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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 255 out of 8,010

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VAERS ID: 1679371 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site warmth, Lymphadenopathy, Mobility decreased
SMQs:, Parkinson-like events (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Visited PCP on 9/07, was prescribed a steroid
CDC Split Type:

Write-up: Injection site warm, difficulty moving arm, swollen lymph nodes


VAERS ID: 1679402 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 LA / IM

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Patient was given expired vaccine. No symptoms reported.


VAERS ID: 1679516 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK LA / IM

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

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

Write-up: Patient was given expired vaccine. No symptoms reported.


VAERS ID: 1679519 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK LA / IM

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was given expired vaccine. No symptoms have been reported.


VAERS ID: 1679522 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK RA / IM

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

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

Write-up: Patient was given expired vaccine. No symptoms were reported.


VAERS ID: 1679523 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-06
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Discharge, SARS-CoV-2 test positive, Uterine spasm
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: Birth control pill (norgestimate and ethinyl-estradiol)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Positive COVID-19 test on September 7, 2021.
CDC Split Type:

Write-up: On August the 31st, 2021, immediately after getting the Pfizer vaccine, I experienced uterine cramping. It was abnormal because I take my birth control pills everyday. This cramping was abnormal. I brushed it off. On September 6th, I began to have abnormal cramping again. I went to the restroom and saw I had brown discharge. I freaked out. The rest of the day there was no discharge. On September 7th, I experienced cramping again. I went to the restroom and had a lot of brown discharge with many small pieces of tissue in it. It looked as if someone had rolled wet toilet tissue in their hands and dipped it in brown chocolate. It scared me. This was very unusual. The rest of the day there was no bleeding. Positive COVID-19 test on September 7, 2021.


VAERS ID: 1679526 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / UNK RA / IM

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Asthma, Chronic Epstein Barr Virus
Allergies: Latex, Aspirin, Macrobid, Penicllin, Sulfa, Prednisone, Ambien Cr
Diagnostic Lab Data: Unknown.
CDC Split Type:

Write-up: Patient was given expired vaccine. No symptoms were reported.


VAERS ID: 1679557 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 RA / IM

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was given expired vaccine. No symptoms reported.


VAERS ID: 1679745 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Allergic to amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pains in center of chest, lasting over the course of a few hours followed by a fever.


VAERS ID: 1679943 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 RA / IM

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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not available
Current Illness: Not available
Preexisting Conditions: Postural orthostatic tachycardia syndrome
Allergies: No
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient vaccinated on Sunday 9/5/2021. She reported to the pharmacy on 9/7/2021 she has numbness in her right thumb and index fingers that started on Monday 9/6/2021 (the day after she received the second dose of Pfizer COVID-19 vaccine). Patient is unsure if it is related to the vaccine. Patient will monitor symptoms and seek medical attention if symptoms don''t subside.


VAERS ID: 1679948 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 LA / IM

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

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

Write-up: patient took claritin. rash was severe, lots of red splotching all on left arm


VAERS ID: 1681248 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abnormal dreams, Chills, Extra dose administered, Lethargy, Lymphadenopathy, Pain, Tenderness
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate Synthroid Phentermine Baby Aspirin Wellbutrin Serenol Ristella
Current Illness:
Preexisting Conditions: Rheumatoid Arthritis SLE Hashimoto PCOS Hx of TIA Anxiety
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Tender, swollen, and enlarged lymph node(s) under left armpit. It hurts to bring arm down. This reaction was not experienced with first and second shots; however, I didn?t start taking methotrexate until after the second shot. I slept beginning Saturday evening and was not functional all day Sunday. I experienced lethargy, chills, vivid dreams, but no fever. My lymph node began to feel terribly uncomfortable Monday, but I am not sure if it was evident on Sunday, because I slept the entire day.


VAERS ID: 1681696 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: severe chills for several hours, moderate fever for several hours, mild fatigue and body aches for several hours


VAERS ID: 1682164 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Eyelid ptosis, Hypersensitivity, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101161255

Write-up: Right eyelid swelling; Right eyelid swelling and drooping/allergic reaction; Right eyelid swelling and drooping/allergic reaction; This is a spontaneous report from a contactable nurse, the patient. A 24-year-old non-pregnant female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FC3184) via an unspecified route of administration in the left arm on 05Sep2021 at 13:30 (at the age of 24-years-old) as a single dose for COVID-19 immunisation. Medical history included COVID-19. The patient had no known allergies. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. On 06Sep2021 at 06:00, the patient experienced right eyelid swelling and drooping/allergic reaction. The events resulted in visit to emergency room/department or urgent care. Therapeutic measures were taken as a result of the reported events and included treatment with steroids (unspecified) and diphenhydramine (BENADRY). Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events right eyelid swelling and drooping/ allergic reaction was unknown at the time of this report.


VAERS ID: 1682191 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 2 RA / IM

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

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild.


VAERS ID: 1682407 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-02
Onset:2021-09-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Polymenorrhoea
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: Zinc, Vitamin D
Current Illness: N/A
Preexisting Conditions: Blood clotting disorder
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: My period started 2 weeks earlier than expected. My periods are always the same time each month. My period started 4 days after receiving the first dose.


VAERS ID: 1682476 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-17
Onset:2021-09-06
   Days after vaccination:81
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027C21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, COVID-19, Condition aggravated, Insomnia, Pain, Pyrexia, SARS-CoV-2 test positive, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: doxycycline
Current Illness:
Preexisting Conditions: appendectomy back pain bladder cancer status post chemotherapy colon polyps colonoscopy diabetes GERD heart attack hyperlipidemia hypertension nephrectomy pacemaker prostate 10 some sleep apnea thyroid disease thyroidectomy tremor
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient presents with back pain and lumbar pain. The onset was 3.5 weeks ago. The course/duration of symptoms is Coming and going. Type of injury: none. Location: lumbar. Radiating pain: none. The character of symptoms is stabbing. The degree at onset was minimal. The degree at present is moderate. The exacerbating factor is none. The relieving factor is none. Risk factors consist of coronary artery disease and hypertension. Prior episodes: occasional. Therapy today: prescription medications including Augmentin. The patient presents to the emergency department with a 3-4 week history of low back pain. He reports the pain is been coming and going. He reports that makes Tested positive on 9/6/2021 The degree at present is moderate. The exacerbating factor is none. The relieving factor is none. Risk factors consist of coronary artery disease and hypertension. Prior episodes: occasional. Therapy today: prescription medications including Augmentin. The patient presents to the emergency department with a 3-4 week history of low back pain. He reports the pain is been coming and going. He reports that makes it difficult to sleep at night. He reports that he has had associated problems with urinating. He reports that when he has the urge to urinate he has had the ability to get to the bathroom quickly and ends up having incontinence. The patient reports that he has seen his physician regarding this and was given a prescription for Augmentin, however he is unsure exactly why. He reports that prior to this he was also on another antibiotic. The patient reports a past medical history of having a bladder cancer with localized chemotherapy to the bladder, and history of kidney cancer with right nephrectomy. He denies having any associated nausea, vomiting, or diarrhea. He denies having any chest pain, chest pressure, or shortness of breath. The patient arrives with a low-grade temp of 100.1?. He denies any bowel incontinence. He denies having any numbness or tingling to his extremities, weakness of his extremities, or saddle anesthesia. He denies any recent trauma or fall. He reports that years ago he did fall off a roof and broke a bone in his back, however he did not require any surgery..


VAERS ID: 1682478 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, Pain in extremity, Thrombosis, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: None
Current Illness: A cyst was detected in my ovary at the beginning of the month of August
Preexisting Conditions: None
Allergies: Penicillin and Ampicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Monday, the day after the vaccine I had a lot of pain in my arm and I still have it. Vaginal bleeding and I''m still bleeding and pains that come and go, and it''s still going down with clots.


VAERS ID: 1682505 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-18
Onset:2021-09-06
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: hospitalization (non-ICU) Lot number / expiration date / route / site not available for 2nd dose


VAERS ID: 1682514 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-09-06
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Gastrointestinal haemorrhage, SARS-CoV-2 test positive
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: hospitalized for GI bleed, SARS-CoV-2 positive


VAERS ID: 1682530 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-06
Onset:2021-09-06
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 RA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682533 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-02-10
Onset:2021-09-06
   Days after vaccination:208
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 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 on 9/6/21


VAERS ID: 1682536 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-02-06
Onset:2021-09-06
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682540 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Feeling hot, Hyperhidrosis, Nausea, Pain, Pallor, Skin laceration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), 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: Patient states he has regularly had syncope following vaccinations and medical procedures for much or all of his life.
Other Medications: * Metformin
Current Illness: * Type 2 diabetes * Recent extremely stressful life events
Preexisting Conditions: * Type 2 diabetes * Stressful living situation * History of syncope after injections, blood draws, and medical procedures or settings.
Allergies: * NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient seemed slightly nervous prior to vaccination. Shortly after we checked on the patient while he was in the post-vaccination observation area, the patient abruptly experienced syncope 5-10 minutes after receiving J&J vaccine while he was seated in the waiting area. The patient slid and/or flopped sideways out of the chair before we could stop his fall, and his head struck the floor, resulting in a 1" laceration on his right forehead. Bleeding controlled with direct pressure and gauze. Patient quickly regained consciousness while in position he fell to, later brought to supine, with knees and feet elevated, and was A&O and PERRLA with BP 90/60 with radial pulse and HR in mid 50s, pale and diaphoretic, minimal nausea, no breathing issues, and mild pain and discomfort. Patient felt warm, wrapped ice pack applied and seemed to help. NKA. Patient stated he had history of type 2 diabetes, regularly took metformin and may not have taken it earlier that day (later said he had taken it after all), and that he had in the past been hospitalized for 4 days for DKA. Patient stated that he had a history of syncope after injections, blood draws, and medical procedures or settings and that in the past he and his healthcare providers had chosen to have him lay down while getting vaccines or possibly certain other treatments. Patient stated he has recently been experiencing extremely stressful events in his life and that he had recently felt more difficulty concentrating or thinking. Patient condition began to improve, with improvement in skin signs and vivaciousness in his conversation with us. FD arrived, patient symptoms and vitals continued to improve, the patient was moved by FD to a seated position, and FD applied steri-strips. Patient stated he did not want to go to a medical facility, in part because of medical anxiety, stating he felt he would likely have syncope again just from going to an ER or urgent care. Patient seemed well enough that with all factors considered emergency transport to the hospital did not seem to medical personnel present like it would be the best option for him. Arranged for patient to be driven home and monitored by family. Patient felt very sad and stressed for a moment. We cleaned up his wound area while leaving the steri-strips in place, and recommended urgent care and PCP follow-up, and talked with him about caring for the laceration. We advised him he may have a concussion injury from his head impacting the ground. We advised him to follow up with a medical provider, and to have 911 called if any concerning signs or symptoms developed. We talked with his family and friends about how they should help him rest while monitoring for any complications and ensuring his safety. The patient remarked he felt much better than he had expected as we walked him to waiting vehicle, patient departed from scene in care of family to be driven home and monitored by family.


VAERS ID: 1682548 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-09
Onset:2021-09-06
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 2 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682559 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-01-28
Onset:2021-09-06
   Days after vaccination:221
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9622 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 mg oral tablet allopurinol (ZYLOPRIM) 100 mg oral tablet aspirin 81 mg oral enteric coated tablet atorvastatin (LIPITOR) 10 mg oral tablet Cholecalciferol, Vitamin D3, 50 mcg (2,000 un
Current Illness:
Preexisting Conditions: CAD Carpal tunnel syndrome CHF Diabetes mellitus type 2, insulin dependent Diabetic neuropathy Essential hypertension Factor V deficiency Heart valve replaced Hyperlipidemia Inflammatory liver disease Motion sickness Myopathy Nonintractable epilepsy with complex partial seizures Osteopenia Renal disease Renal transplant recipient SDH Elevated troponin Abnormal ECG Hypersomnolence Homonymous hemianopsia, right Acute renal failure Expressive aphasia Pneumonia ESRD Immunosuppression Moderate malnutrition Type 1 diabetes mellitus with diabetic neuropathy Ataxia Hip fracture requiring operative repair, left, closed, initial encounter Closed fracture of distal end of right femur, initial encounter Fall from slip, trip, or stumble Anemia in chronic renal disease Aortic stenosis Atherosclerosis of coronary artery Colitis, enteritis, and gastroenteritis of presumed infectious origin Colonization with MSSA Cystic thyroid nodule Diabetic opthalmopathy Epstein-Barr virus viremia Essential tremor Gastric ulcer due to Helicobacter pylori Difficult intubation Herpes zoster Urinary retention Hearing loss Herniated cervical disc Homocystinemia Hyperparathyroidism due to renal insufficiency Inclusion body myositis Inflammatory liver disease PAD Pleural effusion, right Pulmonary nodules Restrictive lung disease Secondary immune deficiency disorder
Allergies: Ace Inhibitors Contrast [Xray Dyes (Nic)] Ibuprofen Levofloxacin Rapamune [Sirolimus] Sulfa (Sulfonamide Antibiotics)
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST 9/6/21


VAERS ID: 1682562 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-02
Onset:2021-09-06
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682566 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-06
Onset:2021-09-06
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682567 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-09-06
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pfizer 3/18 and 4/12. Positive on 9/6 admitted 9/6 to current


VAERS ID: 1682602 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 062E212 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ARIPiprazole 2 mg tablet buprenorphine 8 mg-naloxone 2 mg sublingual tablet Doxepin 100 mg capsule OLANZapine 10 mg tablet pregabalin 300 mg capsule venlafaxine ER 37.5 mg capsule,extended release 24 hr
Current Illness: NONE
Preexisting Conditions: mixed anxiety and depressive disorder neuropathy posttraumatic stress disorder spondylosis
Allergies: Keflex Sulfa (Sulfonamide Antibiotics)
Diagnostic Lab Data:
CDC Split Type:

Write-up: He had his COVID vaccine 6 days prior at Walgreens and since that time he has developed periorbital edema, rash and is concerned he has had an "allergic reaction" to the vaccination. He has noted rash on his arms and face.


VAERS ID: 1682615 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-24
Onset:2021-09-06
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: dyslipidemia, vitamin d deficiency
Allergies: No known allergies
Diagnostic Lab Data: COVID-19 positive
CDC Split Type:

Write-up: Patient hospitalized on 9/6/21 with positive COVID-19 diagnosis


VAERS ID: 1682619 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-01
Onset:2021-09-06
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

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

Write-up: Patient developed COVID-19 requiring hospitalization post-vaccine.


VAERS ID: 1682640 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-26
Onset:2021-09-06
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: HTN, COPD, Lung CA, Asthma, CHF
Allergies: no known allergies
Diagnostic Lab Data: COVID-19 positive
CDC Split Type:

Write-up: Patient admitted to hospital with positive COVID-19 diagnosis


VAERS ID: 1682721 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-27
Onset:2021-09-06
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 RA / IM

Administered by: Work       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: 9/7/21 SARS-COV2, Positive
CDC Split Type:

Write-up: COVID positive $g14 days post vaccine series.


VAERS ID: 1682761 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Ear discomfort, Headache, Hypertension, Migraine, Muscle spasms, Musculoskeletal stiffness, Vaccination complication, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: buPROPion XL 150 MG 24 hr tablet levothyroxine 100 MCG tablet DULoxetine 30 MG capsule
Current Illness: N/A
Preexisting Conditions: Asthma Hypothyroidism Overweight
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms: blurred vision, clogged ears, migraine, fever, stiff neck, high blood pressure Adverse effect of COVID-19 vaccine Acute nonintractable headache, unspecified headache type Trapezius muscle spasm Pseudotumor migraine Migraine cocktail and CT scan performed Symptoms were much better after


VAERS ID: 1682820 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-02
Onset:2021-09-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Vaginal ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (narrow)

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

Write-up: patient developed vaginal ulcers 4 days after 2nd vaccine for this series without evidence of illness or trauma


VAERS ID: 1682828 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-13
Onset:2021-09-06
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ELO142 / 2 UN / IM

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

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

Write-up: PT WAS VACCINATED USING PFIZER VACCINE ON 12/23/20 (ELO410) + 1/13/21 (ELO142) + 9/4/21 (FC3182). S/O BEGAN 9/05/21, TESTED + 9/06/21


VAERS ID: 1682851 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939906 / 3 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hurthle cell carcinoma of thyroid, acute myeloblastic leukemia (on CPX + venetoclax therapy), hypertension, biopolar disorder, hyperlipidemia, dysuria
Allergies: Acetaminophen, albuterol, buproprion, advair, venetoclax, lamotrigine, levofloxacin, levothyroxine, magic mouthwash, nystatin, ondansetron, posaconazole, quetiapine, rosuvastatin, sucralfate, tamsulosin, valacyclovir, xyloxylin oral suspension
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the hospital for fever and chills two days after vaccine administration with some cough and SOB once admitted. Afebrile now on antibiotics and improving.


VAERS ID: 1682864 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-09-06
   Days after vaccination:186
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea, Palpitations, SARS-CoV-2 test positive, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ? albuterol HFA (PROVENTIL;VENTOLIN HFA) 90 mcg/actuation Inhl inhaler Inhale 1-2 puffs every 4 (four) hours as needed for Shortness of breath. 1 Inhaler 11 ? Drospirenone-Ethinyl Estradiol (JASMIEL, 28,) 3-0.02 mg oral tablet Jasmiel (28)
Current Illness:
Preexisting Conditions: ? Anemia, unspecified type 4/17/2017 ? DeQuervain''s disease (tenosynovitis) ? Diabetes mellitus, gestational 1/23/2015 ? Elevated fasting glucose 4/17/2017 ? Gestational hypertension 5/19/2009 ? Hx gestational diabetes 4/17/2017 ? Low vitamin D level 4/17/2017 ? Major depressive disorder with single episode, in partial remission (HCC) 4/17/2017 ? Numbness and tingling in hands 3/21/2012 ? Prediabetes 4/19/2017 ? PROM (premature rupture of membranes) 2/20/2015 ? Snoring 10/4/2019 ? Status post repeat low transverse cesarean section 12/4/2011
Allergies: LATEX
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST 9/6/21. COUGH AND SINUS CONGESTION. LOSS OF TASTE AND SMELL. RACING HEARTBEAT AND SHORTNESS OF BREATH.


VAERS ID: 1682870 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-09-06
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30130BA / 3 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Decreased appetite, Musculoskeletal discomfort, Pyrexia, SARS-CoV-2 test positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID PCR test was performed no 9/6/21 and was positive.
CDC Split Type:

Write-up: Patient presented to facility with syncope, neck pressure, decreased appetite, chills, fevers. Pt was admitted to facility.


VAERS ID: 1682891 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-31
Onset:2021-09-06
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Skin reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Localized reaction. Redness, swelling, and itching to injection site. symptoms started 6 days post vaccination and localized to injection site. Treatment ice, hydrocortisone cream, and Claritin.


VAERS ID: 1682897 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-02-01
Onset:2021-09-06
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0112M0A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC) 5 mg Oral Tab aspirin 81 mg oral enteric coated tablet betamethasone dipropionate (MAXIVATE) 0.05 % Top Oint ointment brimonidine 0.15% (ALPHAGAN) 0.15 % Opht Drop calcium carbonate (C
Current Illness:
Preexisting Conditions: Acid reflux disease Adenocarcinoma of prostate Angina Allergic rhinitis Arthritis Asthma Testicular cancer COPD DJD Elevated LDL cholesterol level Foot pain Glaucoma Heart disease Heartburn Hypertension Hypothyroid Interstitial emphysema of lung Lumbosacral neuritis MI Mucous cyst of finger Nocturnal leg cramps NSTEMI Numbness and tingling Pain bilat arm and neck Spinal stenosis, lumbar Spontaneous rupture of flexor tendon of right forearm
Allergies: Atenolol Lipitor [Atorvastatin] Pollen (Nic)
Diagnostic Lab Data:
CDC Split Type:

Write-up: POSITIVE COVID TEST 9/6/21. DRY COUGH FOR 10 DAYS PRIOR TO TEST


VAERS ID: 1682934 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-09-06
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, Dialyvite vitamin, cinacalcet, ferric citrate, metoprolol, mupirocin ointment, omeprazole.
Current Illness:
Preexisting Conditions: CKD, hypertensive retinopathy of both eyes, OSA, acanthosis nigricans, vitamin D deficiency, obesity, ESRD, Steal syndrome as complication of dialysis Access, Chronic congestive heart failure, anti-cardiolipin antibody syndrome, anemia, anxiety, depression, dilated cardiomyopathy, hidradenitis suppurativa, hypertension, hypertensive heart and kidney disease, interstitial lung disorders, Lupus nephritis, os trigonum, pulmonary hypertension, renal osteodystrophy, SLE, SLE glomerulonephritis syndrome, vitamin D Deficiency
Allergies: Hydroxychloroquine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received first and only dose to be fully vaccinated with the J&J Janssen vaccine on 4/7/2021. Pt began to have symptoms of COVID and tested positive on 9/6/2021 at a local ED. He was then transferred later that day for inpatient care. He is still currently inpatient being treated for covid on our general med unit.


VAERS ID: 1683029 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-29
Onset:2021-09-06
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014CZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ongoing headache and joint/muscular pain


VAERS ID: 1683079 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Dizziness, Dyspnoea, Fatigue, Feeling of body temperature change, Headache, Injection site pain, Myalgia, Nasal congestion, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Shortness of breath chest pain, hot/ cold, head ache, sharp pain in stomach, dizziness, fatigue, fever, nasal congestion, muscle pain, Injection Site Pain, nausea


VAERS ID: 1683098 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-26
Onset:2021-09-06
   Days after vaccination:223
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Work       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: 9/7/21 SARS-COV2, NAAT Positive
CDC Split Type:

Write-up: Covid-19 positive $g14 days post vaccine series


VAERS ID: 1683129 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-14
Onset:2021-09-06
   Days after vaccination:115
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood magnesium, Blood phosphorus, Blood thyroid stimulating hormone, Brain natriuretic peptide, Dehydration, Differential white blood cell count, Dizziness, Dyspnoea, Fibrin D dimer, Full blood count, International normalised ratio, Metabolic function test, Nausea, Prothrombin time, Troponin I, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (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: BRAIN NATRIURETIC PEPTIDE COMPREHENSIVE METABOLIC PANEL D-DIMER QUANTITATIVE LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL MAGNESIUM PHOSPHORUS PROTIME/INR TROPONIN I TSH REFLEX Icon Imaging Orders Placed Today Imaging Tests EKG XRAY CHEST PORTABLE -
CDC Split Type:

Write-up: Dizziness Dehydration Nausea and vomiting, intractability of vomiting not specified, unspecified vomiting type Dyspnea, unspecified type


VAERS ID: 1683144 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-17
Onset:2021-09-06
   Days after vaccination:142
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Computerised tomogram, Echocardiogram, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood work, CT scan, stress test/echocardiogram
CDC Split Type:

Write-up: I was recently diagnosed with a suspected case of sudden onset pericarditis. I was diagnosed by ER physicians at the Hospital, and held overnight for additional tests and observation. The condition resolved within hours after being treated with intravenous anti-inflammatory medication (Toridol) and oral inflammatory medication (Colchicine).


VAERS ID: 1683146 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-31
Onset:2021-09-06
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 LA / IM

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

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

Write-up: Patient received the vaccine on 8/31/21 and developed hives on both of her legs on the evening of 9/6/21. During the early morning hours of 9/7/21 the rash proceeded to go up her buttocks and both upper arms. The patient took Claritin and it improved her symptoms.


VAERS ID: 1683153 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-21
Onset:2021-09-06
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Work       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: 9/7/21 SARS-COV-2, NAAT positive
CDC Split Type:

Write-up: COVID-19 positive $g14 days post vaccine series.


VAERS ID: 1683205 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-12
Onset:2021-09-06
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Arthralgia, C-reactive protein, Contusion, Dehydration, Differential white blood cell count, Dizziness, Fall, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Skin abrasion, Troponin I, Urine analysis, X-ray
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Arthritis (broad), Dehydration (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: Lab Tests Completed C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL PROTIME/INR PTT TROPONIN I URINALYSIS DIPSTICK REFLEX TO MICROSCOPIC URINALYSIS MICROSCOPIC Icon Imaging Orders Placed Today Imaging Tests EKG XRAY PELVIS WITH HIP 1 VIEW LT XRAY RIBS UNILAT MIN 3 VIEWS RT WITH CHEST 1 VIEW
CDC Split Type:

Write-up: dizziness, fall Fall, initial encounter Skin abrasion Contusion of right back wall of thorax, initial encounter Acute hip pain, left Dizziness Dehydration


VAERS ID: 1683256 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-28
Onset:2021-09-06
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysmenorrhoea, Fatigue, Flushing, Heavy menstrual bleeding, Pain
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (broad)

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

Write-up: Unusually heavy cramping and menstrual flow following 2nd Pfizer vaccine. NSAIDs resolved cramping/pain. Aside from the noted change in my monthly period (assuming a one time change since my will have adjusted from here forward), all other vaccine symptoms experienced were relatively mild: fatigue, light flushing and body aches (akin to work out soreness) experienced within 48 hours after receiving 2nd dose.


VAERS ID: 1683301 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-02
Onset:2021-09-06
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Groin pain
SMQs:, Osteonecrosis (broad)

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

Write-up: Developed achey pain in R groin that has been consistent and not yet resolved. with concern it could be the developement of a blood clot. But unknown at this time


VAERS ID: 1683321 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-03
Onset:2021-09-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO172 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blister, Rash morbilliform, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Morbilliform rash with blisters and swelling. Ranging from large patches to multiple areas of small bumps across different areas (legs, thighs, neck, ribs, arms).


VAERS ID: 1683345 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-03
Onset:2021-09-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Echocardiogram, Echocardiogram normal, Electrocardiogram, Fatigue, Headache, Myocardial necrosis marker increased, Myocarditis, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKGs, Echo, ultrasound heart, bloodwork
CDC Split Type:

Write-up: 09/04/21 9:00am fever aches headache 09/05/21 dull headache and fatigue most of day 09/06/21 5:00 am chest pains few hours while laying 09/07/21 3:30 am chest pain radiating to both arms while laying 09/07/21 8am called physician 10am ER 09/07/21 6pm transferred to hospital - myocarditis: high cardiac markers 09/07-08/21 Echo, enormal


VAERS ID: 1683355 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Unknown  
Location: Virginia  
Vaccinated:2021-09-01
Onset:2021-09-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Lethargy, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Thyroid medication
Current Illness: None
Preexisting Conditions: Hypo Thyroid
Allergies: None
Diagnostic Lab Data: Hospital Visit 9/7/2021. No virus, no medical issues requiring emergency services
CDC Split Type:

Write-up: Lethargy, confusion, overall sick felling


VAERS ID: 1683374 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Pain in extremity, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: My arm hurt for 1 day and then 2 days of eye lid swelling which dosent go away. Pain around swelling.


VAERS ID: 1683468 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 - / -

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

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

Write-up: Headache, then chills and fever, then body aches, then diarrhea in that succession over 2 day period


VAERS ID: 1683680 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Arm swelled really badly to tetanus vaccine as a child
Other Medications: Vitamin c, Vitamin d3, zinc, quercetin probiotics
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to nuts, bananas melons, dust, mold, pet dander, pencillan
Diagnostic Lab Data:
CDC Split Type:

Write-up: My arms broke out in hives 2 days after injection.


VAERS ID: 1683685 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

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

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

Write-up: day after receiving vaccine pt has redness at injection site the size of baseball, itching, redness, pain and itching that went up shoulder. It was getting worse so patient called pharmacy


VAERS ID: 1684243 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Injection site erythema, Injection site pruritus, Injection site reaction, Skin lesion
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Covid arm without itchiness at 2 nd Covid Moderna vaccination
Other Medications: Crestor Vitamin D Aspirin Losartan
Current Illness: Lupus Hypertension
Preexisting Conditions:
Allergies: Shrimp
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid Arm Large red lesion at vaccination site Became very itchy Took antihistamine Applied steroid creams and Benadryl Cream - nothing helped. As of September 9, 2021 arm isno longer itchy but still red


VAERS ID: 1684249 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Anal haemorrhage, Anosmia, Bone pain, Cough, Dermatitis allergic, Diarrhoea, Dyspnoea, Fatigue, Flatulence, Headache, Nasal congestion, Oropharyngeal pain, Pain in extremity, Pruritus, Rash, Renal pain, Skin discolouration, Swelling face, Thirst, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune 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: N/A
Current Illness: No
Preexisting Conditions: Asthma, Allergic rhinitis, Atopic dermatitis, Gastritis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Gas, severe headache, difficulty breathing, cough stuffy nose no odor, allergy skin with rash and itchy welts, swelling in the face with color. Sore throat, tiredness, pain like gastritis, slight anal bleeding diarrhea at times, pain in the arm, pain in the bones of the other am. kidney discomfort need of water.


VAERS ID: 1684254 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast 10 mg, Plexus Triplex, One daily multivitamin, aloe vera capsules, cinnamon, garlic oil, elderberry, chia oil, ashwaganda, Nexium 20 mg, vitamin d 3
Current Illness: None
Preexisting Conditions: Fibromyalgia, Asthma
Allergies: Penicillin, vancomycin, clindamycin, relafen, bactrum
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rash over most of my body, developed about 1 hour after vaccine injection. Benadryl was given by pharmacist, and continued for 36 hours at 50mg every 6 hours. After approximately 36 hours, rash was mostly gone.


VAERS ID: 1684733 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Postmenopausal haemorrhage, Ultrasound pelvis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10mg escitalopram
Current Illness: Diverticulitis
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Pelvic ultrasound Hormone bloodwork
CDC Split Type:

Write-up: Vaginal bleeding after 7 years menopausal


VAERS ID: 1684778 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-05
Onset:2021-09-06
   Days after vaccination:124
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Blood glucose normal, Blood potassium decreased, COVID-19, Cough, Dyspnoea, Hypoxia, Oxygen saturation decreased
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad), Hypokalaemia (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: MS, brain tumor-meningioma S/P resection in the 70s, hyperlipidemia, despression
Allergies: Cafergot, ciprofloxacin, sulfadiazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9/6/21: Patient arrived at the ER due to shortness of breath and increased weakness having multiple episodes of hypoxia at home with oxygen saturations in the low to mid 70s. Patient was diagnosed with COVID on 9/1. Over the last week she has had increase in weakness and shortness of breath. She also has a intermittent cough. Symptoms started about a week and half prior to arrival to hospital. Her oxygen saturations were 89% on room air in the emergency department. She was on 94% and satting well. Remainder of vitals are within normal limits. Lab work revealed potassium of 3.4 and blood sugar of 183-she is on steroids on outpatient basis for COVID.


VAERS ID: 1684785 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-18
Onset:2021-09-06
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Malaise
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: A. fib, dyslipidemia, obstructive sleep apnea, COPD, CKD.
Allergies: Levaquin
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Only 1 Pfizer vaccine shows up in MCIR. Patient states he is fully vaccinated. Trying to get nurse to look at vaccine card. Symptoms are shortness of breath, cough, and malaise. Hospitalization.


VAERS ID: 1684833 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-17
Onset:2021-09-06
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9267 / 2 LA / IM

Administered by: Pharmacy       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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for COVID-19.


VAERS ID: 1684881 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-01
Onset:2021-09-06
   Days after vaccination:67
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Confusional state, Cough, Gait disturbance, Mental status changes, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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 (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: MD documented: Past Medical History: Thyroid Problems, Congestive Heart Failure, Hypertension Other Medical History: gi bleed, afib, kidney disease, gout Past Surgical History: Other
Preexisting Conditions:
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt contracted COVID-19, POSITIVE TEST ON 9/8/21 ED Notes: Patient is a 82-year-old male presents with complaint of altered mental status. Patient was actually here to have a cardiac procedure done as an outpatient but the family noted that the patient was a little confused and weaker than normal over the last couple days the cardiac procedure was canceled and he was sent here to the ED for further evaluation. Patient is actually awake and alert and answering questions appropriately. Family says that the patient has had a cough. They deny any fevers. Denies any urinary symptoms. Denies any chest pain. Family says that that he has been weaker walking and has had episodes of confusion. Patient denies any confusion or weakness


VAERS ID: 1684981 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Lip swelling, Muscle spasms, Nasal congestion, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine, estradiol, progesterone, pregabalin, fexofenadine
Current Illness: No
Preexisting Conditions: hypothyroidism, menopausal hot flashes, chronic neck pain
Allergies: Iron causes a rash. Nickel causes a rash.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soon after receiving the vaccine she started getting a terrible headache, migraine like. Within 2 hours of receiving the vaccine her nose swelled and she was unable to breathe out of it, her lips swelled, and her tongue felt swollen. Swelling improved by the next day. She also had bad muscle spasms in her legs, arms, and hips which hurt for 2 days.


VAERS ID: 1685031 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-25
Onset:2021-09-06
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054E21A / 1 LA / IM

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

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

Write-up: 1.5cmx0.5cm enlarged left clavicular lymph node.


VAERS ID: 1685040 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 AR / IM

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

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

Write-up: ADMINISTRATION ERROR : Administered 3 days after expiration date. 09/05/2021


VAERS ID: 1685053 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 AR / IM

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

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

Write-up: ADMINISTRATION ERROR : Administered 3 days after expiration date. 09/05/2021


VAERS ID: 1685065 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 2 AR / IM

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

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

Write-up: ADMINISTRATION ERROR : Administered 3 days after expiration date. 09/05/2021


VAERS ID: 1685070 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 AR / IM

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

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

Write-up: ADMINISTRATION ERROR : Administered 3 days after expiration date. 09/05/2021


VAERS ID: 1685072 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-09-06
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: PT VACCINATED USING JANSSEN 4/8/21 (LOT 201A21A). S/O BEGAN 9/1/21, TESTED + 9/6/21


VAERS ID: 1685097 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperventilation, Nausea, Palpitations
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: C1 Protein Inhibitor for hereditary angioedema
Current Illness:
Preexisting Conditions: Hereditary angioedema was only one disclosed
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient became very faint, light headed, sweaty and was breathing heavily within 5-10 minutes of vaccination. Patient was alert and oriented the whole time, but felt like her heart racing was getting worse and began feeling nauseous. Patient requested 911 be called. EMTs took patient to the hospital. Patient called to say she was treated, but did not know with what and she is now home and feeling fine.


VAERS ID: 1685195 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-01
Onset:2021-09-06
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Aortic arteriosclerosis, Atelectasis, COVID-19, Cerebral atrophy, Cerebral small vessel ischaemic disease, Chest X-ray abnormal, Computerised tomogram head abnormal, Diarrhoea, Essential hypertension, Gastrooesophageal reflux disease, Loss of consciousness, Magnetic resonance imaging head abnormal, Nausea, SARS-CoV-2 test positive, Seizure, Sinusitis, Syncope, Tremor, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: 9/6/2021 COVID - PCR -Detected 9/6/2021 - Chest x-ray - Atherosclerotic Aorta; Left basilar atelectasis; Osseous changes as described 9/6/2021 CT of Brain WO Contrast - No acute intracranial abnormalities; Mild to moderate cortical atrophy; Sinusitis 9/7/2021 MRI of Brain WO Contrast - No acute infarct; Diffuse cerebral volume loss with chronic small vessel ischemic changes
CDC Split Type:

Write-up: Feeling nauseous with vomiting and diarrhea for 1 week. Passed out on the bathroom floor and son found him shaking and unresponsive. Diagnosed with Syncope with Convulsions; COVID-19 Infection; Essential Hypertension and GERD


VAERS ID: 1685272 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-02-15
Onset:2021-09-06
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 4 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol HFA, Tylenol, Lyrica, Zoloft, Flovent, Premarin tab, Lidoderm patch, Myrbetriq
Current Illness: unknown - pt confused
Preexisting Conditions: HTN, Breast cancer s/p bilateral mastectomy, Asthma, Depression, Interstitial cystitis, Trigeminal neuralgia
Allergies: Penicillin''s
Diagnostic Lab Data:
CDC Split Type:

Write-up: breakthrough covid in september


VAERS ID: 1685287 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Nausea, Pain, Pain in extremity, Tinnitus, Vertigo
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (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: na
CDC Split Type:

Write-up: Most unusual event was tinnitus and vertigo about 3 or 4 hours after injection. Lasted for about 5 minutes though was the worst for about a minute then got better. Others are more typical, sore arm, nausea for about the first 2 hours after injection, slight chills no fever, a little achy, feeling very fatigued for 2 days. Generally feeling off but never really bad.


VAERS ID: 1685338 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SC3183 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Hypertension, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: VIXLOA
Current Illness: NONE
Preexisting Conditions: ASTHMA
Allergies: NONE
Diagnostic Lab Data: ekg and blood work
CDC Split Type: vsafe

Write-up: after the vaccination same day i had tingling in my arms and legs and sharp pain in my chest and contacting my doctor the next day and they told me to go to there and they did the ekg and then i went to the doctor and they did the blood work. i still have the tingling in my legs and my blood pressure is really high


VAERS ID: 1685419 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-14
Onset:2021-09-06
   Days after vaccination:84
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0175 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0217 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Feeling abnormal, Headache, Memory impairment, Myalgia, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Vomiting, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: severe asthma
Allergies: unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: admitted to Hospital 9/06/2021 through emergency room with fever, cough, SOB, loss of smell/taste, runny nose, congestion, vomiting, diarrhea, wheezing, headache, fatigue, myalgias, chills, memory issues, "brain fog". Still admitted as of 9/09/2021


VAERS ID: 1685501 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2020-12-29
Onset:2021-09-06
   Days after vaccination:251
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive Covid-19 PCR test 9/8/21
CDC Split Type:

Write-up: Covid-19 infection s/p vaccination


VAERS ID: 1685518 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-02
Onset:2021-09-06
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Diplopia, Magnetic resonance imaging normal
SMQs:, Ocular motility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone, Estrogen, Vitamin D, Vitamin C, Magnesium
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI & Blood work on 9/7/2021
CDC Split Type:

Write-up: Sept 6th, 7:00 p.m. had double vision. Went to Hospital Emergency Room on Sept. 7th, 2:00 pm. and they ran blood work, and MRI. Results showed no stroke, bleeding on the brain or tumor. ER Dr. couldn''t diagnose why I was having double vision which is neurological disorder. Referred me to Neuro Ophthamologist.


VAERS ID: 1685532 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-07-12
Onset:2021-09-06
   Days after vaccination:56
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Echocardiogram, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin 500 mg bid, metoprolol 25mg bid
Current Illness: None
Preexisting Conditions: Mitral valve regurgitation and sleep apnea
Allergies: Benadryl and eryremicn
Diagnostic Lab Data: Echocardiogram 9/7/21 and ekg 9/6/21
CDC Split Type:

Write-up: Developed AFIB never had before


VAERS ID: 1685537 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Hypertension, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Pruritus, Taste disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Low dose Aspirin, Rabeprazole; Carvedilol, Lisinopril; Carafate, Calcium, Probiotics
Current Illness: N/A
Preexisting Conditions: Hypertension, Reflux , Thalassemia
Allergies: Tylenol
Diagnostic Lab Data: EKG
CDC Split Type: vsafe

Write-up: I waited for fifteen minutes and I was a little dizzy, I had had a strange taste in my mouth within a few minutes of the shot. When I got the next morning and I was still dizzy and my blood pressure was very high. I went to the ER and I was advised to take Ibuprofen 800 mg. I took the medication as advised the next day I noticed that the area around where I got the shot was very hard and sore. It is swollen and red with a ring around the site of the shot. On the third day my arm was itchy and I tried some Benadryl. My arm was warmer and warmer and I went to the doctor. It has been five days and my arm is still very warm so the doctor advised to take some Benadryl and he gave me Prednisone.


VAERS ID: 1685576 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: hives/rash constant Benadryl may need steroids


VAERS ID: 1685625 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Hypoaesthesia, Pain, Paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (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:
Current Illness: None
Preexisting Conditions:
Allergies: Peanuts, bees
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chest pain, shortness of breath, and numbness/tingling on right side. Chest pain is sometimes severe. Vision is a bit blurry on right side. Chest pain radiates to left side at times.


VAERS ID: 1685677 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase increased, Chest X-ray normal, Chest pain, Chills, Dyspnoea, Electrocardiogram normal, Full blood count normal, Headache, Hyperventilation, Metabolic function test normal, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG normal, CXR normal. BMP and CBC normal. CPK mildly elevated at 183. Symptoms improved with IV hydration.
CDC Split Type:

Write-up: Chest pain and shortness of breath following cross country practice. Developed myalgias, headache and hyperventilation. Subjective fever and chills. Seen ED, Afebrile, SaO2 100% on room air.


VAERS ID: 1685947 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3181 / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Fatigue, Feeling of body temperature change, Myalgia, Pyrexia, Seizure, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None. I had a virtual medical consultation to confirm with a doctor the side effects I was experiencing are often experienced by vaccine-takers.
CDC Split Type:

Write-up: Adverse effects after taking the second dose of the Pfizer vaccine. 1) Non-stop brutal convulsions starting 15-16h after the shot and lasting 1h30 combined with fever (alternation of extreme heat and extreme cold feeling). 2) Then shaking and feeling that my body was being electrocuted and my organs were trying to continually resist the electric shock, all combined with muscle pain diffused through my body. Lasted for at least 10 hours after the start of the side effects. 3) General exhaustion and mild muscle pain throughout the body for the next 48 hours. I have a great immune system, eat healthy (mostly vegan), don''t have any diseases nor take any medications/prescriptions. No genetic health concerns in my family.


VAERS ID: 1686000 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-02-18
Onset:2021-09-06
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9266 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asymptomatic COVID-19, COVID-19, Cystitis, Fall, Head injury, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen PRN, baby aspirin, vitamin D, donepezil, furosemide, melatonin, oxybutynin, potassium chloride, tramadol
Current Illness:
Preexisting Conditions: Hard of hearing, dementia, atrial fibrillation, and history of breast cancer
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 9/6/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 1/23/21 and 2/18/21. On 9/6/21, patient presented to our facility due to having 3 falls in the adult facility and did hit her head. COVID status positive upon admission without any symptoms. Patient admitted for falls related to acute cystitis. As of 9/9/21, patient is still admitted in the med/surg setting.


VAERS ID: 1686012 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-01
Onset:2021-09-06
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac disorder, Lymphadenopathy, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine and losartan
Current Illness: None
Preexisting Conditions: Thyroid problems
Allergies: Musinex
Diagnostic Lab Data: I went to physician about the lymph nodes now I?m waiting to hear back from her about what to do about this heart dipping situation.
CDC Split Type:

Write-up: First it was swollen lymph nodes on the left side of my neck but either 3 or 4 days ago my heart started dipping or like a hard thump in the center of my chest. I?ve done a report on the lymph nodes already now this heart stuff has started.


VAERS ID: 1686214 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-05
Onset:2021-09-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Feeling cold, Feeling hot, Heart rate increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: I feel super faint and am about to faint, my stomach has stabbing pains like knifes, my heart starts beating super fast, and get extremely hot or really cold.


VAERS ID: 1686215 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-27
Onset:2021-09-06
   Days after vaccination:132
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Cough, Diarrhoea, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol inh PRN, losartan, omeprazole, triamcinolone nasal inh PRN
Current Illness:
Preexisting Conditions: Barrett''s esophagus, GERD, chronic ear infections
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 9/3/21.
CDC Split Type:

Write-up: Patient received Pfizer COVID vaccine on 3/30/21 and 4/27/21. Patient tested positive for COVID on 9/3/21. On 9/6/21, patient was brought in by EMS with worsening shortness of breath of the last 3 days and 8 days symptoms of fever, cough, SOB, and diarrhea. Patient admitted for acute hypoxic respiratory failure and COVID pneumonia. As of 9/9/21, patient is still admitted in the med/surg unit.


VAERS ID: 1686229 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-06
Onset:2021-09-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Back pain, Chills, Dyskinesia, Headache, Hyperhidrosis, Injection site erythema, Injection site swelling, Joint stiffness, Mobility decreased, Nausea, Oedema peripheral, Pain in extremity, Pyrexia, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Verapimil ER 120mg, Loratadine, potassium, Zyrtec, Suphedrine PE
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Stayed home. self care. still lingering but not severe. at 6pm was able to get a shirt on arm.
CDC Split Type:

Write-up: Lower back and leg pain, stiffness in joints making movement very hard and unsteady. Fever 26 hrs, chills 5-6 hrs, sweets 14 hrs. Extremely nausiated. Some headache not intense. injectionsight swollen and red size of baseball. swelling in armpit and on upper side of chest 5" w x 7"h. entire shoulder area hurt.


VAERS ID: 1686457 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-07-28
Onset:2021-09-06
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, COVID-19, COVID-19 pneumonia, Endotracheal intubation, Hypoxia, Intensive care, Pneumonia bacterial, SARS-CoV-2 test positive, Sepsis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alprazolam PRN, clonidine, guaifenesin ER PRN, levetiracetam, metformin, naproxen PRN, risperidone
Current Illness:
Preexisting Conditions: History of seizure, diabetes mellitus type 2, down syndrome, and severe developmental delay (non verbal)
Allergies: NKDA
Diagnostic Lab Data: COVID status positive on 9/6/21.
CDC Split Type:

Write-up: Patient received Janssen COVID vaccine on 7/28/21. On 9/6/21, patient was admitted to our facility CCU for hypoxia (requiring intubation), sepsis, AKI, and COVID/bacterial pneumonia. COVID status positive upon admission. As of 9/9/21, patient is still in CCU and intubated with severe refractory hypoxemia.


VAERS ID: 1688666 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3180 / 3 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Forteo
Other Medications: Vitamin D3, Mag 64, 81 MG Aspirin, 0.5 mg ClonazePAM, Trelegy Elipta, Levealbuterol, Calcium, Ezetimibe, CoQ10, Famotidine, Buspirone, Livalo,
Current Illness: COPD, severe osteoporosis, fractured T8 vertebrae, GERD
Preexisting Conditions: Severe COPD/Emphysema, severe osteoporosis, fractures of almost all vertebrae, GERD
Allergies: Sulfa drugs, opioid medications,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe dizziness, onset early a.m. Monday September 6th, 2021 and continued through Wednesday September 8th, 2021. Lack of appetite during same time frame.


VAERS ID: 1688667 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-03
Onset:2021-09-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel 24 (birth control)
Current Illness:
Preexisting Conditions:
Allergies: Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unexplainable itchy hands without bumps or rashes. It feels extremely itchy but when scratched it is unsatisfying and still feels itchy. Kind of hard to explain so I hope you?ll understand.


VAERS ID: 1688833 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-08-06
Onset:2021-09-06
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 2 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anosmia, Dysgeusia, Immediate post-injection reaction, Nasal disorder, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Hypersensitivity (narrow), Immune-mediated/autoimmune 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: Allegra, amlodipine bestylate, amitriptyline, azelystine, tamoxifin
Current Illness: None
Preexisting Conditions: High blood pressure, fibromyalgia
Allergies: Numerous
Diagnostic Lab Data:
CDC Split Type:

Write-up: Post menopausal vaginal bleeding. Minor immediate reactions after 1st shot is a funny metallic taste in my mouth that hasn''t gone away and a funny smell in my nose reducing my sense of smell.


VAERS ID: 1688963 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-16
Onset:2021-09-06
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I currently have an outbreak of shingles(herpes zoster) covering my left lower back and stomach. I have never had shingles before. I am young (35), have no medical problems and have rarely been sick a day in my life. This started approximately 3 weeks after receiving the booster(3rd shot) of the Pfizer vaccine. I am currently taking antiviral medication, steroids and gabapentin to manage the outbreak and symptoms.


VAERS ID: 1689124 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-20
Onset:2021-09-06
   Days after vaccination:139
Submitted: 0000-00-00
Entered: 2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Anion gap increased, Blood bicarbonate decreased, Blood glucose increased, Blood potassium increased, Blood sodium decreased, COVID-19, Chest X-ray abnormal, Chronic respiratory failure, Cough, Decreased appetite, Hyperglycaemia, Hypervolaemia, Lung opacity, Myalgia, Nausea, Pain, SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, type II DM, hypertension, diastolic heart failure, end-stage renal disease on hemodialysis (TTS), Psychological/Psychiatric condition, Current smoker
Allergies:
Diagnostic Lab Data: 09/06/2021 PCR+ COVID-19 test at Health System
CDC Split Type:

Write-up: Breakthrough COVID-19 case with Muscle or body aches, Cough (new onset or worsening of chronic cough), Nausea or vomiting, Abdominal pain. Patient presented with nausea and vomiting of 2 days duration. She developed generalized abdominal pain nausea loss of appetite and vomiting of ingested material since 2 days back. She denies fever but has been having cough. She has chronic respiratory failure she is on 4 L of oxygen at home and has not noticed any change in shortness of breath denies any palpitation or chest pain. She states she is fully vaccinated against COVID-19. She continues to take her insulin and her last dose was this morning. Her last dialysis was on Saturday. Investigations in the ED revealed hyperglycemia with blood glucose level of 1296, sodium level of 117 and potassium level of 5.7. Bicarb level was 13 and anion gap was 22. WBC count was within normal range. Chest x-ray showed bilateral opacities suggestive of volume overload vers


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