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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 251 out of 8,010

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VAERS ID: 1726476 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Michigan  
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 (MODERNA)) / MODERNA 029L20A / 2 UN / UN

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

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

Write-up: Emergency room visit, COVID positive with symptoms. Fully vaccinated March 2021. Received Regeneron antibodies in ED.


VAERS ID: 1726643 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-30
Onset:2021-09-07
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, Fatigue, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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:
CDC Split Type:

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose03/09/2021 2nd dose03/30/2021 Diagnosed covid positive:09/06/21 Symptom onset:09/07/21 Exposure: Symptoms:fatigue,sore throat,diarrhea,runny nose


VAERS ID: 1726677 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-26
Onset:2021-09-07
   Days after vaccination:193
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Exposure to SARS-CoV-2, Fatigue, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/05/21 2nd dose02/26/21 Diagnosed covid positive:09/14/21 Symptom onset:09/07/21 Exposure:travel Symptoms:fever,cough,fatigue,muscle aches,sore throat,chills


VAERS ID: 1726836 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-26
Onset:2021-09-07
   Days after vaccination:134
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose04/06/21 2nd dose04/26/21 Diagnosed covid positive:09/12/21 Symptom onset:09/07/21 Exposure:Travel Symptoms:cough loss of smell/taste


VAERS ID: 1726933 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Pennsylvania  
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 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Contusion, Dyspnoea, Fatigue, Headache, Hypoaesthesia, Injection site pruritus, Injection site swelling, Nausea, Purpura, Pyrexia, Rash, Rash pruritic, Taste disorder, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), 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), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levoxyl prometrium vivelle dot
Current Illness:
Preexisting Conditions:
Allergies: latex prednisone
Diagnostic Lab Data: took benedryl for hives sneezing bed rest sleep
CDC Split Type:

Write-up: hives under left eye arm selling & bruise where injected slight numbness left cheek right after shot sneezed several times about 30 min after headache funny taste in mouth for couple days fever 100 degrees for 2 days nausea itchy rash left hand itchy rash near injection site 2 weeks later large bruises right arm, right knee smaller bruises on arms, legs 2 purpura spots right arm heart fluttering & shortness of breath 1st week fatigue feeling off ~ 7-10 days 1st five days were ? nightmare


VAERS ID: 1727243 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-08-24
Onset:2021-09-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EC3184 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Menstrual disorder
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: Nortrel birth control.
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Missed menstrual cycle after 1st dose of Pfizer vaccine. 1st day of previous menstrual cycle was 8/10/2021, received 1st dose of Pfizer on 8/24/2021 and was supposed to get menstrual cycle on 9/7/2021 and completely missed.


VAERS ID: 1728716 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-08-25
Onset:2021-09-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Chest X-ray, Computerised tomogram thorax, Condition aggravated, Dehydration, Dysphagia, Electrocardiogram, Eyelid ptosis, Immunoglobulin therapy, Laboratory test, Myasthenia gravis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (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), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 12.5 mg per day Hydrochlorothiazide 25mg per day Atorvastatin 20mg per day Aspirin 81mg per day Caltrate 800mg Fish Oil 1000 Miralax Vitamin B12
Current Illness: None
Preexisting Conditions: Myasthenia Gravis Hypertension Hypercholesterolemia Right Kidney resection for benign tumor (renal oncocytoma) Right hip injury--gluteal tendon tear Sleep Apea--on CPAP
Allergies: None
Diagnostic Lab Data: 9/14/2021--EMS transport and ER evaluation (labs, EKG, CXR, Chest CT, IVFs) 9/17/2021--ER evaluation (labs, EKG, CXR, Chest CT, IVFs) 9/30/2021 surgery to repair hip is postponed
CDC Split Type:

Write-up: Myasthenia Exacerbation: Left eyelid droop; Loss of speech; difficulty with swallowing. IVIG infusion 9/13/2021 and 9/15/2021. Episode of syncope due to dehydration on 9/14/2021. ER visit 9/14/2021 and 9/17/2021 for IV hydration. Increased prednisone to 40mg per day. Plan for IVIG in October. Continued difficulty with speech and swallowing as of 9/23/2021.


VAERS ID: 1730458 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-23
Onset:2021-09-07
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3128 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Basedow's disease, Dizziness, Rheumatoid arthritis, Systemic lupus erythematosus, Vertigo
SMQs:, Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Optic nerve disorders (broad), Hyperthyroidism (narrow), Vestibular disorders (narrow), Arthritis (narrow), Immune-mediated/autoimmune disorders (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: VITAMIN D [VITAMIN D NOS]; VITAMIN C [ASCORBIC ACID]; SELINUM COREANUM; ZINC; ALPRAZOLAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy; Graves'' disease; Lupus syndrome; Rheumatoid arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192522

Write-up: RA; Lupus; Graves; vertigo; dizziness; This is a spontaneous report from a contactable consumer (patient). A 43-year-old female non-pregnant patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 23Aug2021 14:30 (Batch/Lot Number: Fc3128) as dose 1, single for covid-19 immunisation. Medical history included Known allergies: Citrate, graves, lupus, RA auto immune. No covid prior vaccination. No covid tested post vaccination. Concomitant medications included vitamin D NOS (VITAMIN D); ascorbic acid (VITAMIN C); selinum coreanum (reported as selinum); zinc; alprazolam (reported as aloprozam). Facility type vaccine: Pharmacy or Drug Store. No other vaccine in four weeks. The patient experienced RA, lupus, graves, vertigo, dizziness, all on 07Sep2021 07:30 with outcome of not recovered. Ae resulted in: Doctor or other healthcare professional office/clinic visit. No treatment received for the events. No follow-up attempts are needed. No further information is expected.


VAERS ID: 1731626 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2020-12-29
Onset:2021-09-07
   Days after vaccination:252
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

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

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

Write-up: COVID 19


VAERS ID: 1731636 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness postural, Headache, Hypoaesthesia, Myalgia, Nausea, Paraesthesia, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: unknown
Preexisting Conditions: none
Allergies: Penicillin
Diagnostic Lab Data: Sed rate-30
CDC Split Type:

Write-up: This is a 33-year-old female who presents with complaints diffuse and not improving headache and myalgias x2 days after receiving Johnson & Johnson Covid vaccine on 9/7/2021. Patient received injection in her left arm and states she has since experienced intermittent paresthesias beginning in her left fingers radiating across her shoulders and into her right upper extremity. She also reports numbness of her bilateral legs when sitting that improves with positional changes as well as intermittent dizziness associated with positional changes, predominantly from sitting to standing. Patient''s headache is diffuse, moderate and characterized as aching in nature which remains unchanged with over-the-counter Tylenol. There is associated nausea without vomiting which the patient is treating with Zofran without relief. She is unable to take over-the-counter ibuprofen due to history of gastric sleeve. There is no associated diarrhea, cough, congestion, fever/chills, shortness of breath or chest pain. Headache not associated with photophobia, diplopia or other visual disturbances. She denies near syncopal or syncopal episodes.


VAERS ID: 1731827 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Burning sensation, Computerised tomogram, Computerised tomogram head, Electric shock sensation, Feeling abnormal, Hypoaesthesia, Limb discomfort, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Codeine; eggs; wheat; milk
Diagnostic Lab Data: CT Scan Brain; CT Scan Lower Back; Bloodwork
CDC Split Type: vsafe

Write-up: It started with a numbness tingling in my left big toe and the pain moved to the rest of my toes in my left foot and then to my whole foot. The pain then moved to my right ankle and the right side of my body. My whole body was burning, it felt like an electrical shock. I went to the ER/Urgent Care where I had a CT of brain/lower back and bloodwork. My whole body just burns and the limbs of my body just feel heavy and dead. Its really miserable.


VAERS ID: 1732054 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Antibody test negative, Herpes zoster, Oral mucosal blistering, Oropharyngeal blistering, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: In medical records
Other Medications: Tramadol, hydroxychloroquine, levothyroxine, B12 inj
Current Illness: None
Preexisting Conditions: Rheumatoid arthritis, rhynod syndrome, anemic, ayaclasia
Allergies: Sulfa, iron, chloraprep, acetaminophen
Diagnostic Lab Data: Dr diagnosed as shingles even though patient has never been exposed to chickenpox and has never had the vaccine. Blood work shows no antibodies for chickenpox tested in June 2021.
CDC Split Type:

Write-up: Severe rash and blisters on roof of mouth and throat.


VAERS ID: 1732124 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-08
Onset:2021-09-07
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Astelin Nasal Spray, Vitamin-D, Restatsis, Flonase, Fluticasone, Mevacor, Singulair, Vigamox, Multi-Vitamin, Prednisolone acetate, chantix
Current Illness: In for H&P for cataract surgery
Preexisting Conditions: high cholesterol, tobacco use
Allergies: Seasonal
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received J&J COVID-19 vaccine on 3/8/21. Pt also received a dose of Pfizer COVID-19 vaccine on 9/7/21.


VAERS ID: 1732322 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-29
Onset:2021-09-07
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor, 5mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None, used cold compress, symptoms started to improved around 10 days later.
CDC Split Type:

Write-up: Left foot second toe became very painful, swollen, red, suspect it was second toe capsulitis. Could not walk or put shoes on. This has never happened to me before, perhaps coincidence but perhaps due to the vaccine.


VAERS ID: 1732800 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 RA / IM

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient Received 2nd dose of Moderna at Day 21. Patient did not experience any problems at of 9/24/2021.


VAERS ID: 1733169 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Joint range of motion decreased, Loss of personal independence in daily activities
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Continued and worsened shoulder pain with limited mobility and limited strength. The pain has gotten worse over the past 2 weeks and is causing an inability to function during my normal daily activities.


VAERS ID: 1733887 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007C21A / 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: Moderna vaccine were inadvertently given past the vaccine beyonduse-date (i.e. past 30 days at fridge temperature) of 9/5/21; This spontaneous case was reported by a pharmacist and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Moderna vaccine were inadvertently given past the vaccine beyonduse-date (i.e. past 30 days at fridge temperature) of 9/5/21) in a 21-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) 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 (Moderna vaccine were inadvertently given past the vaccine beyonduse-date (i.e. past 30 days at fridge temperature) of 9/5/21). On 07-Sep-2021, EXPIRED PRODUCT ADMINISTERED (Moderna vaccine were inadvertently given past the vaccine beyonduse-date (i.e. past 30 days at fridge temperature) of 9/5/21) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided. Treatment information was not provided. This case was linked to MOD-2021-320876 (Patient Link).


VAERS ID: 1734039 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 035C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Dyskinesia, Eye swelling, Feeling abnormal, Headache, Hypoaesthesia, Influenza like illness, Lethargy, Loss of personal independence in daily activities, Muscular weakness, Ocular discomfort, SARS-CoV-2 antibody test, SARS-CoV-2 test, Secretion discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma (Sever e Asthmatic.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210604; Test Name: COVID-19 Antibody test; Test Result: Positive ; Result Unstructured Data: Positive; Comments: tested positive for natural antibodies to COVID-19; Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive; Test Date: 20210422; Test Name: COVID-19 virus test; Test Result: Positive ; Result Unstructured Data: Positive
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Drooping of the left side of my face; numbness on the left side of my face; severe weakness of both of my legs and left arm; brain fog; severe lethargy; heaviness in my left eye; swelling in my left eye; I was in bed Wednesday and Thursday.; flu like symptoms; could not lift my head up; headache; started having a lot of mucus; This spontaneous case was reported by a consumer and describes the occurrence of BELL''S PALSY (Drooping of the left side of my face) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 035C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Asthma (Sever e Asthmatic.). On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 07-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SECRETION DISCHARGE (started having a lot of mucus). On 08-Sep-2021, the patient experienced INFLUENZA LIKE ILLNESS (flu like symptoms), DYSKINESIA (could not lift my head up) and HEADACHE (headache). On 09-Sep-2021, the patient experienced OCULAR DISCOMFORT (heaviness in my left eye), EYE SWELLING (swelling in my left eye) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (I was in bed Wednesday and Thursday.). On 10-Sep-2021, the patient experienced BELL''S PALSY (Drooping of the left side of my face) (seriousness criterion medically significant), HYPOAESTHESIA (numbness on the left side of my face), MUSCULAR WEAKNESS (severe weakness of both of my legs and left arm), FEELING ABNORMAL (brain fog) and LETHARGY (severe lethargy). At the time of the report, BELL''S PALSY (Drooping of the left side of my face), SECRETION DISCHARGE (started having a lot of mucus), INFLUENZA LIKE ILLNESS (flu like symptoms), DYSKINESIA (could not lift my head up), OCULAR DISCOMFORT (heaviness in my left eye), EYE SWELLING (swelling in my left eye), HYPOAESTHESIA (numbness on the left side of my face), MUSCULAR WEAKNESS (severe weakness of both of my legs and left arm), FEELING ABNORMAL (brain fog), LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (I was in bed Wednesday and Thursday.), LETHARGY (severe lethargy) and HEADACHE (headache) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In January 2021, SARS-CoV-2 test: positive (Positive) Positive. On 22-Apr-2021, SARS-CoV-2 test: positive (Positive) Positive. On 04-Jun-2021, SARS-CoV-2 antibody test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant products were not provided. Treatment medication were not reported. This case concerns a 57-year-old male patient with relevant medical history of severe Asthma who experienced the unexpected event of Bell''s palsy. The event occurred 3 days after first dose of mRNA-1273. The rechallenge was not applicable as the patient had the first dose and not eligible for second dose at the time of the report base on dosing schedule. Causality assessment for the event was not provided by the reporter. The event is consistent with the current understanding of the mechanism of action of mRNA-1273. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting and event is a medical important event.; Sender''s Comments: This case concerns a 57-year-old male patient with relevant medical history of severe Asthma who experienced the unexpected event of Bell''s palsy. The event occurred 3 days after first dose of mRNA-1273. The rechallenge was not applicable as the patient had the first dose and not eligible for second dose at the time of the report base on dosing schedule. Causality assessment for the event was not provided by the reporter. The event is consistent with the current understanding of the mechanism of action of mRNA-1273. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event seriousness assessed as per Regulatory Authority reporting and event is a medical important event.


VAERS ID: 1734069 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Bone pain, Nasopharyngitis, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Soreness in her back, legs and feet; Cold symptoms; Bones were hurting; Soreness in her back, legs and feet; This spontaneous case was reported by a consumer and describes the occurrence of BACK PAIN (Soreness in her back, legs and feet), NASOPHARYNGITIS (Cold symptoms), BONE PAIN (Bones were hurting) and PAIN IN EXTREMITY (Soreness in her back, legs and feet) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. Unknown) for COVID-19 vaccination. No Medical History information was reported. On 07-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced BACK PAIN (Soreness in her back, legs and feet), NASOPHARYNGITIS (Cold symptoms), BONE PAIN (Bones were hurting) and PAIN IN EXTREMITY (Soreness in her back, legs and feet). At the time of the report, BACK PAIN (Soreness in her back, legs and feet), NASOPHARYNGITIS (Cold symptoms), BONE PAIN (Bones were hurting) and PAIN IN EXTREMITY (Soreness in her back, legs and feet) outcome was unknown. No concomitants medication were provided. No treatment medication were provided. No lab data has been provided by the reporter. Reporter did not allow further contact


VAERS ID: 1734138 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Poor quality product administered, Product temperature excursion issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101169081

Write-up: product was stored under refrigeration and reached its allowable 31-days in the fridge on 31Aug2021 and remained in the vial under refrigeration until being diluted and given on 07Sep2021; product was stored under refrigeration and reached its allowable 31-days in the fridge on 31Aug2021 and remained in the vial under refrigeration until being diluted and given on 07Sep2021; This is a spontaneous report from a contactable Nurse reported for a patient. A 13-years-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Dose: 0.3 mL, Lot number: EW0178, Expiration date: 30Nov2021) intramuscular, administered in left deltoid on 07Sep2021 (age at vaccination was 13 years) as dose 1, 0.3 ml single for COVID-19 immunization. The patient''s medical history was unknown. The patient''s concomitant medications were not reported. The product was given in one of the satellite offices. The patient did not receive any prior vaccinations within 4 weeks and last vaccines were in 2012. The additional vaccines administered on same date of the Pfizer Suspect included first dose of HPV Vaccine (Lot number: T027789, Expiration date: 27Feb2023, administered in right deltoid), first dose Meningococcal Vaccine (Lot number: AMVA568A, Expiration date: 31May2022, administered in right deltoid) and first dose of Tdap (Lot number: E55XZ, Expiration date: 24Jun2022, administered in left deltoid). The caller reported a possible invalid dose of Comirnaty (Pfizer-BioNTech COVID-19 vaccine) for a patient. The caller reported that the product was stored under refrigeration and reached its allowable 31-days in the fridge on 31Aug2021. The product reached it''s 31 days in the refrigerator on 31Aug2021 and the dose was given that day, 07Sep2021. The product was stored in the vial in the fridge before being diluted and remained in the vial under refrigeration until being diluted and given on 07Sep2021. A dose of Comirnaty given after the beyond use date to a patient. This was the first dose for the patient, he was the only patient involved. The caller asked if the dose should be readministered. The patient did not require a visit to Emergency room or Physician office. It was unknown if any relevant test were done. The case was assessed as non-serious. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1734889 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Burning sensation, Confusional state, Dizziness, Fatigue, Hyperhidrosis, Immediate post-injection reaction, Migraine, Musculoskeletal stiffness, Nausea, Vertigo, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (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: compounded natural thyroid meds
Current Illness: hypothyroid, hashimotos, RA,
Preexisting Conditions: Juvenile Rheumatoid Arthritis, hashimotos
Allergies: sulfa, bactrim, penicillin, mold, fructose
Diagnostic Lab Data: next med appt 9/27/21
CDC Split Type:

Write-up: immediate hot burning up shoulder, neck into head and across forhead into an instant migraine, profuse sweating, sharp stomach pain, nausea, vertigo, fatigue, dizzy, confusion, vision blirry, stiff neck


VAERS ID: 1734968 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-08
Onset:2021-09-07
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Foetal heart rate abnormal, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (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: Pre-natal pills
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was 3 weeks pregnant when I received my first dose of Pfizer vaccine. At my first ultrasound they could not detect a heartbeat and I had a miscarriage. I had undergone alot of testing before I got pregnant and all my tests showed that I was perfectly healthy.


VAERS ID: 1735474 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-31
Onset:2021-09-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash erythematous
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: Stelara
Current Illness: none
Preexisting Conditions: Crohns, ileal carcinoma s/p resection
Allergies: sulfa, infliximab, iron dextran, azathioprine
Diagnostic Lab Data:
CDC Split Type:

Write-up: onset of diffuse erythematous rash day 8 post vaccination that persisted for 2 weeks. Prednisone and benadryl used


VAERS ID: 1735491 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 RA / IM

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

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

Write-up: Site: Pain at Injection Site-Mild, Additional Details: PATIENT CAN''T LIFT UP RIGHT ARM 3 DAYS AFTER HE RECEIVED THE VACCINE. COMPLAINS OF "HEAVY ARM"


VAERS ID: 1735982 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH OFC3184 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Chills, Illness, Migraine, Photophobia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone, thyroxine
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood draw on 9/23/2021 results not in yet. returened to doctor on 09/24/2021. unknown if permanent nerve damage is present , too soon to tell.
CDC Split Type:

Write-up: Fever for 11 straight days reaching 104.3 and averaging 103.7, Severe chills for same duration, migraines, sensitivity to light and day 14 developed Bells Palsy induced by the vaccine. I have not been sick at all for 18 months and was deathly ill within 24 hours after the shot!Blood draw on 09/23/2021 and bells Palsy symptom''s started same day, returned to doctor on 09/24/2021 with confirmation of bells palsy.


VAERS ID: 1737118 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Diarrhoea, Fatigue, Gastrointestinal pain, Headache, Photosensitivity reaction
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (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: 1st vaccine slight/1day. 2nd vaccine more/3days.
Other Medications: iest; Voltaren; hydrochlorothiazide; hydroxychloroquine; Lidoderm; losartan; metformin; prednisone; progesterone; testosterone; tramadol; turmeric; omega-3; Claritin; calcium; vit 3; flaxseed; glucosamine; probiotic
Current Illness:
Preexisting Conditions: Lupus arthritis
Allergies: Sulphate; zolpidem; fluoxetine; cyclobenzaprine; Sam-E; cat dander; wheat; horse flies; dairy; dust mites; mosquitoes; pollen;
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache; joint aches; fatigue; intestinal cramps; diarrhea; photosensitivity.


VAERS ID: 1737334 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-08-25
Onset:2021-09-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Blood creatinine increased, Blood potassium increased, Blood urea increased, Extra dose administered, Haemodialysis, Immunoglobulin therapy, Myocarditis, Myositis, Pericarditis, Rhabdomyolysis, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Retroperitoneal fibrosis (broad), Cardiomyopathy (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Medication errors (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? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, biotin, finasteride, fish oil, propranolol, sumatriptan, oxycodone, ipilimumab, nivolumab
Current Illness: none reported
Preexisting Conditions: hyperlipidemia, hypertension, migraine headaches, renal cell carcinoma, lung metastases, unilateral nephrectomy, renal calculus, colon polyps, diverticulitis
Allergies: none reported
Diagnostic Lab Data: Initial creatinine: 6.36 mg/dL, BUN: 121 mg/dL, potassium 6.2 mmol/L, CK: 17,662 U/L; SARS-CoV-2: negative
CDC Split Type:

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: patient hospitalized for rhabdomyolysis, myositis, and myocarditis/pericarditis after starting checkpoint inhibitors while taking atorvastatin and recently received third dose of COVID-19 vaccination. Event attributed to checkpoint inhibitors. Patient received hemodialysis, steroids, and IVIG and improved. Discharged to home medically stable.


VAERS ID: 1737434 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC318L / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Ear pain, Fatigue, Feeling abnormal, Herpes zoster, Pyrexia, Rash, Semen discolouration, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Fertility disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Amoxicillin
Diagnostic Lab Data: 9/21 - Urgent Care
CDC Split Type:

Write-up: Day 1 - 4:100-102.4 degree fever; Day 5 -10: Exaustion feeling, not feeling like self, back pain and felt like other systems were effected (possibly liver and kidneys); Day 6 - 7 - semen had very dark color, not normal; Day 11 - ear ache started; Day 13 - ear ache, face rash; Day 15 - went to doctor and said the vaccine caused shingles outbreak; Day 16 - brownish specks in semen, semen dark colored and not normal; Day 21 - still dealing with shingles outbreak and severe ear pain


VAERS ID: 1737572 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-25
Onset:2021-09-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Appendicitis, C-reactive protein increased, Chest pain, Diarrhoea, Dyspnoea, Hypotension, Portogram, Rash, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity, otherwise none
Allergies: NKDA
Diagnostic Lab Data: Troponin 0.35 (downtrended) CRP 179 ESR 34
CDC Split Type:

Write-up: Patient presented to us with 3 day history of worsening chest pain, SOB, slight rash on hands/chest/legs, and abdominal pain and diarrhea. Was found to have elevated troponins to 0.35 and a/ which showed appendicitis. Patient was found to be hypotensive and did require a brief period of Norepinephrine, but quickly was able to de-escalate off vasoactive support. He was discharged home.


VAERS ID: 1737651 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Chills, Headache, Hypoaesthesia, Lymphadenopathy, Nausea, Paraesthesia, Pyrexia, Skin swelling, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 325 mg Bayer aspirin due to recent MCL knee surgery; glucosomine/chondroitin, Caltrate, Vitafusion Multivitamin/gummy
Current Illness: None; knee surgery on torn MCL was 8/16/21
Preexisting Conditions: none
Allergies: Keflex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe allergic reaction resulting in very large welt approximately 3 inches in size and swollen for a week. Arm pit lymph nodes were swollen and very painful as well. I contacted my physician and they recommended Benadryl OTC. I also had severe headache, chills, nausea, fever, tingling down left arm and numb hand. Residual pain in armpit lymph nodes lasted over a week and I still have sensitivity and sore to the touch on 9/27/21, almost 3 weeks later.


VAERS ID: 1739962 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-07
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Lymph node pain, Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Dementia (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: USJNJFOC20210949854

Write-up: PAINFUL LYMPH NODE IN THE ARM WHERE VACCINE SHOT WAS GIVEN; FEELING BAD; RASH ON ARM; SWOLLEN LYMPH NODE IN THE ARM WHERE VACCINE SHOT WAS GIVEN; CHILLS; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. 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: Unknown) dose was not reported, administered on 07-SEP-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 07-SEP-2021, the patient experienced chills. On 07-SEP-2021, the patient experienced headache. On 08-SEP-2021, the patient experienced painful lymph node in the arm where vaccine shot was given. On 08-SEP-2021, the patient experienced feeling bad. On 08-SEP-2021, the patient experienced rash on arm. On 08-SEP-2021, the patient experienced swollen lymph node in the arm where vaccine shot was given. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills, headache, swollen lymph node in the arm where vaccine shot was given, rash on arm, painful lymph node in the arm where vaccine shot was given and feeling bad was not reported. This report was non-serious.


VAERS ID: 1740022 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04AF21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Breast pain, Chills, Feeling abnormal, Illness, Lymphadenopathy, Migraine, Neck pain, Pain, Pain in extremity, Vaccination site rash
SMQs:, Dementia (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: migraine; injection site big red dot or rash; had a chill; swollen lymph nodes; pain in her left breast; pain in her neck on the left; she did not feel good; felt like she was getting sick; pain under her left arm/pain in her left leg; pain in her arm/pain in her left arm; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (pain in her arm/pain in her left arm), BREAST PAIN (pain in her left breast), NECK PAIN (pain in her neck on the left), FEELING ABNORMAL (she did not feel good) and ILLNESS (felt like she was getting sick) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 04AF21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 07-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, the patient experienced PAIN IN EXTREMITY (pain in her arm/pain in her left arm). On 13-Sep-2021, the patient experienced BREAST PAIN (pain in her left breast), NECK PAIN (pain in her neck on the left), FEELING ABNORMAL (she did not feel good), ILLNESS (felt like she was getting sick), PAIN (pain under her left arm/pain in her left leg ), CHILLS (had a chill) and LYMPHADENOPATHY (swollen lymph nodes). On 16-Sep-2021, the patient experienced VACCINATION SITE RASH (injection site big red dot or rash). On an unknown date, the patient experienced MIGRAINE (migraine). At the time of the report, PAIN IN EXTREMITY (pain in her arm/pain in her left arm) had resolved and BREAST PAIN (pain in her left breast), NECK PAIN (pain in her neck on the left), FEELING ABNORMAL (she did not feel good), ILLNESS (felt like she was getting sick), PAIN (pain under her left arm/pain in her left leg ), MIGRAINE (migraine), CHILLS (had a chill), LYMPHADENOPATHY (swollen lymph nodes) and VACCINATION SITE RASH (injection site big red dot or rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. No treatment information was provided. Patient had pain in her arm, which lasted for 3 days. Most recent FOLLOW-UP information incorporated above includes: On 16-Sep-2021: Newevent Injection site big red dot or rash was added.


VAERS ID: 1740843 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-01 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81 mg Daily Supplement
Current Illness: Ear Infection
Preexisting Conditions: None
Allergies: Seasonal Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Twitching under right eye, Benadryl.


VAERS ID: 1741348 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER FC3184 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (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: Vitamin D Antibiotic
Current Illness: No
Preexisting Conditions: No
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness in left side of face, arm and entire left leg.


VAERS ID: 1741356 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 091D21A / 3 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rovestatin and vitamins
Current Illness:
Preexisting Conditions:
Allergies: Malarone
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: redness, pain and warmth on left arm, pain and swelling of left hand


VAERS ID: 1741625 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-26
Onset:2021-09-07
   Days after vaccination:165
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Lethargy, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: I tested positive for Covid-19 on 09/09/2021.
CDC Split Type: vsafe

Write-up: Breakthrough case: On 09/07/2021, I developed these symptoms; congestion in the head, fever, coughing, and I was lethargic. One day I felt good and the next day I would feel wiped out.


VAERS ID: 1741647 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Immunisation, Syringe issue, Underdose
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NO
Preexisting Conditions: MIGRAINES, HYPERTENSION, MORBID OBESITY, HYPERLIPIDEMIA, ANXIETY & DEPRESSION
Allergies: ALLERGIES TO PENICILLIN G, HYDROCODONE-ACETAMINOPHEN
Diagnostic Lab Data:
CDC Split Type:

Write-up: While administering the vaccine, the Medical Assistant states she did not fully clear the syringe when she pulled the needle back out of the patient, resulting in the vaccine to spill/spray out. Based on the event, it was discussed with Provider and Pharmacist and it was recommended to revaccinate the patient in one week to assure she receives the full dose for her 1st dose of Moderna vaccine. Vaccination from 9/7/2021 was determined to be invalid and removed from WIR. Patient returned to clinic on 9/14/2021 to receive the revaccination of her 1st dose. Patient is scheduled for her 2nd dose of Moderna on 10/12/2021.


VAERS ID: 1741710 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-11
Onset:2021-09-07
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Gait disturbance, Pain in extremity, Peripheral swelling, Skin reaction, Skin warm, Tenderness, Thrombosis, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu vaccine in multidose vial caused anaphylaxis
Other Medications: aspirin 325 mg one tablet per day
Current Illness: none
Preexisting Conditions: none
Allergies: old-fashioned iodine contrast dye; flu vaccine in multi-dose vials--both caused anaphylactic reaction. Has sunsequently had preservative-free flu vaccine each year with no problems.
Diagnostic Lab Data: ultrasound 9/7/2021
CDC Split Type:

Write-up: Received vaccine on 8/11/2021. While in location for work, he experienced severe left leg pain and marked swelling on 9/7/2021. He went to the emergency department and saw a physician assistant whose name he does not recall. He had a blot clot diagnosed by ultrasound. The PA told him "it''s not a DVT but the clot is deeper than a superficial thrombophlebitis." The area was markedly swollen, very tender, red and warm to the touch, and caused difficulty with walking. 4 days later it has substantially improved and is almost completely resolved at this point; swelling is gone, no redness, just tender.


VAERS ID: 1741743 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-09-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Stabbing pain in my chest where my heart is. Pulsed with my heartbeat. Very intermittent.


VAERS ID: 1741802 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 211A21A / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Headache, Pain, Respiratory rate increased, Symptom recurrence
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500 mg PO BID, Atorvastatin 5 mg PO at bedtime, cortisone topical cream.
Current Illness: N/A
Preexisting Conditions: Diabetes, Psoriasis
Allergies: Seasonal Allergies in spring to pollen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: One hour after receiving 1st pfizer dose patient started to experience trouble swallowing. Headache then body aches followed shortly after. For about 4 hours client experienced increased breathing then went to bed. Duration of 48 hours for difficulty swallowing, headache, and body aches and they all self resolved (no medications taken). Client did not follow up with primary care physician. Client then experienced throat symptoms of difficulty swallowing after having 1 beer at family party 4 days after pfizer 1st dose vaccination date. Symptoms lasted for about 3 hours and then the client went to bed. The next morning symptoms self resolved. Medical consult was elevated through health care coordinators. Janssen as second dose was recommended by MD.


VAERS ID: 1742389 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Injection site erythema, Injection site reaction, Lethargy, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, multivitamin, magnesium, vitamin D
Current Illness:
Preexisting Conditions: Epilepsy
Allergies: Penicillin, Zithromax, tetracycline
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bad headache for 24 hours, lethargic for 3 days, red welt at injection site for 2 weeks, continuing dizziness off and on


VAERS ID: 1743007 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Cold sweat, Diarrhoea, Dyspnoea, Feeling abnormal, Headache, Muscle spasms, Myalgia, Nausea, Pain, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), 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? 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: I went to urgent care and the doctor put me on Tylenol 500mg and ibuprofen 600mg, yo be taken together 3 times a day with meals, she send me home and said that I would have to go to my primary physician to treat each symptom individually.
CDC Split Type:

Write-up: That evening I started feeling aches, fell asleep, woke up in pain, through out the day fever spiked, also had cold sweat, chills, headache, diarrhea, nausea, muscle and joint pain, brain fog, muscle spasms. I felt those symptoms for 3 days, on friday I was able to get up, the majority of the symptoms went away, I still have headaches, muscle and joint pain, shortness of breath, and muscle spasms.


VAERS ID: 1743683 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose, Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: INSULIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Type 1 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: blood sugars; Result Unstructured Data: Test Result:continually high
CDC Split Type: USPFIZER INC202101197455

Write-up: struggling to keep his blood sugar in check/blood sugars have been continually high; This is a spontaneous report from a contactable consumer (patient). A 28-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number FC3184), via an unspecified route of administration, administered in arm left on 07Sep2021 08:30 as dose 1, single for covid-19 immunisation. Medical history included type 1 diabetes. Concomitant medication included insulin taken for type 1 diabetes, start and stop date were not reported. The patient did not receive other vaccines in four weeks. It was unknown if the patient had covid-19 prior to the vaccination. The patient informed that he was a type 1 diabetic and; he has been struggling to keep his blood sugar in check on 07Sep2021 since receiving the vaccine. His blood sugars have been continually high for no apparent reason since 07Sep2021, and his insulin dosage has increased immensely to compensate the high glucose levels (also reported as no treatment received). The patient had not recovered from the adverse event at the time of the report. The patient had not been tested for covid-19 post vaccination. Follow-up (17Sep2021): Follow-up attempts are completed. No further information is expected.


VAERS ID: 1743741 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye inflammation, Eye swelling, Hordeolum, Ophthalmological examination
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210809; Test Name: Eye exam; Result Unstructured Data: Test Result:Eye stye; Comments: Floaters-eye stye
CDC Split Type: USPFIZER INC202101218521

Write-up: eye styes; eye inflammation; swelling of eye; This is a spontaneous report from a contactable pharmacist (patient). A 59-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm right on 06Sep2021 15:15 (Lot Number: FC3182) as dose 2, single at the age of 59-years-old for covid-19 immunization. The patient medical history was not reported. There were no concomitant medications. No prior other vaccinations (within 4 weeks). No family medical history relevant to the events. The patient previously took first dose of bnt162b2 (Lot Number: FA7485, Expiration Date: 30Oct2021) in right arm on 06Aug2021 05:00 PM and experienced rapid heart rate (heart rate went up to 140) on 07Aug2021 with outcome of not recovered. The patient experienced eye styes, eye inflammation, swelling of eye, all on 07Sep2021 07:00 with outcome of not recovered. Seriousness criteria for all events was disability, medically significant. AE required visit to: physician office. Relevant tests: Eye exam on 09Aug2021: Eye sty (Floaters-Eye sty).


VAERS ID: 1744141 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Palpitations, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Systemic: palpitations-Severe, Systemic: Tachycardia-Severe, Additional Details: patient came in seeking 2nd vaccine on 9/28/21. Discussed with patients of risk and advised patient to see doctor prior to recieving 2nd shot


VAERS ID: 1744527 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-17
Onset:2021-09-07
   Days after vaccination:52
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Anoro Slipta, Dorzolamide-Timolol, Eliquis, Lantanoprost,
Current Illness: Unknown
Preexisting Conditions: HTN, Hyperlipidemia, COPD, Sleep apnea, Thyroid disease, Macular degeneration
Allergies: PCN
Diagnostic Lab Data: Not yet repeated
CDC Split Type:

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


VAERS ID: 1744966 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-29
Onset:2021-09-07
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Ageusia, Alanine aminotransferase increased, Anion gap, Anosmia, Aspartate aminotransferase normal, Basophil percentage decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood lactic acid, Blood potassium normal, Blood sodium normal, Blood urea decreased, Brain natriuretic peptide normal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Carbon dioxide normal, Cough, Diarrhoea, Dyspnoea, Eosinophil percentage decreased, Fibrin D dimer, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, Hypoxia, Immature granulocyte count, International normalised ratio normal, Lipase normal, Lymphocyte percentage decreased, Mean cell volume normal, Monocyte percentage, Neutrophil count, Oxygen saturation decreased, Platelet count normal, Prothrombin time prolonged, Pyrexia, Red blood cell count increased, Red blood cell nucleated morphology, Red cell distribution width normal, SARS-CoV-2 test positive, Troponin I normal, White blood cell count normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None
Preexisting Conditions: None
Allergies: Ampicillin
Diagnostic Lab Data: Results for patient as of 9/29/2021 09:20 9/7/2021 20:37 NA: 138 K: 3.5 CL: 101 CO2: 26 BUN: 8 CREAT: 0.72 ANION GAP4 SERPL: 11 GLUC: 95 TROPONIN I: <0.02 BNP: 25 ALT: 41 AST: 25 ALKP: 64 LIPASE: 17 TBILI: 0.6 GFR-AFRAM: $g60 GFR NONAFR AMER: $g60 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE CRP, SER QL: 6.2 (H) LACTATE: 1.0 WBC: 9.2 RBC''S: 5.08 HGB: 15.6 HCT: 45.2 MCV: 89 RDW, RBC: 12.0 PLT: 233 IMMAT GRANULO % AUTO: 0 NRBC: 0 NEUTROPHILS % AUTO: 78 (H) ANC: 7.2 LYMPHS % AUTO: 16 MONOS % AUTO: 6 EOS % AUTO: 0 BASO''S % AUTO: 0 PT: 13.7 INR: 1.1 D-DIMER: 0.43
CDC Split Type:

Write-up: Reason for Hospital Admission (Admitting Diagnosis): SOB/Hypoxia/COVID 29 y.o male with no PMHx here with COVID. See admission H&P for details of his presentation. History: 29 y.o male with no PMHx who presented to ER with worsening cough, decreasing O2 saturation at home, fevers. Patient reports that he developed dry cough in the evening of 8/31/2021. He got tested for COVID at work on 9/1/2021 and the test came back positive. He has been isolating himself since then at home. He reports that his cough got worse during the last week and Mucinex, Tessalon Perles and Robitussin have not been helping much. He reports SOB only when he is having a coughing fit. Otherwise, denies SOB with ambulation. No CP. He was measuring his O2 saturation at home which was around 95% for most of the days but today came back 90-93% on one time check (unclear if patient was coughing at the time). He also reports fevers up to 101 that started about couple of days ago. Last time took Tylenol 500 mg at about 2 PM today. Patient denies any N/V. He did loose the sense of smell and taste but his appetite has been relatively OK. He reports some loose stools but no actual diarrhea. No abdominal pain. He was asked to do 10 squats in the ER room after which he felt very SOB. Per patient, has done squats in the past and never felt that SOB when doing them prior to COVID diagnosis. Per RN documentation, "pt not able to tolerate doing 10 squats in room. Pt desated to 86%RA, RR 42 and HR 137". Patient lives with his parents and sister who all have been OK and all tested negative for COVID recently. They have all been vaccinated. Patient works in School - possibly got sick from one of the kids. COVID Pneumonia, Acute hypoxemic Respiratory failure - Symptom onset on 8/31/21. COVID positive on 9/1/21. Last fever on 9/7. - Was on nasal Cannula at 2 Lpm. Still borderline hypoxic with activity but sats fine ($g93%) on room air at rest. Feels ok to go home today. - Got Decadron and Remdesivir on 9/8 and 9/9. - Supportive cough medication as needed. - Close outpatient follow up.


VAERS ID: 1745049 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Lymphadenopathy, Oedema, Palpitations
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: levothyroxine
Current Illness: none, very healthy
Preexisting Conditions: hypothyroidism
Allergies: none
Diagnostic Lab Data: no testing, office visit to primary MD on 09/15/21 for medication
CDC Split Type:

Write-up: post vaccine day 4 developed facial shingles left bridge of nose, day 12 developed sudden onset of left parotid gland edema and left neck lymphadenopathy, days 3-26 intermittent palpitations


VAERS ID: 1745297 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-07-30
Onset:2021-09-07
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH I DON''T HAVE / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anti-platelet factor 4 antibody negative, Hyphaema, Immune thrombocytopenia, Immunoglobulin therapy, Platelet count decreased, Platelet transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: End stage renal disease on dialysis hyperlipidemia valvular heart disease diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt presented with hyphema and platelet count of 2K on 9/7/21. He received pfizer Covid vaccine on 7/30/21 and 8/20/21. Platelet count was normal (208K) on 8/31/2021. PF4 was negative. No thrombosis. Pt was felt to have ITP, and was treated with platelet transfusion, steroids, and IVIG. Platelet count on 9/27 was 133K


VAERS ID: 1745543 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-09-07
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 1805018 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, 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? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for COVID 8/29/21. ED visit and hospital admission 9/7/21 for COVID pneumonia.


VAERS ID: 1747507 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Rash with intense itching for 21 days, general malaise and achyness for 10 days after shot. This rash appeared in small red dots about 1/8th inch in diameter, showing in circles about an inch in diameter. Extreme itch and soreness underneath the rash for sever days after which the rash would fade. The worst on was under my left arm, went on for 5 days.


VAERS ID: 1747810 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-11
Onset:2021-09-07
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Illness, Migraine, Myalgia, Pain of skin, Pruritus, Pyrexia, Rash, Skin irritation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Raised dry lumps on scalp after second shot; Itchy scalp constantly after second shot; Pain in scalp constantly after second shot; Rash spots on the scalp spread more after second shot; Fever $g101.2F after second shot; Chills after second shot; Aches entire body after second shot; Very ill after second shot; Migraine headache after second shot; This spontaneous case was reported by a consumer and describes the occurrence of ILLNESS (Very ill after second shot), MIGRAINE (Migraine headache after second shot), SKIN IRRITATION (Raised dry lumps on scalp after second shot), PRURITUS (Itchy scalp constantly after second shot) and PAIN OF SKIN (Pain in scalp constantly after second shot) in a 50-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 035C21A and 006D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 11-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 2 dosage form. On 07-Sep-2021, the patient experienced ILLNESS (Very ill after second shot), MIGRAINE (Migraine headache after second shot), PYREXIA (Fever $g101.2F after second shot) and CHILLS (Chills after second shot). 07-Sep-2021, the patient experienced MYALGIA (Aches entire body after second shot). On 08-Sep-2021, the patient experienced SKIN IRRITATION (Raised dry lumps on scalp after second shot), PRURITUS (Itchy scalp constantly after second shot), PAIN OF SKIN (Pain in scalp constantly after second shot) and RASH (Rash spots on the scalp spread more after second shot). On 09-Sep-2021, ILLNESS (Very ill after second shot), PYREXIA (Fever $g101.2F after second shot), CHILLS (Chills after second shot) and MYALGIA (Aches entire body after second shot) had resolved. On 14-Sep-2021, MIGRAINE (Migraine headache after second shot) had resolved. At the time of the report, SKIN IRRITATION (Raised dry lumps on scalp after second shot), PRURITUS (Itchy scalp constantly after second shot) and RASH (Rash spots on the scalp spread more after second shot) outcome was unknown and PAIN OF SKIN (Pain in scalp constantly after second shot) had resolved. No concomitant medications were reported. No treatment medications were reported. This case was linked to MOD-2021-326169 (Patient Link).


VAERS ID: 1748008 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Body temperature, Chills, Headache, Hyperhidrosis, Insomnia, Myalgia, Nasal congestion, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bad dreams; COVID-19 (him and his wife were diagnosed with Covid and were quarantined for 10 days)
Allergies:
Diagnostic Lab Data: Test Date: 20210907; Test Name: Fever; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC202101212266

Write-up: Headache; major backpains like all my muscles still hurt at my back; my muscles at my back are still killing me; can not sleep; sore arm; muscle ache; congestion; Caller states they still have aches and pains/major body aches like we have gotten beat up; achy and sore; fever; shivers/chills; soaked in sweat; This is a spontaneous report from a contactable consumer (patient) reporting the same events under the same suspect product for 2 patients. This is the one of two reports. A 51-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: FE3592), via an unspecified route of administration, administered in arm right on 06Sep2021 (at the age of 51-years-old) as dose 1, single for COVID-19 immunisation. Medical history included COVID-19 (Caller states him and his wife were diagnosed with Covid and were quarantined for 10 days) from 28Aug2021 to 28Aug2021 and bad dreams from an unknown date. The patient''s concomitant medications were not reported. The patient experienced congestion (nasal congestion), headache, major backpains like all his muscles still hurt at his back; his muscles at his back are still killing him, cannot sleep, sore arm and muscle ache on an unspecified date; aches and pains/major body aches like they have gotten beat up; achy and sore, fever, shivers/chills and soaked in sweat on 07Sep2021 at 01:30. The clinical course was as follows: Him and his wife were diagnosed with Covid and were quarantined for 10 days, which they did. On the 10th day, they called the nurse and the pharmacy and they both agreed they could receive the vaccine. He was feeling good the day he received the vaccine but the next morning after receiving the vaccine him and his wife had fever, chills, and shivers that lasted about a day and a half. They felt good on the day they received it but then woke up at 10:30 the next day with the whole 9 yards. Caller states they still have aches and pains. Caller states that when they went to the hospital the doctor asked why they received the vaccine, that they were supposed to wait 90 days after having Covid, but they are supposed to come back in 3 weeks for their second dose, and asks do they wait 90 days for the second dose? Adverse events: Consumer stated "I started feeling the side effect when they gave me the injection on labor day, I was great that day, my wife was there with me, we both got it, we were both quarantine, then 6 of this was our last day of quarantine so we called the hospital back and said when can we receive our vaccine, well the lady we called says you are good you can come get it now, we got to the pharmacy the pharmacy checked our paper work, they said you are good, you can get it today if you say you are done, the doctor then gave it to us and said yeah you are good, so we went ahead and got it, that night about 1:30 in the morning we both woke up soaked in sweat, shivering, the chills, fever, major body aches like we have gotten beat up real achy and sore and we were feeling like that the day on Monday that we got it till that night so it happens pretty quick." Other medical conditions: Consumer stated, "No, sir that is the only thing I have right now is chills, the headache, the major backpains like all my muscles still hurt at my back, the sore arm which lasted like 3 days but all my muscles at my back are still killing me and my headache is not going away, they go away for a while and they come back." Other medications: Consumer stated "No, just the (incomplete sentence), I stopped taking the Ibuprofen (hence captured as suspect product) they prescribed me because it was giving me bad dreams, so I stopped taking that, I am just taking Tylenol (treatment) and a decongestive syrup (further clarification unknown) for the congestion." When probed if still experiencing all adverse events: Consumer stated, "Yes." Outcome of event: Consumer stated, "Pretty much persisting, they are same, they have just been steady, I get up in the morning, work back, I try to sleep, I cannot sleep long cause my back hurting my muscles and my back are hurting really bad, then the headache sometimes, it just hurts my head on the pillow, so it is a really bad headache." Treatment (other than Tylenol) for adverse events: Consumer stated, "No, nothing else just that, the syrup for the congestion and the Tylenol that is it." Date of second dose of vaccine: Consumer stated, "Well they said in three weeks, which would be on 27th, I have not received it yet but my concern is because when we got it on the 6th my wife went back to the doctor she was experiencing the same exact thing I am experiencing, so she went on Tuesday and they said no you are supposed to wait 90 days until you are better, all this nursling telephone, the health center and the doctor told us we were good, so we did it and when we found out we were supposed to wait 90 days so we are curious we can get the second dose on the 27th or we wait and our doctor told us to contact you all directly to contact you cause even she did not have an answer". The patient underwent lab tests and procedures which included body temperature: unknown results on 07Sep2021. Therapeutic measures were taken as a result of congestion, headache and muscle ache. The outcome of the events was unknown. No follow-up attempts are completed. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-202101214581 Same reporter, drug, event and different patient


VAERS ID: 1748019 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301208A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: SARS-CoV-2 test, Scleritis
SMQs:, Scleral disorders (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210909; Test Name: PCR via Nasal swab; Test Result: Negative
CDC Split Type: USPFIZER INC202101218127

Write-up: Scleritis; This is a spontaneous report from a contactable other healthcare professional (patient). A 45-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: 301208A), via an unspecified route of administration, administered in left arm on 03Sep2021 15:30 (at the age of 45 years old) as dose 1, single for COVID-19 immunisation. The patient has no medical history and has no known allergies. The patient is not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. There were no concomitant medications. No other vaccine was given in four weeks and no other medications in two weeks. On 07Sep2021 21:45, the patient developed scleritis in her right eye. The event resulted in Doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of scleritis which included Steroid eye drops every 2 hours x 14 days. The patient underwent lab tests and procedures which included COVID test post vaccination: PCR via nasal swab on 09Sep2021 which was negative. The outcome of the event was recovering.; Sender''s Comments: Based on the information available and a close temporal association a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported event Scleritis. 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: 1749348 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cognitive disorder, Feeding disorder, Feeling abnormal, Gait disturbance, Head discomfort, Headache, Hypoaesthesia, Impaired work ability, Mobility decreased, Muscular weakness, Paraesthesia, Photophobia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: velafaxene xr 150 restoril 30 mg hs
Current Illness: none
Preexisting Conditions: none
Allergies: levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache chills fever 103 photophobia inabililty to walk for 8 hours due to severe weakness in legs. No ability to eat of drink x 12 hours . Unable to move out of fetal position x 8 hours . Severe numbness and tingling x 4 hours. Severe headache and photophobia contd x 72 hours . Cognition was limited x 72 hours. Unable to work x 5 days. Severe headache and brain fog contd x 2 weeks . Intermittent headaches still continued at this time.Ny head feels at times still like it is being hit with a ping pong paddle across the room .


VAERS ID: 1749799 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Exercise tolerance decreased, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: mild asthma
Allergies: none
Diagnostic Lab Data: Two ER visits (one on 9/9 and one on 9/19) - they did blood work, chest xrays, and electrocardiograms I now see a cardiologist. I just had an echocardiogram done.
CDC Split Type:

Write-up: Shortness of breath and chest pain began three days after receiving the first Moderna shot. Symptoms have worsened in the 3 weeks that followed. Heart palpitations and exercise intolerance made things worse. All symptoms are still present over 3 weeks later.


VAERS ID: 1749818 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xulane patch, Claritin 10mg tablet daily
Current Illness: None
Preexisting Conditions: Acne, s/p prophylactic salpingo-oophorectomy
Allergies: None
Diagnostic Lab Data: COVID-19 PCR test was positive on 9/7/21 and 9/10/21
CDC Split Type:

Write-up: I was contacted by VSAFE and told to file a VAERS report due to being diagnosed with COVID-19 on 9/7/21.


VAERS ID: 1749914 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Colitis ulcerative, Condition aggravated, Defaecation urgency, Diarrhoea, Fatigue
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal ulceration (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tacrolimus Cellcept Magnesium (MgPlus-133mg) Entyvio Ursodiol Men?s Multivitamin Cymbalta
Current Illness: None
Preexisting Conditions: Ulcerative Colitis Liver Transplant Recipient (09-2018)
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ulcerative Colitis flare up - severe stomach pain, diarrhea, urgency, fatigue, stomach cramps


VAERS ID: 1749970 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-09-07
   Days after vaccination:166
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Headache, Myalgia, Nasal congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: humira 40 mg/0.4 ml
Current Illness: none
Preexisting Conditions: Crohn
Allergies: aspirin, nitrofurantoin
Diagnostic Lab Data: sars-cov-2 rna, naat - positive on 9/9/2021
CDC Split Type:

Write-up: covid positive on 9/9/2121, had symptoms of myalgia, headache and nasal congestion


VAERS ID: 1750094 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Heart palpitations while sitting at desk lasting about 3 minutes one hour post vaccination Sharp, stabbing pain in chest about 5 days, 13 days and 19 days post vaccination. These all lasted less than one minute.


VAERS ID: 1750248 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Patient came to pharmacy on 09/30/21 and stated that since she had her second dose of the vaccine she has been experiencing pain at the injection site that radiates up her shoulder. It is not relieved by OTC pain medications and the pain occurs at rest as well. Patient was informed that she needs to contact her doctor and if she does not have one, she needs to see a doctor to be evaluated. She was also given a pamphlet on V-SAFE.


VAERS ID: 1750265 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-03
Onset:2021-09-07
   Days after vaccination:188
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 AR / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Lower respiratory tract infection, SARS-CoV-2 test negative
SMQs:, 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: Vyvanse, Strattera, prenatal vitamin
Current Illness: None
Preexisting Conditions: ADHD, PCOS
Allergies: None
Diagnostic Lab Data: COVID-19 test, results negative.
CDC Split Type:

Write-up: Honestly, I may have recorded things wrong in the check-in. I just had a chest cold that knocked me down for several days. Got tested for COVID and it was negative. Apologies if I accidentally caused a flag to be raised!


VAERS ID: 1750446 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-27
Onset:2021-09-07
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AR8730 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic 10 mg. Tamsulosin 0.4 mg. Olmesartan Medoxomil 20 mg. Nifedipine 60 mg. Potassium 20 meq. Victoza 0.6 mg.
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies: n/a
Diagnostic Lab Data: Cov-2-RNA Star RT PCR TEST - LUX Diagnostic Lab
CDC Split Type:

Write-up: Contracted Covid a systematic that lasted 21 days


VAERS ID: 1750514 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-08-24
Onset:2021-09-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody positive, Full blood count, Metabolic function test, Rash erythematous, Red blood cell sedimentation rate increased, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole 40 mg daily Allopurinol 200 mg daily Vitamin B-12 1,000 micrograms daily
Current Illness: None
Preexisting Conditions: Nephrolithiasis GERD
Allergies: No known
Diagnostic Lab Data: CBC, CMP normal, W Sed rate 17. ANA positve 1:40
CDC Split Type:

Write-up: The patient developed "Covid toe" with an erythematous zone starting 2/3 up the toe in an expanding width to several inches and restrictied to mid foot (I have picutes) and a 2nd erythematous patch about 3x3" on the opposite ankle region. The patient was placed on 81 mg Aspirin daily and 7 days of prednisone 40 mg per day to taper over 3 days . He had a full and complete resolution of the rash.


VAERS ID: 1751819 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-17
Onset:2021-09-07
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood blister, Body temperature, Chills, Pyrexia, Rash erythematous, Rash macular, Rash pruritic, Vaccination site rash, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LIVALO; LETROZOLE; ARNUITY ELLIPTA; ALBUTEROL [SALBUTAMOL]; PROBIOTIC [BIFIDOBACTERIUM INFANTIS;LACTOBACILLUS ACIDOPHILUS]; VITAMIN D [ERGOCALCIFEROL]; VITAMIN B COMPLEX; BUPROPION
Current Illness: Breast cancer; Bronchiectasis (Chronic); Depression; Drug allergy (Sertraline - sickness and diarrhea); Drug allergy (Codeine - sickness and diarrhea)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 99.7 degree Fahrenheit
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Rash on her arm after the third shot; Rash on arm after third shot, it was a bit swollen; Had little blood blisters come up after the third shot; Mild fever; Chills; rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones; Rash was very itchy/very very itchy on the neck; rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones; This spontaneous case was reported by a consumer and describes the occurrence of BLOOD BLISTER (Had little blood blisters come up after the third shot), RASH ERYTHEMATOUS (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones), RASH PRURITIC (Rash was very itchy/very very itchy on the neck), RASH MACULAR (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones) and VACCINATION SITE RASH (Rash on her arm after the third shot) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 037F21A, 018B21A and 048A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Bronchiectasis (Chronic) since 01-Nov-2013, Breast cancer since 02-Jul-2021, Drug allergy (Codeine - sickness and diarrhea), Drug allergy (Sertraline - sickness and diarrhea) and Depression. Concomitant products included LETROZOLE from 28-Jul-2021 to an unknown date for Breast cancer, FLUTICASONE FUROATE (ARNUITY ELLIPTA) from 2018 to an unknown date and ALBUTEROL [SALBUTAMOL] from 2018 to an unknown date for Bronchiectasis, PITAVASTATIN CALCIUM (LIVALO) from 01-Jan-2010 to an unknown date for Cholesterol high, BUPROPION from 2018 to an unknown date for Depression, BIFIDOBACTERIUM INFANTIS, LACTOBACILLUS ACIDOPHILUS (PROBIOTIC [BIFIDOBACTERIUM INFANTIS;LACTOBACILLUS ACIDOPHILUS]), ERGOCALCIFEROL (VITAMIN D [ERGOCALCIFEROL]) and VITAMIN B COMPLEX for an unknown indication. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 16-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-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 RASH ERYTHEMATOUS (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones), RASH PRURITIC (Rash was very itchy/very very itchy on the neck) and RASH MACULAR (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones). On 08-Sep-2021, the patient experienced PYREXIA (Mild fever) and CHILLS (Chills). On 18-Sep-2021, the patient experienced BLOOD BLISTER (Had little blood blisters come up after the third shot). On an unknown date, the patient experienced VACCINATION SITE RASH (Rash on her arm after the third shot) and VACCINATION SITE SWELLING (Rash on arm after third shot, it was a bit swollen). The patient was treated with IBUPROFEN on 08-Sep-2021 for Chills and Fever, at an unspecified dose and frequency. On 22-Sep-2021, BLOOD BLISTER (Had little blood blisters come up after the third shot), RASH ERYTHEMATOUS (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones), RASH PRURITIC (Rash was very itchy/very very itchy on the neck) and RASH MACULAR (rash appeared down her neck/tiny little pin red marks/3 red ones about 2mm/7 pinholes on chest/on stomach 3 larger ones) had resolved. At the time of the report, VACCINATION SITE RASH (Rash on her arm after the third shot), VACCINATION SITE SWELLING (Rash on arm after third shot, it was a bit swollen), PYREXIA (Mild fever) and CHILLS (Chills) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 99.7 (High) 99.7 degree Fahrenheit. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. The patient reported that her arm was swollen, red and itchy the day after the 3rd shot of the vaccine. A few days later, a rash appeared on the right side of her neck. On 18-Sep-2021, she took a shower and noticed 7 pinhole bright red spots across her upper chest, 3 (also reported as 4) on her stomach, a couple on her upper arms and upper legs and one on her breast. On an unknown date, the patient''s temperature was noted to be 99.7 F. An outcome was not provided, however, the patient reported that the reaction stopped on 22-Sep-2021. Most recent FOLLOW-UP information incorporated above includes: On 23-Sep-2021: Follow up includes additional event details, reaction stop date and dates of concomitant medications and patient characteristics.


VAERS ID: 1751876 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-06
Onset:2021-09-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 LA / OT

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

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

Write-up: Sore arm; Seizures; This spontaneous case was reported by a consumer and describes the occurrence of SEIZURE (Seizures) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 048F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included Seizures since an unknown date. Concurrent medical conditions included Epilepsy. Concomitant products included CARBAMAZEPINE (TEGRETOL) and PHENYTOIN (DILANTIN [PHENYTOIN]) for an unknown indication. On 06-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced SEIZURE (Seizures) (seriousness criterion medically significant). On an unknown date, the patient experienced PAIN IN EXTREMITY (Sore arm). At the time of the report, SEIZURE (Seizures) and PAIN IN EXTREMITY (Sore arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Patient had 1 seizure on 07-Sep-2021, 5 seizures on 10-Sep-2021 and another seizure on 18-Sep-2021. Patient had no other adverse event or pre-existing condition. No allergy was reported. Patient had not visited primary care yet regarding this event. No treatment information was provided. Company Comment: This case concerns a 61-year-old, female patient with previous relevant medical history of seizures, epilepsy and use of concomitant medication, who experienced the unexpected event of seizure. The event occurred 1 days after the first dose of mRNA-1273. The rechallenge was unknown since no information about the outcome of the events was disclosed. The medical history of seizures, epilepsy and use of concomitant medication remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report.; Sender''s Comments: This case concerns a 61-year-old, female patient with previous relevant medical history of seizures, epilepsy and use of concomitant medication, who experienced the unexpected event of seizure. The event occurred 1 days after the first dose of mRNA-1273. The rechallenge was unknown since no information about the outcome of the events was disclosed. The medical history of seizures, epilepsy and use of concomitant medication remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report.


VAERS ID: 1752161 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-02
Onset:2021-09-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PC3182 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (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: VENLAFAXINE ER; LOSARTAN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: heart seemed to be beating fast/thumping; Result Unstructured Data: Test Result:Fast
CDC Split Type: USPFIZER INC202101241756

Write-up: shortness of breath; heart seemed to be beating fast/thumping; dizziness; extreme fatigue; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 42-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 20:00 (at the age of 42 years) (Batch/Lot Number: PC3182) as DOSE 2, SINGLE for covid-19 immunisation at Pharmacy or Drug Store. The patient was not pregnant at the time of vaccination. The patient medical history was not reported. Concomitant medications included venlafaxine hydrochloride (VENLAFAXINE ER); losartan taken for an unspecified indication, start and stop date were not reported. Patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in Arm Left on 12Aug2021 08:00 PM (at the age of 42 years) (Batch/Lot Number: FD8448) for covid-19 immunisation. On 07Sep2021 09:00 the patient experienced, approximately 5 days after receiving the second dose of the vaccine began to have shortness of breath, heart seemed to be beating fast/thumping, dizziness, and extreme fatigue. This was still occurring as of 21Sep2021. The events resulted in visit to doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included heart rate increased: fast on an unspecified date. The patient received treatment was unknown. The clinical outcome of events was not recovered at the time of report. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1752168 (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: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac discomfort, Chest discomfort, Cold sweat, Dizziness, Dyspnoea, Heart rate, Heart rate decreased, Hyperhidrosis, Hypoaesthesia, Hypoaesthesia oral, Insomnia, Muscle twitching, Musculoskeletal discomfort, Palpitations, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), COVID-19 (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Dust allergy; Food allergy; Fruit allergy (Allergic to strawberries.)
Allergies:
Diagnostic Lab Data: Test Date: 202109; Test Name: Heart rate; Result Unstructured Data: Test Result:Dropped; Comments: Heart rate dropped to 41 bpm; Test Date: 20210917; Test Name: Fulgent; Test Result: Negative ; Comments: Nasal Swab
CDC Split Type: USPFIZER INC202101252903

Write-up: chest was heavy; heart felt discomforting; back were in extreme discomfort; had trouble breathing and taking deep breaths; Right leg and face began to twitch; heart began to pound really hard; felt dizzy; face from left side of mouth and chin felt numb; face from left side of mouth and chin felt numb; Hands began to get clammy and sweaty; Hands began to get clammy and sweaty; That same night I had hard time sleeping from discomfort; Heart rate dropped to 41 bpm; This is a spontaneous report from a contactable consumer (patient). A 34-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: FC3184), via an unspecified route of administration, administered in Arm Left on 07Sep2021 17:45 (at the age of 34-year-old) as dose 1, single for covid-19 immunisation. Medical history included asthma, Allergic to strawberries, dust, and possibly wheat. There were no concomitant medications. Patient did not receive any other vaccine in four weeks and did not receive any other medications in two weeks. Patient was not pregnant at the time of vaccination. On 07Sep2021, the patient experienced 5 minutes after receiving the vaccine her heart began to pound really hard, felt dizzy, face from left side of mouth and chin felt numb, and hands began to get clammy and sweaty. Advised pharmacist and observed her for 30 minutes. At approximately 7:05 pm, chest was heavy, and heart felt discomforting. 30 minutes later her chest and back were in extreme discomfort, heart was pounding more, had trouble breathing and taking deep breaths, and her right leg and face began to twitch. That same night she had hard time sleeping from discomfort and her heart rate dropped to 41 bpm. Seriousness of the events was reported as non-serious. The patient underwent lab tests and procedures which included heart rate: dropped on Sep2021 Heart rate dropped to 41 bpm, sars-cov-2 test: negative on 17Sep2021 Nasal Swab. Patient did not have covid prior vaccination and covid was tested post vaccination by nasal swab (Fulgent) technique on 17Sep2021 and result was negative. Adverse events resulted in doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. The patient received treatment (unspecified) in hospital. The outcome of events was recovered with sequelae on an unspecified date of Sep2021. Follow-up attempts are completed. No further information is expected.


VAERS ID: 1753574 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: swelling R foot and leg


VAERS ID: 1753740 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-05
Onset:2021-09-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Burning sensation, Diarrhoea, Electric shock sensation, Gait disturbance, Headache, Hypoaesthesia, Limb discomfort, Muscle twitching, Pain in extremity, Paraesthesia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valacyclovir, Vitamin B, , D-3, E, and Zinc, Magnesium and Lysine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I gave a blood sample to my doctor on Tuesday, 28 Sep 2021. Permanent disability has not been concluded at this date.
CDC Split Type:

Write-up: I have tremors throughout my body (like a low voltage shocking), nerve twitches in hands, arms, and legs, legs feel extremely heavy and the left leg hurts 24-7, feet feel like the bottoms are burned, toes and fingers tingle at times and then feel numb at times, headaches with sharp pains going up the back of my head and through my forehead, explosive diarrhea, and trouble walking due to the left leg and left foot pain.


VAERS ID: 1754030 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Electrocardiogram normal, Feeling abnormal, Flushing, Full blood count normal, Head discomfort, Headache, Hypoaesthesia, Metabolic function test, Muscular weakness, Nausea, Paraesthesia, Peripheral coldness, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (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: esomeprazole, Vitamin C, Daily multivitamin
Current Illness: none
Preexisting Conditions: GERD
Allergies: Elimination diet for Wheat and Milk due to eosinophilic esophagitis (resolved at time of vaccination)
Diagnostic Lab Data: During 8 days of symptoms ( September 20th - 27th, 2021) Patient visited emergency room twice, with no abnormal findings. Diagnostics included,: Radiograph of Thorax, EKG, CBC & Chemistry, CT scan with and without contrast.
CDC Split Type:

Write-up: Full body flushing & tingles, numbness in face, feeling faint, dizzy, weak legs and arms, cold feet, head felt heavy, felt spacy, headaches, slight nausea. Normal heart rate, normal breathing. Lasted 1 day post first vaccination on August 9, 2021 and lasted 3 days post second vaccination on September 7th, 2021. Then ALL the same symptoms returned exactly 2 weeks post 2nd vaccination and lasted for 8 days ( September 20th - 27th, 2021). Patient is still dealing with headaches, some flushing and dizziness today Oct 1st, 2021


VAERS ID: 1754093 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Heart palpitations with dizziness


VAERS ID: 1754097 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-01-25
Onset:2021-09-07
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

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

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

Write-up: Breakthrough Case following full vaccination.


VAERS ID: 1754119 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-02-10
Onset:2021-09-07
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 LA / IM

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

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

Write-up: Breakthrough COVID following full vaccination.


VAERS ID: 1754229 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia, Dyspnoea, Fatigue, Feeling of body temperature change, Headache, Pain, Pallor, Presyncope, Sinusitis
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 8/10/2021 - COVID Moderna vaccine - adverse events as reported
Other Medications: Claritin; Flonase
Current Illness: Yes - I had the sinusitis diagnosis - it after first COVID vaccine; symptoms had not yet resolved - most of what I had experienced after the first vaccine were still persisting at the time of second vaccine.
Preexisting Conditions: No
Allergies: Grass
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Body aches and those lasted 16 -18 hours. And they went away and have not re-occurred. They were actually horrible. I am currently in physical therapy for my knee and during two of those physical therapy appts (started on the 8th of September and then again on the 17th) - during those workouts, I clammed up (like I was hot - felt sticky and cold at the same time: heart rate increased and I couldn''t catch my breath and I almost passed out both times. The physical therapist said he could see could see the color leave my face. I almost passed out but and they were able to get me to lay me down in a dark room and then I left when I felt better. I still have the fatigue, the sinusitis symptoms, headaches, indigestion (still there but has gotten a little bit better) and so for those reasons and the passing out, I called the doctor again to schedule an appt. (Note: The physical therapy sessions were started back in May 2021 and I''ve been going to see him continuously since then and those symptoms (that were pre-existing for the knee have gotten better).) I have a doctor visit scheduled for this coming Wednesday - I''m waiting to get in.


VAERS ID: 1757038 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Pain, Pain in extremity, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Nexium
Current Illness: None
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Doctor didn?t order any , suggested an X-ray but it wouldn?t show anything other then something broken .
CDC Split Type:

Write-up: Vaccine was put below muscle toward the side of right arm , within a few minutes of vaccine I felt a lot of arm / shoulder pain , by the next day I had increased pain , swelling and numbness radiating from right side of my neck , arm and shoulder down to my hand . Still to date pain and swelling .


VAERS ID: 1757137 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-09-07
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Condition aggravated, Cough, Dyspnoea, Hypoxia, 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine Omeprazole Tamsulosin Fenofibrate Fluticasone
Current Illness: Cough Shortness of Breath
Preexisting Conditions: Obesity COPD
Allergies: None
Diagnostic Lab Data: Covid test
CDC Split Type:

Write-up: Patient who was fully vaccinated against Covid-19 presented to the ER with cough and shortness of breath. He was found to have covid and was admitted for further management. Patient was treated with remdesivir and dexamethasone. His hypoxia improved and he was discharged home with home o2 and virtual hospital. Pt is on warfarin for a h/o afib, inr is supratherapeutic, pt was advised to hold warfarin and have inr check in 1-2 days. Pt discharging home in good condition.


VAERS ID: 1757143 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Blood test normal, Chest pain, Computerised tomogram normal, Dysarthria, Dyspnoea, Electrocardiogram ambulatory normal, Hypoaesthesia, Laboratory test normal, Peripheral coldness, X-ray normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: No
Allergies: NA
Diagnostic Lab Data: Labs, X-RAY, CT scan, Doppler done, heart monitor, complete autoimmune panel done All tests were normal
CDC Split Type:

Write-up: received her vaccine @ 3:00pm on 9/7/21. Around 7: pm came to tell me she was having problems with her speech. Then by 7:30 pm she was having trouble breathing. speech was slurred and was having a hard time getting her words out. Chest hurt to breathe and her hands were very cold to touch . Her hands were numb. was transported by ambulance to the Hospital. was admitted to the hospital for 2 days. Labs, X-RAY, CT scan, Doppler done, heart monitor,


VAERS ID: 1759073 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-27
Onset:2021-09-07
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Accelerated hypertension, Ageusia, Anosmia, Asthenia, Blood creatinine normal, Blood urea normal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Cough, Decreased appetite, Diarrhoea, Electrocardiogram normal, Exposure to SARS-CoV-2, Fatigue, Lung infiltration, Myalgia, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin 81 mg tablet biotin 5,000 mcg tablet,disintegrating cholecalciferol, vitamin D3, 125 mcg (5,000 unit) capsule cyanocobalamin (VITAMIN B-12) 500 mcg tablet esomeprazole (NexIUM) 40 mg capsule fenofibrate (TRICOR) 145 mg tablet
Current Illness:
Preexisting Conditions: Respiratory Pneumonia due to COVID-19 virus Circulatory Hypertension Stenosis of right internal carotid artery Bilateral carotid artery stenosis Genitourinary Acute cystitis without hematuria CKD stage G2/A2, GFR 60-89 and albumin creatinine ratio 30-299 mg/g Endocrine/Metabolic Type 2 diabetes mellitus Hypothyroidism Infectious/Inflammatory COVID-19
Allergies: Codeine Lipitor [Atorvastatin]
Diagnostic Lab Data: 09/14/21 2141 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/14/21 1649 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 09/14/21 2141 Covid-19 PCR Collected: 09/14/21 1649 | Final result | Specimen: Swab from Nasopharynx Procedure Component Value Ref Range Date/Time X-ray chest 1 view - Portable Resulted: 09/14/21 1721 Order Status: Completed Updated: 09/14/21 1721 Narrative: XR CHEST 1 VW PORT IMPRESSION: Infiltrates in the infralateral right lower lung zone for which developing Covid pneumonia suspected. END OF IMPRESSION: INDICATION: COVID+, cough. 83 years TECHNIQUE: AP chest COMPARISON: 7/5/2021 FINDINGS: The heart is normal in size. Infralateral infiltrates in the right hemithorax are new. There is no pleural effusion. There is no pneumothorax.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/14/2021 - 9/17/2021 (3 days) Last attending ? Treatment team Pneumonia due to COVID-19 virus History of Present Illness Sent from urgent care after she tested positive for COVID-19 Patient is an 83 y.o. female. Presented to the ER for evaluation of chills, sore throat, cough and loss of appetite. Patient reported exposure to COVID-19. The source of COVID-19 is her son who was admitted to the hospital. Patient has been symptomatic for about a week. Patient also is complaining of myalgia and loss of smell and taste. Patient also reported diarrhea but no vomiting. She denies abdominal pain. She was seen at urgent care today.Patient tested positive for COVID-19 in urgent care. Patient received vaccination for Covid 19 in May , 2021. Patient also reported significant weakness and fatigue. Vitals showed low-grade fever, tachycardia, accelerated hypertension, patient oxygen saturation is 99 and was put on oxygen via nasal cannula. Labs, reviewed CBC and CMP and showed GFR of 69.4 with normal BUN and creatinine otherwise unremarkable. CRP was 153.1. Lactic acid level was 1.2 and was normal. COVID-19 was positive. Blood culture was collected Chest x-ray showed right lower lobe infiltrate. EKG was normal Review of Systems Constitutional: Positive for activity change, chills and fatigue. HENT: Negative. Eyes: Negative. Respiratory: Positive for cough and shortness of breath. Cardiovascular: Negative. Gastrointestinal: Positive for diarrhea. Endocrine: Negative. Genitourinary: Negative. Musculoskeletal: Negative. Skin: Negative. Allergic/Immunologic: Negative. Neurological: Positive for weakness. Psychiatric/Behavioral: Negative.


VAERS ID: 1759348 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-01
Onset:2021-09-07
   Days after vaccination:190
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 - / -

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? Yes
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: Non-Hodgkins Lymphoma, immunocompromised
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt was hospitalized with Covid 19


VAERS ID: 1759517 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Fatigue, Hypoaesthesia, Loss of personal independence in daily activities, Muscle spasms, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Dementia (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: Xeljanz, NP thyroid, L-Thyroxine, Prometrium, spironolactone, sumitriptan, ubrelvey, magnesium, fiber(methylcellulose), Lipitor Vitamin D3, Zinc
Current Illness:
Preexisting Conditions: Ulcerative colitis, fibromyalgia, migraines
Allergies: Iodine dye, percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue started at 8pm and was sudden onset, but felt like I couldn''t move. Extreme exhaustion remained through the night and an additional 2 days. Activities of daily living were very difficult. I developed numbness in my arms(from elbows to hands) that still persists today. I also suffered from cramping in my lower legs, preventing me from sleeping or getting comfortable. The cramping turned to muscle spasms


VAERS ID: 1759740 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-20
Onset:2021-09-07
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Appendicitis perforated, Blood culture positive, Blood electrolytes, Blood test, Computerised tomogram, Escherichia test positive, Full blood count
SMQs:, Gastrointestinal perforation (narrow), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Revlimed, dexamethasone, daratumumab, asa, lisiapril
Current Illness: Myeloma
Preexisting Conditions:
Allergies: Statins
Diagnostic Lab Data: Ct scans x2, blood cultures x2 with E. coli noted on one culture, several other blood tests for electrolytes and blood counts
CDC Split Type:

Write-up: Ruptured appendicitis, surgical removal. 5 day hospitalization, with IV antibiotic therapy. Stable recovery post hospital therapy.


VAERS ID: 1761200 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-26
Onset:2021-09-07
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 RA / IM

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

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

Write-up: Tested Positive for Covid


VAERS ID: 1761538 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004CZ1A / 1 LA / IM

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

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

Write-up: Was given the incorrect brand of vaccination due to his age. Was told that the Moderna vaccination was not approved for his age.


VAERS ID: 1761584 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: ADMINISTRATION ERROR : Underage Pt. was given the 1st dose of Moderna 09/17/2021, no occurring symptoms.


VAERS ID: 1761729 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761733 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761737 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761744 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761747 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761748 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Unknown  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761750 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761753 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761844 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-01
Onset:2021-09-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Local reaction, Migraine, Migraine without aura, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: . Local reaction to COVID-19 vaccine 2. Migraine without aura and without status migrainosus, not intractable PLAN Imitrex/Benadryl/Phenergan in the emergency department. Supportive care regarding the vaccine reaction. Discharge Instructions There is no blood clot in the arm. This is a local reaction of the vaccine. It should get better with time. You can use Tylenol safely to the extent that you tolerate it. COURSE & MEDICAL DECISION MAKING 10: 53. Imitrex 6 subcu. Benadryl 50 mg IM. Phenergan 25 mg IM. CHIEF COMPLAINT Chief Complaint Patient presents with ? Arm Swelling is a 44 y.o. female who presents to the ED with swelling and pain in the right arm since receiving a Pfizer Covid vaccine in the right deltoid 1 week ago. The pain has been severe. No fevers or chills. The patient also has a recurrent migraine consistent with previous migraines and requests her usual cocktail for this.


VAERS ID: 1761942 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error: Vaccine administered past its beyond use date. The vaccine stored in the freezer beyond the timeframe recommended by the manufacturer.


VAERS ID: 1761947 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-07
Onset:2021-09-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.


VAERS ID: 1761981 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-08-31
Onset:2021-09-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C and D Elderberry
Current Illness: none
Preexisting Conditions: none
Allergies: Slight reaction to Amoxicillin one time.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Exactly one week later, I had hives all over my body for 4 days. I went to the doctors on the fourth day and said everything was fine. I took Benadryl.


VAERS ID: 1762302 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-05
Onset:2021-09-07
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray, Dizziness, Exposure to SARS-CoV-2, Pyrexia, Rhinorrhoea, SARS-CoV-2 test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Humira 40 mg every couple of weeks.
Current Illness: None.
Preexisting Conditions: Psoriasis.
Allergies: None.
Diagnostic Lab Data: Chest Xray, Covid Test
CDC Split Type: vsafe

Write-up: My covid symptoms started on 09/07/2021 and I only experienced a runny nose, and I had a report from a kid that goes to school with my kid that their kid tested positive so I had a rapid test and it was negative and on Tuesday I had another test and I got the results on the 09/11/2021. My symptoms lasted probably for 7 days. The only other that showed up apart from the runny nose was a little light headedness. After 7 days it was gone. They did administer monoclonal antibodies. I had a fever for one day after the antibodies but that?s it. I wanted to get advice on Humira--is it an immune suppressant drug? Did the vaccine work? Should I get a booster or not? Or Should I wait to get the booster? There?s no clarity. How about some information on immunosuppressant drugs and their effect on the vaccine?


VAERS ID: 1764252 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-15
Onset:2021-09-07
   Days after vaccination:235
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: received his 3rd dose despite not being immunocompromised; Received an expired dose; This spontaneous case was reported by a consumer and describes the occurrence of OFF LABEL USE (received his 3rd dose despite not being immunocompromised) and EXPIRED PRODUCT ADMINISTERED (Received an expired dose) in an 86-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 030L20A and 028A21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 11-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-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 OFF LABEL USE (received his 3rd dose despite not being immunocompromised) and EXPIRED PRODUCT ADMINISTERED (Received an expired dose). On 07-Sep-2021, OFF LABEL USE (received his 3rd dose despite not being immunocompromised) and EXPIRED PRODUCT ADMINISTERED (Received an expired dose) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were reported. No treatment information was provided by the reporter. Patient received 3rd dose despite not being immunocompromised. Patient entered the lot number of third dose into the Moderna online Expiration Date Lookup tool and it showed that that lot expired on 28Apr2021. Patient received the first 2 doses from doctor, and the lot of 1st dose is missing from the card.


VAERS ID: 1764267 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-03
Onset:2021-09-07
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 015M20A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Feeling abnormal, Gastrointestinal pain, Headache, Nausea, Pain in extremity, Peripheral swelling, Photophobia, Swelling of eyelid
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (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: Systemic lupus erythematosis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: a blood vessel burst in her right eye; intestinal pain; loose stools; swollen left arm that was hot; light sensitivity like someone piercing eye with hot poker; swelling of her right eyelid; She has deterioration in her spine & lower back due to her history of lupus & that acted up; brain fog; then was sore; fatigue; joint aches; nausea; headache; dizziness; This spontaneous case was reported by a consumer and describes the occurrence of EYE HAEMORRHAGE (a blood vessel burst in her right eye), GASTROINTESTINAL PAIN (intestinal pain), DIARRHOEA (loose stools), PERIPHERAL SWELLING (swollen left arm that was hot) and PHOTOPHOBIA (light sensitivity like someone piercing eye with hot poker) in a 73-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 058E21A and 015M20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Systemic lupus erythematosis since 1979. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 07-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 DIZZINESS (dizziness) and HEADACHE (headache). On an unknown date, the patient experienced EYE HAEMORRHAGE (a blood vessel burst in her right eye), GASTROINTESTINAL PAIN (intestinal pain), DIARRHOEA (loose stools), PERIPHERAL SWELLING (swollen left arm that was hot), PHOTOPHOBIA (light sensitivity like someone piercing eye with hot poker), SWELLING OF EYELID (swelling of her right eyelid), CONDITION AGGRAVATED (She has deterioration in her spine & lower back due to her history of lupus & that acted up), FEELING ABNORMAL (brain fog), PAIN IN EXTREMITY (then was sore), FATIGUE (fatigue), ARTHRALGIA (joint aches) and NAUSEA (nausea). At the time of the report, EYE HAEMORRHAGE (a blood vessel burst in her right eye), GASTROINTESTINAL PAIN (intestinal pain), DIARRHOEA (loose stools), PERIPHERAL SWELLING (swollen left arm that was hot), PHOTOPHOBIA (light sensitivity like someone piercing eye with hot poker), SWELLING OF EYELID (swelling of her right eyelid), CONDITION AGGRAVATED (She has deterioration in her spine & lower back due to her history of lupus & that acted up), FEELING ABNORMAL (brain fog), PAIN IN EXTREMITY (then was sore), FATIGUE (fatigue), ARTHRALGIA (joint aches), HEADACHE (headache) and NAUSEA (nausea) outcome was unknown and DIZZINESS (dizziness) had resolved. Patient had significant reactions involving a # of systems that lasted 16 days before she began a one week course of Prednisone. The prednisone quieted everything down starting the day patient first took it on day 17 after her 3rd dose. By the next day her symptoms had mostly resolved. Most of her symptoms are part of the lupus but the vaccine made them worse. Company Comment: This case concerns a 73-year-old female patient with relevant medical history of Systemic lupus erythematosis, who experienced unexpected events of dizziness, eye haemorrhage, gastrointestinal pain, diarrhoea, peripheral swelling, photophobia, swelling of eyelid, condition aggravated, feeling abnormal and pain in extremity. The event dizziness occurred approximately 1 day after the third dose of mRNA-1273. The other events occurred on an unknown date after the third dose of mRNA-1273. The rechallenge was not applicable as no additional dosing is expected. Medical history of Systemic lupus erythematosis remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report. The event eye haemorrhage is marked serious by the auto-seriousness tool. Case downgraded to non-serious due to the lack of evidence of seriousness from a clinical or regulatory standpoint, and reporter assessed the case as non-serious. This case was linked to MOD-2021-333655, MOD-2021-333670 (Patient Link).; Sender''s Comments: This case concerns a 73-year-old female patient with relevant medical history of Systemic lupus erythematosis, who experienced unexpected events of dizziness, eye haemorrhage, gastrointestinal pain, diarrhoea, peripheral swelling, photophobia, swelling of eyelid, condition aggravated, feeling abnormal and pain in extremity. The event dizziness occurred approximately 1 day after the third dose of mRNA-1273. The other events occurred on an unknown date after the third dose of mRNA-1273. The rechallenge was not applicable as no additional dosing is expected. Medical history of Systemic lupus erythematosis remains a confounder. The benefit-risk relationship of mRNA-1273 is not affected by this report. The event eye haemorrhage is marked serious by the auto-seriousness tool. Case downgraded to non-serious due to the lack of evidence of seriousness from a clinical or regulatory standpoint, and reporter assessed the case as non-serious.


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