystectomy, Computerised tomogram, Fibrin D dimer increased, Hepatic enzyme increased, Magnetic resonance imaging, Pancreatic enzymes increased, Pancreatitis, Pulmonary embolism, Urine analysis, X-ray
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Gallbladder related disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Oxycodone 10 mg Morphine 20mg Dexalant Maloxicame Cymbalta Gabapentin Prozac Lisinapril
Current Illness: Lower back problems L5-S1 Rynards Prehypertension Reflux
Preexisting Conditions: Severe lower back problems Rynards Prehypertension Reflux
Allergies: None
Diagnostic Lab Data: Blood work Urine analysis Ct MRI xray
CDC Split Type:

Write-up: Pulmonary embolisms Elevated liver enzymes Elevated D-dimer Elavated and inflamed pancreas Gallbladder needed ingredients to be removed


VAERS ID: 1722945 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-18
Onset:2021-09-07
   Days after vaccination:173
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Illness, Influenza, Malaise, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: COVID test and referred for monoclonal antibody treatment.
CDC Split Type: vsafe

Write-up: Patient felt unwell on 09/07/2021; chills, cough, mild flu, illness was persistent and he sought medical treatment on 09/09/2021 and was diagnosed with COVID and referred for monoclonal antibody treatment on 09/12/2021.


VAERS ID: 1723371 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Cold sweat, Discomfort, Dizziness, Electrocardiogram, Heart rate increased, Hyperhidrosis, Musculoskeletal discomfort, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Mild sinus allergy (seasonal)
Preexisting Conditions: Asthma
Allergies: Allergic to Strawberries, dust, possibly wheat
Diagnostic Lab Data: September 8 - went to urgent care with sad symptoms as after taking the vaccine. They did not know what was wrong with me and to rest and take a steam bath. Was advised if still felt same way to go to ER. September 9 - took steam bath as instructed and was unable to breath. went to ER hospital with same symptoms since the day of vaccine,. Was given EKG, chest X-ray, a medication to decrease the inflammation in my chest, heart wall, and back, and was perscribed prednisone
CDC Split Type:

Write-up: Approximately 5 minutes after receiving the dose my heart started pounding hard and fast, I then began to start feeling clammy, sweat at the hands and felt dizzy, and around my left side of mouth to chin felt numb. I advised the pharmacist and he told me to sit down and breath. My heart continued to feel pounding and felt light headed. After monitored for 30 mins I was sent home. At approximately 7:05pm my breast and back began to feel extremely heavy and heart felt discomforting. About 30 minutes after my whole chest was in extreme discomfort, I was beginning to have trouble breathing and taking deep breaths, light headed, and my right leg started twitching and at the same time my face would twitch moving to the left. I was unable to sleep that night due to the chest and back discomfort, and my heart rate dropped to 41. Two weeks after the vaccine I still feel my heart differently, chest still feels discomfort here and there. Those areas do not feel the same. My heart beat is my main concern now cause it has not felt the same.


VAERS ID: 1723617 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 2 AR / SYR

Administered by: Military       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, 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: No Medications
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: No known drug allergies
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Patient was given 2nd Pfizer dose one week too early. Received first dose on 08/24/2021 and second dose on 09/07/2021. No adverse events were reported by the patient.


VAERS ID: 1724101 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Contusion, Erythema, Insomnia, Nausea, Pain in extremity, Peripheral swelling, Skin exfoliation, Skin warm
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, Daysee, multivitamin, calcium, vitamin B12, magnesium, atorvastatin
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: NKA
Diagnostic Lab Data: Went to the ER on 9/7/2021
CDC Split Type:

Write-up: Covid arm-arm was all red, slightly raised, painful, warm to the touch and some bruising that started the following day around 3:30 pm. The area that looked like bruising started to look like a sunburn and is currently peeling. Nausea and insomnia for about a week after


VAERS ID: 1725284 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210941267

Write-up: RASH /RASH SPREAD EVERYWHERE; This spontaneous report received from a patient concerned a 34 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 ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: 21-SEP-2021) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-SEP-2021, the patient experienced rash /rash spread everywhere. Treatment medications (dates unspecified) included: triamcinolone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash /rash spread everywhere. This report was non-serious.


VAERS ID: 1725312 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-06
Onset:2021-09-07
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Diarrhoea, Fatigue, Headache, Influenza like illness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Flu like symptoms; Diarrhea; Headaches; Joint pains; Chills; Fever; Vomiting; Fatigue; This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), HEADACHE (Headaches), ARTHRALGIA (Joint pains), CHILLS (Chills) and PYREXIA (Fever) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 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 INFLUENZA LIKE ILLNESS (Flu like symptoms), HEADACHE (Headaches), ARTHRALGIA (Joint pains), CHILLS (Chills), PYREXIA (Fever), DIARRHOEA (Diarrhea), VOMITING (Vomiting) and FATIGUE (Fatigue). The patient was treated with IBUPROFEN for Fever, at a dose of 1 dosage form. On 10-Sep-2021, PYREXIA (Fever) had resolved. At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms), HEADACHE (Headaches), ARTHRALGIA (Joint pains), CHILLS (Chills), DIARRHOEA (Diarrhea), VOMITING (Vomiting) and FATIGUE (Fatigue) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medications provided. This case was linked to MOD-2021-317521 (Patient Link).


VAERS ID: 1725411 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-11
Onset:2021-09-07
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031620A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ascites, Balance disorder, Blindness, Confusional state, Disorientation, Dizziness, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALBUTEROL [SALBUTAMOL]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Paracentesis (5 liters of fluid was drained by paracentesis on 2sep2012)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: ascites; Gradually lost eyesight; Complete kidney shutdown; Confused; Disoriented; Dizzy; Unabalanced; This spontaneous case was reported by a consumer and describes the occurrence of RENAL IMPAIRMENT (Complete kidney shutdown), BLINDNESS (Gradually lost eyesight), ASCITES (ascites), CONFUSIONAL STATE (Confused), DISORIENTATION (Disoriented), DIZZINESS (Dizzy) and BALANCE DISORDER (Unabalanced) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002FZ1A, 001A21A and 031620A) for COVID-19 vaccination. The patient''s past medical history included Paracentesis (5 liters of fluid was drained by paracentesis on 2sep2012) on 02-Sep-2012. Concomitant products included ALBUTEROL [SALBUTAMOL] for COPD. On 11-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 03-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 CONFUSIONAL STATE (Confused) (seriousness criterion hospitalization), DISORIENTATION (Disoriented) (seriousness criterion hospitalization), DIZZINESS (Dizzy) (seriousness criterion hospitalization) and BALANCE DISORDER (Unabalanced) (seriousness criterion hospitalization). On 08-Sep-2021, the patient experienced RENAL IMPAIRMENT (Complete kidney shutdown) (seriousness criteria hospitalization, disability and medically significant). On 09-Sep-2021, the patient experienced BLINDNESS (Gradually lost eyesight) (seriousness criteria hospitalization, disability and medically significant). On an unknown date, the patient experienced ASCITES (ascites) (seriousness criteria hospitalization and medically significant). The patient was hospitalized on 07-Sep-2021 due to ASCITES, BALANCE DISORDER, BLINDNESS, CONFUSIONAL STATE, DISORIENTATION, DIZZINESS and RENAL IMPAIRMENT. At the time of the report, RENAL IMPAIRMENT (Complete kidney shutdown), BLINDNESS (Gradually lost eyesight), ASCITES (ascites), CONFUSIONAL STATE (Confused), DISORIENTATION (Disoriented), DIZZINESS (Dizzy) and BALANCE DISORDER (Unabalanced) outcome was unknown. No treatment information was provided. This case concerns a 63-year-old, female patient with previous relevant medical history of chronic obstructive pulmonary disease, (COPD) , paracentesis and use of concomitant medication, who experienced the unexpected events of renal impairment, blindness, ascites, confusional state, disorientation, dizziness and balance disorder. The events occurred approximately 10 days after the third dose of mRNA-1273. The rechallenge was positive due the patient developed ascites after the second dose. The medical history of chronic obstructive pulmonary disease, (COPD), paracentesis and use of concomitant medication remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report. This case was linked to MOD-2021-320732, MOD-2021-320769 (Patient Link).; Sender''s Comments: This case concerns a 63-year-old, female patient with previous relevant medical history of chronic obstructive pulmonary disease, (COPD) , paracentesis and use of concomitant medication, who experienced the unexpected events of renal impairment, blindness, ascites, confusional state, disorientation, dizziness and balance disorder. The events occurred approximately 10 days after the third dose of mRNA-1273. The rechallenge was positive due the patient developed ascites after the second dose. The medical history of chronic obstructive pulmonary disease, (COPD), paracentesis and use of concomitant medication remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report.


VAERS ID: 1725482 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac flutter, Hypoaesthesia, Inappropriate schedule of product administration, Palpitations
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy; Sulfonamide allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101176701

Write-up: Heart palpitations, faster and fluttering; Heart palpitations; dose 1 on 01Apr2021/dose 2 on 07Sep2021; left hand felt somewhat numb; This is a spontaneous report from a contactable consumer (patient). A non-pregnant 62-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in left arm on 07Sep2021 at 08:45 am (Lot Number: EW0177, unknown expiration) as dose 2, single at the age of 62 years old for COVID-19 immunisation. Medical history included penicillin allergy and sulfa allergy. The patient''s concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EP6955) on 01Apr2021 at 10:00 am in the left arm at the age of 61 years old for COVID-19 immunization and experienced heart palpitations, faster and fluttering/pounding heart rate (1st vaccine heart related reaction lasted 4 weeks). No history of COVID prior to vaccination and has not been tested for COVID post vaccination. No other vaccine in four weeks. On 07Sep2021 at 17:30, the patient experienced heart palpitations, faster and fluttering after the second vaccine. Events still present this morning. Pounding heart rate is not as bad as first vaccine but concerning. While waiting at the hospital after receiving the vaccine on 07Sep2021, the patient''s left hand felt somewhat numb, but subsided. The patient did not receive treatment for the events. The patient recovered from left hand numb on 07Sep2021, while the patient has not yet recovered from the remaining events. No follow-up attempts are possible; information about batch number was already obtained.


VAERS ID: 1725505 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USPFIZER INC202101179446

Write-up: Redness; Broken out in a rash; A few small hives; Blotches on my left forearm; Experiencing itchy skin around my neck/ itchiness; Pain; Swelling; This is a spontaneous report from a contactable consumer (patient). A 30-years-old female non pregnant patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FC3181), dose 2 via an unspecified route of administration in left arm on 03Sep2021 at 13:30 (Age at vaccination: 30-years-old) as dose 2, single for COVID-19 immunization. The patient had no known allergies. Medical history and concomitant medications were reported. Patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FC3181), via an unspecified route of administration in left arm on 13Aug2021 at 05:45PM (Age at vaccination: 30-years-old) as dose 1, single for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received no other medications within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 07Sep2021 at 09:00 AM, the patient was experiencing itchy skin around her neck, had itchiness, pain, and swelling. On 08Sep2021, she woke to a few small hives and blotches on my left forearm. By 2pm, she had broken out in a rash and by 5pm, her entire upper body was covered in hives and redness. The adverse events result in doctor or other healthcare professional office/clinic visit. Treatment received for the adverse event was Benadryl and Pepcid. The outcome of events was not recovered. Follow-up attempts were completed. No further information was expected.


VAERS ID: 1725515 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:2020-12-19
Onset:2021-09-07
   Days after vaccination:262
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, Illness, SARS-CoV-2 test
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: tested Positive for covid; Test Result: Positive
CDC Split Type: USPFIZER INC202101182753

Write-up: tested positive for covid yesterday; tested positive for covid yesterday; I am so sick; This is a spontaneous report from a contactable consumer (patient) or other non-health care professional. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on 19Dec2020 as dose number unknown, single for covid-19 immunization. The patient medical history and concomitant medications were not reported. On 07Sep2021 yesterday, the patient got that booster out and tested positive for covid and on an unspecified date in 2021 reported that patient was so sick and stated that we were no longer protected. The patient underwent lab tests and procedures which included sars-cov-2 test: positive on 07Sep2021. Outcome of the events were unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1725626 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaccination site pain, Vaccination site pruritus
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: SYNTHROID; VITAMIN D3; SINGULAIR
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101233962

Write-up: Left arm itches right where the injections site is and aches like a tooth ache; Left arm itches right where the injections site is and aches like a tooth ache; This is a spontaneous report from a contactable consumer, the patient. A 48-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3182) via an unspecified route of administration in the left arm on 07Sep2021 at 10:15 (at the age of 48-years-old) as a single dose for COVID-19 immunisation. The patient had no relevant medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included levothyroxine sodium (SYNTHROID), colecalciferol (VITAMIN D3), montelukast sodium (SINGULAIR), unspecified probiotics and cholesterol pill; all for unknown indication from unknown date and unknown if ongoing. On 07Sep2021 at 11:00, the patient''s left arm was itching right where the injections site was and ached like a tooth ache. The events did not result in a visit to the doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events left arm itches right where the injections site is and aches like a tooth ache was not resolved at the time of this report. No follow-up attempts are possible. No further information is expected.


VAERS ID: 1726244 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-02-19
Onset:2021-09-07
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 UN / IM

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

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

Write-up: Diagnosed and hospitalized with COVID while fully vaccinated


VAERS ID: 1726251 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-06-30
Onset:2021-09-07
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / IM

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

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

Write-up: Diagnosed and hospitalized with COVID while fully vaccinated


VAERS ID: 1726317 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-03-10
Onset:2021-09-07
   Days after vaccination:181
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 2 LA / IM

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

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

Write-up: Diagnosed and hospitalized with COVID


VAERS ID: 1726332 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 LA / IM

Administered by: Private       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: Acetaminophen 650 take 2 caps every 8 hours PRN Amlodipine 10 mg take 1 cap daily Aspirin 81 mg take 1 cap daily Docusate Sodium 250 mg @ HS PRN Lisinopril 20 mg take 1 cap daily Lisinopril 20 mg -Hydrochlorothiazide 12.5 mg take 1 cap dail
Current Illness: Osteoarthritis, Tobacco Use, HTN, Constipation
Preexisting Conditions: Osteoarthritis, Tobacco Use, HTN, Constipation
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient was given expired vaccine


VAERS ID: 1726359 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine 10 mg take 1 tab daily Bupropion 300 mg, XR take 1 tab daily Lisinopril 30 mg take 1 tab daily Naltrexone 50 mg take 1 tab daily Vitamin D2 50,000 IU take 1 cap weekly
Current Illness: Generalized Anxiety Disorder, Hyperlipidemia, Alcohol Use Disorder, Vitamin D Deficiency, HTN, Tobacco Use, Prediabetes
Preexisting Conditions: Generalized Anxiety Disorder, Hyperlipidemia, Alcohol Use Disorder, Vitamin D Deficiency, HTN, Tobacco Use, Prediabetes
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient was given expired vaccine


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