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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 269 out of 8,010

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VAERS ID: 1675129 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Severe Muscle pain in left leg. Had severe cramping like a Charlie horse and now it?s hard to walk. It?s in my thigh.


VAERS ID: 1675143 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? 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: 103 degree fever and body aches


VAERS ID: 1675144 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Malaise, Sleep disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: In the middle of the night he woke up not feeling well and the parent went to give tylenol and the patient passed out. They took him to the ER and he was administered fluids and he began to feel better.


VAERS ID: 1675145 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 2 - / SYR

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

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

Write-up: Severe and prolonged dizziness.


VAERS ID: 1675165 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 3 RA / IM

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

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

Write-up: Patient reports swelling and redness at site of injection with onset one day after. Swelling has spread to axilla. Patient will follow up with provider if persists or worsens.


VAERS ID: 1675191 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-25
Onset:2021-09-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Venous thrombosis limb
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Otrexup 12.5mg SQ weekly; Protonix; Folic Acid; Vitamion C;Carafate; Zinc; Prednisone; Xarelto 20 mg daily; lasix 40mg daily; Adderall 25mg; Plaquenil 200mg BID; Super B complex; Calcium; Vat D3; Omega 3; Ditropan Xl 5mg; Symbicort inhaler
Current Illness: Vasculitis ,Wegeners Granulomatosis, Microscopic Ployangiitis
Preexisting Conditions: Same as above
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Small blood clots in veins in hands and both arms from elbows down appear reddened


VAERS ID: 1675194 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-09-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Herpes zoster reactivation, Injection site reaction
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Activation and outbreak of Herpes Zoster under where the vaccine was administered in the left arm. Never before has an outbreak of Herpes Zoster been activated in that area.


VAERS ID: 1675212 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-01-03
Onset:2021-09-04
   Days after vaccination:244
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Malaise, 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 S/S of COVID and COVID + after being COVID vaccinated.


VAERS ID: 1675215 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-08-26
Onset:2021-09-04
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 square inch round red spot at injection site. The spot is itchy, hot to touch, sore to touch. Spot was small after initial injection, went away after 3 days. Came back on 9/4/21 larger than the original spot. Continues to get larger each day.


VAERS ID: 1675221 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-19
Onset:2021-09-04
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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

Write-up: Sore thraot, cough, chills, loss of taste and smell, and nasal congestion. COVID (+), Vaccinated


VAERS ID: 1675232 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / -

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

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

Write-up: Swollen arm and redness (large than ususal injection site )


VAERS ID: 1675243 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Conjunctival haemorrhage, Nephritis, Pneumonia, Vomiting
SMQs:, Acute renal failure (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Husband stated around midnight after dose in morning wife started to vomit frequently. He took her to ER , eyes were even blood spots on whites of eyes from vomiting so much. Temperature of 101.8 degrees. Husband states inflamed kidney, pneumonia from vomiting so much.


VAERS ID: 1675246 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 LA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Incorrect route of product administration, Injection site erythema, Vaccination site pain
SMQs:, Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), 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: Zoloft/Topamax/iron/atorvastatin
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: When I was given my second shot I was not given it IM Like it?s supposed to be given, instead I was given it Subq on the very far side of my arm close to my armpit. I now have a red painful patch adjacent to the vaccine site. The pharmacy has apologized and said they have opened an incident report (I?m not sure with who) but I want to make sure it?s reported here bc now I don''t know if my vaccine is even effective and this isn''t exactly the experience I expected on a vaccine that I''ve been hesitant on from the beginning . They are monitoring my arm and if it spreads I have to go to the doctors to have it checked


VAERS ID: 1675264 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-08-14
Onset:2021-09-04
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

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

Write-up: Patient reported tingling and a twitch in vaccine administered arm ~3 weeks after Pfizer dose 1. It was a single episode that resolved after a few hours.


VAERS ID: 1675271 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: The Pfizer-BioNTech COVID-19 EUA Vaccine was administered to patient in error as the patient is not yet 12 years and above. A follow up with the patient and his family confirms that so far the patient is feeling well without any problems for now.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The child is still feeling well at the moment.


VAERS ID: 1675274 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dyskinesia, Eye movement disorder, Immediate post-injection reaction, Injection site hypoaesthesia, Pallor, Physical examination, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Patient was taken to ER on 9/4/21 where blood work, physical exam was performed. According to ER physician nothing remarkable was found. patient was observed for a couple hours and was sent home.
CDC Split Type:

Write-up: syncope episode occurred about one minute after shot was administered. Patient was slumped in her chair and eyes were rolling to the back of her head, and had sporadic arm/leg movement. Episode lasted approximately 1 minute. Patient was intermittently responsive during episode, opening her eyes and acknowledging questions. face looked very pale. Her significant other or partner who was with her mentioned she hadn''t eaten anything all day (it was 4:00 pm). 911 was called, and ems arrived shortly. She was taken by ambulance. We followed up with the patient the next day and she said her arm was numb from the wrist to the shoulder with diminished sensation in the arm she received the vaccine. Otherwise she was feeling ok.


VAERS ID: 1675283 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E21A / 2 LA / IM

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

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

Write-up: Patient felt chest pain the following day (Saturday 9/4) after the second dose and called the pharmacy on Sunday to inform us of his symptom.


VAERS ID: 1675284 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Extremity contracture, Eye movement disorder, Headache, Joint contracture, Loss of consciousness, Musculoskeletal stiffness, Seizure, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Patient reports passing out from shots other than vaccines. vaccine was administered, and we continued a conversation for 5 minutes before the patient became verbally unresponsive. Then, Patient''s eyes rolled back, and body convulsed. Legs, arms, and trunk went stiff, hands/fingers and feet/toes curled under, lasting about 30 secs. Patient opened her eyes, but was still unresponsive for another 30 secs. I laid her in the floor after she was able to talk again. Patient was asking where she was and was asking for her mother (who was not present). She could not recall the 5 minute conversation from the vaccine that led to the episode, the episode, or the conversation immediately after. she reported a throbbing headache, but that she was feeling much better. She moved back to the chair slowly. She did not want to have an ambulance, so I recommended her friend drive her somewhere to get evaluated. She had someone to drive her home and could walk without aid.


VAERS ID: 1675290 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arnold-Chiari malformation, Blister, Chest pain, Herpes zoster, Paraesthesia, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Congenital, familial and genetic disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: About 24 hour after he felt burning, tingling and itching on his chest. Hours later turned to blisters. Called urgent care and they confirmed he had shingles on video phone call.


VAERS ID: 1675301 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Lymphadenopathy, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: One a day multivitamin
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: None. I haven''t went to the doctor for the side affects.
CDC Split Type:

Write-up: Fever that reached 103.2 degrees. Headache, body aches, chili''s. Swollen lymph node under right arm appeared this morning 9/5/2021. Fever has reduced to 101 degrees without tylenol, or ibuprofen


VAERS ID: 1675327 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 058E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac flutter, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Tachyarrhythmia terms, nonspecific (narrow), 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: Ibuprofen 400 mg, amox-clav 500-125 mg tablet
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart flutters, rapid heart beat


VAERS ID: 1675333 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain
SMQs:, Retroperitoneal fibrosis (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: Diltiazem, Corlinor, Pepcid, Tirosint, Liothyronine, Zyrtec, multivitamin
Current Illness: Arthritis, GERD
Preexisting Conditions: Arthritis, GERD
Allergies: Methotrexate, sulfa, IVP dye, phenergan, phenothiazines, reglan,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe lower left back pain, still there third day after vaccination.


VAERS ID: 1675338 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, 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: Norgest/ethi Estrad Tab (birth control), Naproxen
Current Illness: None
Preexisting Conditions: None
Allergies: Latex, Lactose
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tenderness and swelling in axillary region of the same arm of the injection site. Potential inflammation of axillary lymph nodes.


VAERS ID: 1675369 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-27
Onset:2021-09-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Cough, Dyspnoea, Hypoaesthesia, Mobility decreased, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: numbness and tingling in arm and hand. Extreme joint pain in left hand. Coughing and difficulty breathing. Decreased mobility and strength in left arm.


VAERS ID: 1675387 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Heart rate increased, Myalgia, Nausea, Pyrexia, Respiratory rate increased, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Nausea, vomiting, fever of 101.2, headache, chills, muscle tenderness, fatigue, increase heart rate 103. Increase respiration. 09/04/2021-09/05/2021


VAERS ID: 1675388 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-30
Onset:2021-09-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Lymphadenopathy, Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Systemic: Pt reports swelling in L armpit and pain radiating down her L arm-Mild, Systemic: Lymph Node Swelling-Mild, Additional Details: Patient reported significan swelling in L armpit 5 days post injection in addition to pain radiating down her arm. This occurred on 9/4/21; patient reported events on 9/5/21 and says these symptoms have resolved.


VAERS ID: 1675392 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-08-24
Onset:2021-09-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Injection site erythema, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Abdominal Pain-Mild, Additional Details: Rash on upper extremeties and torso


VAERS ID: 1675555 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 FC3183 / 2 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: covid-19
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe headache and fatigue low grade fever ranging from 100.1 to 100.9 took tylenol for fever and headache


VAERS ID: 1675559 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 EW0217 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Cough, Myalgia, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), 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: Multiple vitamins daily, loratadine 10mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever (99.8), congestion, runny nose, cough, sore throat, myalgia, arthralgias. Treated with ibuprofen 600mg PO q8hx3 doses, phenylephrine 10mg PO x1 dose, phenylephrine nasal x1spray each nostril once. Fever, myalgia, arthralgias resolved in 36 hours. Cough, congestion still resolving.


VAERS ID: 1675562 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 617E21A / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax, Pulmonary embolism, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CT angiogram of chest
CDC Split Type:

Write-up: Bilateral pulmonary emboli, syncopal episode


VAERS ID: 1675566 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   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: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Injection site pruritus, Injection site swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins, a, c, b, d, cranberry, d-mannose, calcium
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Large swelling and redness at injection site. Tiredness, chills, muscle ache.


VAERS ID: 1675575 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 FL3184 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: penicilin
Diagnostic Lab Data:
CDC Split Type:

Write-up: At exactly 5pm I was driving and starting to feel weak, I saw my left arm (not on the site of the injection) and I had raised, itchy, red rash (hives) on the front part of my elbow and forearm. I took a picture of it at exactly 5:17pm that I could stop driving. I saw my neck and it was also itchy and red. I got home and at 5:40pm took 1 pill of loratadine 10mg, the hives vanished an hour later, the itchiness in my neck, face and arms didn''t. So I took another loratadine 10mg at 10pm and applied my self an intramuscular shot of Chlorphenamine. The next morning I had no itchiness or hives on arms, though the skin around my neck and chin stills feels kind of itchy, but not like it was on saturday. I am visiting the country, I am a dentist, so I came prepared and treated myself. I just want to know if I should get or not the 2nd dose.


VAERS ID: 1675582 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dysgeusia, Lip swelling, Nausea, Oral discomfort, Salivary hypersecretion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: with a flu shot-fever, sick to my stomach etc.
Other Medications: Tylenol
Current Illness: tooth work done at dentist for cavities.
Preexisting Conditions: Rhuematoid arthritis
Allergies: Almost all antibiotics, blue dye in foods, wool, lanolin.
Diagnostic Lab Data: 0
CDC Split Type:

Write-up: Almost immediately after receiving the shot, I could taste a strong metalic taste in my mouth. My saliva increased. It made me feel very nauseous. About two hours later, my bottom lip started to swell and my mouth on the inside and outside felt like it was on fire. About 4 hours later I felt very weak. After drinking tons of water, these symptoms disapated. The next day, my mouth was better but not completely free of the bitter, bitter taste!


VAERS ID: 1675586 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Disorientation, Dizziness, Eye movement disorder, Fall, Feeling abnormal, Feeling hot, Flushing, Head discomfort, Loss of consciousness, Musculoskeletal stiffness, Nausea, Tremor, Vision blurred, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 21 hours after my 2nd dose while waiting in line at a restaurant i began to feel very hot. I suddenly became nauseated and dizzy. I began to feel my body stiffen and start to shake but I could not stop it. The harder I tried the worse it got, my vision became distorted and I don''t remember much after that. According to witnesses I was talking during the shaking and began to fall, they helped me to the floor where my eyes rolled back in my head and I proceeded to pass out. They advised I was out for maybe 30 sec before I began to come to. I was disoriented and feeling very flushed, I felt very fuzzy and everything was in a haze. I could not move at this point. Slowly as i began to get my bearings about me i began to talk and console my mother verbally as they kept me on the ground till paramedics showed up. They advised my blood sugar was at 120 , my bp was palpable at 70 systolic. The restaurant was too loud for them to get a reg. bp. The FD and Police were on scene. This all occurred at the cafe in the mall as there were many many witnesses. I do not have ins. so I did not want to be taken to the hospital. There has been pressure in my head ever since the episode. No new meds or food has been introduced to my system. I do not have any significant medical history. None that would have caused an episode as this.


VAERS ID: 1675612 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse reaction, Dysphonia, Injection site erythema, Lacrimation increased, Lip swelling, Nausea, Pain of skin, Paraesthesia oral, Photophobia, Rhinorrhoea, Sensation of foreign body, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamterene 37.5mg, Vitamin B12 5000mcg
Current Illness: N/A
Preexisting Conditions: n/a
Allergies: Losarten, shellfish,
Diagnostic Lab Data: Adverse reaction to COVID-19 vaccine, Received meds through IV at ER, sent home with prescriptions for continuation of meds. 9/6/21 I am better, voice still very raspy sounding, arm still very red at injection site.
CDC Split Type:

Write-up: About 15 minutes from injection, tongue tingling, about an hour waves of nausea, eyes watering & sensitive to light, nasal drips, about 3 hours after, felt like stinging on ankles, arms, moving to different parts of body, about 6 hours, welt & red streak on arm at injection, lips swelling, tongue swelling, and throat felt like it had something in it. Very hoarse voice. Took 2 benadryl and went to ER.


VAERS ID: 1675617 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Pain
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Centrun Silver vitamins; probiotics; magnesium; glusosamine; chrondrotin
Current Illness: None
Preexisting Conditions: Recovering cancer, 3 years; heart valve disease, no treatment needed yet; macular degeneration, stable;
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, body aches, fatigue 4 hours after til 45 hours after; chills 28 hours after til 32 hours after; diarrhea 40 hours after til 45 hours after


VAERS ID: 1675618 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-01-08
Onset:2021-09-04
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 UN / SYR

Administered by: Senior Living       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: Furosemide, Levothyroxine, Omeprazole, potassium chloride, Vitamin B12
Current Illness:
Preexisting Conditions: Transient Cerebral Ischemic attack, HTN, Hyperlipidemia, CHF, hypothyroidism
Allergies: NKA
Diagnostic Lab Data: SARS-CoV-2 9/2/2021
CDC Split Type:

Write-up: weekly covid testing due to outbreak, resident converted to positive


VAERS ID: 1675661 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-01-08
Onset:2021-09-04
   Days after vaccination:239
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 1 UN / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 UN / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, Levothyroxine, memantine, Quetiapine Fumarate, Simvastatin, Vitamin D
Current Illness:
Preexisting Conditions: Alzheimer''s unspecified, hyperlipidemia, impaired glucose tolerance, light chain (AL) amyloidosis
Allergies: cefixime, citalopram, Demerol, donepezil, Premarin, sertraline
Diagnostic Lab Data: vikor SARS-CoV-2 9/2/2021
CDC Split Type:

Write-up: covid outbreak testing


VAERS ID: 1675666 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Site of injection is swollen and red hot and hurts to the tough. It is also itchy and very firm and red. It?s very noticeable and is approximately 2?3 inches in diameter. It still has not gone away after 48 hours


VAERS ID: 1675670 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 FE3592 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Back pain, Chest pain, Crying, Hallucination, auditory, Headache, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (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: About 9 hours after the vaccine I had a very strange reaction. I don''t know if it was a panic attack or a little heart issue. Suddenly my chest hurt badly in the middle, and then my back hurt in the middle, and then my head hurt, and then my legs hurt. I was full of anxiety and started crying. It lasted about 10 or 15 minutes and then everything went away and I was back to perfectly normal. A few seconds before this ?episode? I had an auditory hallucination which was the first and only one I have ever had. In my 57 years of life I have only had one ?panic attack? which was 22 years ago during a divorce. Nothing else unusual or out of the ordinary happened on this day except for the vaccine. I was in a normal good mood and having a normal day before it happened, and it went away as fast as it came after about 10 - 15 minutes.


VAERS ID: 1675682 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, 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? 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: redness and swelling at the site of injection


VAERS ID: 1675691 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939901 / 3 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood urine present, Injection site erythema, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Extravasation events (injections, infusions and implants) (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: Adderall XR, lialda, spironolactone, Zyrtec, topamax, metoprolol, Entyvio
Current Illness: RSV (3weeks prior)
Preexisting Conditions: Ulcerative Colitis
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, redness at injection site, bright red blood in urine for 2 days


VAERS ID: 1675709 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
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: Diarrhoea, Heart rate increased, Hyperhidrosis, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu
Other Medications: Metfoemin, oz em pic, Trejo, larsarton, meloxicam
Current Illness: Sinus infection and cephalexin
Preexisting Conditions: Diabetic
Allergies: Pennicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sweats aches and pains and diaherra, high heart rate


VAERS ID: 1675720 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-01
Onset:2021-09-04
   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 DIDNT GET / 1 RA / IM

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

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

Write-up: Site: Itching at Injection Site-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe


VAERS ID: 1675728 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
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: Eye pain, Eyelid disorder, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Periorbital and eyelid disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine pamoate
Current Illness: GERD, anxiety
Preexisting Conditions: GERD, anxiety
Allergies: Walnut (tree nut)
Diagnostic Lab Data: None - clinical workup.
CDC Split Type:

Write-up: Pain to right eye with inability to fully close eyelid on Saturday evening (no vision changes). Numbness and tingling to right-side of face and cheek onset Sunday. Family medical history indicates sister has shingles.


VAERS ID: 1675779 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 053E21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate abnormal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: patient went to the ER later on in the night from abnormal heart rate (high), in teh 140s.


VAERS ID: 1675814 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048F21A / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: patient experience redness and swelling at injection site, was seen by physician and diagnosed as cellulitis. antibiotic was prescribed for treatment
Current Illness: none
Preexisting Conditions: mentally disabled- lives in assisted living
Allergies: nka
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: patient experienced mild redness and swelling about injection site, physician was consulted and antibiotic was prescribed


VAERS ID: 1675819 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 049E4A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Constipation, Fatigue, Headache, Hyperhidrosis, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

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

Write-up: Severe body aches, headache, sweating, constipation, and fatigue.


VAERS ID: 1675821 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-09-04
   Days after vaccination:184
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: COVID PCR positive 9/4/21
CDC Split Type:

Write-up: Hospitalized with breakthrough COVID infection after vaccination


VAERS ID: 1675825 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-08-27
Onset:2021-09-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 AR / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3183 / 2 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Blood test, Ultrasound abdomen abnormal, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Xrays, blood test, urine test, IV, ultrasound. All performed September 5th, 2021
CDC Split Type:

Write-up: 2nd Covid-19 Pfizer vaccine received on August 27th, 2021 for my 15 year old daughter. 8 days later, on September 4th 2021, my daughter started vomiting without stopping for 24 hours straight. Went to the nearby emergency room and was admitted to ER. Transported from one hospital to another after administering IVs, Xray, blood tests, and urine tests. Transferred by ambulance to Hospital to be seen by a pediatrician at another hospital. Vomiting continued. Ultrasound test revealed inflamed appendix, and emergency appendectomy was performed on September 5th 2021.


VAERS ID: 1675837 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 2 RA / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I have experienced body aches, a fever of 103 degrees, fatigue, dizziness, and soreness at the injection site.


VAERS ID: 1676059 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   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: Unknown       Purchased by: ?
Symptoms: Chills, Discomfort, Headache, Malaise, Muscle spasms, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: 102+ fever, chills, spasms, headache, moderate malaise, lasting approximately 24 hours Acetaminophen for discomfort and fever reduction


VAERS ID: 1676248 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Product administered to patient of inappropriate age
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None- 11 years old
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: A pfizer vaccine ( first dose) was given to wrongfully to 11 years old and 4 months child by accident. Patient reported soar arms only.


VAERS ID: 1676260 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Red, swollen big toe with pus, moderate to no pain


VAERS ID: 1676639 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Electrocardiogram abnormal, Myocarditis, Troponin
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ECG abnormal 9/6/21 Troponin level at 17.6 9/6/21
CDC Split Type:

Write-up: Myocarditis


VAERS ID: 1676643 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain
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: Gabapentin Klonopin
Current Illness: None
Preexisting Conditions: None
Allergies: Bactrim
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme radiating pain from injection side down arm all the way into elbow and then fingers. Pain also radiated into axillary area towards breast and into the back toward scapula.


VAERS ID: 1677112 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Joint swelling, Limb discomfort, Movement disorder, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness: Alcohol use (occasionally, one may be less than one); Diabetes; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies, and patient was very healthy. The patient was not on heavy medication except regular over the counter medications.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210908962

Write-up: RIGHT KNEE SWOLLEN AND ACTING WEIRD; BOTH LEGS SWOLLEN BUT IT MORE ON THE RIGHT ONE; HAS TO WAIT A LITTLE WHEN TRYING TO GET UP FROM SITTING POSITION BECAUSE LEG LIKE FREEZING; UNCOMFORTABLE GETTING IN OR OUT OF THE CAR/THE LEG BOTHERS WHEN TRYING TO EXTEND IT; This spontaneous report received from a patient concerned a 72 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: diabetes, occasional alcohol user, and non smoker, and other pre-existing medical conditions included: The patient had no known allergies, and patient was very healthy. The patient was not on heavy medication except regular over the counter medications. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 03-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-SEP-2021, the patient experienced right knee swollen and acting weird. On 04-SEP-2021, the patient experienced both legs swollen but it more on the right one. On 04-SEP-2021, the patient experienced has to wait a little when trying to get up from sitting position because leg like freezing. On 04-SEP-2021, the patient experienced uncomfortable getting in or out of the car/the leg bothers when trying to extend it. The action taken with covid-19 vaccine was not applicable. The outcome of the uncomfortable getting in or out of the car/the leg bothers when trying to extend it, right knee swollen and acting weird, both legs swollen but it more on the right one and has to wait a little when trying to get up from sitting position because leg like freezing was not reported. This report was non-serious.


VAERS ID: 1677113 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Muscle tightness, Pain, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Sometimes a glass of wine.); Asthma (Uses inhalers.); Non-smoker; Penicillin allergy (Happened when was a child and did not remember, possibly anaphylactic.); Seasonal allergy.
Preexisting Conditions: Comments: The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210908971

Write-up: ANXIETY; MILD ACHES; FELT LIKE PINCHING IN THE ARMPIT (FURTHER MENTIONED NOT IN THE ARMPIT AND MORE TOWARDS THE TOP PART OF THE SHOULDER ON THE LEFT SIDE); PULSATING FEELING (FELT BLOOD PUMPING FROM PALM UP TO ELBOW AND HIS SHOULDER AND THE CHEST) BUT ONLY ON THE LEFT SIDE; TIGHT MUSCLE FEELING IN THE CHEST, SHOULDER AND THE ARM ON THE LEFT SIDE; This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included: asthma, penicillin allergy, seasonal allergies, alcohol use, and non-smoker, and other pre-existing medical conditions included: The patient had no drug abuse or illicit drug usage. The patient received COVID-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1821286, expiry: 21-OCT-2021) dose was not reported, administered on 04-SEP-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-SEP-2021, the patient experienced pulsating feeling (felt blood pumping from palm up to elbow and his shoulder and the chest) but only on the left side. On 04-SEP-2021, the patient experienced tight muscle feeling in the chest, shoulder and the arm on the left side. On 04-SEP-2021, the patient experienced mild aches. On 04-SEP-2021, the patient experienced felt like pinching in the armpit (further mentioned not in the armpit and more towards the top part of the shoulder on the left side). On 05-SEP-2021, the patient experienced anxiety. Treatment medications (dates unspecified) included: acetylsalicylic acid, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pulsating feeling (felt blood pumping from palm up to elbow and his shoulder and the chest) but only on the left side on 04-SEP-2021, was recovering from mild aches, and had not recovered from tight muscle feeling in the chest, shoulder and the arm on the left side, anxiety, and felt like pinching in the armpit (further mentioned not in the armpit and more towards the top part of the shoulder on the left side). This report was non-serious.


VAERS ID: 1678302 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-01
Onset:2021-09-04
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Liothyronine,Aspirin, Ibuprofen
Current Illness: None
Preexisting Conditions: Hashimoto disease
Allergies: Sulfa, citrus, eggplant,
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Blood Clot in left lowere leg, shin


VAERS ID: 1678312 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 FC3183 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Injection site erythema, Injection site pain, Injection site swelling, Mouth swelling, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild


VAERS ID: 1678316 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 FC3184 / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Hypertension, 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), Hypertension (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Hypertension-Severe, Additional Details: Patient received vaccine and waited in store for 15 minutes with his father. When leaving the store, patient fainted in parking lot. Ambulance summoned. Per patient''s father on 9/6/21, patient had a blood pressure spike. Patient''s primary dr will evaluate and has instructed patient to cancel second vaccine dose.


VAERS ID: 1678321 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-02
Onset:2021-09-04
   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 - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax, Echocardiogram normal, Myocarditis, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: wellbutrin XL 300mg daily. tylenol started once fever and chest pain developed
Current Illness: none
Preexisting Conditions: anxiety
Allergies: NKDA
Diagnostic Lab Data: troponin (TnT) 337. normal ECHO. Normal CTPA. cardiology consult. placed on solumedrol, NSAIDs
CDC Split Type:

Write-up: Patient developed fever, chest pain w/i 2 days of vaccine. He was admitted on 9/5/2021 to and diagnosed with myocarditis.


VAERS ID: 1678479 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Lymphadenopathy, Pain, 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Good: Melons, Tree Nuts and Peanuts, Bananas, and Avocado Medications: PCN, Sulfa Drugs, CT Dye
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Sore arm, fatigue, fever (up to 102.6), chills, body aches, headache (severe), swollen lymph nodes under right arm (vaccination side (size of a tennis ball))- up to 72 hours post vaccination.


VAERS ID: 1678508 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA OO8C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Arthralgia, Fatigue, Headache, Injected limb mobility decreased, Injection site erythema, Injection site inflammation, Injection site swelling, Injection site warmth, Mobility decreased, Movement disorder, Nausea, Pharyngeal oedema, Pyrexia, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: flu vaccine - anaphylaxis, mantoux skin test serum - anaphylaxis
Other Medications: Levothyroxine Multi-Vitamin Zinc B12
Current Illness: COVID positive 7/8/21
Preexisting Conditions: hypothyroid due to hashimoto''s, MTHFR clotting disorder
Allergies: All seafood - anaphylaxis, flu vaccine - anaphylaxis, TB skin test serum - anaphylaxis, fabric softener - hives/localized reaction
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: day of injection - small amount of angioedema to eyelids, lips, and throat tightness behind ears. Injection site redness/swelling/inflammation and heat to be expected however the injection site decreased mobility in my right arm and shoulder for several days - despite doing physical exercise/movement to the area to promote range of motion 20+ hours after injection - extreme fatigue, horrible headache, nausea, vomiting, fever of 103 that did not respond to tylenol/motrin for several hours nearly 12 hours for temp to move below 100. I had sensations of not being able to move my legs/arms even though I could physically move them - my sensation was not there that they were moving. The pain in my joints and specifically in my hips felt like someone poured boiling hot liquid into my joints and they were burning from the inside out. Decreased mobility due to pain in these joints. It is excruciatingly painful and the tylenol/motrin does not help with pain control.


VAERS ID: 1678512 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-09-04
   Days after vaccination:145
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, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pfizer 3/22 and 4/12. Positive on 9/2 admitted on 9/4 to current


VAERS ID: 1678514 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-11
Onset:2021-09-04
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 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: Janssen on 3/11. Positive on 9/1 admitted 9/4 to current


VAERS ID: 1678516 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-22
Onset:2021-09-04
   Days after vaccination:166
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, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pfizer on 3/1 and 3/22. Positive on 9/4 admitted 9/4 to current


VAERS ID: 1678519 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cardiac disorder, Fatigue, Feeling hot, Headache, Hyperhidrosis, Hypersomnia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins C0Q10 D3
Current Illness: Recently diagnosed with alopecia and autoimmune disease
Preexisting Conditions: Eczema
Allergies: Amitriptyline Cefprozil Divalproex Lamotrigine Nortriptyline Oxcarbazepine TB skin test
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had side effects with the first dose too but this time was worse. Shortly after receiving the vaccine I got muscle and joint aches. Next I felt hot and got really sweaty. Then I got a bad headache. Then the joint pain got worse. Then I got real sweaty. The worse thing was in the middle of the night I felt like my heart stopped twice. I had the headache for 3 days. I also felt really tired and slept a lot. I had the joint and muscle pain for two days. The heart episode happened once. I won''t get a booster bc of all the problems I had.


VAERS ID: 1678534 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-30
Onset:2021-09-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016C21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Eye irritation, Facial paralysis, Headache, Hypoaesthesia oral, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Hearing impairment (broad), Vestibular 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: Prozac Prilosec Metoprolol HCTZ Vyvanse
Current Illness:
Preexisting Conditions: HTN
Allergies: PPD skin test
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 5 post injection: dizziness, headache, nauseous Day 6 post injection: numbness to my tongue, left eye burning Day 7 post injection: unable to blink my left eye, total paralysis of left side of my face


VAERS ID: 1678544 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Hypersomnia, Irritability, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Does not take medications
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: He started feeling bad around midnight 9/3-9/4/2021, he vomited, tiredness, dizzy, shortness of breath, fever, chills. His mother gave him Tylenol. He slept most of the day. Mom reports he was irritable when he was awake but he slept most of the day. Started feeling better around lunchtime on Sunday, 9/5/2021.


VAERS ID: 1678560 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-23
Onset:2021-09-04
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 - / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Cough, Dyspnoea, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

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

Write-up: The patient presents with weakness. The onset was 1 weeks ago. Risk factors consist of hypertension and HYPERLIPIDEMIA. 86-YEAR-OLD FEMALE PAST MEDICAL HISTORY HYPERTENSION, HYPERLIPIDEMIA PRESENTS WITH 1 WEEK HISTORY OF FEELING GENERALIZED WEAKNESS. PATIENT STATES THAT A COUPLE WEEKS AGO SHE DID HAVE A RUNNY NOSE AND COUGH THAT HAS SINCE RESOLVED. PATIENT IS FULLY VACCINATED FOR COVID-19 WITH PFIZER. DENIES ANY ABDOMINAL PAIN, NAUSEA VOMITING DIARRHEA. REPORTS SOME SHORTNESS OF BREATH..


VAERS ID: 1678561 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 2nd dose of Moderna vaccine
Other Medications:
Current Illness:
Preexisting Conditions: Pulmonary hypertension; scleroderma
Allergies:
Diagnostic Lab Data: I have an ultrasound coming up
CDC Split Type: vsafe

Write-up: I had a fever, chills, body aches, swelling in pain. Swollen lymph nodes. I have recovered from everything except the swollen lymph nodes.


VAERS ID: 1678596 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 FD0809 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Ibuprofen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Hydration and extended observation.
CDC Split Type:

Write-up: Patient complained of nausea and dizziness.


VAERS ID: 1678598 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-20
Onset:2021-09-04
   Days after vaccination:168
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Dyspnoea exertional, Nausea, Oxygen saturation decreased, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: he patient presents with difficulty breathing. The course/duration of symptoms is 61-year-old female asthmatic presents with increasing shortness of breath. Patient diagnosed at home 1 week ago with coronavirus. Patient states she did get the Johnson & Johnson vaccination back in March or April. Patient states that she went to have the outpatient autoimmune immunoglobulins given however her O2 sats were below 90 and she was instructed to go to the hospital. In triage on room air her O2 sat was 86%. She denies coughing up any sputum she does complain of shortness of breath with any exertion. She has had some body aches. She has had no fever. She has had some nausea but no vomiting. She states her whole family at home has coronavirus. She does work in daycare.. Degree at onset mild. Degree at present severe. The Exacerbating factors is exertion. The Relieving factors is oxygen. Risk factors consist of asthma. Prior episodes: none. Therapy today: none. Associated symptoms: cough and nausea.


VAERS ID: 1678617 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 EW0186 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abnormal dreams, Arthralgia, Change of bowel habit, Chest discomfort, Chest pain, Cognitive disorder, Dyspnoea, Fatigue, Feeling jittery, Heart rate increased, Hot flush, Migraine, Nausea, Night sweats, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Noninfectious diarrhoea (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: High fever after pertussis as baby
Other Medications: None
Current Illness: Slight cold a few weeks before
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None yet. Considering going to hospital soon
CDC Split Type:

Write-up: Arm sore Tired Nauseous Night sweat Fast heartbeat, pulse Extremely jittery Hot flashes Ocular migraine Vivid dreams Trouble focusing and remembering what I?m doing/saying Heartburn? Not sure if that?s the right word but a pain/tightness in chest The need to do a little cough Feels like not enough breath to talk Wrist pain (feels like my blood is too thick or something. No other way to describe it)


VAERS ID: 1678623 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Hives appeared on 9/4/21, present all over the body. Very itchy. Benadryl helped symptoms subside.


VAERS ID: 1678624 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   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 30135BA / 2 AR / IM

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

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

Write-up: Patient was coming into clinic to receive their second dose of Moderna, but received Pfizer.


VAERS ID: 1678626 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 FD8448 / 3 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling cold, Headache, Injection site pain, Injection site warmth, Lethargy, Lymphadenopathy, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

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

Write-up: Patient reports chills, headache and fever even after taking Tylenol. Soreness and hot to the touch at the injection site - resolved after 24 hours. Swollen gland in neck - still present. Very lethargic for about 20 hours. Rash that started on trunk and moved to legs and arms that is still present. Patient wished all symptoms to be reported even after speaking with staff about how it is all to be expected.


VAERS ID: 1678644 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-16
Onset:2021-09-04
   Days after vaccination:172
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 047A21A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 03621A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Metabolic encephalopathy, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The patient presents with difficulty breathing. Patient presents to emergency department cough as well shortness of breath or 1 week. Patient describes fevers. Patient with chest pain as well as vomiting but no diarrhea. Patient states the vomiting has resolved. Patient''s symptoms have been constant since onset. Patient has been on her normal O2 at home for her COPD. Patient with recent admission for metabolic encephalopathy discharged on August 26. Patient was negative for COVID at that time. Patient had a COVID-19 vaccination in April of this year..


VAERS ID: 1678664 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-27
Onset:2021-09-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 059E21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: About a week after injection I started to notice some itching at the injection site on my left arm. I didn''t think anything of it until it continued for another day or two. It felt a bit warm and started to notice some redness. I then googled it and read about Covid arm. On day 2/3 a small rash appeared and on day 4/5 it more than doubled in size and is rather itchy.


VAERS ID: 1678672 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-31
Onset:2021-09-04
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen with codeine, Aspirin, Vitamin D, Fluticasone nasal solution, lisinopril, metformin, nystatin cream, omeprazole, ondansetron, sertraline
Current Illness:
Preexisting Conditions: Essential hypertension, type 2 diabetes, obstructive sleep apnea, high cholesterol, morbid obesity, anxiety
Allergies: Atenolol - myalgia, Ciprofloxacin - rash, influenza virus vaccine - flu like symptoms, Macrobid - nausea, Statins - myalgia, Sulfa antibiotics - rash, hives
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was admitted to hospital for COVID-19 + pneumonia. In ER patient had temp of 100. Patient received steroids and remdesivir. Patient was discharged on oxygen.


VAERS ID: 1678684 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Malaise, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz 1 tab PO daily Vitamin D Gummies PO BID
Current Illness: Denies
Preexisting Conditions: Per client she was seen in 2019-2020 in ER for "liver issues" but was not diagnosed with anything.
Allergies: Amoxicillin- swelling of face, eyes, or tongue
Diagnostic Lab Data: COVID-19 Cue Molecular Test on 09/07/2021 was negative Client was advised to go to her primary care physician or walk-in clinic for additional testing for influenza A/B.
CDC Split Type:

Write-up: Client states, "about 24 hours after my vaccine I felt super sick, my arm hurt really bad, and I had a fever. I was dizzy and just felt super super sick." Per client she was unsure of what her fever was as her thermometer wasn''t working correctly.


VAERS ID: 1678689 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-09-04
   Days after vaccination:152
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Dyspnoea exertional, Myalgia, Productive cough, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: ED Note: 84-year-old male with past medical history of multiple myeloma, CKD, squamous cell carcinoma of the lung (diagnosed in 2008 status post left upper lobectomy), clear cell carcinoma of the kidney (diagnosed in 2009 status post left nephrectomy), and anemia presented to the emergency room complaint of shortness of breath. He states his symptoms began 1 week ago. He states initially started off as a cough which was mostly dry, occasionally productive with clear sputum. He states he then began to experience some shortness of breath which she described as trouble catching his breath, and states worse with exertion. He states last week he was having some chills and myalgias. He went to the drugstore on Wednesday, 9/1/2021, and tested positive for Covid. He denies any trauma, injury or fall. Denies any fevers, headache, vision changes, eye pain, neck pain, back pain, chest pain, palpitations, lightheadedness, dizziness, syncope, hemoptysis, abdominal pain, nausea, vomiting, diarrhea, dysuria, hematuria, extremity numbness or tingling, or focal weakness.


VAERS ID: 1678734 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 3 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Hypertension, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypoglycaemia (broad)

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

Write-up: The day after receiving the vaccination on 09/04 had a severe headache, achiness, tiredness, fatigue. On 09/05 not as achy, but still tired. On 09/06 tiredness continued. On 09/07 exhaustion and shaky, blood pressure 162/100.


VAERS ID: 1678764 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-08
Onset:2021-09-04
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (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: Hospitalization - acute hypoxemic respiratory failure due to COVID-19


VAERS ID: 1678766 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-04
Onset:2021-09-04
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031L20A / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Fatigue, Oropharyngeal pain, SARS-CoV-2 antibody test, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: "ACTIVE - CEFTIN 250MG BY MOUTH 2 TIMES A DAY" "ACTIVE - CULTURELLE 1 CAPSULE BY MOUTH DAILY" "ACTIVE - LOSARTAN 100MG BY MOUTH DAILY" "ACTIVE - MAGNESIUM 400MG BY MOUTH DAILY" "ACTIVE - PROZAC 20MG BY MOUTH DAILY" "ACTIVE - ROBITUSSIN SEVE
Current Illness:
Preexisting Conditions: Depression, Dyslipidemia, GERD, HTN; :Atrial fibrillation (disorder), , h pylori. Hysterectomy, L TKA. Smoking Status Never Smoker. Alcohol Use Denies. Illicit Drug Use Denies.
Allergies: Codeine, cortisone
Diagnostic Lab Data: 09/02 - preadmission SARS-CoV-2 PCR (+) 09/04 - on admission, SARS-CoV-2 Antigen + SARS-CoV-2 IgG2 QT-SPIKE antibodies $g8000
CDC Split Type:

Write-up: 86 year old lady who has hx permanent atrial fibrillation on HTN, HLP, fibromyalgia, lives independently at senior living facility, presents for weakness, fatigue, dry cough, sore throat, was prescribed ceftin by PMD, was found to have COVID last Monday, presents for further evaluation and was found to be COVID 19 positive on rapid Sars.


VAERS ID: 1678775 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-22
Onset:2021-09-04
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Cough, Hypoxia, Malaise, Oxygen saturation decreased, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10 mg Tablet Directions: 1 tablet oral daily (Active) atorvastatin 40 mg Tablet Directions: 1 tablet oral daily (Active) calcium carbonate-vitamin D3 (Calcium 500 + D) 500 mg calcium (1,250 mg)-400 unit Tablet Directions: 1
Current Illness:
Preexisting Conditions: Diabetes, Dyslipidemia, HTN; r Rheumatoid Arthritis. P: Arthroplasty of knee (procedure). Smoking Status Never Smoker. Alcohol Use Denies. Illicit Drug Use Denies. Pregnant No.
Allergies: IVP dye, iodine, seasonal allergies
Diagnostic Lab Data: SARS-CoV-2 Antigen (+) 9/2/21
CDC Split Type:

Write-up: Patient is 74 years old female with PMX. of HTN, HLD, DM, obesity, RA came to hospital for Regeneron infusion, found to have hypoxia with O2sat at low 80''s and was sent to ER without infusion Patient reported that 1 week ago she began feeling ill with cough and bodyaches. Yesterday she developed fevers and felt generally weak She has no report of chest pain, being lightheaded or SOB. She took a home COVID test yesterday and was positive. Patient was referred today for the infusion. While being triaged, patient was found to be hypoxic. There has been no report of vomiting or diarrhea.


VAERS ID: 1678785 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Fatigue, Pain
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aimovig, metoprolol tartrate, feverfew, ginkgo biloba, melatonin, stool softener, zyrtec, magnesium,vitamin c and zinc. Omeprazole with sodium bicarbonate
Current Illness: None
Preexisting Conditions: None
Allergies: Aspirin, doxycycline, clindamycin, topiramate, cleocin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme body aches, fatigue, feeling like passing out, diarrhea


VAERS ID: 1678786 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-21
Onset:2021-09-04
   Days after vaccination:136
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioplasty, COVID-19, Chest discomfort, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Troponin increased
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine-benazepril 10 mg-40 mg Capsule Directions: 1 capsule oral daily (Active) escitalopram oxalate 10 mg Tablet Directions: 1 tablet oral daily (Active)
Current Illness:
Preexisting Conditions: Hypertension, anxiety. Cholecystectomy. Smoking Status Never Smoker.
Allergies: Demerol
Diagnostic Lab Data: SARS-CoV-2 Antigen (-) on 9/4/2021, BUT SARS-CoV-2 PCR (+) on 9/4/2021
CDC Split Type:

Write-up: 60-year-old female with a history of hyperlipidemia, increased BMI family history of cardiovascular disease (father had CEA in 1996, CABG in 1998 and likely died at age 77 of an MI) book keeper for local podiatrist who came to the emergency room with complaints of chest tightness. Patient was initially placed in observation and then flipped admission troponins came high patient was seen by Cardiology in his awaits transferred for angioplasty patient is chest pain-free at this time. Transfer held as PCR came back POSITIVE for COVID-19


VAERS ID: 1678821 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bladder pain, Blood pressure increased, Blood urine present, Change of bowel habit, Dyspnoea, Headache, Visual impairment
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (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: Finasteride; baby aspirin
Current Illness: None apparent
Preexisting Conditions: weak veins in legs; copd?; borderline diabetic (insulin resistant); prostate & bladder problems-2 decades; no none cancer; 33% body fat;
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Some shortness of breath, Blood Pressure Spike 15 points or more both ends, mild bleeding in urine; some vision difficulties early in the day; headaches, some disruption-mild of bowel movement (probably anxiety due to above); some soreness near bladder area-mild


VAERS ID: 1678829 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-29
Onset:2021-09-04
   Days after vaccination:218
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Diarrhoea, General physical health deterioration, Presyncope
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Pt is a 84 y.o. female with history of hypertension, hyperlipidemia, coronary artery disease s/p stenting, heart failure with reduced ejection fraction (48%), TIA s/p right carotid endarterectomy, CKD stage 3, mild cognitive impairment who is brought in by her daughter for worsening functional decline, diarrhea, and a near syncopal episode. She has limited ability to provide history and her history was provided by her daughter.


VAERS ID: 1678855 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-02
Onset:2021-09-04
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 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 9/4/2021


VAERS ID: 1678877 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: New York  
Vaccinated:2021-02-16
Onset:2021-09-04
   Days after vaccination:200
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Hypoxia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad)

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: shortness of breath and hypoxia, requiring hospitalization. Treated with oxygen delivery via HFNC as well as steroids and lovenox


VAERS ID: 1678895 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / IM

Administered by: Work       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Chills, Epistaxis, Fatigue, Lymph node pain, Lymphadenopathy, Pain, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After second dose of COVID 19 vaccination, similar effects no lymphadenopathy
Other Medications: Pepcid, methotrexate, hydroxychloroquine, Anastrazole
Current Illness: None
Preexisting Conditions: Rheumatoid arthritis, breast cancer
Allergies: Sulfa, Cipro, adhesive tape
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, chills, body and joint aches, fatigue and lymph node enlargement and tenderness in the axilla on the shot side. Lasting 24 hours except for the lymph nodes which are still enlarged and painful. Nosebleed x 2 on 9/5.


VAERS ID: 1678905 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Epilepsy, Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levetiracetam 500mg tab, Bupropion XL 150mg, Cyanocobalamin 1000mcg/ml inj, L-Methyfolate 7.5mg, Methylcobalamin 500mcg,
Current Illness: none
Preexisting Conditions: Generalized Convulsive Epilepsy-well controlled, Depressive disorder, Anxiety, GERD, Headache, Cervico-occipital neuralgia, Vit B12 def, Tobacco dependence
Allergies: Phenytoin, Latex Gloves, Bactrim DS
Diagnostic Lab Data: Pt reports having a grand mal seizure. Pt has never had a grand mal prior and has been partial seizure free for over 2 years.
CDC Split Type:

Write-up: Grand Mal Seizure, unknown, follow up needed.


VAERS ID: 1678913 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-09-04
   Days after vaccination:119
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031B21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Communication disorder, Confusional state, Cough, Dyspnoea, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (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), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: allopurinol 300 mg, PO, Daily Imbruvica 560 mg, PO, Daily
Current Illness:
Preexisting Conditions: Cataract Insertion of implantable venous access port Mantle cell lymphoma
Allergies: NKA
Diagnostic Lab Data: POSITIVE COVID TEST
CDC Split Type:

Write-up: SOB and cough x 4 weeks. EMS found pt to be saturating 79% on room air with a fever of 101. Pt confused/ poor historian


VAERS ID: 1678993 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-03
Onset:2021-09-04
   Days after vaccination:213
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tested NAAT positive for COVID 9/4/21 after being fully vaccinated.


VAERS ID: 1679011 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-04
   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 / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Rash erythematous, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine on Thursday and reports an itchy rash that feels like a sunburn. Rash started on Saturday on forearms that spread to legs, torso, and lower back. Symptoms relieved with oatmeal bath.


VAERS ID: 1679026 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-01-01
Onset:2021-09-04
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Malaise
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: Patient admitted with COVID symptoms. Had vaccine at another location. unknown dates and vaccine specifics.


VAERS ID: 1679028 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   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 FD0809 / 2 LA / SC

Administered by: Private       Purchased by: ?
Symptoms: Brain natriuretic peptide normal, Chest pain, Echocardiogram normal, Full blood count normal, Metabolic function test normal, Oropharyngeal discomfort, Oropharyngeal pain, Painful respiration, Pyrexia, Troponin increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: similar symptoms with first vaccine but less severe.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponin 0.3 (PIH Downey) -- $g 1.41 (CHOC ED) -- $g 0.55 (CHOC CVICU) BNP Normal, CBC, CMP normal ECHO - Normal biventricular function, normal anatomy, normal coronaries and aortic arch.
CDC Split Type:

Write-up: Shortly after vaccination, patient began developing low grade fevers, sore throat/throat discomfort, as well as worsening substernal chest pain that was worse with inspiration by post-vaccine day 2.


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