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From the 7/23/2021 release of VAERS data:

Found 506,830 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 259 out of 5,069

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VAERS ID: 1417987 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-27
Onset:2021-06-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

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:
Other Medications: Nil
Current Illness: Nil
Preexisting Conditions: Nil
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hive like rashes


VAERS ID: 1418008 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1418070 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047B214 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Decreased appetite, Dizziness, Fatigue, Headache, Injection site pain, Malaise, Pain, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular 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: flu shots make me very ill for up to a week
Other Medications: Zegrid, Focus Factor, 5 HTP
Current Illness:
Preexisting Conditions: Ulcerative colitis, Heart murmur, asthma, fibromyalgia
Allergies: Iodine, Keflex, penicillian
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever of 103 for 4 days, severe chills, headaches, body aches, blurry vision, dizzy even laying down. no appetite, soreness at injection site, malais, exhaustion lasted for 2 weeks


VAERS ID: 1418097 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1418158 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1418173 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1418346 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1418613 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-04
Onset:2021-06-02
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Fatigue, Myalgia, Productive cough
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Atorvastatin, ezetimibe, baby aspirin
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: high temperature up to 103 degrees, chills, muscle aches, fatigue / tired started next day and continued for 3 days. then they subsided, then developed lingering cough and coughing up white flehm.


VAERS ID: 1420185 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 2 LA / SYR

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

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

Write-up: Moderate unilateral throat pain on side vaccinations recieved. Appeared with 24 hours of injection, resolved within 7 days. Treated with ibuprofen with minimal relief


VAERS ID: 1420244 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1420271 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1420280 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1420512 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Joint lock, Menstrual disorder, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: i had the shakes and a fever, my joints were locked, and i started getting my period every other week


VAERS ID: 1421080 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421091 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 RA / IM

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

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

Write-up: Pt received 2nd dose of Moderna vaccine from a vial that had reached it''s beyond use date 10 days prior. Pt did not experience any adverse effects or side effects from this vaccine.


VAERS ID: 1421106 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421109 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown, vaccine given at a community outreach event.
Current Illness: Unknown, vaccine given at a community outreach event.
Preexisting Conditions: Unknown , vaccine given at a community outreach event.
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Recipient was inadvertently was given 2nd dose of Moderna vaccine from a vial that had reached its beyond use date 10 days prior.


VAERS ID: 1421152 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood pressure medication
Current Illness: Unknown, vaccine given at a community outreach event.
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: She was inadvertently given 2nd dose of Moderna vaccine from a vial that had reached its beyond use date 10 days prior. She denied any adverse effects or side effects from the vaccine administered.


VAERS ID: 1421165 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421172 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Mother brought her son to get his second dose of Pfizer vaccine and it was discovered that he was only 11 years old. She wanted me to give him the 2nd dose, but I told her that he needed to be 12 years old and we would need to wait until 6/30/21 before administering the 2nd dose due to his age. Mom filled out son''s date of birth wrong and age: 12 on the administration form that was filled out on 6/2/21. No adverse events occurred after 1st dose was administered and mother wanted to get son a second dose as quickly as possible. This form required that I fill in a date and time of adverse event but no adverse event was reported.


VAERS ID: 1421173 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421176 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421181 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421303 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-28
Onset:2021-06-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 003C21A / 2 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: I''ve been getting bloody noses a lot (at least every three days, and sometimes 3 or 4 times a day). The bleeding also lasts much longer than I''ve had before, and will sometimes soak entirely through a tissue or two before stopping.


VAERS ID: 1421372 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421436 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421772 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Irritability, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Your Current Medications Are albuterol HFA 90 mcg/actuation inhaler (Taking) INHALE 2 PUFFS INTO LUNGS EVERY 6 HOURS AS NEEDED FOR WHEEZING atropine (ISOPTO ATROPINE) 1 % ophthalmic solution (Taking) INSTILL ONE DROP IN TO THE RIGHT EYE EV
Current Illness: Respiratory Acute allergic rhinitis Asthma Moderate persistent asthma without complication Digestive Chronic constipation Chronic gastritis without bleeding Dental caries Gastroesophageal reflux disease without esophagitis Nervous and Auditory Cerebral palsy, quadriplegic (HCC) Intractable generalized idiopathic epilepsy without status epilepticus (HCC) Neuronal ceroid lipofuscinosis (HCC) Spastic quadriplegic cerebral palsy (HCC) Musculoskeletal and Integument Decubitus ulcer of back, stage 1 Decubitus ulcer of sacral region, stage 1 Flexion contracture of wrist joint, left Flexion contracture of wrist joint, right Other osteoporosis with current pathological fracture Scoliosis Skin infection at gastrostomy tube site (HCC) Genitourinary Recurrent scrotal infection Testicular torsion Other Annual physical exam Cataract of right eye Central corneal opacity of right eye Contracture, joint, multiple sites Fecal incontinence Fever, low grade Flexion contracture of elbow, left Flexion contracture of right elbow Right retinal detachment S/P percutaneous endoscopic gastrostomy (PEG) tube placement (HCC) Seizure (HCC) Severe intellectual disability Testicular swelling Urinary incontinence Vaccination reaction
Preexisting Conditions: Asthma Chronic constipation Chronic gastritis without bleeding Gastroesophageal reflux disease without esophagitis Cerebral palsy, quadriplegic (HCC) Intractable generalized idiopathic epilepsy without status epilepticus (HCC) Neuronal ceroid lipofuscinosis (HCC) Spastic quadriplegic cerebral palsy (HCC) Flexion contracture of wrist joint, left Flexion contracture of wrist joint, right Other osteoporosis with current pathological fracture Scoliosis Skin infection at gastrostomy tube site (HCC) Testicular torsion Cataract of right eye Central corneal opacity of right eye Contracture, joint, multiple sites Fecal incontinence Flexion contracture of elbow, left Flexion contracture of right elbow Right retinal detachment Seizure (HCC) Severe intellectual disability Urinary incontinence
Allergies: Allergies as of 6/23/2021 Pediasure [food Supplemt, Lactose-reduced] Valproic Acid
Diagnostic Lab Data:
CDC Split Type:

Write-up: INCREASED DIAPHORESIS, INCREASED IRRITATION, NEW SEIZURE ACTIVITY AFTER 2 WEEKS OF VACCINE


VAERS ID: 1421774 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-24
Onset:2021-06-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram, Mobility decreased, Myocarditis, Pain, Palpitations, Pericarditis, Ultrasound scan, X-ray
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Testosterone Cypionate Celexa
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ekg, CT scan, bloodwork, ultrasound - hospital 6/11/2021 Ekg, X-ray, bloodwork, ultrasound - BI 6/17/2020
CDC Split Type:

Write-up: Heart inflammation (diagnosis myocarditis from one hospital & pericarditis by the other) Chest pains, trouble breathing, cannot move easily without pain., heart palpitations (those ended). Started off being told to take Advil every 6 hours. That didn?t help, went to a new ER, they gave me colchicine. It?s helping but I still am pretty much bedridden.


VAERS ID: 1421803 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1421805 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Muscle strain, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (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 reports approximately 1 week after receiving Moderna COVID vaccine she started to have tingling in her left arm down to her left hand. The tingling also went back up her arm to her neck causing muscle strain in the area and causing her to crack her neck. Patient''s primary care provider told her this tingling is a result of the vaccine being given too low on the arm. Patient also reports she has gone to physical therapy as a result of this adverse event she associates with the Moderna vaccine.


VAERS ID: 1422077 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1422513 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1422526 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1422557 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Unknown  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1422744 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1423321 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Disorientation, Dysarthria, Fatigue, Hypertension, Incontinence, Lethargy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamins Levothyroxine Blood Pressure medication eye vitamins
Current Illness: none
Preexisting Conditions: Heart Disease Smoker
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient became disoriented incontinent extremely high blood pressure lethargic exhausted confused jumbled speech


VAERS ID: 1423346 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1423354 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8729 / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Error: Improper Storage (temperature)


VAERS ID: 1423532 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Zoloft, zertec,gilpezide,
Current Illness:
Preexisting Conditions: Fibromyalgia, diabetes, asthma, PTSD, bpd
Allergies: Toradol, walnuts
Diagnostic Lab Data: 2 EKGS, 1 on 6/4 and the other on 6/11, showing possible enlargement of left atrial valve. Blood tests on 6/4 normal. ECG on 6/24, waiting for results.
CDC Split Type:

Write-up: Severe chest pains found to not be myocarditis or pericarditis. However, the vaccine may have inflamed a previously unknown heart condition.


VAERS ID: 1423794 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041CZ1A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Feeding disorder, Feeling abnormal, Migraine, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin 300mg 2xdaily Verapamil 40mg 2xdaily Tizanidine 40mg 2xdaily
Current Illness:
Preexisting Conditions: Migraines Pinched Nerve in neck
Allergies: Shellfish Contrast
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: He woke up with a severe migraine, was kind of foggy. He felt like he had been poisoned. He was nauseous, spinning, and couldn''t eat. He rode it out. It took 1 day to get back to normal.


VAERS ID: 1423855 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Ageusia, Anosmia, Decreased appetite, Dizziness, Fatigue, Gait disturbance, Headache, Lethargy, Muscle spasms, Nausea, Respiratory tract congestion, Sinusitis, Stomatitis, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Budesonide 3mg/once daily
Current Illness:
Preexisting Conditions: Crohns, celiac, IBS, COPD, asthma, GIST tumor
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Full body cramping. Stomach feel like it?s in knots. Headache. Nausea. Vomiting. Stumbling. Dizziness. Sinuses and mouth scratchy. Congestion. Severe fatigue and lethargic. Loss of appetite, taste and smell.


VAERS ID: 1424072 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-03
Onset:2021-06-02
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029K20A / 2 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor 5 mg every day Ecotrin - 1 p.o. every day
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: Allergic to tomatoes Allergic to IV Iodine
Diagnostic Lab Data: Tested positive for COVID-19 (PCR) on 6/2/2021.
CDC Split Type:

Write-up: Breakthrough vaccine.


VAERS ID: 1424129 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-05-07
Onset:2021-06-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Joint range of motion decreased
SMQs:, 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: Men?s daily multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint pain started about 3 weeks after vaccine. First affected joints in both hands and finger, has progressed to knee pain since first noticed. Range of motion in hands is limited due to pain and loss of flexibility. Range of motion in knees is currently unaffected but pain is moderate during daily activities and work. No prior history of injuries to hands or knees.


VAERS ID: 1424284 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-06-02
   Days after vaccination:83
Submitted: 0000-00-00
Entered: 2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Angiogram pulmonary abnormal, Anti factor X activity increased, Anticoagulant therapy, Antiphospholipid antibodies negative, Arteriogram carotid normal, Asthma exercise induced, Atrial septal defect, Blood folate normal, Blood homocysteine increased, Cardiolipin antibody negative, Cerebral artery occlusion, Cerebral artery thrombosis, Cerebral infarction, Chest discomfort, Computerised tomogram head abnormal, Deep vein thrombosis, Dysarthria, Dyspnoea, Dyspnoea exertional, Echocardiogram, Echocardiogram abnormal, Facial paralysis, Factor II mutation, Gene mutation identification test negative, Headache, Intensive care, International normalised ratio normal, Muscular weakness, Paradoxical embolism, Protein C increased, Protein S increased, Prothrombin time prolonged, Pulmonary embolism, Thrombectomy, Thrombolysis, Upper motor neurone lesion, Vitamin B12 normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Ischaemic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: norgestimate-ethinyl estradiol (Tri-Sprintec, 28,) 0.18/0.215/0.25 mg-35 mcg (28) Oral Tab Sig: Take 1 tablet by mouth daily Cyclobenzaprine (FLEXERIL) 10 mg Oral Tab Sig: Take 1 tablet by mouth 3 times a day as needed for muscle spasms
Current Illness: Thoracic Spine Pain
Preexisting Conditions:
Allergies: nkda
Diagnostic Lab Data: Ref. Range 6/14/2021 16:24 6/16/2021 18:22 FOLATE Latest Ref Range: $g=4.0 ng/mL 12.0 HOMOCYSTEINE Latest Ref Range: 0.0 - 13.9 umol/L 14.4 (H) VIT B12 Latest Ref Range: $g=200 pg/mL 357 Results as of 6/24/2021 13:13 Ref. Range 6/14/2021 11:32 6/14/2021 16:24 6/15/2021 15:00 6/15/2021 21:12 6/16/2021 03:10 6/16/2021 07:01 6/16/2021 16:10 6/21/2021 13:33 APTT Latest Ref Range: 23.8 - 36.1 second(s) 24.1 28.9 PT Latest Ref Range: 11.7 - 14.3 second(s) 13.6 INR Latest Units: Ratio 1.1 PROT C Latest Ref Range: 70 - 130 % TND 87 193 (H) PROT S Latest Ref Range: 65 - 140 % TND 90 196 (H) ANTICOAG Unknown NOT IND NOT IND CARDIOLIPIN AB, SER Latest Ref Range: NEGATIVE NEGATIVE LEIDEN FACTOR ANAL Unknown NEGATIVE LUPUS ANTICOAG Latest Ref Range: NEGATIVE TND NEGATIVE NEGATIVE ANTI XA, HEP UNFR Latest Units: U/mL <0.10 0.15 0.27 0.16 COMMENT, COAGULATION Unknown SEE NOTE F2 GENE P. G20210A MUTATION Unknown NEGATIVE
CDC Split Type:

Write-up: 35 Y female no signif PMH but with OCP (TriSprintec) since at least 2018, family hx of strokes in family members'' 40s, daily marijuana use, and recently (10 days ago) seen in clinic for shortness of breath who per chart review was in her usual state of health until 10:30 am today shen she developed R sided headache, slurred speech, and L arm weakness while she was working out at the gym. At the time she was doing light cardio exercise including jumping jacks and lunges. On arrival stroke scale - 3 for facial palsy, left arm drift, and mild dysarthria. CT H demonstrated hyperdense R MCA which corresponded with a filling defect in the R MCA (M2/M3 segment) c/w thrombosis; her CTa neck was normal and there were no e/o hemorrhage. Furthermore, this same CTa showed extensive bilateral PE. An extended stroke alert was called and she was given IV tenecteplase at 1250pm and underwent thrombectomy. 2 weeks ago (6/2) she was seen in clinic for sudden onset shortness of breath, thought at that time by that clinician to be most likely exercise-induced asthma vs less likely ACS. She was advised to use her already written albuterol and had follow up in 2 days (6/4). At that time it was noted she had more SOB with exercises and increased chest tightness that were both relieved with inhaler use. She has a family history of strokes: Maternal uncle and maternal aunt strokes in their 40s Recent surgeries/immobility/travel: No surgeries, no more than a 2 hour car ride Smoking history: Dialy cannabis smoking but no tobacco smoking Age appropriate cancer screen: Yes Family history of cancer: breast cancer in grandmother Baseline functional status Full IADL''s and A&O x4. At time of ICU consult, temp 98, BP 140/89, HR 88, RR 18. Patient received: intraop NS, Versed, fentanyl, tenecteplase for thrombectomy Labs notable for All labs wnl 35 y.o female with no significant PMH on OCP presented with shortness of breath and slurred speech and LUE weakness found to have acute right M1 occlusion. She underwent thrombolysis with successful recanalization. Deficits resolved. She was also found bilateral PE and non occlusive DVT. Repeat imaging stable. TTE with evidence of small PFO. Today, she is feeling well, denies shortness of breath or new neurological complaints/deficits. 1. R MCA infarct s/p TNK and thrombectomy 6/14 with no residual deficits - secondary to paradoxical embolism. Appreciate neurology recommendations. Small PFO found on TTE, appreciate cardiology evaluation for closure. 2. Bilateral PE/non occlusive DVT - mildly elevated homocysteine level. Rest of hypercoagulable workup pending. Continue heparin gtt, transition to Pradaxa with Lovenox bridging.


VAERS ID: 1426761 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-06-02
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bursitis, X-ray
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Lupus Glaucoma Poly Kendistris Livedo Reticularis Vaculitis Tachycardia fibromyalgia Immune Deficiency
Allergies: Penicillin Erythromycin Sulfa Spiro Drugs
Diagnostic Lab Data: x-ray
CDC Split Type: vsafe

Write-up: I went to hospital on 06/04/2021. They x-rayed it and wrapped it. I followed up with my rheumatologist. She put a drain in it but it came back that night. They diagnosed it as olecranon bursitis. All I have on now is a compression wrap.


VAERS ID: 1426763 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: patient said she had numbness occure 2 hours after first shot. numbness in left neck,left chest,left arm,left shoulder


VAERS ID: 1427413 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Public       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? Yes
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: Urticaria and rash 7 days after first dose.


VAERS ID: 1427695 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-02-25
Onset:2021-06-02
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Dyspnoea, Respiratory syncytial virus test positive, SARS-CoV-2 test negative, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Venlafaxine
Current Illness: none
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: Covid Negative 6/10 RSV positive 6/10
CDC Split Type:

Write-up: Around the 2nd I was coughing up green phlegm and had a severe cough. After getting antibiotic, the symptoms were not better after the dosage was over. I started getting more of a wet, heavy cough. Most of the phlegm I was coughing up was coming from my lungs. I was getting light headed and breathing was getting very struggled. On the evening of 6/10/2021, my mom advised that I go to the ER as my breathing was getting very taxed. During this visit I was diagnosed with RSV and tested COVID negative.


VAERS ID: 1427760 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chills, Dizziness, Fatigue, Hemiparesis, Muscle tightness, Musculoskeletal stiffness, Sinusitis, Visual impairment
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Immediately after receiving vaccine, patient felt dizzy but waited 15 minutes and felt ok to drive home. Upon arriving home, she felt sensation of weakness on her left side. She stated that her vision was somewhat impaired and that she felt weak, although able to move her arms and legs. This lasted for around one hour. She also started to have symptoms of fatigue, stiffness of neck and shoulders(bilaterally), chills, tightness of the upper back and chest but no shortness of breath noted. These symptoms continue. She went to an urgent care office on 6/11/21 and was diagnosed with a sinus infection. No lab work or medical tests were performed. She was prescribed Augmentin and finished full regimen of medication. The symptoms of fatigue, stiffness of neck and shoulders(bilaterally), chills, tightness of the upper back and chest continue today.


VAERS ID: 1427867 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Patient describes flushing and face, neck and upper chest, dizziness and lightheadedness that started 45 minutes after the vaccine was administered. She had already left the clinic at this time. She did not take any medications or seek any medical attention. The symptoms resolved 45 minutes after they started. She subsequently consulted with her primary care provider, who advised her not to get her second vaccine dose and referred her to an allergist for further evaluation and advice.


VAERS ID: 1427884 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-06-02
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: PRN Tylenol, Ventolin inhaler, Dulcolax PRN, multivitamin, miralax
Current Illness: No acute conditions noted.
Preexisting Conditions: Type 2 Diabetes, anemia, hypercholesteremia, vitamin d deficiency, CKD, hypertension, goiter
Allergies: Niacin preparations, actos
Diagnostic Lab Data: PCR on 05/28/2021 confirming COVID diagnosis.
CDC Split Type:

Write-up: Patient fully vaccinated, admitted to hospital on 05/28/2021 for COVID pneumonia, after being diagnosed per PCR on 05/28/2021. Patient discharged home on 06/02/2021 and then readmitted 06/08/21 to 06/10/21 for failure to thrive. Discharge home with homecare on 06/10/21.


VAERS ID: 1427983 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWNWILLCALL / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blister, Diarrhoea, Headache, Pain in extremity, Rash, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, ibuprofen
Current Illness: none
Preexisting Conditions: arthritits
Allergies: Keflex-rash Hydrocodone-rash Codeine-rash
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: Starting on the day of the vaccine, 6 hours afterwards I had left arm pain and notice a blister appeared. I also had upset stomach, headache, and diarrhea. By the next morning, most symptoms resolved but the rash remaining and diarrhea. The rash is raised, blister-like, measles looking, itchy and painful and now all over my body from head to toe. I did not take any medication. I went to see the doctor and was prescribed 2 topical creams which not help. The rash continue to spread. I let it run its course and now it''s slowly improving. I am still having daily diarrhea.


VAERS ID: 1428099 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site swelling, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: patient reported increased swelling and pain at injection site day after receiving the second dose of moderna vaccine followed by admission to hospital for 2 days with reported oxygen support.


VAERS ID: 1428243 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-02-25
Onset:2021-06-02
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood urine present, Culture negative, Haematuria
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Tubulointerstitial diseases (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: simvastatin, olanzapine, lisinoplil, allopurinol, levothyroxin
Current Illness:
Preexisting Conditions: schizophenia, hypothyroidism, hypertension
Allergies: none
Diagnostic Lab Data: hematuria, culture negative
CDC Split Type:

Write-up: blood in urine


VAERS ID: 1429319 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-01
Onset:2021-06-02
   Days after vaccination:93
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029A21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Chills, Cough, Dizziness, Fatigue, Illness, Productive cough, Pulmonary congestion, Sinus congestion
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTRADIOL; PROGESTERONE; BABY ASPIRIN; ESCITALOPRAM; CRESTOR; CLARITIN [LORATADINE]; FLONASE [FLUTICASONE PROPIONATE]; MAGNESIUM; VITAMIN C [ASCORBIC ACID]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: Joint pain; Chills; Congested chest; So bad COVID-19 infection after the 2nd dose; Very sick; A lot of phlegm; Lots of coughing; Congested head/ Sinus infection; Dizziness; Fatigue; This spontaneous case was reported by a patient and describes the occurrence of PULMONARY CONGESTION (Congested chest) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020B21A and 029A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included ESTRADIOL, PROGESTERONE, ACETYLSALICYLIC ACID (BABY ASPIRIN), ESCITALOPRAM, ROSUVASTATIN CALCIUM (CRESTOR), LORATADINE (CLARITIN [LORATADINE]), FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]), MAGNESIUM and VITAMIN C [ASCORBIC ACID] for an unknown indication. On 01-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Jun-2021, the patient experienced PULMONARY CONGESTION (Congested chest) (seriousness criterion medically significant), COVID-19 (So bad COVID-19 infection after the 2nd dose), ILLNESS (Very sick), PRODUCTIVE COUGH (A lot of phlegm), COUGH (Lots of coughing), SINUS CONGESTION (Congested head/ Sinus infection), DIZZINESS (Dizziness), FATIGUE (Fatigue) and CHILLS (Chills). On an unknown date, the patient experienced ARTHRALGIA (Joint pain). At the time of the report, PULMONARY CONGESTION (Congested chest), COVID-19 (So bad COVID-19 infection after the 2nd dose), ILLNESS (Very sick), PRODUCTIVE COUGH (A lot of phlegm), COUGH (Lots of coughing), SINUS CONGESTION (Congested head/ Sinus infection), DIZZINESS (Dizziness), FATIGUE (Fatigue), ARTHRALGIA (Joint pain) and CHILLS (Chills) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient took Aleve, Mucinex DM to breakup the phlegm, Tylenol, and Pain pill as a treatment medications. Company Comment : For the event of COVID-19:Based on mechanism of action of mRNA -1273 vaccine, the event is assessed as unlikely related to mRNA-1273.(Moderna COVID-19 Vaccine) For other events:Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Reporter did not allow further contact; Sender''s Comments: For the event of COVID-19:Based on mechanism of action of mRNA -1273 vaccine, the event is assessed as unlikely related to mRNA-1273.(Moderna COVID-19 Vaccine) For other events:Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1429599 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Dyspnoea, Electrocardiogram, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (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: Pepcid, Zyrtec, escitalopram, synthtoid, ambien, trazodone
Current Illness: None
Preexisting Conditions: Hypothyroid, asthma, insomnia, sleep apnea
Allergies: Seasonal, dairy, cross reactive to grains
Diagnostic Lab Data: EKG, epi pen, steroids, blood work, increased blood pressure
CDC Split Type:

Write-up: Shortness of breath, increased heart rate beginning after 2 weeks


VAERS ID: 1429705 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-28
Onset:2021-06-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Fatigue, Vertigo, Vestibular neuronitis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benazapril, atorvastatin, levothyrozine, hydrochlorothiazide, calcium, mutli vits, magnesium, vit D
Current Illness: none
Preexisting Conditions: hypertension, hypothyroid, hyperlipidemia
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Sudden onset severe vestibular neuritis with vertigo, vomiting, extreme prostration - extremely symptomatic with significantly elevated BP - severely symptomatic x 36 hrs - mildly symptomatic for another 3 days


VAERS ID: 1429732 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:1991-12-07
Onset:2021-06-02
   Days after vaccination:10770
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

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

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

Write-up: pt feeling extreme nauseous from 6/2 after her 2nd dose of covid vaccine.


VAERS ID: 1429757 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspepsia
SMQs:, Gastrointestinal nonspecific dysfunction (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: Oxcarbazepime 600mg x2 daily
Current Illness: None
Preexisting Conditions: Seizures
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Heartburn


VAERS ID: 1429764 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-24
Onset:2021-06-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site erythema, Injection site reaction
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: Birth control, vitamin d, multi-vitamin, benadryl
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Covid arm" , oval shaped red patch around injection site. Lasted 3 weeks plus, still mildly present at time of second dose, then more pronounced.


VAERS ID: 1429798 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Fall, Speech disorder
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow)

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

Write-up: Systemic: Stroke-Severe, Additional Details: Spouse of patient states that wife fell on 6/2/21 and went to the emergency room. States that MD said patient no histoy of blood disorder and believes patient got a stroke due to COVID vaccine. Currently taking blood thinners for incident. Now has trouble speeking due to blood clot/stroke.


VAERS ID: 1429949 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

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

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

Write-up: No reported adverse event- 2nd dose given out of CDC guidelines. 2nd dose was administered at 21 days, instead of 28. The patient reports having no issues with either vaccination.


VAERS ID: 1430057 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever of 102, chills, pain in arm, weakness, fatigue, headache


VAERS ID: 1430158 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-28
Onset:2021-06-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase, Blood creatine phosphokinase MB, Burning sensation, C-reactive protein, Cardiac discomfort, Catheterisation cardiac, Chest X-ray, Echocardiogram, Electrocardiogram, Fibrin D dimer, Glomerular filtration rate, Lipids, Myocardial necrosis marker, Myocarditis, Red blood cell sedimentation rate, Respiratory viral panel, Troponin
SMQs:, Peripheral neuropathy (broad), Cardiomyopathy (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvastatin, Estarylla, vitafusion probiotic for digestive health
Current Illness: None
Preexisting Conditions: High cholesterol (hereditary)
Allergies: Alcohol (beer, cider, liquor, etc)
Diagnostic Lab Data: EKGs (x5), SARS antigen test, cardiac stat panel, glomerular filtration rate, CK total and CKMB, c reactive protein, sedimentation rate, d-dimer test, lipid panel, troponin tests (x4) chest X-ray, echocardiogram, heart cath procedure, all performed from June 2nd to June 4th.
CDC Split Type:

Write-up: Woke up with burning sensation and pressure in my heart, felt like a heart attack and was treated with Myocarditis, treated with metoprolol succinate to help heal the inflammation of my heart.


VAERS ID: 1430172 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-21
Onset:2021-06-02
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9263 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Dyspnoea, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metmorfin, premadone, magnesium, aspirin, crestor
Current Illness: none
Preexisting Conditions: diabeties type 1, heart one stint.
Allergies: betablockers
Diagnostic Lab Data: contact Dr.
CDC Split Type:

Write-up: Arrhythmia, shortness of breath and numbness in legs


VAERS ID: 1430175 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angina pectoris, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Other ischaemic heart disease (narrow)

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

Write-up: Over the course of the day I felt numbness in my arm and by the evening I felt excruciating heart pain


VAERS ID: 1430666 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053C21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Asthenia, Dysphagia, Dysphonia, Feeling abnormal, Gait disturbance, Heart rate increased, Oral discomfort, Peripheral coldness, Pharyngeal swelling, Presyncope, Rash macular, Swelling, Throat irritation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Hives, Asthma, Red blotches, fast heart beat / 58yrs old / 11-05-2020 / Fluzone PFS 2020-21 INJ 0.5ML
Other Medications: None during that day. Benadryl was taken for two weeks until the day before the vaccine appointment.
Current Illness: None.
Preexisting Conditions: Asthma, Ankylosing Spondylitis.
Allergies: FluzonePFS, Aspirin, Imitrex, Prilosec, Chemicals, Mold, Pineapple, Kiwi.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: After 7 minutes of the shot, the following events/symptoms started and gradually developed within 25 minutes: Fast heart beat, change in eyesight and then a feeling of neck disappearing-non existent. Episodes similar to Vasovagal (3) Involuntary movement of arms and legs Extremely cold hands, but I did not feel cold Burning sensation inside the mouth Numbness of mouth and lips, similar as when the dentist applies anesthesia Mild Swelling of the mouth and tongue Tightness and feeling of swollen throat and neck Difficult to speak-speaking as in slow motion Trouble swallowing Trouble walking, legs weakness (continue in next paragraph) For approximately 45 minutes Healthcare personnel at the facility provided lots of fluids and assistance until there were neither episodes similar to Vasovagal nor involuntary movement of arms and legs, the hands had a normal temperature, some strength was regained, the symptoms remain mild (did not increase) and there were no new symptoms. Hives in forehead, and red blotches in right cheek, neck, chest Hoarseness and feather sensation in throat After 2 hours of the shot, the hives and red blotches in the right cheek, neck, chest and the hoarseness and feather sensation in the throat developed. The mouth, tongue and neck were still swollen and numb. At that time, 50mg of Benadryl were ingested, again at bedtime, and for the next 2 weeks.


VAERS ID: 1431456 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvastatin 40 mg, synthroid 0.125, sertraline 100mg . metformin 500 mg, topiramate,50mg, Irvesarten 75mg, vitamin D 125 mcg, vepropion 150 mg,
Current Illness: no
Preexisting Conditions: pre diabetes high blood pressure one kidney
Allergies: penicillin, codeine, antibiotic with cillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: severely started with feet itching, base of wrist . Then Center scape and nap of the neck . Rash between breast . Thighs, neck ,most itching on left side .Welps up after itching. sometimes eyelids.


VAERS ID: 1431759 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-03
Onset:2021-06-02
   Days after vaccination:91
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Too many to list
Current Illness: none
Preexisting Conditions: diabetes, High blood pressure, and hyperlipidemia all well controlled
Allergies: Tetracycline and Brylinta
Diagnostic Lab Data: Diagnosed with chest car scan on6/2/21
CDC Split Type:

Write-up: Bilateral extensive pulmonary embolism


VAERS ID: 1432790 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Lethargy, Pain, SARS-CoV-2 test, Tinnitus
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hashimoto''s disease; Iodine contrast media allergy (Tightness in chest and throat and hives); Non-smoker
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20200301; Test Name: COVID-19 PCR test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210650238

Write-up: BODY ACHES; LETHARGY; TINNITUS ON THE LEFT EAR (LOW PITCH AND HIGH PITCH); This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hashimoto''s disease, abstains from alcohol, non smoker, and orange peel (has epi pen for) iodinated contrast. The patient experienced extreme bloating when treated with clarithromycin, and neurological side effects when treated with levofloxacin, and lips swelled up, rash and throat tightened up when treated with cortisone, high blood pressure when treated with prednisone, and rash when treated with methocarbamol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 02-JUN-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-MAR-2020, Laboratory data included: COVID-19 PCR test (NR: not provided) positive. On 02-JUN-2021, the subject experienced body aches. On 02-JUN-2021, the subject experienced lethargy. On 02-JUN-2021, the subject experienced tinnitus on the left ear (low pitch and high pitch). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and lethargy on 04-JUN-2021, and had not recovered from tinnitus on the left ear (low pitch and high pitch). This report was non-serious.


VAERS ID: 1433184 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Oropharyngeal pain, Orthostatic hypertension, Parosmia, Rhinitis, Taste disorder, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: escitalopram, aspirin, gabapentin, insulin determir, insulin aspart, ondansetron, rosuvastatin
Current Illness: None
Preexisting Conditions: uncontrolled type 2 diabetes, hypertension, charcot foot, obesity
Allergies: Demerol, morphine, Lyrica
Diagnostic Lab Data: Nothing in office, patient was sent to ER, no records received yet.
CDC Split Type:

Write-up: Fatigue, decreased sense of taste and smell, headache, rhinitis, sore thoraot, cough, dyspnea, diarrhea, nausea, vomiting, myalgia, blurry vision since 2nd Moderna dose, not tested for COVID, was sent to ER when presented to office w/ symptoms and orthostatic hypotension.


VAERS ID: 1433202 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-02-01
Onset:2021-06-02
   Days after vaccination:121
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), 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), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Acute kidney injury


VAERS ID: 1433258 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 023C21A / 1 LA / IM

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

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

Write-up: Rash on arm and chest. It was itching. Started 1-2 days after vaccine. Lasted 1 week after vaccine. Tried cortisone 10 and took plenty of showers to help with itching


VAERS ID: 1433405 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-06-02
   Days after vaccination:95
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Facial paralysis, Hyponatraemia
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Hearing impairment (broad), Chronic kidney disease (broad)

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

Write-up: FACIAL DROOP E87.1 - Hyponatremia


VAERS ID: 1433434 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-26
Onset:2021-06-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / UNK - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Visual disturbance


VAERS ID: 1434692 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SC

Administered by: Senior Living       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity, Periarthritis
SMQs:, Parkinson-like events (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisonpril Cymbalta levothyroxin ozempic
Current Illness: None
Preexisting Conditions: Thyroid and pre diabetes controlled blood pressure and diabetes
Allergies: Demerol
Diagnostic Lab Data: Waiting on Dr visit
CDC Split Type:

Write-up: My left arm feels frozen hurts can''t use lift it above my head. I can''t stretch out my arm.


VAERS ID: 1435918 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-27
Onset:2021-06-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebrovascular accident, Chills, Headache, Loss of consciousness, Nausea, Subarachnoid haemorrhage
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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: Comments: No medical history was reported.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: headache; nausea; chills; Hemorrhage brain; stroke; subarachnoid hemorrhage; was asleep and not aware of anything for 3 days; This spontaneous case was reported by a consumer and describes the occurrence of CEREBRAL HAEMORRHAGE (Hemorrhage brain), CEREBROVASCULAR ACCIDENT (stroke), SUBARACHNOID HAEMORRHAGE (subarachnoid hemorrhage), HEADACHE (headache), LOSS OF CONSCIOUSNESS (was asleep and not aware of anything for 3 days), NAUSEA (nausea) and CHILLS (chills) in a 49-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No medical history was reported. On 27-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-Jun-2021, the patient experienced CEREBRAL HAEMORRHAGE (Hemorrhage brain) (seriousness criteria hospitalization, medically significant, life threatening and intervention required), CEREBROVASCULAR ACCIDENT (stroke) (seriousness criteria hospitalization, medically significant, life threatening and intervention required) and SUBARACHNOID HAEMORRHAGE (subarachnoid hemorrhage) (seriousness criteria hospitalization, medically significant, life threatening and intervention required). On an unknown date, the patient experienced HEADACHE (headache) (seriousness criteria hospitalization, life threatening and intervention required), LOSS OF CONSCIOUSNESS (was asleep and not aware of anything for 3 days) (seriousness criteria hospitalization, medically significant, life threatening and intervention required), NAUSEA (nausea) (seriousness criteria hospitalization and life threatening) and CHILLS (chills) (seriousness criteria hospitalization and life threatening). The patient was hospitalized on 02-Jun-2021 due to CEREBRAL HAEMORRHAGE, CEREBROVASCULAR ACCIDENT, HEADACHE and SUBARACHNOID HAEMORRHAGE. The patient was treated with PARACETAMOL (TYLENOL) for Headache, at a dose of 1 dosage form. At the time of the report, CEREBRAL HAEMORRHAGE (Hemorrhage brain), CEREBROVASCULAR ACCIDENT (stroke), SUBARACHNOID HAEMORRHAGE (subarachnoid hemorrhage), HEADACHE (headache), LOSS OF CONSCIOUSNESS (was asleep and not aware of anything for 3 days), NAUSEA (nausea) and CHILLS (chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. The patient had brain hemorrhage and stroke. The patient was airlifted to nearby hospital from local hospital spent 8 days in the ICU. It was called subarachnoid hemorrhage. They took patient in ambulance and then they found blood in her brain so they flew her to nearby hospital for neurological ICU did EKG, MRIs and ultrasounds of brain (results were not provided). The patient had no underlying health conditions. After getting the vaccine, patient had the worse headache was screaming. The headaches very soon after the vaccine and it kept on getting worse and worse. The patient was taking Tylenol but it was not taking the pain away. The patient was asleep and not aware of anything for 3 days and then patient called an ambulance. The patient had nausea and chills was scared to get the second shot. No concomitant medication were provided. Company Comment: This case concerns a 49-year-old female hospitalized with serious unexpected events of cerebral haemorrhage, cerebrovascular accident, subarachnoid haemorrhage, loss of consciousness, headache, nausea, and chills. Event onset 6 days after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 49-year-old female hospitalized with serious unexpected events of cerebral haemorrhage, cerebrovascular accident, subarachnoid haemorrhage, loss of consciousness, headache, nausea, and chills. Event onset 6 days after second dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1437361 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO182 / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Myocarditis
SMQs:, Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG and CAT scan
CDC Split Type:

Write-up: Developed Myocarditis that lasted 12 hours. Went to hospital in for treatment.


VAERS ID: 1437471 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-25
Onset:2021-06-02
   Days after vaccination:97
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3246/PFIZER / 2 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Breast swelling, Breast tenderness, Dysmenorrhoea, Heavy menstrual bleeding, Menstruation delayed, Menstruation irregular, Nausea
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

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

Write-up: Irregular period starting at the end of May 2021. Heavy bleeding, severe cramping, and nausea lasting 1-2 days. Late start to period. Consistent breast tenderness and growth.


VAERS ID: 1437494 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-27
Onset:2021-06-02
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Pain
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Increased tiredness, dizziness, body aches


VAERS ID: 1437495 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-17
Onset:2021-06-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH G00177 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Numbness of the pinkie toe of the right foot. First noticed 2-3 weeks after first dose, still present 6 weeks after vaccination. Exacerbated after a hot shower and while walking.


VAERS ID: 1437529 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-01
Onset:2021-06-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chills, Gait inability, Hyperhidrosis, Impaired work ability, Injection site nodule, Mobility decreased, Pain, Peripheral swelling, Pyrexia, Scan normal, Ultrasound scan normal, Urine analysis normal, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: PCOS, Trigeminal Neuroglia, Obesity, A-Fib, Migraines, Back Injury, and Diabetes
Allergies: No
Diagnostic Lab Data: Scan of my arm, urine test, blood test, and ordered an Ultrasound to see if there were any other issues (hematoma or other issues). All the tests came back negative.
CDC Split Type: vsafe

Write-up: I started sweating and aching plus there was a knot in my left arm where the vaccine was administered. I contacted my doctor and he said that it injured the tissue in my arm (caused the swelling). I had two weeks of fever and chills, not being able to walk, vomiting, and my arm was so swollen until I had to go to urgent care because I could not wear my shirts (looked like a bee sting reaction). I couldn''t bend my arm and was not able to work during that time. I ended up going to the ER for my arm and the fever. The doctors said that I would eventually recover from the adverse event in time. It lasted for 8 days or 9 days (arm gradually went down approximately a week afterwards).


VAERS ID: 1437557 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024C21A / 1 LA / IM

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

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

Write-up: Swelling of lymph nodes, swelling under armpit on left side of body


VAERS ID: 1437680 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-30
Onset:2021-06-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Inflammation, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad)

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

Write-up: Irritation in my throat, getting hard to swollen, muscles in my throat felt tight. Which lead me to visit the doctor. Diagnosed with inflammation in the throat. Prescribed over the counter medication.


VAERS ID: 1437788 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 1 LA / IM

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

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

Write-up: patient said she had swelling in the left arm for two weeks. patient put on the ice pack and swelling went away


VAERS ID: 1437932 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-28
Onset:2021-06-02
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN O42A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Postmenopause, Vaginal haemorrhage
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: No e
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 days after my shot, I began to bleed. I continued to bleed vaginally for 5 days. have been post menopausal for about 2 years.


VAERS ID: 1437994 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-15
Onset:2021-06-02
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Haemorrhage, Ultrasound scan, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: Ultrasound
CDC Split Type: vsafe

Write-up: I learned I was pregnant the day after the first dose of my vaccine. Two and a half weeks after the second dose I experienced bleeding when my pregnancy was at seven weeks. I had spotting for two days. Two weeks after that I had heavier bleeding. I thought my pregnancy was progressing but it was confirmed that the baby stopped growing at seven weeks. I should have been eleven and a half weeks pregnant at that time. Due Date: 01/08/2022 Pregnancy: fourth


VAERS ID: 1438281 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-05-12
Onset:2021-06-02
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 8735? / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain natriuretic peptide increased, Cardiac imaging procedure abnormal, Chest pain, Computerised tomogram normal, Computerised tomogram thorax, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Headache, Immunoglobulin therapy, Intensive care, Myocarditis, Neck pain, Oedema, Pallor, Troponin increased, Vomiting
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: no
Allergies: NKDA
Diagnostic Lab Data: 6/2/21 (Chest CT scan): Medical Center - no pulmonary embolus Transferred to Hospital with chest pain with elevated troponin to 7.8, BNP of 175; presumed myocarditis post COVID Vaccine from 05/12/2021. 06/03/2021 (echo: Myocardial dysfunction with an LV ejection fraction of 35% 06/04/2021 (CMR: Epicardial and mid myocardial delayed enhancement of the inferior and inferolateral walls of the mid and basilar left ventricle consistent with myocarditis 06/05/2021 (echo: Myocardial dysfunction with an LV ejection fraction b/w 37-45% 06/07/2021 (echo: Myocardial improvement with an LV ejection fraction of 62%
CDC Split Type:

Write-up: On 06/02/2021, (23 days after vaccine) the patient and his identical twin brother were at dinner when patient had shortness of breath and chest pain. They brought the patient to Medical Center where a CT of the chest was performed to rule out a pulmonary embolus. No pulmonary embolus was identified and patient was transferred the patient via ambulance to Hospital to the intensive care unit. He was noted to have an elevated troponin, an elevated BNP and a left ventricular ejection fraction of 35%. He underwent a cardiac MRI on 06/04/2021 documenting delayed enhancement in the inferior and inferolateral walls of the left ventricle consistent with myocarditis. The patient''s chest pain was quite severe and was only relieved once he was in the intensive care unit at Hospital. He did well for 2-3 days and did not require inotropes but his troponin vacillated and his ejection fraction remain low. He was given IVIG non 06/05/2021 after his echo showed an ejection fraction between 37 in 45%. He subsequently developed headache emesis and neck pain. On hospital day 5, the father was quite concerned for his son and thought ?he was going to die?. The father shared pictures of the edematous, pale son that he took with his phone. He improved over the next 1-2 days and was discharged from the hospital with an ejection fraction on 06/07/21 of 62%.


VAERS ID: 1438444 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: After receiving his second dose, the patient reported having a seizure about 2 hours after his first dose. He said the episode lasted about 4-5 minutes, and he was covered in sweat afterwards. He did not follow up with a physician because he does not have insurance. He also did not inform the pharmacy until later because he was afraid we would refuse to administer the second dose.


VAERS ID: 1439841 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstrual disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO; COLLAGEN HYDROLYSATE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021709501

Write-up: My period started two days early on 02Jun (which by itself is not an issue) but I have not stopped bleeding since then and am still passing actual tissue/clots almost daily.; I have not stopped bleeding/ am still passing actual tissue/clots almost daily; This a spontaneous report from consumer (Patient). A 47-year-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0187), via an unspecified route of administration on 29May2021 (at the age of 47)(at 11:30 AM), as dose 2, single in left arm for covid-19 immunization at vaccine clinic. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient medical history was not reported and ha d no allergies to medications, food, or other products. Device Date was reported as 15Jun2021. The patient''s concomitant medications included lexapro (escitalopram oxalate) and collagen powder(collagen hydrolysate). The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0173) via unspecified route on left arm on 01May2021 01:30 PM for COVID-19 Immunization. On 02Jun2021 (at 12:00PM), patient experienced her period started two days early on 02Jun (which by itself is not an issue) but she has not stopped bleeding since then and still passing actual tissue/clots almost daily. The outcome of the events was not recovered.


VAERS ID: 1439867 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021716279

Write-up: Tinnitus after the second dose; This is a spontaneous report from a contactable consumer (reporting himself). A 72-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0182), via an unspecified route of administration in left arm on 29May2021 at 10:00 (age at the time of vaccination was 72-years-old) as a single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to the vaccination. Since the vaccination, the patient had not been tested for COVID-19. The patient had no known allergies. The patient had no relevant medical history. The patient did not receive any other medications within 2 weeks of vaccination. Previously, the patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0164), via an unspecified route of administration in left arm on 29Apr2021 at 09:00 as a single dose for COVID-19 immunization. On 02Jun2021, the patient experienced tinnitus after the second dose and resulted in disability or permanent damage. The patient did not receive any treatment medication for the event. The outcome of the event was not resolved. Information on Lot/Batch number is available; Further information has been requested.


VAERS ID: 1440243 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033B21A / 1 LA / IM

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

Write-up: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Lymph Node Swelling-Mild


VAERS ID: 1440514 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-16
Onset:2021-06-02
   Days after vaccination:78
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Laboratory test, Rheumatoid arthritis, X-ray
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Mild flu-like symptoms
Other Medications: One a Day Prenatal Vitamin with Choline, Lamotrigine 100mg, cyclobenzaprine 5mg, ibuprofen 800mg, Gabapentin 400mg, Vitamin b-12, vitamin D, Benadryl 4/day, percoset 7.5/325
Current Illness: None
Preexisting Conditions: Bipolar disorder, anxiety disorder, nerve damage from neck fusion at C1, osteoarthritis
Allergies: Adhesives, cats, grass, oak
Diagnostic Lab Data: X-ray on June 30, 2021. Blood test on July 1, 2021.
CDC Split Type:

Write-up: All joints hurt when I wake in the morning. The doctor suspects Rheumatoid Arthritis, but tests have not been completed and final diagnosis has not been made.


VAERS ID: 1440678 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 02C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood culture, Cardiac telemetry, Dizziness, Palpitations, Scan, Urine analysis abnormal
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: venlafaxine xr 225 mg daily(increased from 150 mg on 05/24/2021), astelazine nasal spray
Current Illness:
Preexisting Conditions: Depression, seasonal allergies
Allergies: penicillin, sulfa
Diagnostic Lab Data: Inpatient workup, including telemetry, blood cultures, scans, and urinalysis performed. urinalysis suggested possible UTI(but was contaminated by culture results) and this was treated. There was no dysuria or flank/suprapubic discomfort to suggest UTI prior or after. Orthostasis persisted even with fluid resuscitation. Midodrine 2.5 mg improved symptoms and patient was able to be discharged to home. Venlafaxine XR was decreased from 225 mg to 150 mg daily. At follow up on 7/1/2021 patient was still orthostatic/lightheaded. pulse 90 seated, bp 120/74; standing pulse 137, bp 90/60
CDC Split Type:

Write-up: symptoms of lightheadedness and racing pulse started about two hours after second shot. these symptoms persisted. seen in clinic and admitted on 06/24/2021 for severe orthostasis.


VAERS ID: 1440775 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Condition aggravated, Pleuritic pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (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: Medical marijuana; Plaquenil; Lexapro; Ativan; Losartan; aspirin; Vyvanse
Current Illness: none
Preexisting Conditions: Lupus; PTSD; ADHD; hypertension; Antiphospholipids syndrome
Allergies: Sulfa drugs; Cipro; Wellbutrin; Levaquin; Terbutaline
Diagnostic Lab Data: none
CDC Split Type: vsafe

Write-up: About 3 days after the vaccine 2nd dose, I noticed I was getting pleurisy chest pains. This time, the pain was on the left side (when normally is on the right side). I went to the doctor and was prescribed colchicine 0.6mg and prednisone 10mg. I am still having chest pains which has not resolved.


VAERS ID: 1441810 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-29
Onset:2021-06-02
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Aphasia, Brain oedema, Cerebral haemorrhage, Cerebral infarction, Cerebral microhaemorrhage, Cerebral small vessel ischaemic disease, Computerised tomogram head normal, Dizziness, Dysarthria, Haemorrhagic transformation stroke, Headache, Intraventricular haemorrhage, Magnetic resonance imaging head abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/A
Preexisting Conditions: Dyslipidemia Prediabetes Sensorineural hearing loss, bilateral
Allergies: None
Diagnostic Lab Data: 6/4/2021 MRI BRAIN: multiple small acute infarcts to left posterior frontal, left parietal and left posterior periventricular regions, mild chronic white matter ischemic changes. 6/26/2021: MRI/MRA brain-- several small acute infarcts in L MCA territory, watershed distribution. There has been interval development of an acute L frontal ICH w/ mild surrounding edema and mass effect w/ a thin adjacent DH and trace IVH. Chronic small vessel ischemic disease, several cortical microbleeds.
CDC Split Type:

Write-up: He then felt dizzines and a headache the following day. On 6/2/2021(4 days after vaccination) he had slurred speech which prompted his family to bring him to ER. CT brain negative for acute CVA. Pt was placed on DAPT (Plavix and ASA). On 6/25/2021-- pt was hospitalized again for severe mixed aphasia and dysarthria--- second stroke with hemorrhagic conversion.


VAERS ID: 1441906 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypertension, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Client reported an onset of "feeling lightheaded" while ambulating from vaccination area to observation area. The client subsequently developed nausea and dizziness following the receiving the 1st COVID vaccine Pfizer. The client notified personnel in the observation area of symptoms and laid down. She states she also developed mild chest tightness which resolved a few hours later. The client was provided a juice in the observation area. The client stated she tried to drink the juice, but spit it up immediately after. No medications were provided at the vaccination site. The client states she sought care at an urgent care immediately following departure from the vaccination site. The client states they obtained "vitals and checked my lungs" at the urgent care. The client also stated "my blood pressure was a little high." The client did not take any medication following the initial episode of feeling lightheaded and dizziness. She states her symptoms resolved about 24 hours after onset. The client stated she reported her initial reaction to her PCP and her PCP gave approval to receive the 2nd COVID Pfizer dose. Vitals obtained by RN Barberan were obtained by RN Barberan at 7:56PM were as follows HR 78 and BP 115/90. A medical consult was submitted via text message. Approval to proceed with 2nd COVID vaccine Pfizer was obtained by Summer Leal, Vaccine Operations via telephone. Client received the 2nd COVID vaccine Pfizer Lot# EW0191 at 8:24PM in the anti-gravity chair. RN Withers educated the client on s/s of anaphylaxis, when to seek EMS, 30 minute observation recommendation, and V-safe. The client voiced understanding of this. At 8:32PM the client reported nausea to EMT Bustamonte. RN Withers responded. Vitals obtained at 8:36PM were as follows: HR 78 and BP 144/100. The client denied SOB or dizziness at the time. The client removed their mask and RN Withers noted pallor on the client''s face. At 8:39PM the client denied any dizziness or feeling lightheaded. Vitals obtained at 08:44PM were as follows: BP 140/98 and HR 74. The client noted mild improvement of her nausea at that time. Repeat vitals obtained at 08:54PM were as follows 142/92 and HR 78. The client reported her nausea was "a little better." At 08:59 PM RN Withers offered to call EMS to evaluate the patient. The client denied EMS. RN Withers let the client know she could seek care at an urgent care, emergency department, or monitor her symptoms at home. The client elected to monitor her symptoms at home. RN Withers reiterated when to seek EMS and s/s of anaphylaxis. The client voiced understanding of this. The client stood up from the anti gravity chair without assistance, ambulated with a steady gait unassisted, and was visualized getting into a person vehicle driven by her husband at 9:03PM.


VAERS ID: 1443035 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-06-02
Onset:2021-06-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 - / -

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? Yes
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: Multiple ED visits/hospitalizations within 6 weeks of COVID vaccination. 6/2/2021 ED, 6/4/2021 ED to Hosp Admission, 6/12/2021 ED, 6/23/2021 hospital admission,


VAERS ID: 1443282 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-30
Onset:2021-06-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006C21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient called on 7/2 stating that 5 days after receiving vaccination started to have trouble walking and has had numb fingers. Patient states this has continued until now. Patient is going to follow up with doctor.


VAERS ID: 1445712 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-06-02
Submitted: 0000-00-00
Entered: 2021-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Blood test, COVID-19, Hyperhidrosis, SARS-CoV-2 test, Sinus disorder, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Non-smoker
Preexisting Conditions: Comments: Patient had no medical history. He had no known allergies and no current illness at the time of vaccination.
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: Blood test; Result Unstructured Data: Unknown; Test Date: 20210602; Test Name: SARS-CoV-2 rapid diagnostic test; Result Unstructured Data: Positive; Test Name: SARS-CoV-2 PCR test; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210701758

Write-up: CONFIRMED CLINICAL VACCINATION FAILURE; CONFIRMED COVID-19 INFECTION; SINUS; SWEATING; This spontaneous report received from a Pfizer on 25-JUN-2021 and concerned a 42 year old male. The patient''s weight was 99.79 kilograms, and height was 191 centimeters. The patient''s concurrent conditions included non smoker and patient had no medical history. He had no known allergies and no current illness at the time of vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1802070, expiry: UNKNOWN) dose was not reported, 1 total administered on 13-MAR-2021 to right arm at 08:30 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date in May 2021, patient underwent blood work a week before he knew he had COVID. On 02-JUN-2021, the patient experienced sinus, fever, body aches, diarrhea, congestion, nausea, headache, mild cough and sweating. On the same day, patient underwent SARS-CoV-2 rapid diagnostic test and the results came out to be positive. On an unspecified date the patient underwent SARS-COV-2 PCR TEST and the results came out to be positive (confirmed covid-19 infection and confirmed clinical vaccination failure). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sinus, and sweating on JUN-2021, was recovering from confirmed covid-19 infection, and the outcome of confirmed clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: 20210701758 -COVID-19 VACCINE AD26.COV2.S-confirmed clinical vaccination failure. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: SPECIAL SITUATIONS.


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