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

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



Case Details (Reverse Sorted by Onset Date)

This is page 262 out of 8,010

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VAERS ID: 1675408 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, bupropion, venlafaxine, iron, d3
Current Illness: N/A
Preexisting Conditions: Sinusitis, fibromyalgia
Allergies: Codeine
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Headache following day, stopped with medication. Swollen and sore left armpit, ongoing


VAERS ID: 1675411 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hot flush, 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: After getting the flu shot (right after giving birth). Age 24. 09/04/2015.
Other Medications: Tylenol
Current Illness: No
Preexisting Conditions: Asthma
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Nausea, fatigue, chills/hot flashes and headache.


VAERS ID: 1675546 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia, Testicular pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, elderberry / vitamin c / vitamin d, antibiotic for acne
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Severe Tree nut allergy
Diagnostic Lab Data: None as of yet.
CDC Split Type:

Write-up: Adverse event reporting: testicular pain (left testicle). He has never had this type of pain before. It mainly hurts when he moves. He also had chills, mild fever (101.5), aches. We knew to expect those but did want to report the testicular soreness since it?s not a listed side effect. It may not be related and just coincidental but wanted to report in case there is a connection.


VAERS ID: 1675551 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient did not say, just said history of vagal syncope to needles
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was given vaccine. Within 5 minutes patient fainted and revived with smelling salts. Patient sat in pharmacy under care for 30 minutes. Patient was ok to leave pharmacy walking by themselves. Patient was checked on 2 hours later and still doing fine.


VAERS ID: 1675553 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 3 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Erythema, Myalgia, Peripheral swelling, Pyrexia, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Fever & chills, feeling bad, after 2nd dose of Moderna, duration of 4 hrs. After 1st dose of Moderna, 1week after administration
Other Medications: Multi vitamin, Omega 3, calcium
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, (101), chills, muscle aches. Arm is swollen, hot to the touch, red. Has lasted over 24 hrs. Taking Ibuprofen, which helps.


VAERS ID: 1675583 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048 F21A / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Headache, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol, verapamil, ezetimibe, aspirin, atorvastatin, lutein, losartin
Current Illness:
Preexisting Conditions: heart disease, prostate cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Soreness, fatigue, swelling, headache, joint pain


VAERS ID: 1675594 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: swollen armpit lymph nodes on side of injection - two days after administration and continuing currently on third day


VAERS ID: 1675595 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products
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: Patient had tingly lips after receiving the first Moderna COVID shot in March. She was 53 years old.
Other Medications: Trulicity, Losartan, Metformin, Pravastatin
Current Illness: None
Preexisting Conditions: High blood pressure, Type 2 diabetes
Allergies: Lisinopril
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient received the Moderna shot in March and had tingly lips, so she did not finish the series. I administered the Pfizer shot 9/5/21 and did not know about the previous shot until I had already given her the Pfizer shot.


VAERS ID: 1675605 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (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: Fish oil, vitamin d, vitamin c, probiotic, iron
Current Illness: Virus with post nasal drip and cough
Preexisting Conditions: Endometriosis
Allergies: Latex, penicillin, Zofran, bananas, certain artificial colors and flavors
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm within hour of injection that got worse with rest, facial paralysis within 3 hours, muscle weakness within 12 hours


VAERS ID: 1675627 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Peripheral swelling, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt stated her arm, face and lips swelled. She went to the hospital and has since recovered.


VAERS ID: 1675654 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dysphagia, Heart rate increased, Hypoaesthesia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), 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), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Sexual dysfunction (broad)

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

Write-up: Left-side numbness, swollen tongue, difficulty swallowing, rapid heart beat, increased blood pressure and dizziness.


VAERS ID: 1675711 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Started with shoulder pain, then in the night I had pain in my forearm down into my wrist and hand that led to tingling in my fingers


VAERS ID: 1675730 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Mild


VAERS ID: 1675740 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chest X-ray normal, Dysphagia, Hypoxia, Rhonchi, Tremor
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (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: Combivent, alprazolam, syprexa, trazadone, amlodipine, cvrverd, carvedilol, acetaminophen, glucagon, glucose gel, humalog, ferrous gluconate tablet, atorvastatin, aspirin, lacosamide, Eppra, metformin, potassium chloride
Current Illness:
Preexisting Conditions: T2DM, seizures, CHF, anemia, asthma, dysphagia, anxiety, hemiplegia and hemiparesis, hyperlipidemia, legal blindness, atheroscleretic heart disease
Allergies: No known allergies
Diagnostic Lab Data: Chest xray done at hospital, results normal.
CDC Split Type:

Write-up: Tremors, difficulty swallowing, rhoncus lung sounds, hypoxia


VAERS ID: 1675767 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Retching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: Patient stated that on 09/05/2021 at approximately 6:00 P.M. that he fainted, he then was dizzy and got the dry heaves. Then started to profusely sweat, applied cold compresses and in 15 to 20 minutes felt better. Later got up from sitting position and fainted again, recovered and was fine. Only treatment he used was cold compresses.


VAERS ID: 1675792 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO287 / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: enalapril
Current Illness:
Preexisting Conditions: ANEURYSM/GUILLAIN-BARR, HTN, HIGH CHOLESTEROL
Allergies: NONSE
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was directed by vaccintor to wait 30 min for observation due to history of Guillain-Barre. While patient was steated she began to have a syncopal episode, observation team member assisted patient to floor, where she was observed to have regular/non-labored breathing, and a heart rate in the 120''s, EMS response was activated. Patient had no hives, no redness, no swelling. Patient denied having any pain, was alert to location and event of receiving vaccine. Patient reported lat oral intake of breakfat between 7-9am this morning, EMS arrived on scene, assuming care, and tranported patient to emergency department for further evaluation.


VAERS ID: 1675828 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erectile dysfunction
SMQs:, Sexual 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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Erectial dysfunction


VAERS ID: 1675842 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SYR

Administered by: Pharmacy       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? 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: NA
CDC Split Type:

Write-up: Hives on trunk of body and on right forearm. Appeared about four hours after the shot and treated with Benadryl. Appeared again about 18 hours after the shot and treated with Benadryl again. Itching stopped but hives were still visible.


VAERS ID: 1675843 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-31
Onset:2021-09-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

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

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

Write-up: Severe body aches, head ache, fever


VAERS ID: 1676050 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Hypotension, Loss of consciousness, Palpitations
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Multivitamin, D3, Magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Heart palpitations subsided by the time I got to ER. Had BP monitor and EKG, metabolic blood panel
CDC Split Type:

Write-up: Day 3 after second dose had heart palpitations for approximately 8 hours, then very low blood pressure, and passed out. Went to urgent care, refered to ER.


VAERS ID: 1676064 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect dose administered, Product preparation error
SMQs:, Medication errors (narrow)

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

Write-up: PT WAS ADMINISTER AN UNDILUTED 0.3 ML DOSE OF THE VACCINE


VAERS ID: 1676480 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: N/a
Diagnostic Lab Data: I had extensive labs drawn right before the vaccine was given on the same day and everything was normal. No new labs drawn since bruising began.
CDC Split Type:

Write-up: Multiple bruises with different sizes on back of thighs on both legs, bruises on knees, shins, and feet.


VAERS ID: 1676782 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Contusion, Dyspnoea, Fatigue, Heart rate irregular, Myalgia, Oral pain, Pain, Pain of skin, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin XL, lo-loestrin fe, melatonin, multivitamin
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: the night of vaccine, i became fatigued and sore. the next day i had a fever of between 100 and 103 F. My muscles and all my joints were incredibly painful. I bruised almost every time something touched me. My scalp was sore and my mouth was sore. When i took/take a deep breath, i feel short of breath. when i am up walking around, i can feel my heart beating funny.


VAERS ID: 1676792 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / SYR

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

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

Write-up: Full upper torso rash from belly button to forhead.


VAERS ID: 1678481 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness postural, Fall, Feeling cold, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient stood up and felt lightheaded, collapsed onto floor shortly after. Pharmacist and technician went out onto sales floor to assist. Patient given water and a chair to sit in. Patient became pale, started sweating and stated he is cold. Took him into immunization room to monitor patient.


VAERS ID: 1678533 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-09-05
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

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

Write-up: Moderna 3/11 and 4/8. Positive on 9/5 admitted 9/5 to current


VAERS ID: 1678541 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: SICCA SYNDROME, IMFLAMMATORY POLYNEUROPATHY,CHRONIC PAIN
Preexisting Conditions: LISTED ABOVE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: REDNEES RASH LEFT ARM AND SWELLING LEFT CERVICAL AREA


VAERS ID: 1678573 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dizziness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: PT c/o dizziness and chest discomfort 15 minutes after taking 2nd dose Pfizer. No shortness of breath noted. No rash or swelling noted. PT remains alert, oriented and talkative. VS taken O2 Sat 100%, HR 72, RR-20, BP 110/70 PT stated that she didn''t eat breakfast and was a little anxious prior to shot. Mom gave food and water which PT tolerated well & stated she felt better. PT monitored for additional 30 minutes and remains alert, oriented & talkative. Vitals RR 18, HR 66, BP 110/70, O2 sat 100%. No further c/o of dizziness or chest discomfort, PT cleared. Parents instructed to seek medical attention if PT''s symptoms return. Parents verbalized understanding. PT walking at steady gait & voices no concerns or questions.


VAERS ID: 1678625 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2020-12-21
Onset:2021-09-05
   Days after vaccination:258
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid-19 PCR test, positive (9/6/21)
CDC Split Type:

Write-up: Developed Covid-19 symptoms, tested positive for infection.


VAERS ID: 1678669 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 3 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Injection site rash, Pain in extremity, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol 90mcg Aspirin 81mg Atorvastatin 40mg Lisinopril 10mg Metoprolol 25 mg Pantoprazole 40mg Vitamin D3 125mg Wixela 50mcg Zyrtec 10mg
Current Illness: None
Preexisting Conditions: Asthma, chest pain, reflux, high cholesterol, high blood pressure, cutaneous T cell lymphoma, osteoporosis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Very bad headache about 3 hours after vaccine on 9/5 Chills, sore arm, headache & palpitations 1am 9/6 Fever. 101.9, headache, sore arm, palpitations most of the day 9/6 Headache & rash at injection site 9/7 Fluids & ibuprofen not helping


VAERS ID: 1678686 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Gait inability, Muscle spasms, Pain
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol 50mg (once daily)
Current Illness: None
Preexisting Conditions: Degenerative Disc Disease Osteoarthritis Nerve Damage in Back and Cervical
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Unable to walk, excruciating muscle spasm in back, legs and arms. Unbearable pain throughout the day. Amplified arthritis pains.


VAERS ID: 1678718 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-12
Onset:2021-09-05
   Days after vaccination:236
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 RA / IM

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

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

Write-up: Breakthrough Covid positive test on 9/5/2021 confirmed by positive PCR test


VAERS ID: 1678741 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-09-02
Onset:2021-09-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC318 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Electrocardiogram, Full blood count, Pain, X-ray
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pertusis
Other Medications: None.
Current Illness:
Preexisting Conditions: Mild exercise-induced asthma.
Allergies: None.
Diagnostic Lab Data: EKG, X-RAY, CBC.
CDC Split Type:

Write-up: 72 hours later, sharp chest pain, feeling of heavy chest. Pain increased with deep inspiration.


VAERS ID: 1678754 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-09-05
   Days after vaccination:149
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Blood immunoglobulin G decreased, Blood immunoglobulin M decreased, COVID-19, Chest X-ray normal, Computerised tomogram head normal, Diarrhoea, Headache, Nausea, SARS-CoV-2 test positive, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC Excedrin
Current Illness: Denied
Preexisting Conditions: Denied
Allergies: Codeine
Diagnostic Lab Data: Outpatient POS COVID-19 Testing SARS-CoV-2 Antigen and PCR testing POS on 9/5/2021 IgM 0.014 IgG 0.03, both on 9/5
CDC Split Type:

Write-up: 56 year old female with hx migranes, no other hx, presents with nausea and vomiting and abdominal cramping, and loose stool x 1, yesterday she was tested positive for COVID 19, she felt worse so was brought tonite with headache and continued nausea and vomiting q 15 minutes, in ED she was given fluids and zofran which was ineffective and then got reglan and pepcid with some relief. She got toradol for headache. No pulmonary symptoms, no cough or shortness of breath, chest xray no infiltrates, CT head done and was negative.


VAERS ID: 1678773 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-05
Onset:2021-09-05
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: Covid disease on 09/07/2021


VAERS ID: 1678781 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Dysmenorrhoea, Nausea, Pain, Pain in extremity, Uterine pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: I experienced the most severe menstural cramps that I have ever had since I started my period as a teenager. Normal pain relief medication did not reduce the pain at all. I was in extreme pain for approximately 6 hours before the cramps stopped on their own. Pain was in my uterus, radiating to my lower back, down the front of my legs, and I had nausea which has never happened to me on my cycle before.


VAERS ID: 1678804 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 1 RA / IM

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

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

Write-up: tinnitus - still ongoing


VAERS ID: 1678810 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-14
Onset:2021-09-05
   Days after vaccination:114
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio, Albumin urine absent, Anion gap, Anticoagulant therapy, Aspartate aminotransferase normal, Atrial fibrillation, Bacterial test, Basophil count, Basophil percentage increased, Bilirubin urine, Bladder catheterisation, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bicarbonate decreased, Blood bilirubin normal, Blood calcium decreased, Blood chloride decreased, Blood creatinine increased, Blood culture, Blood glucose increased, Blood ketone body, Blood lactic acid, Blood magnesium normal, Blood pH normal, Blood potassium increased, Blood sodium decreased, Blood urea increased, COVID-19, Carbon dioxide decreased, Cardiomegaly, Chest X-ray abnormal, Computerised tomogram head normal, Condition aggravated, Confusional state, Culture, Culture urine, Electrocardiogram T wave abnormal, Electrocardiogram abnormal, Eosinophil count decreased, Eosinophil percentage decreased, Globulin, Glomerular filtration rate normal, Glucose urine present, Haematocrit normal, Haemoglobin normal, Heart rate irregular, Hyperglycaemic hyperosmolar nonketotic syndrome, Hypoxia, Inflammatory marker test, Intensive care, Lung opacity, Lymphocyte count decreased, Lymphocyte percentage decreased, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume increased, Mean platelet volume normal, Metabolic encephalopathy, Monocyte count, Monocyte percentage, Neutrophil count increased, Neutrophil percentage increased, Nitrite urine absent, PCO2 decreased, PO2 decreased, Platelet count increased, Pleural effusion, Protein total decreased, Red blood cell count normal, Red blood cells urine negative, Red cell distribution width normal, SARS-CoV-2 test positive, Specific gravity urine normal, Troponin increased, Urinary casts absent, Urinary occult blood negative, Urinary sediment present, Urine analysis normal, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine decreased, Vaccine breakthrough infection, Ventricular extrasystoles, White blood cell count increased, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (broad), Asthma/bronchospasm (broad), Haematopoietic leukopenia (narrow), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Medications Valid as of: September 07, 2021 - 11:32 AM Generic Name Brand Name Tablet Size Instructions for use Acetaminophen (Tab) Tylenol 500 MG Take 1,000 mg by mouth every 6 hours as needed for Pain. Albuterol Sulfate (Aero Soln) Vento
Current Illness: N/A
Preexisting Conditions: Asthma Atrial fibrillation (HCC) Chronic CHF (congestive heart failure) (HCC) Constrictive pericarditis Mitral regurgitation Pneumonia Pulmonary hypertension (HCC) Renal cyst Shingles Sinusitis Type II or unspecified type diabetes mellitus without mention of complication, not stated as uncontrolled (HCC) Vitiligo
Allergies: Allergies: AMOXIL - Rash,Itch DOXYCYCLINE - Rash EES [ERYTHROMYCIN BASE] - Rash,Itch
Diagnostic Lab Data: M.D. Physician Hospitalist Note H&P Addendum Addendum Expand All Collapse All Expand widget buttonCollapse widget button Show:Clear all ManualTemplateCopied Added by: M.D. Hover for detailscustomization button Admission History and Physical Admitting Physician: M.D. Attending Physician: Hospitalist Service Primary Care Physician: D.O. Date of Admission: 9/5/2021 1:09 PM CC: Not feeling well HPI: Patient is a 59 Y female with past medical history of atrial fibrillation, CHF, pulmonary HTN, asthma, constrictive pericarditis, DM type 2 who presents to the Emergency Department today with complaints of not feeling well. Patient is very confused and not able to give any further history. On arrival she was noted to have a temperature of 98.2?, pulse is varying between 49-136, respiration around 28 and blood pressure 103/62 with O2 sat 90% on room air. Labs showed a white count of 12.2, platelets of 454, sodium of 132, potassium 5.2, bicarbonate of 18, anion gap of 18, BUN 51, creatinine 1.34, glucose of 682, beta hydroxybutyrate of 2.9. Venous blood gas with pH of 7.39, pCO2 34, PO2 75 and O2 sat of 95% on room air. Urinalysis was normal. COVID-19 PCR was positive. Patient had blood culture done x2, given IV fluids, started an insulin drip, started on Cardizem drip for rapid AFib and is now admitted to the hospitalist service. Review of systems: Not obtainable as patient is very confused Allergies: Allergies Allergen Reactions ? Amoxil Rash and Itch ? Doxycycline Rash ? Ees [Erythromycin Base] Rash and Itch Medications: Prior to Admission Medications Prescriptions Last Dose Informant Patient Reported? Taking? Insulin Aspart FlexPen 100 UNIT/ML SOPN Yes No Sig: Inject 18 units sub-q before breakfast, 18 units before lunch and 18 units before supper. May use sliding scale at bedtime if sugar is high. DX: E11.9 LON:99 Insulin Pen Needle (B-D ULTRAFINE III SHORT PEN) 31G X 8 MM MISC No No Sig: Use one needle as directed four times daily. Umeclidinium Bromide (Incruse Ellipta) 62.5 MCG/INH AEPB No No Sig: Inhale 1 inhalation once daily. Ventolin HFA 108 (90 Base) MCG/ACT inhaler No No Sig: INHALE 2 PUFFS BY MOUTH EVERY 6 HOURS AS NEEDED FOR WHEEZING acetaminophen (Tylenol) 500 MG tablet Yes No Sig: Take 1,000 mg by mouth every 6 hours as needed for Pain. budesonide-formoterol 160-4.5 mcg/act (Symbicort) 160-4.5 MCG/ACT AERO inhaler No No Sig: Inhale 2 inhalations twice daily. bumetanide (BUMEX) 1 MG tablet No No Sig: TAKE 2 TABLETS BY MOUTH DAILY WITH BREAKFAST fluticasone (Flonase) 50 MCG/ACT nasal spray No No Sig: 2 sprays in each nostril once daily. glucose blood VI test strips (ONETOUCH VERIO) No No Sig: Patient tests blood sugar up to 4 times daily. DX E11.9, LON 99 insulin detemir (Levemir FlexTouch) 100 UNIT/ML injection Yes No Sig: Inject 60 units under the skin with breakfast and 16 units at night. ipratropium-albuterol (Duoneb) 0.5-2.5 (3) MG/3ML nebulizer solution No No Sig: Take 1 vial by nebulizer 4 times daily. magnesium 250 MG TABS No No Sig: Take 1 tablet by mouth twice daily. metFORMIN (Glucophage) 1000 MG tablet No No Sig: Take 1 tablet by mouth daily with breakfast. metoprolol succinate XL (Toprol XL) 50 MG XL tablet Yes No Sig: Take 50 mg by mouth twice daily. montelukast (SINGULAIR) 10 MG tablet No No Sig: Take 1 tablet by mouth at bedtime. nystatin (MYCOSTATIN) cream No No Sig: APPLY 1 APPLICATION TWICE DAILY TO AFFECTED AREAS OF BOTH UPPER ARMS rivaroxaban (Xarelto) 20 MG TABS No No Sig: Take 1 tablet by mouth daily with supper. rosuvastatin (Crestor) 40 MG tablet No No Sig: Take 1 tablet by mouth once daily. sacubitril-valsartan 97-103 mg (Entresto) 97-103 MG TABS No No Sig: Take 1 tablet by mouth twice daily. spironolactone (Aldactone) 50 MG tablet Yes No Sig: Take 1 tablet by mouth daily with breakfast. triamcinolone 0.1% cream (KENALOG) 0.1 % cream Yes No Sig: Apply 1 Application topically 3 times daily as needed. To affected area of both upper arms vitamin D2, Ergocalciferol, 1.25 MG (50000 UT) CAPS No No Sig: TAKE 1 CAPSULE BY MOUTH 2 TIMES A WEEK Facility-Administered Medications: None Past Medical History: Past Medical History Past Surgical History: Past Surgical History Family History: Family History Social History: Social History Socioeconomic History ? Marital status: Spouse name: Not on file ? Number of children: Not on file ? Years of education: Not on file ? Highest education level: Not on file Occupational History ? Occupation: Babysitter Tobacco Use ? Smoking status: Never Smoker ? Smokeless tobacco: Never Used Vaping Use ? Vaping Use: Never used Substance and Sexual Activity ? Alcohol use: No ? Drug use: No ? Sexual activity: Not on file Other Topics Concern ? Not on file Social History Narrative ? Not on file Social Determinants of Health Financial Resource Strain: ? Difficulty of Paying Living Expenses: Food Insecurity: ? Worried About Running Out of Food in the Last Year: ? Ran Out of Food in the Last Year: Transportation Needs: ? Lack of Transportation (Medical): ? Lack of Transportation (Non-Medical): Physical Activity: ? Days of Exercise per Week: ? Minutes of Exercise per Session: Stress: ? Feeling of Stress : Social Connections: ? Frequency of Communication with Friends and Family: ? Frequency of Social Gatherings with Friends and Family: ? Attends Religious Services: ? Active Member of Clubs or Organizations: ? Attends Club or Organization Meetings: ? Marital Status: Intimate Partner Violence: ? Fear of Current or Ex-Partner: ? Emotionally Abused: ? Physically Abused: ? Sexually Abused: Physical Exam: Vitals: BP: (!) 141/70 Pulse: 112 Resp: 26 SpO2: 92 % Temp: 97.4 ?F (36.3 ?C) Height: 149.9 cm (4'' 11") Weight: 133 lb (60.3 kg) General: Normal built. Lying in bed, in no obvious distress. Skin: normal with no recent rashes or bruising Eyes: Pupils equally reacting to light. Extra ocular movements intact. Sclera nonicteric Ears/Nose/Mouth/Throat: Mucous membranes are dry. Hears normal conversation without any difficulty. No oral ulcers. No tonsillar enlargement. Tongue is midline. Neck : supple and free of adenopathy, or masses. No jugular venous distention. Respiratory: Clear to auscultation bilaterally. No wheezes, rhonchi or crepitations. Cardiovascular: Pulse is regular. Heart sounds are normal, no murmurs, clicks, gallops or rubs. Gastrointestinal: Non-distended. Soft, non-tender. Bowel sounds are present. No hepatosplenomegaly. Genitourinary: Foley in place, draining clear urine Musculoskeletal: Good range of movements in all extremities. No pedal edema Peripheral pulses are present and strong. Neurologic: Looks confused. Cannot answer simple questions Psychiatric: Alert and oriented to self and place. Lymphatic: No cervical or supraclavicular lymphadenopathy. ALL LAB RESULTS (PAST DAY) Admission on 09/05/2021 Component Date Value Ref Range Status ? White Blood Cells 09/05/2021 12.20* 3.8 - 10.8 K/uL Final ? Red Blood Cells 09/05/2021 4.22 3.90 - 5.11 M/uL Final ? Hemoglobin 09/05/2021 13.2 11.7 - 15.7 g/dL Final ? Hematocrit 09/05/2021 41.4 35.1 - 45.6 % Final ? MCV 09/05/2021 98.2* 80 - 97 fL Final ? MCH 09/05/2021 31.4 26.4 - 33.0 pg Final ? MCHC 09/05/2021 32.0 31.8 - 35.3 g/dL Final ? RDW 09/05/2021 14.2 11.2 - 15.6 % Final ? Platelet Count 09/05/2021 454* 140 - 390 K/uL Final ? MPV 09/05/2021 9.0 6.7 - 10.6 fL Final ? Neutrophil % 09/05/2021 94.2 % Final ? Lymphocyte % 09/05/2021 0.9 % Final ? Monocyte % 09/05/2021 3.8 % Final ? Eosinophil % 09/05/2021 0.0 % Final ? Basophil % 09/05/2021 1.1 % Final ? Absolute Neutrophils 09/05/2021 11.49* 1.8 - 7.1 K/uL Final ? Absolute Lymphocytes 09/05/2021 0.10* 0.9 - 3.5 K/uL Final ? Absolute Monocytes 09/05/2021 0.47 0.2 - 0.9 K/uL Final ? Absolute Eosinophils 09/05/2021 0.00 0.0 - 0.5 K/uL Final ? Absolute Basophils 09/05/2021 0.14 0.0 - 0.2 K/uL Final ? Sodium 09/05/2021 132* 133 - 144 mEq/L Final ? Potassium 09/05/2021 5.2* 3.5 - 5.0 mEq/L Final ? Chloride 09/05/2021 96 95 - 107 mEq/L Final ? Carbon Dioxide 09/05/2021 18* 22 - 32 mEq/L Final ? Anion Gap 09/05/2021 18* 6 - 15 mEq/L Final ? BUN 09/05/2021 51* 8 - 24 mg/dL Final ? Creatinine 09/05/2021 1.34* 0.50 - 1.20 mg/dL Final ? Glomerular Filt Rate 09/05/2021 43* $g60 mL/min Final CKD-EPI calculation used. For multiply result by 1.159. ? Glucose 09/05/2021 682* 70 - 100 mg/dL Final CRITICAL ? Albumin 09/05/2021 2.3* 3.5 - 5.2 g/dL Final ? Calcium 09/05/2021 8.1* 8.6 - 10.4 mg/dL Final ? AST 09/05/2021 20 11 - 41 IU/L Final ? ALT 09/05/2021 24 9 - 40 IU/L Final ? Alkaline Phosphatase 09/05/2021 335* 35 - 121 IU/L Final ? Bilirubin, Total 09/05/2021 0.4 <1.5 mg/dL Final ? Total Protein 09/05/2021 5.5* 6.2 - 8.5 g/dL Final ? Globulin 09/05/2021 3.2 1.8 - 3.7 g/dL Final ? A:G Ratio 09/05/2021 0.7* 1.2 - 2.7 Final ? Magnesium 09/05/2021 1.8 1.8 - 2.3 mg/dL Final ? Troponin, High Sensitivity 09/05/2021 22* <12 ng/L Final Comment: (NOTE) Reference Range Interpretation --------------------- -------------------------- Less than 12 ng/L Normal 12-51 ng/L Nonspecific myocardial injury Greater than 51 ng/L Abnormal; consistent with acute myocardial infarction Elevated biotin levels may cause a false decrease for this test. ? Ventricular Rate 09/05/2021 144 BPM Final ? Atrial Rate 09/05/2021 138 BPM Final ? QRS Duration 09/05/2021 58 ms Final ? Q-T Interval 09/05/2021 262 ms Final ? QTC Calculation(Bezet) 09/05/2021 405 ms Final ? Calculated R Axis 09/05/2021 104 degrees Final ? Calculated T Axis 09/05/2021 15 degrees Final ? Diagnosis 09/05/2021 Final Value:** Poor data quality, interpretation may be adversely affected Atrial fibrillation with rapid ventricular response with premature ventricular or aberrantly conducted complexes Anterolateral infarct (cited on or before 05-SEP-2021) Abnormal ECG When compared with ECG of 25-AUG-2021 15:18, Vent. rate has increased BY 58 BPM Nonspecific T wave abnormality has replaced inverted T waves in Anterior leads ? SARS-CoV-2 Source 09/05/2021 Corrected Value:NASOPHARYNGEAL Updated on 09/05 AT 1344: previous report: NASAL ? SARS-CoV-2 by PCR 09/05/2021 Detected* NOTD Final Comment: The Xpert Xpress SARS-CoV-2 test on the GeneXpert is intended for the qualitative detection of SARS-CoV-2 nucleic acid. This assay has EUA from the FDA for nasopharyngeal, nasal, and mid-turbinate swab and nasal wash/aspirate specimens from individuals suspected of COVID-19 by their healthcare provider. The Xpert Xpress SARS-CoV-2 Letter of Authorization, Fact Sheet for Healthcare ? Lactate 09/05/2021 1.9 0.4 - 2.0 mmol/L Final ? Specimen Description 09/05/2021 Final Value:BLOOD Drawn from Left Antecubital area. BLOOD DRAWN FROM IV SITE NO VP CHARGE 3 mL Pediatric bottle only ? Culture 09/05/2021 Pending Incomplete ? Report Status 09/05/2021 Pending Incomplete ? Specimen Description 09/05/2021 BLOOD Drawn from Right hand. Venipuncture LMH 0.5 mL Pediatric bottle only Final ? Culture 09/05/2021 Pending Incomplete ? Report Status 09/05/2021 Pending Incomplete ? Source 09/05/2021 Corrected Value:Urine Clean Catch Updated on 09/05 AT 1538: previous report: URINE ? Color, Urine 09/05/2021 Yellow Final ? Appearance, Urine 09/05/2021 Clear Final ? Glucose, Urine 09/05/2021 3+* NEG Final ? Bilirubin, Urine 09/05/2021 Negative NEG Final ? Acetone, Urine 09/05/2021 Trace* NEG Final ? Specific Gravity, Urine 09/05/2021 1.016 1.003 - 1.035 Final ? Occult Blood, Urine 09/05/2021 Negative NEG Final ? pH, Urine 09/05/2021 5.0 4.6 - 8.0 Final ? Albumin, Urine 09/05/2021 Negative NEG Final ? Urobilinogen, Urine 09/05/2021 Normal NORM Final ? Nitrite, Urine 09/05/2021 Negative NEG Final ? Leukocyte Esterase, Urine 09/05/2021 Negative NEG Final ? White Blood Cells, Urine 09/05/2021 1 0 - 2 /hpf Final ? Red Blood Cells, Urine 09/05/2021 <1 0 - 2 /hpf Final ? Squamous Epithelial Cells, Urine 09/05/2021 <1 0 - 10 /hpf Final ? Casts, Hyaline 09/05/2021 0 0 - 6 /lpf Final ? Bacteria 09/05/2021 Negative NEG Final ? Reflex Request 09/05/2021 No culture per provider criteria Final ? Critical Value 09/05/2021 Final Value:Result called to and read back by: RN Test(s) Reported: Glucose 9/5/2021 @ 14:04 by MLS ? Beta-Hydroxybutyrate 09/05/2021 2.9* <0.3 mmol/L Final ? Troponin, High Sensitivity 09/05/2021 21* <12 ng/L Final Comment: (NOTE) Reference Range Interpretation --------------------- -------------------------- Less than 12 ng/L Normal 12-51 ng/L Nonspecific myocardial injury Greater than 51 ng/L Abnormal; consistent with acute myocardial infarction Elevated biotin levels may cause a false decrease for this test. ? pH 09/05/2021 7.39 7.31 - 7.41 Final ? PCO2, Venous 09/05/2021 34* 45 - 55 mm Hg Final ? PO2, Venous 09/05/2021 75* 30 - 50 mm Hg Final ? Saturation, Venous 09/05/2021 95* 60 - 80 % Final ? Specimen type 09/05/2021 Venous Final ? Glucose 09/05/2021 526* 70 - 100 mg/dL Final CRITICAL EKG: Personally reviewed. EKG with atrial fibrillation, heart rate of 144, normal axis, no acute ST T-wave changes. Few PVCs noted IMAGING: Chest x-ray Cardiomegaly with patchy bilateral airspace opacities and small bilateral pleural effusions. The findings may be seen in the setting of cardiogenic pulmonary edema. Correlate clinically for a superimposed infectious process. Advance Directives: Code Status: Full Code Advance care planning was discussed with the patient, and there is currently an Advance Care Plan or surrogate decision maker on file in the Medical record. ASSESSMENT: Active Problems: Atrial fibrillation with rapid ventricular response (HCC) Hyperglycemic, hyperosmolar nonketotic state COVID 19 infection with hypoxia Acute metabolic encephalopathy Assessment and plan; 59 Y female with past medical history of atrial fibrillation, CHF, pulmonary HTN, asthma, constrictive pericarditis, DM type 2 who presents to the Emergency Department today with complaints of not feeling well and admitted with atrial fibrillation with RVR, Hyperglycemic Hyperosmolar non ketoticstate, acute metabolic encephalopathy, moderate COVID-19 infection with hypoxia Atrial fibrillation thought RVR Admitted to ICU Status post IV Cardizem bolus x2 and Cardizem drip in the ED Rate appears better control and has been off the drip for some time Placed on metoprolol 50 milligram b.i.d. Continue anticoagulation with Xarelto Hyperglycemic, hyperosmolar nonketotic state IV fluids, insulin drip BMP q.4 hours Electrolytes also checked and to be supplemented Currently on normal saline at 150 milliliters an hour Blood sugar down from 682 to 300 Once blood sugar is below 250, can switch to D5 and a half normal saline Once anion gap is closed times 2, can be given long acting insulin and insulin drip can be stopped after 2 hours Patient can be fed at that time COVID 19 infection with hypoxia This is a breakthrough infection as patient has already been vaccinated Not needing oxygen at this time but oxygen saturation in the ED was 90% Is a candidate for remdesivir which was started on September 5, 2021 Inflammatory markers followed Also placed empirically IV ceftriaxone to cover for bacterial pneumonia Acute metabolic encephalopathy This is secondary to hyperglycemia and COVID-19 infection hypoxia Stat CT of the head was negative for any infarct or bleed DVT prophylaxis with SCDs and Xarelto Patient is full code Comments: I certify that this patient requires inpatient services at this time and in accordance with regulation. The expected length of stay is greater than 2 midnights. Refer to admit order for the reason the inpatient services were required. Post-discharge planning information can be found in the discharge summary, discharge patient instructions order, or progress notes. M.D. ED to Hosp-Admission (Current) on 9/5/2021 Revision History Detailed Report Note shared with patient Note filed date Sun Sep 5, 2021 9:24 PM
CDC Split Type:

Write-up: COVID-19 infection on 9/5/21 and Hospitalization


VAERS ID: 1678814 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-27
Onset:2021-09-05
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth
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: Cymbalta, Zocor, Prilosec, Zyrtec, Propanalol, Nasonex, Pataday Vitamin D, Vitamin K, Zinc, Elderberry, Quercetin
Current Illness:
Preexisting Conditions: Allergies - year round
Allergies: Sulpha
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injection site was very sore and red for five days. Hurt to lift my arm and took Aleve. Nine days after injection, I noticed that the injection site was becoming red, warm and itching. On the tenth day the affected area had increased in size by three inches. I have never had a vaccine have such a delayed reaction. I have read articles that call this Covid Arm, but nobody knows why it is happening. This makes me very nervous to get the second dose.


VAERS ID: 1678815 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Mobility decreased, Pain in extremity, Peripheral swelling, Sensitive skin, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A - I do get sick often, unsure why. Have not been able to receive answers from a doctor.
Allergies: Allergic to something in both red and white wine, but unsure exactly what.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I received the first dose around 5:00pm and finished up by 5:09. I was asked to wait 10 minutes to make sure there were no immediate reactions. I left around 5:21 or so. I got in my car and a few moments later noticed my left side of my face beginning to feel numb. Not extremely, but it felt similar to when novocaine begins wearing off after a dental appointment, but I still had muscle movement. By day two my arm was extremely sore and very sensitive to touch. Could not lift it at all, and definitely could not move it around to stretch it out. It felt a little warm and was swollen. Unable to even put a semi-snug fitting T-shirt on because the pressure from it was painful on my arm. However I had woken up with the numbness no longer there in my face (went to bed around 12 or 1am and woke up around 8am). Day 3 now and the tenderness is still there but have subsided a bit. Still sore but not excruciating like yesterday.


VAERS ID: 1678872 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-10
Onset:2021-09-05
   Days after vaccination:179
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 LA / IM

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

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

Write-up: Positive COVID19 Test on 09/05/2021


VAERS ID: 1678921 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-21
Onset:2021-09-05
   Days after vaccination:137
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Positive PCR test for COVID on 9/5/21
CDC Split Type:

Write-up: Patient presented to the hospital on 9/5/21 with worsening dyspnea that had been going on for a month. He tested positive for COVID on 9/5/21. He is currently still hospitalized and on 7L of Oxygen


VAERS ID: 1678995 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Cold sweat, Injection site hypoaesthesia, Migraine, Nasal congestion, Oropharyngeal pain, Pain, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: Flu vaccine 6 years ago
Other Medications: Zyrtec, bupropion, buspirone, metformin, melatonin
Current Illness: N/a
Preexisting Conditions: After having COVID in January 2021 diagnosed with diabetes, enlarged heart
Allergies: Zpac, norco, Gluten, dairy sensitivity, fake sugars cause migraines
Diagnostic Lab Data: Going in to see Dr 9/7/21
CDC Split Type:

Write-up: Migraine, cold sweats about 20 minutes after injection, body aches and pains entire body, chest pain, sore throat, nasal passage restrictions- still able to breath just more difficult, left arm/armpit numbing sensation all started later Sunday night and has been progressively getting worse. Woke up with abdominal cramping as if I was going to start my period and when I went to the bathroom and wiped I was spotting blood. I had a hysterectomy 4 months ago and have been completely healed for a while. Throat soreness as well started the evening of the 5th.


VAERS ID: 1679024 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adenovirus infection, Aphasia, Blood test, Cognitive disorder, Communication disorder, Computerised tomogram, Electrocardiogram, Pyrexia, Rhinovirus infection, Seizure like phenomena
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None, although hospitalization visit indicated he had rhinovirus and adenovirus
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Yes 9/6, see documents. Bloodwork taken on 9/6, CT Scan and EKG.
CDC Split Type:

Write-up: Seizure like activity at 6:30pm, high fever, unable to speak or communicate, eyes closed. Called 911, taken to hospital via ambulance. Admitted to ER with cognitive deficits, admitted to neuroscience overnight.


VAERS ID: 1679033 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products
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: Pfizer BioNTech COVID-19 Vaccine EUA / Moderna COVID-19 Vaccine EUA: Patient received Pfizer Vaccine on 9/5/2021 and was subsequently discovered that patient had received Moderna vaccines on 3/9/2021 and 4/7/2021.


VAERS ID: 1679086 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

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

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

Write-up: fever, headache


VAERS ID: 1679109 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-21
Onset:2021-09-05
   Days after vaccination:227
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Small intestinal obstruction
SMQs:, Gastrointestinal obstruction (narrow)

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

Write-up: Hospitalized for small bowel obstruction.


VAERS ID: 1679116 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-01-08
Onset:2021-09-05
   Days after vaccination:240
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Mental status changes, SARS-CoV-2 test positive
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Presented with altered mental status, is hospitalized, and found to be positive for COVID.


VAERS ID: 1679123 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-13
Onset:2021-09-05
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive, Systemic inflammatory response syndrome
SMQs:, Tumour lysis syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, albuterol, asprin, azithromiycin, cefUROXime, cyanocobalamin, enoxaparin, famotidine, melatonin, metoprolol succinate, ondansetron, prochlorperazine,
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to hospital admitted as inpatient on 9/5/21 due to SIRS (systemic inflammatory response syndrome. Patient was tested for COVID-19 and was positive on 9/5/21.


VAERS ID: 1679125 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-09-05
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pulmonary embolism, SARS-CoV-2 test positive
SMQs:, Embolic and thrombotic events, venous (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Hospitalized for bilateral pulmonary embolism and was found to be positive for COVID.


VAERS ID: 1679164 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-02-01
Onset:2021-09-05
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Pulmonary embolism, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Embolic and thrombotic events, venous (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rituxan, Zyrtec, Lipitor, Coreg, Colestid, Losartan, Prilosec, Glipizide, Metformin, Imodium, Glucosamine, Vitamin B12, Vitamin D
Current Illness:
Preexisting Conditions: RA, CKD3a, OSA, DM, AFib, HLD, HTN
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: breakthrough COVID infection in September some increased oxygen needs but otherwise unremarkable hospitalized for pulmonary embolism


VAERS ID: 1679210 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-26
Onset:2021-09-05
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Nausea, SARS-CoV-2 test, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hyoscyamine, ondansetron, bisoprolol-hydrochlorothiazide, Hydrocortisone topical, flurandrenolide topical, sucralfate, escitalopram betamethasone
Current Illness: recovering addict and obesity
Preexisting Conditions: recovering addict and obesity
Allergies: Motrin, Darvocet A500, Thorazine
Diagnostic Lab Data: rapid covid swab
CDC Split Type:

Write-up: Nausea vomiting diarrhea


VAERS ID: 1679242 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-05
Onset:2021-09-05
   Days after vaccination:243
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: PATIENT HAD COVID-19 VACCINE ON Dose 1 date: 01/05/2021, Dose 2 date: 01/26/2021, AND TESTED POSITIVE TO COVID-19 TODAY 9/7/21.


VAERS ID: 1679763 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OS8E2IA / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Biopsy endometrium, Postmenopausal 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: Allopurinol 100mg Daily
Current Illness: None
Preexisting Conditions: Gout diagnosed 7/2020 controlled on medication
Allergies: NKDA
Diagnostic Lab Data: Pending results of endometrial biopsy.
CDC Split Type:

Write-up: Postmenopausal bleeding started 17 hours after 2nd dose, lasting 3 days which caused me to go to gynecologist and endometrial biopsy was performed. Currently still having bleeding but not as severe as days 1 and 2.


VAERS ID: 1679769 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Breast pain, Nodule, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (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: Losartan100mg , Remicade IV treatment was on 8/17/2021
Current Illness: None
Preexisting Conditions: Ankylosis Spondylitis , High Blood Pressure, Glaucoma, Pre Diabetes , Asthma ,Obesity
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Right armpit nodules swollen sharp aching pain striking and radiating in armpit towards right breast


VAERS ID: 1679954 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-08-16
Onset:2021-09-05
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (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: Allegra
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin (rash)
Diagnostic Lab Data: 9/6/21 - Lymes test pending
CDC Split Type:

Write-up: Bell?s palsy, onset 21 days after vaccination, symptoms still ongoing since, on day 2 of prednisone and valtrex, started treatment about 24 hours after symptom onset, pending Lymes test


VAERS ID: 1679964 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-17
Onset:2021-09-05
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202 A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: unaccounted, unusual bruising on right arm and left hip. No treatment.


VAERS ID: 1680788 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety
SMQs:, 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: Pre natal, omega 3, probiotics
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 days after the shot had cropping anxiety (I''ve only had this style of anxiety after drinking too much caffeine). It''s come in strong waves from then ti up now (now being 4 days later)


VAERS ID: 1681474 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-09-05
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Blood pressure high; Hashimoto''s disease; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and no history of drug abuse or illicit drug use
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210908758

Write-up: POTENTIAL DVT; LEG SWELLING; INTERMITTENT LEG PAIN/ PAIN ABOUT 3 AND HALF INCHES DISTAL TO THE KNEE ON THE LATERAL PART OF THE LEFT CALF/ PAIN TOWARDS BACKSIDE; This spontaneous report received from a patient concerned a 51 year old female of unknown ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: non alcohol user, non smoker, Hashimotos disease, and high blood pressure, the patient was on medication for high blood pressure and Hashimoto''s and other pre-existing medical conditions included: The patient had no known allergies and no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A and expiry: UNKNOWN) on left arm, dose was not reported, frequency one total administered on 04-SEP-2021 at 10:00 for prophylactic vaccination. No concomitant medications were reported. On 05-SEP-2021, the patient experienced leg swelling and intermittent leg pain/pain about 3 and half inches distal to the knee on the lateral part of the left calf, and sometimes pain just towards the backside, and potential DVT. The patient who is HCP, also shared that the pain is a bit worse if she presses down on the spot. She noted that it was started in morning of 05-SEP-2021 about 11 o clock. She was keeping the leg elevated at the heart but did not confirm if she had any plan to contact her PCP as she was concerned of potential DVT. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from intermittent leg pain/ pain about 3 and half inches distal to the knee on the lateral part of the left calf/ pain towards backside, and the outcome of leg swelling and potential dvt was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210908758-COVID-19 VACCINE AD26.COV2.S- Potential DVT. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1681487 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-05
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Fatigue, Hypokinesia, Muscle spasms, Pain
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (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: USJNJFOC20210910724

Write-up: FEELING WAY MORE ACHE AND SORE; BURNING SENSATION IN ARMS; CRAMPY LEGS; CANT GET MOVING; TIRED; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 05-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 05-SEP-2021, the patient experienced tired. On 06-SEP-2021, the patient experienced feeling way more ache and sore. On 06-SEP-2021, the patient experienced burning sensation in arms. On 06-SEP-2021, the patient experienced crampy legs. On 06-SEP-2021, the patient experienced cant get moving. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling way more ache and sore, and the outcome of tired, burning sensation in arms, crampy legs and cant get moving was not reported. This report was non-serious.


VAERS ID: 1682066 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypomania, Mania
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Hostility/aggression (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: Lithium, bupropion, duloxetine, alprazolam
Current Illness: NA
Preexisting Conditions: Dysthymia, Non24, PTSD, Ehlers Danlos-hypermobile, uveitis, scoliosis
Allergies: Nka
Diagnostic Lab Data: NA- not an illness measurable by lab tests.
CDC Split Type:

Write-up: Mania and hypomania triggered since 2 days post injections in a bipolar naive patient. Positive mental health diagnosis of fluctuating major depression and dysthymia and PTSD for ~20 years. No cyclothymic, no bipolar dx or any other mood disorders present in history.


VAERS ID: 1682070 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-31
Onset:2021-09-05
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007M20A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Infection
SMQs:

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

Write-up: Breakthrough-Hospitalized


VAERS ID: 1682165 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate, Heart rate increased, Myalgia, Pain in jaw
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 20210905; Test Name: Heart rate; Result Unstructured Data: Test Result:Rapid; Comments: At 08:00
CDC Split Type: USPFIZER INC202101161256

Write-up: Rapid heart rate during resting; Pain in jaw and face muscles; Pain in jaw and face muscles; This is a spontaneous report from a contactable consumer, the patient. A 59-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 04Sep2021 at 10:30 (at the age of 59-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included vitamins (unspecified) and supplements (unspecified); both for an unknown indication from an unknown date and unknown if ongoing. On 05Sep2021 at 08:00, the patient experienced rapid heart rate during resting, pain in jaw and face muscles. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the reported events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events rapid heart rate during resting, pain in jaw and face muscles were recovering at the time of this report. The lot number for BNT162b2 was not provided and will be requested during follow up.


VAERS ID: 1682179 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Hypotension, Loss of consciousness, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe, Systemic: Shakiness-Medium, Systemic: Weakness-Medium, Additional Details: vasovagal syncope/fainting. Patient was unconscious between 30 seconds to 1 minute. Held seated patient to prevent injury from fall and choking. After patient regained consciousness, had him lie down for $g30 minutes and monitored his pulse/heart rate. Was able to leave without assistance after about 45 minutes.


VAERS ID: 1682406 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-01-26
Onset:2021-09-05
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Asthenia, Atrial fibrillation, COVID-19, Cerebral ischaemia, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram neck, Computerised tomogram normal, Electrocardiogram abnormal, Fall, Hypoacusis, Loss of personal independence in daily activities, Magnetic resonance imaging head abnormal, SARS-CoV-2 test positive, Troponin, White blood cell count normal, X-ray of pelvis and hip normal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ischaemic 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), Accidents and injuries (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, APAP, atorvastatin, cardizem, zyrtec, vitamin D, colace, B12, diclofenac 1% gel, fenofibrate, lasix, levothyroxine, lexapro, melatonin, sennosides, flomax, trazodone, xarelto
Current Illness:
Preexisting Conditions: Dementia, chronic A. fib, neuropathy, history of lymphoma/prostate cancer
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 92-year-old male nursing home resident recently diagnosed with Covid 3 days ago rapid test antigen test is positive here in the ER history of dementia presents to the hospital because of a fall. Negative trauma work-up. Patient''s oxygen saturation was 90% on room air when he got here. ER put him on 2 L and is 98% now. Patient is not a good historian because of his dementia. Troponin 0.04. No lymphopenia. White count is normal. Chest x-ray is normal. Hip x-ray is normal. CT head, CT cervical spine is normal. EKG reveals rate controlled A. fib. Patient has a history of chronic A. fib. Patient was admitted to medical floor, due to presenting symptoms MRI brain was obtained. MRI did show evidence of recent ischemic change to posterior left frontal or parietal lobe. He was started on aspirin in conjunction with home atorvastatin and Xarelto. PT and OT were consulted, patient did have difficulty participating in PT, his understanding is fine however his hearing is significantly impaired and I think it was more of a communication issue rather than an understanding of directions issue. On my exam today I was able to write out my questions and his diagnostic findings, he was able to answer questions appropriately and verbalized understanding of findings he was able to follow commands without difficulty. Neurology was consulted, await their recommendations. Once cleared by neurology plan for discharge for further PT. Per daughter, patient does not appear he has had any significant change in his understanding though he does have continued weakness. This is likely attributed to both covid and his recent stroke, after long discussion she would like to pursue further PT and strengthening.


VAERS ID: 1682418 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-20
Onset:2021-09-05
   Days after vaccination:138
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Pyrexia, Wheelchair user
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: History of seizures, arthritis, venous insufficiency.
Allergies: Erythromycin, morphine, penicillins
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Fever, diarrhea, weakness, Patient is wheelchair bound. Hospitalized.


VAERS ID: 1682431 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-07-22
Onset:2021-09-05
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Contusion, Laboratory test normal, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: zinc, vitamin d, vitamin k, vitamin c
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: see above. and i have reports that i would be happy to send you
CDC Split Type:

Write-up: Not 100% certain when adverse event started. had noticed bruising over last month, but was setting appointment for a routine colonoscopy, and they wanted check blood. my platelets came back at 45 (on 4 sept). they thought could be incorrect in test. tested again (6 sept) and platelets came back at 24. they told me go to hospital immediately. a bunch of more tests showed negative for many things. most everything else in blood within range. they took blood 6:30 am on 7 september. platelets came back at 39. so they let me out of the hospital, but have no understanding of why this happened


VAERS ID: 1682479 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-28
Onset:2021-09-05
   Days after vaccination:220
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Craniocerebral injury, Fall, Head injury, Pain, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: defibrillator AFib bipolar COPD depression heart failure hypertension pacemaker pulmonary thromboembolism respiratory failure schizophrenia smoking history stroke in tubal ligation
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: This very pleasant 52 year-old female from a nursing nursing home fell and sustained traumatic brain injury and was admitted;---more detailed history per attending physician, is verified and reproduced below ..... Tested positive on 9/6/2021 This very pleasant 52 year-old female from a nursing nursing home fell and sustained traumatic brain injury and was admitted;---more detailed history per attending physician, is verified and reproduced below The patient presents following fall. The onset was just prior to arrival. The occurrence was single episode. The fall was described as UNKNOWN. The location where the incident occurred was REHAB FACILITY. Location: Right head. The character of symptoms is pain. The degree at present is minimal. The exacerbating factor is none. The relieving factor is none. Risk factors consist of age and anticoagulated. The patient''s dominant hand is the right hand. Therapy today: emergency medical services. Preceding symptoms PATIENT UNCERTAIN. Associated symptoms: none. PATIENT RECENTLY DISCHARGED FROM THE HOSPITAL ON ELIQUIS. STROKE.. PATIENT INITIALLY EVALUATED IN RAPID ASSESSMENT BY MIDLEVEL PROVIDER. I ASSUMED ALL CARE POST ASSESSMENT..


VAERS ID: 1682517 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-01
Onset:2021-09-05
   Days after vaccination:66
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Atrial fibrillation, Blood test normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Decreased appetite, Diarrhoea, Dyspnoea, Malaise, Oxygen saturation decreased, Pneumatic compression therapy, Pneumonia, SARS-CoV-2 test positive, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies: sulfa drugs
Diagnostic Lab Data: ED H&P: Patient is a 82-year-old male presenting with feeling generally unwell. Patient states has been mild for multiple days. Is got mild cough and is been having diarrhea no appetite. Denies abdominal pain, chest pain, shortness of breath. Just feels weak all over. Dictation Patient is an 82-year-old male presenting with weakness, shortness of breath, cough. Found to be Covid positive. He was in new atrial fibrillation. Patient troponin was mildly elevated. Blood work otherwise was reassuring. Chest x-ray showed a pneumonia left side. Given he is Covid positive will hold off given antibiotics, ever, patient will be given a full dose of Lovenox for his A. fib. Spoke with cardiology they agreed to consultation and recommendation of Lovenox. Patient started to drop his O2 saturations during evaluation into the 80s and thus I gave him Decadron for Covid pneumonia. Patient will be admitted for further evaluation. Patient met under IPC.
CDC Split Type:

Write-up: Patient developed COVID and was positive on 9/6/21, patient hospitalized for low 02 levels


VAERS ID: 1682521 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-15
Onset:2021-09-05
   Days after vaccination:202
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 2 LA / IM

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

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

Write-up: hospitalized with diarrhea due to COVID-19, SARS-CoV-2 positive


VAERS ID: 1682523 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-10
Onset:2021-09-05
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682553 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-09-05
   Days after vaccination:153
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

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

Write-up: Pfizer on 3/15 and 4/5. Positive on 9/5 admitted 9/5 to current


VAERS ID: 1682569 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-06-08
Onset:2021-09-05
   Days after vaccination:89
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

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

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

Write-up: hospitalization (non-ICU)


VAERS ID: 1682578 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-02-01
Onset:2021-09-05
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Bundle branch block left, COVID-19, Chest X-ray abnormal, Cough, Dyspnoea, Electrocardiogram abnormal, Hypoxia, Muscular weakness, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Somnolence, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Dementia (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), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Chief Complaint COVID+ yesterday. SOB, cough, and fever last noc requiring O2 so nursing home staff wanted pt evel''d further History of Present Illness The patient is a very pleasant 56yo F. LUE fistula, insulin-dependent diabetes mellitus type II, chronic pain on chronic opiates, GERD, and gout who was brought to the ED today for evaluation of dyspnea and cough. History is difficult as she is somewhat somnolent and dyspneic. She reports that she was feeling in her usual state of health until yesterday, when she noticed that her legs were weak, so she asked to be tested for COVID-19 and the test was positive. She then developed a cough and fever yesterday evening. Overnight, she became hypoxic and ultimately required oxygen supplementation, so staff brought her to the ED for evaluation. She has been vaccinated against COVID-19 and reports that she only goes to dialysis, so is not sure where she was exposed. She denies chest pain, nausea, vomiting, diarrhea, constipation, abdominal pain. In the ED today, CXR shows bilateral pneumonia and she is requiring 4L O2. Troponin is mildly elevated at 0.11 which is stable compared to previous troponin results here; she denies chest pain and EKG shows LBBB similar to previous with no new ST-T changes. She received dexamethasone 6mg PO once. She has been a very difficult IV stick but eventually IV access was obtained.


VAERS ID: 1682650 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2020-12-30
Onset:2021-09-05
   Days after vaccination:249
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

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

Write-up: patient HAD PFIZER COVID-19 VACCINE ON Dose 1 date: 12/30/2020, Dose 2 date: 01/20/2021, AND TESTED POSITIVE TO COVID.


VAERS ID: 1682667 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-14
Onset:2021-09-05
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions:
Allergies: amoxicillin, cipro, demerol, flagyl
Diagnostic Lab Data: COVID-19
CDC Split Type:

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


VAERS ID: 1682746 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ANTHRAX VACCINE - SWELLING AND HEAT. UNKNOWN AGE, DATE, BRAND
Other Medications: VITAMIN D3 1000IU QD, ELDERBERRY QD, VITAMIN C 500MG QD
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: FULL BODY RASH. TREATED WITH OATMEAL BATH, AVEENO LOTION, HYDROCORTISONE CREAM, BENADRYL 25MG 2 EVERY MORNING, 1 AT LUNCH, 2 EVERY EVENING. PEPCID 20MG 1 EVERY MORNING AND 1 EVERY EVENING.


VAERS ID: 1682749 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 3 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Cough, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, Amlodipine, aspirin, atorvastatin, cetirizine, dasatinib, Euthyrox, ferrous sulfate, fluticasone nasal spray, lisinopril, melatonin, metformin, metoprolol tartrate, montelukast, ondansetron
Current Illness: Possible community acquired pneumonia
Preexisting Conditions: Chronic myeloid leukemia (on dasatanib), CKD, hypertension, hypothyroidism, T2DM, mild asthma
Allergies: Invokana [canagliflozin] - Yeast infection Penicillins - Facial swelling and redness. Trulicity [dulaglutide] - Tachycardia; palpitations. Tetracycline - reaction not specified
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient admitted day after vaccination for mild fever and cough (however states cough was present prior to vaccination). Also notes some mild pain at injection site. CT chest showing possible right lower lobe pneumonia however present in previous imagining as well, potentially concerning for community pneumonia exacerbated by vaccination.


VAERS ID: 1682773 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-16
Onset:2021-09-05
   Days after vaccination:201
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Oropharyngeal pain, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: codeine-guaiFENesin; acetaminophen; amLODIPine; atenolol, azithromycin, clonazePAM, cyclobenzaprine, doxepin, ezetimibe, famotidine, fluticasone, lamoTRIgine, linaclotide, lurasidone, omeprazole, ondansetron, oxybutynin, Pancrelipase, tam
Current Illness: Food poisoning 12/27/2021
Preexisting Conditions: Acute anxiety, Colon polyps, Depression, Enlarged prostate, Gastritis. GERD , Hemochromatosis, Hyperlipidemia, Hypertension, Irritable bowel syndrome, Schizo affective schizophrenia, Sleep apnea, Tardive dyskinesia, Vertigo
Allergies: Iodinated Diagnostic Agents, Morphine
Diagnostic Lab Data: Covid-19, Flu, RSV by NAA: COVID Dectected: 9/5/2021
CDC Split Type:

Write-up: Presents with multiple complaints including body aches, chills, cough, and sore throat.


VAERS ID: 1682790 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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? 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: chills fever sore arm


VAERS ID: 1682837 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-01
Onset:2021-09-05
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Alcohol use, Angiogram abnormal, Anion gap, Blood calcium decreased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood lactic acid, Blood pH decreased, Blood phosphorus increased, Blood potassium increased, Blood sodium decreased, Blood urea increased, Brain natriuretic peptide increased, Carbon dioxide decreased, Chest X-ray abnormal, Confusional state, Drug abuse, Drug screen positive, Ejection fraction decreased, Glomerular filtration rate decreased, Haematocrit increased, Haemoglobin increased, Hyperkalaemia, Intensive care, Mental status changes, Muscle oedema, Musculoskeletal pain, Pain in extremity, Platelet count normal, Pneumonia, Procalcitonin, Red blood cell count increased, Resuscitation, Rhabdomyolysis, Tachycardia, Troponin I increased, Troponin increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (broad), Cardiac failure (narrow), Lactic acidosis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Drug abuse and dependence (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clobetasol shampoo and neosporine ointment
Current Illness: none
Preexisting Conditions: Anxiety, migraine, and insomnia.
Allergies: none
Diagnostic Lab Data: Upon admission on 09/06 at 0838: Na+ 144, K+ 5.0, CO2 15 (low), anion gap 27 (high), calcium 9.7. BUN 28 (high), creatinine 1.95 (high), GFR 47 (low), WBC 21.1 (high), RBC 6.38, hemoglobin 18.9 (high), HCT 60 (high), platelets 277. trop 0.21 (high), procalcitonin 12.27 (high). 09/06 at 1121, CK was $g40,000. whole blood lactate 3.9. 2.6 at 1433. lactate 2 hour was 3.4 at 1645. At hospital at 2056, sodium 134 (low, potassium 8.9 (high), CO2 14 (low), calcium 7.4 (low). At 2204 on 09/06, WBC 20.5 (high), AN 17.4 (high), B type natr peptide 314 (high), troponin I 0.37 (high), lactate 3.3 (high), phos 5.3 (high), pH blood gas 7.22, CK 80,000 (high), procalcitonin 46.65 (high). CK on 09/08 64,000.
CDC Split Type:

Write-up: Patient was vaccinated on 09/01 with first dose of Pfizer vaccine. Patient was transferred to hospital on the evening of 09/06. Patient was found with altered mental status in a camper by friend. Friend said they had been drinking and snorting cocaine. Upon arrival of first hospital, patient was tachycardic, confused, had LLE pain, and left buttock pain (concerning for compartment syndrome). CT angio runoff of bilateral LE showed nonspecific muscular edema involving left gluteus, adductor musculature, and left hamstring musculature. CXR results consistent with pneumonia. Initial procal was 12 at another hospital, was 47 when arrived here. Initial CK was 40,000, but had increased to more than 80,000 one day later. K+ was 8.9 and serum creatinine was 3. BNP was 314 and lactate was 3.3. Patient required pressors at first hospital (dobutamine and levophed) but was off by the time he arrived here. UDS was presumed positive for cocaine. Initial EF was 20-30%, which was concerning for cardiogenic shock. Once transferred to MICU, patient was treated for rhabdomyolysis and hyperkalemia. Treated hyperkalemia with bicarb, dextrose, insulin, and calcium. Rhabdo was treated with IV fluid resuscitation (lactated ringers). It is unclear if events was substance use rhabdomyolysis or vaccine induced. Unable to verify causation.


VAERS ID: 1682868 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: High fever (103.5) for 1.5 days that resolved Swollen painful axillary lymph nodes started 8 hours after, ongoing


VAERS ID: 1682882 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Muscle spasms, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Redness over entire bicep. muscle spasms over entire body, fever,


VAERS ID: 1682905 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-09-05
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, COVID-19, Disorientation, Hypoxia, Mental status changes, Road traffic accident, SARS-CoV-2 test positive
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: emergency room after motor vehicle accident and mental status changes. Patient denies any injury but remained disoriented. Patient does not recall what happened. Patient work-up in ER essentially negative but this morning he is COVID-19 test came positive. Patient is slightly hypoxic. Patient admitted for management. Patient denies chest pain shortness of breath cough congestion abdominal pain nausea vomiting diarrhea and answer question appropriately


VAERS ID: 1682981 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Muscle spasms, Pain in extremity, Paraesthesia, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (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: throat swelling three years ago to flu shot
Other Medications: PROCARDIA, METOPROLOL, CHLORTHALIDE,ASPIRIN
Current Illness: NONE
Preexisting Conditions: HTN
Allergies: SULFA, AMIODARONE, SHELLFISH,TOMATOES
Diagnostic Lab Data:
CDC Split Type:

Write-up: woke up at 2 AM WITH RIGHT HAND TOTALLY CRAMPED UP AND PAINFUL; NOW RIGHT HAND IS TINGLY AND PAINFUL AT TIMES; SPEAKING TO MD today


VAERS ID: 1683067 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-09-05
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Biliary obstruction, Blood culture, Blood lactic acid, Blood magnesium, C-reactive protein, Computerised tomogram abdomen, Culture urine, Differential white blood cell count, Electrocardiogram, Full blood count, Haematemesis, Hypokalaemia, Inflammation, Influenza A virus test, Influenza B virus test, Lipase increased, Liver function test abnormal, Metabolic function test, Nausea, Occult blood, Respiratory syncytial virus test, SARS-CoV-2 test, Scan with contrast, Secondary hypertension, Urine analysis, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL DIAGNOSTIC OCCULT BLOOD (GUAIAC), SPECIMEN 1 LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LAB ONLY-URINE MICROSCOPIC REFLEX LACTIC ACID LIPASE MAGNESIUM SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE CULTURE, BLOOD performed 2 times Imaging Tests CT ABDOMEN PELVIS WITH CONTRAST EKG
CDC Split Type:

Write-up: Abdominal Pain Vomiting Hematemesis with nausea Right upper quadrant abdominal pain Hypokalemia Other secondary hypertension Abnormal LFTs Elevated lipase Calculus of bile duct without cholangitis with obstruction


VAERS ID: 1683083 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037FZIA / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bronchitis, Condition aggravated, Headache, Oropharyngeal pain, Pain, Pyrexia, Sinusitis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Adderall and Xanax
Current Illness: None
Preexisting Conditions: COPD
Allergies: Dairy
Diagnostic Lab Data: Virtual visit on 9/7 and call with Uncle who is a doctor. I have chronic bronchitis which mimics symptoms post vaccine
CDC Split Type:

Write-up: Initial first few days normal symptoms (aches, fever, headache), few days later followed by sore throat, sinus infection, and bronchitis


VAERS ID: 1683094 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-26
Onset:2021-09-05
   Days after vaccination:163
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Brain natriuretic peptide, C-reactive protein, Chest X-ray, Culture urine, Differential white blood cell count, Electrocardiogram, Full blood count, Metabolic function test, Troponin I, Urinary retention, Urine analysis
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BRAIN NATRIURETIC PEPTIDE C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LAB ONLY-URINE MICROSCOPIC REFLEX PSA MEDICARE SCREEN TROPONIN I URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE EKG XRAY CHEST PA AND LATERAL
CDC Split Type:

Write-up: Reason for Visit Abdominal Pain Other Diagnosis Urinary retention discharged with catheter/leg back and will return to follow up.


VAERS ID: 1683118 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Deafness neurosensory, Deafness unilateral, Dizziness, Nausea, Tinnitus, Tympanometry
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), 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: Acarbose, Losartan 100mg, Hy-Alanine 25mg, Fluoxitine 20 mg, Metoprolol 100 mg,
Current Illness: None
Preexisting Conditions: Diabetes, left neprectomy
Allergies: Morphine, demorol
Diagnostic Lab Data: Compressive hearing test and Tympanometry. Results: Sensorineural Hearing loss of right ear . Tinnitus of right ear.
CDC Split Type:

Write-up: I woke up the next morning feeling dizzy, nauseous and complete hearing loss in right ear.


VAERS ID: 1683145 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-25
Onset:2021-09-05
   Days after vaccination:164
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Breakthrough covid positive after vaccination


VAERS ID: 1683166 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-03
Onset:2021-09-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Cough, Headache, Pyrexia, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre/Probiotic, Vitamin Supplements, Flaxseed Oil, Vitamin C; Garlic tablets No prescription medication
Current Illness: No previous illness
Preexisting Conditions: Celiac Disease
Allergies: Rocephin, PCN, Thimerosol, Bananas, Strawberries, Cedar Wood; Thieves Essential Oil products (causes a anaphylactic type reaction) Some cleaning products (cause a difficulty in breathing) Patient had a rash reaction to a Rocephin shot and the Dr. was unsure whether it was the Rocephin or possibly the Lidocaine instead that caused the reaction.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started as a rash on the upper arms, then it spread to the legs and eventually over most of the body. The patient also had chills and ran a fever, along with having a headache and slight cough, The rash itches with heat and has spread over the course of a few days. The rash did not spread onto the hands, feet, or face. The patient has taken Benadryl and noted that it has seemed to be helping. Today the patients only complaint was of the rash, though she said it seemed to be improving.


VAERS ID: 1683216 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-03-04
Onset:2021-09-05
   Days after vaccination:185
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 12A21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Asthma, Coronary Artery Disease, Congestive Heart Failure (EF 55-60% 10/17), COPD (O2 HS ), Diabetes (Type II. ), Hypertension, Myocardial Infarction, Obstructive Sleep Apnea (cpap), Renal Disease (stage 3) and Other (Bacteremia)
Allergies: Levofloxacin, bacitracin, bacitracin zinc, benzalkonium chloride, gramicide D, neomycin, neomycin sulfate, niacin, polymyxin B, polymyxin B sulfate, simvastatin
Diagnostic Lab Data: Positive covid PCR test 9/5
CDC Split Type:

Write-up: Hospitalization with covid after being fully vaccinated


VAERS ID: 1683219 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Insomnia
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall. Mobil. Plaqunil. Cymbolta. Amolodipine. Linzess vit c vit d calcium melontonin methotrexate
Current Illness:
Preexisting Conditions: High blood pressure Rheumatoid Arthritis Sleep apnea
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Insomnia. Can?t stay asleep. 3 nights in a row. I?m so tired I can?t function today.


VAERS ID: 1683236 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-07-30
Onset:2021-09-05
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049C21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 - / IM

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

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

Write-up: developed symptoms of COVID, tested positive for COVID after being fully vaccinated, 2 months later.


VAERS ID: 1683262 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-09-05
   Days after vaccination:150
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Diarrhoea, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Advair; Biofreeze gel; Claritin; Probiotic; Ventolin; Xanax; Vitamin D; Flonase
Current Illness: none
Preexisting Conditions: ADHD; anxiety; GERD; irritable bowel syndrome; moderate persistent asthma; hiatal hernia; recurrent yeast infections
Allergies: Ibuprofen; Bacitracin
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache, body aches, fatigue, sore throat, headache, fever, nonproductive cough, diarrhea, sinus congestion, starting on 9/5/21


VAERS ID: 1683275 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-08-30
Onset:2021-09-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Laboratory test, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: pericarditis


VAERS ID: 1683290 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Red bumps that look like mosquito bites all over left arm where the shot was given. Bumps also on left leg and some on right arm as well. They are very itchy and are raised. Started 1 day after the shot and have not gone down. Have taken over the counter medicine to help reduce the itch and used Cortizone cream as well.


VAERS ID: 1683460 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-09-05
Onset:2021-09-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Headache, Vision blurred, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Environmental only: tree, grass, weed, cockroach, dust mite, cat and dog
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received second dose of COVID vaccine 9/5/21 at 2pm. Had chills, h/a, stomach ache for a day. Felt fine for almost a day and then headache returned. No history of migraines/headaches. Headache is 8/10 on the pain scale and accompanied by blurry vision and fixed spots in her vision.


VAERS ID: 1683495 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 3 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I took the following medications: ALIGLN; alerted; B-100; calcium+D-3; COQ-10; MINCO botanicals brain, POST DEFENSE; levothyroxine; metoprolol succinate 24-hours; modafinil; SINGULAR; guaifenesin; multivitamins; omega 3; pantoprazole sodium
Current Illness: No
Preexisting Conditions: Chronic Kidney Disease; Asthma; and Breast Cancer Survivor
Allergies: I allergic to Cortisone injections; Iodine and Betadine; and Morphine drip
Diagnostic Lab Data: Not applicable
CDC Split Type: vsafe

Write-up: I experienced extreme aches, rash, and pains on the following day (3"); then, the next day, (4") it was really hot and swollen and then the following day the size increase to 4.2." By Monday, it increased in swelling. I called the Urgent Care Nurse and she told me to take Ibuprofen; however, I took Tylenol and put ice on it. On Tuesday, I called my doctor and he was not ablle to get back to me until 09/07/2021 and by then it was getting better. It''s still red, warm, and swollen but it''s not as bad. I was surprised because I didn''t have a reaction after the previous dosages of the vaccine.


VAERS ID: 1683563 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-05
Submitted: 0000-00-00
Entered: 2021-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Burning sensation, Fatigue, Hypokinesia, Muscle spasms, Pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210906; Test Name: Body temperature; Result Unstructured Data: 100.2 (unit unspecified)
CDC Split Type: USJNJFOC20210910920

Write-up: TEMPERATURE 100.2; TIRED; CAN''T GET MOVING; Burning sensation in arms; Crampy legs; FEEL ACHE; SORE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 05-SEP-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 05-SEP-2021, the patient experienced can''t get moving. On 05-SEP-2021, the patient experienced burning sensation in arms. On 05-SEP-2021, the patient experienced crampy legs. On 05-SEP-2021, the patient experienced feel ache. On 05-SEP-2021, the patient experienced sore. On 05-SEP-2021, the patient experienced tired. On 06-SEP-2021, the patient experienced temperature 100.2. Laboratory data included: Body temperature (NR: not provided) 100.2 (unit unspecified). The action taken with covid-19 vaccine was not applicable. The patient had not recovered from temperature 100.2, feel ache, tired, burning sensation in arms, crampy legs, sore, and can''t get moving. This report was non-serious.


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