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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 27 out of 1,889

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VAERS ID: 1284717 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no history of known drug allergies and no drug abuse or drug illicit use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502299

Write-up: DROWSINESS; FEELING PAIN IN ARM; TIREDNESS; FEVER; This spontaneous report received from a consumer concerned a 50 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included the patient had no history of known drug allergies and no drug abuse or drug illicit use.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 18-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-APR-2021, the subject experienced feeling pain in arm. On 18-APR-2021, the subject experienced tiredness. On 18-APR-2021, the subject experienced fever. On 01-MAY-2021, the subject experienced drowsiness. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feeling pain in arm, and tiredness, and had not recovered from fever, and drowsiness. This report was non-serious.


VAERS ID: 1284755 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Body temperature increased, Chest discomfort, Dizziness, Dyspnoea, Heart rate, Hypertension, Musculoskeletal stiffness, Oropharyngeal discomfort, Palpitations, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: METOPROLOL; TYLENOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: blood pressure; Result Unstructured Data: Test Result:high blood pressure around 180/123 mmHg; Test Date: 20210418; Test Name: heart palpitations; Result Unstructured Data: Test Result:rapid; Test Date: 20210109; Test Name: COVID; Test Result: Positive
CDC Split Type: USPFIZER INC2021432028

Write-up: light headed; heat inside her left arm then her chest; heart palpitations rapid; high blood pressure around 180/123mmhg; Neck stiffness; throat becoming stiff; Very difficult breathing; tightness in her chest; This is a spontaneous report from a contactable other health professional (patient). A 49-year-old female patient (not pregnant) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0161), via an unspecified route of administration, administered in left arm on 18Apr2021 11:45 am (at 49-year-old, not pregnant at the time of vaccination) at single dose for COVID-19 immunisation. Medical history included hypertension, Covid-19 from 09Jan2021. Tested positive for COVID on 09Jan2021 and have antibodies after infection. Patient took vaccine under 100 days after COVID infection. No known allergies. Concomitant medications included metoprolol; paracetamol (TYLENOL extra strength), and multi vitamin. No other vaccine in four weeks. On 18Apr2021 11:52 (reported as 7 minutes after BNT162B2 1st dose), the patient experienced light headed, heat inside her left arm then her chest, tightness in her chest, felt heart palpitations rapid, high blood pressure around 180/123 mmhg. Neck stiffness and throat becoming stiff. Very difficult breathing after all symptoms were present. The events resulted in emergency room/department or urgent care, hospitalization. The days of hospitalization was 1 day. Therapeutic measures were taken as a result of the events, which included aspirin/ 2 bags of 1000 ml Sodium chloride. The outcome of the events was recovering. No COVID tested post vaccination.; Sender''s Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of reported events cannot be excluded. The case will be reassessed if additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1284765 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation, Dry throat, Dysphagia, Feeling hot, Hypoaesthesia, Muscular weakness, Nausea, Syncope, Thirst, Tremor, Vaccination site pain, Vertigo, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021432644

Write-up: fainting; hot burning sensation down left arm from injection site to wrist; hot burning sensation down left arm from injection site to wrist; hot burning sensation down left arm from injection site to wrist; dry throat; intense thirst; difficulty swallowing; vertigo; cloudy vision; waves of nausea; weak/numb hands; weak/numb hands; uncontrollable shaking; This is a spontaneous report from a contactable consumer (patient). A 50-year-old non-pregnant female patient received the first dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in Arm Left on 18Apr2021 at 09:45 (Batch/Lot Number: EW0164) as single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient previously took pneumococcal vaccine for immunisation and experienced allergy, tylenol and experienced allergy, codeine and experienced allergy. The patient experienced fainting, hot burning sensation down left arm from injection site to wrist, dry throat, intense thirst, difficulty swallowing, vertigo, cloudy vision, waves of nausea, weak/numb hands, uncontrollable shaking; all on 18Apr2021 with outcome of recovered in Apr2021. No treatment received for the events. All events resulted in doctor or other healthcare professional office/clinic visit.


VAERS ID: 1284787 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Nervousness, Vaccination site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (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:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021433198

Write-up: she is nervous and fretting; inserted the needle in her arm, she started to bleed and bleed and bleed; This is a spontaneous report from a non-contactable consumer (reporting for herself) via the medical information team. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 18Apr2021 (Batch/Lot number was not reported) as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On 18Apr2021, as soon as the pharmacist inserted the needle in her arm, the patient started to bleed and bleed and bleed. The patient stated the RPh wiped off the blood and she started to bleed again. The patient questioned if the vaccine actually went into her arm and asked if did the vaccine get a chance to penetrate into her muscle or not. The patient stated her first vaccine went OK but her second one had a bad outcome. The patient asked if there was nothing that says when a person bleeds while the vaccine was being administered means that the vaccine did not go in. The patient asked if there was information about anyone bleeding instantly once the needle goes in. On an unspecified date, The patient was nervous and fretting. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1284800 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021434240

Write-up: He has had blood in his stool, since yesterday, three separate times; This is a spontaneous report from a contactable consumer (patient). A male patient of an unspecified age received the first dose of BNT162B2 (Lot number and expiry date were not reported), via an unspecified route of administration on 18Apr2021 as single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient received his first dose of the covid vaccine yesterday (18Apr2021). He has had blood in his stool, since yesterday (18Apr2021), three separate times. He was asking if this is normal. He has been waiting for a long time already. The outcome of the event was unknown. Information about lot/batch number has been requested.


VAERS ID: 1284843 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW153 / 2 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Underdose, Vaccination site haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021450710

Write-up: jabbed her or inserted the needle, blood spewed out of her arm/ She was bleeding bleeding bleeding; she didn''t know if the medicine from the vaccine actually had a chance to go into her arm, and into the tissues it was supposed to; This is a spontaneous report from a contactable consumer (the patient). A 64-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number EW153), via an unspecified route of administration in the right arm on 18Apr2021 (at the age of 64-years-old) as a single dose for COVID-19 immunization. The patient had no medical history and no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number ER8330 or ER8730), via an unspecified route of administration in the left arm on an unspecified date (age at vaccination unknown) as a single dose for COVID-19 immunization. The patient received the second COVID shot and as soon as they jabbed her or inserted the needle, blood spewed out of her arm. She was bleeding, bleeding, bleeding. She was concerned, because she didn''t know if the medicine from the vaccine actually had a chance to go into her arm, and into the tissues it was supposed to. Her arm was bleeding as soon as the needle went in. She wanted to know if there was a way to know if she got the medicine. The outcome of the events was unknown.


VAERS ID: 1285554 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Oligomenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pentasa, vitamin d, zinc, NAC, l-glutathione
Current Illness: none
Preexisting Conditions: crohns disease
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: ended up having a 10 day menstrual period


VAERS ID: 1286139 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Public       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: Levothyroxin, vit B12
Current Illness: no
Preexisting Conditions: no
Allergies: pennicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: serious hives from neck to groin area, including both arms and itchy hands.


VAERS ID: 1288128 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-15
Onset:2021-04-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pacemaker insertion (cardiac)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Arrhythmia; This spontaneous case was reported by a consumer and describes the occurrence of ARRHYTHMIA (Arrhythmia) in an 89-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included Pacemaker insertion (cardiac) since an unknown date. On 15-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Apr-2021, the patient experienced ARRHYTHMIA (Arrhythmia) (seriousness criterion medically significant). On 22-Apr-2021, ARRHYTHMIA (Arrhythmia) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No relevant concomitant product use was reported. Treatment details included Metoprolol.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. However, patient''s history of pacemaker is a confounding factor which may play a possible contributory role.


VAERS ID: 1288359 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH OER8731 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Blood pressure measurement, Feeling hot, Headache, Heart rate, Heart rate decreased, Lethargy, Malaise, Nasopharyngitis, Near death experience, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (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), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: Blood pressure; Result Unstructured Data: Test Result:75/48; Comments: blood pressure dropped to 75/48, dropped to 75 over 48; Test Date: 20210418; Test Name: Blood pressure; Result Unstructured Data: Test Result:kept dropping; Test Date: 20210418; Test Name: Blood pressure; Result Unstructured Data: Test Result:went down to 78/48; Test Date: 20210418; Test Name: Blood pressure; Result Unstructured Data: Test Result:78/45; Test Date: 20210418; Test Name: Blood pressure; Result Unstructured Data: Test Result:went back to normal; Test Date: 20210418; Test Name: Heart rate; Result Unstructured Data: Test Result:40; Comments: heart rate was in the 40''s
CDC Split Type: USPFIZER INC2021431922

Write-up: Feverish; Headache; Lethargic; achiness/feels achy; sore arm; Not feeling well; Cold; he (her husband) could have died; Blood pressure at 78/45/blood pressure dropped to 75/48; pulse in the 40s/heart rate was in the 40''s; warm sensation in his upper torso; This is a spontaneous report from a Pfizer-sponsored program COVAX US Support. A contactable consumer (patient''s wife) reported that a 64-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: OER8731), via an unspecified route of administration, administered in Left arm on 18Apr2021 (at the age of 64-year-old, Time the Vaccination Was Given also reported as 15550 18Apr2021) at single dose for Covid-19 Virus. The patient medical history was not reported. No family medical history relevant to events. There were no concomitant medications. No additional vaccines administered on same date of the Pfizer suspect. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EO6955, Expiry date: Jun2021), intramuscularly administered in Left arm on 28Mar2021 (at the age of 64-year-old) at single dose for Covid-19 Vaccination and had no problems. No other prior vaccinations within 4 weeks and no events following prior vaccinations. Patient received second dose on 18Apr2021. He sat down in his chair stayed for 15 mins after his vaccine like they asked to. All of a sudden, he had a warm sensation in his upper torso on 18Apr2021. Blood pressure at 78/45 and pulse in the 40s on 18Apr2021. They called the ambulance and he was taken to the hospital. His blood pressure had since recovered but he''s not feeling well on 18Apr2021. 19Apr2021 he had achiness and a sore arm, reporter asked could he take Tylenol. They were told by the nurse to try to delay medication as much as possible. Reporter also reported that he (her husband) could have died, they felt like they should have been warned about the adverse event her husband went through. Patient was not feeling well today 19Apr2021 and had not contacted his physician yet. Patient felt a warm sensation over his upper torso and felt like getting a CT/CAT scan with contrast on 18Apr2021. His blood pressure dropped to 75/48 (also reported as dropped to 75 over 48) and heart rate was in the 40''s on 18Apr2021. The nurse who gave him the injection came, laid him down, called an ambulance for him and he had to go to the hospital. When the ambulance got there, the EMS tried to stand him up and his blood pressure kept dropping and so they took him to the hospital. Patient started not feeling well within minutes after getting the vaccine on 18Apr2021. He felt better than yesterday (18Apr2021) though. She said that 19Apr2021 he just felt achy and feverish, he had a headache and is lethargic today 19Apr2021. Patient experienced the warm sensation in his torso a few minutes after getting the injection and it lasted about 3 minutes. Yesterday (18Apr2021) evening he stabilized and when his blood pressure went back to normal the emergency room let him go home. He was kept in the ER for observation and was not admitted. Events blood pressure dropped to 75/48 and Heart rate in the 40''s required a visit to Emergency Room, no physician office visit. Reporter further reported that after 15 minutes of vaccine on 18Apr2021, patient''s blood pressure went down to 78/48 and he was cold. The outcome of the events blood pressure decreased and heart rate decreased was recovered on 18Apr2021, warm sensation was recovered on 18Apr2021 for about 3 minutes, not feeling well was recovering, outcome of events could have died and cold was unknown, outcome of the other events was not recovered.


VAERS ID: 1288361 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling of body temperature change, Gait disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021432150

Write-up: dizzy; having a hard time to breathe; hard to control walking; kept going from cold and hot; This is a spontaneous report from a contactable consumer (patient''s husband). A 38-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 18Apr2021 10:00 (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Historical vaccine included 1st dose of BNT162B2 for Covid-19 immunization. Around 19:00 on 18Apr2021, patient was dizzy, having a hard time to breathe, hard to control walking and kept going from cold and hot. Caller stated they put ice on her head, she took ibuprofen and they put two to three pillows on her head to help her breathe. Outcome of the event was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1288382 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-02
Onset:2021-04-18
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pulmonary embolism, SARS-CoV-2 test
SMQs:, Embolic and thrombotic events, venous (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LEXAPRO; TYLENOL
Current Illness: Knee ligament repair
Preexisting Conditions: Medical History/Concurrent Conditions: Anterior cruciate ligament tear; Esophageal motility disorder; Thyroid nodule
Allergies:
Diagnostic Lab Data: Test Date: 20210405; Test Name: COVID Nasal Swab; Test Result: Negative ; Test Date: 20210418; Test Name: COVID Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021437415

Write-up: Hospitalized 18Apr2021 with bilateral Pulmonary embolism; This is a spontaneous report received from a contactable nurse (who is also the patient). A 42-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date unknown), via an unspecified route of administration in the left arm, on 02Apr2021 11:00, as single dose, for COVID-19 immunisation, at a pharmacy/drug store. Medical history included esophageal dysmotility, thyroid nodules, ACL tear and ACL repair on 15Apr2021. The patient did not have COVID-19 prior to vaccination. The patient was not pregnant at the time of vaccination. Concomitant medications included escitalopram oxalate (LEXAPRO); and paracetamol (TYLENOL), both taken for unspecified indications, start and stop dates were not reported. The patient previously took prochlorperazine (COMPAZINE) and experienced allergies. Historical vaccine included the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number was not reported) at age 42 years, via an unspecified route of administration in the left arm, on 19Mar2021, for COVID-19 immunisation. The patient did not receive other vaccines in four weeks. The patient was hospitalized on 18Apr2021 with bilateral pulmonary embolism (onset date was 18Apr2021). Treatment for the event included Lovenix. The patient underwent COVID nasal swab on 05Apr2021 and 18Apr2021 which both resulted to negative. The outcome of the event was not recovered. Information on the lot/batch number has been requested.; Sender''s Comments: Based on the information available, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported bilateral pulmonary embolism occurred in a plausible temporal relationship. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1288411 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: School       Purchased by: ?
Symptoms: Joint range of motion decreased, Muscle spasms, Nerve injury, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Accidents and injuries (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:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021439277

Write-up: sustain cramps in her right leg; limited range of motion; not sure if there was a nerve that has been damaged or early stage of thrombosis; not sure if there was a nerve that has been damaged or early stage of thrombosis; severe arm pain; This is a spontaneous report from a contactable consumer reporting for herself. A 56-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number/expiration date: not provided), via an unspecified route of administration, on 12Apr2021 at 09:30 (at the age of 56 years old) as a single dose in the right arm for COVID-19 IMMUNIZATION. Relevant medical history and concomitant medication was none. The patient did not have any known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not pregnant at the time of vaccination. On 18Apr2021 at 18:00, the patient experienced severe arm pain that was described as arm pain was too painful and have been woken up out of her sleep and she has limited range of motion and she was not sure if there was a nerve that has been damaged or early stage of thrombosis. On 20Apr2021, the patient experienced sustain cramps in her right leg. The patient did not receive treatment for the events. The outcome of the events was not recovered. Since the vaccination, the patient had not been tested for COVID-19. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up.


VAERS ID: 1289464 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN L808982 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Contusion, Limb discomfort
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone Melatonin Unisom
Current Illness: None
Preexisting Conditions: Lynch''s Syndrome
Allergies: Keflex Sulfa Duracef
Diagnostic Lab Data: Blood work
CDC Split Type:

Write-up: Approximately 1.5 weeks after vaccination, patient began to notice bruising to lower legs and feet, one bruise as "big as a coffee cup" on inner right knee. She was seen by her PCP on 4/21. Lab work done. No specific treatment other than observation.


VAERS ID: 1291205 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Drug ineffective, SARS-CoV-2 test, SARS-CoV-2 test positive
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: Covid-19 test; Test Result: Positive ; Comments: Tested positive for the Covid virus, after the first Covid vaccine
CDC Split Type: USPFIZER INC2021440199

Write-up: Tested positive for the Covid virus, after the first Covid vaccine; Tested positive for the Covid virus, after the first Covid vaccine; This is a spontaneous report from a contactable consumer (patient) from a Pfizer-sponsored program. A 23-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number: unknown), dose 1 via an unspecified route of administration on an unspecified date two weeks ago as SINGLE DOSE for covid-19 immunisation. The patient''s medical history was not reported. The patient''s concomitant medications were not reported. The patient will be due for his second dose of vaccine, but tested positive for the covid virus on 18Apr2021. The patient underwent lab tests and procedures which included sars-cov-2 test: positive, tested positive for the Covid viruson 18Apr2021, after the first Covid vaccine. The outcome of tested positive for the covid virus was unknown. Information about the Lot/batch number has been requested.


VAERS ID: 1291332 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Herpes zoster, Loss of consciousness, Migraine
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), 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: IBUPROFEN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021457285

Write-up: Migraine to the point of a blackout; Migraine to the point of a blackout; Shingles Breakout; This is a spontaneous report from a contactable nurse (patient). A 28-year-old non-pregnant female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm left on 10Apr2021 at 13:00 as a single dose for COVID-19 immunisation. Medical history was not reported. Concomitant medication included ibuprofen taken for an unspecified indication, start and stop date were not reported. The patient experienced shingles breakout migraine to the point of a blackout on 18Apr2021. There was no treatment received for the events. The outcome of the events was not recovered. Information about lot/batch has been requested.; Sender''s Comments: Based on the available information and known product profile, the causal relationship between the report migraine to the point of a blackout and the use of BNT162B2 cannot be fully excluded. The case will be assessed further upon receipt of additional information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.


VAERS ID: 1291334 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-02-04
Onset:2021-04-18
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Peanut allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: Cov sars pcr (Nasal Swab); Test Result: Positive ; Test Date: 20210419; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021458882

Write-up: COVID-19 confirmed by positive COVID-19 test/Got infected with covid 19 and was symptomatic; COVID-19 confirmed by positive COVID-19 test Got infected with covid 19 and was symptomatic; This is a spontaneous report from a contactable nurse (patient) A 27-years-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 intramuscular, administered in Arm Left on 04Feb2021 08:00 (Batch/Lot Number: El9262) as SINGLE DOSE, dose 1 intramuscular, administered in Arm Left on 06Jan2021 12:00 (Batch/Lot Number: El0142) as single dose for covid-19 immunization. Medical history included peanut allergy. The facility in which the vaccine was administered was a hospital. No other vaccines were given within 4 weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. There were no concomitant medications. On 18Apr2021, at 23:00, The patient experienced covid-19 confirmed by positive covid-19 test/got infected with covid 19 and was symptomatic .The patient underwent Lab tests include SARS-CoV-2 test (PCR test Nasal Swab) on 18Apr2021 results positive, SARS-CoV-2 test (Nasal swab) on 19Apr2021 results positive. Treatment was given for the events. The clinical outcome of the events was recovering


VAERS ID: 1293865 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / SC

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram normal, Magnetic resonance imaging normal, Muscular weakness, Nervousness, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cetirizine 10mg prn allergies
Current Illness: some chronic left $g right leg numbness
Preexisting Conditions: allergic rhinitis, remote vestibular schawanoma on R resected 7/10 - no recurrence on MRI 4/30/21
Allergies: ADR - Phenergan - respiratory depression when combined with hydromorphone post op
Diagnostic Lab Data: MRI brain WWO contrast 4/30/21 - No evidence of hemorrhage, mass, or acute infarction. The ventricles are normal in size and morphology. Stable postoperative changes EKG 4/22/21 - NSR normal
CDC Split Type:

Write-up: note time of vaccination unknown Morning of 4/18 after up for a few hours noted "humming sensation" "internally shaking" mostly on left side - shoulder, chest, abdomen - less in leg. She didn''t think these were palpatations. This symptom decreased some over time but still present today. Afternoon 4/18 - left arm felt "tired" ? weak for about 3 days - resolved before I saw her in clinic on 4/22


VAERS ID: 1294683 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-18
Onset:2021-04-18
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood gases, Blood test, Eyelid ptosis, Pain in extremity, SARS-CoV-2 test, Vital capacity, Vital signs measurement
SMQs:, Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CADUET; LISINOPRIL; CARVEDILOL; TADALAFIL; XANAX; ROPINIROLE; CLONAZEPAM; CARBIDOPA/LEVODOPA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anxiety; Hypertension; Neurological disorder NOS; Restless leg syndrome; Sleep disorder; Spinal fusion
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: ABG; Result Unstructured Data: Test Result:Unknown; Test Date: 20210418; Test Name: Blood test; Result Unstructured Data: Test Result:Normal; Test Date: 20210418; Test Name: COVID-19; Test Result: Negative ; Test Date: 20210418; Test Name: Vital capacity; Result Unstructured Data: Test Result:Unknown; Test Date: 20210418; Test Name: Vital signs measurement; Result Unstructured Data: Test Result:Normal
CDC Split Type: USPFIZER INC2021444120

Write-up: ptosis of right eye; leg pain (both legs); This is a spontaneous report from a consumer. A 64 years old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration on 18Mar2021 (Lot Number: EN6208) as SINGLE DOSE (at age of 64 years old) for covid-19 immunisation. Medical history included hypertension from an unknown date and unknown if ongoing , anxiety from an unknown date and unknown if ongoing, restless legs syndrome from an unknown date and unknown if ongoing, sleep disorder from an unknown date and unknown if ongoing, Neurological Disease from an unknown date and unknown if ongoing, spinal fusion from an unknown date and unknown if ongoing (had 2 spinal fusions. One spinal fusion was of the cervical spine with hardware, and the other spinal fusion was of the lumbar spine with hardware). Concomitant medications included amlodipine besilate, atorvastatin calcium (CADUET) strength 5mg/20mg taken for an unspecified indication, start and stop date were not reported; lisinopril taken for an unspecified indication, start and stop date were not reported; carvedilol taken for an unspecified indication, start and stop date were not reported; tadalafil 5 mg taken for enlarged prostate, start and stop date were not reported; alprazolam (XANAX) 0.5 mg taken for anxiety, start and stop date were not reported; ropinirole (ROPINIROLE) taken for restless leg syndrome, start and stop date were not reported; clonazepam taken for sleep disorder, start and stop date were not reported; carbidopa, levodopa 50mg/200mg taken for an unspecified indication, start and stop date were not reported. Historical vaccine information included BNT162B2, dose 1 on 28Feb2021 (Lot Number: EN6205) dose 1, for covid-19 immunization at age of 63 years old. He received second dose on 18Mar2021; 30 days later 18Apr2021 woke up at 5 A.M., noticed ptosis of right eye on 18Apr2021. Concerned she took him to the hospital where he was assessed for stroke, TIA, all tests were negative. Consumer states, "my fiance was hospitalized over the weekend, we do feel it was exactly 30 days after second dose of Pfizer dose, from what I read in medical articles. I see that there were some cases of Palsy experienced by people in clinical trial. He is currently at home. He was in the hospital (emergency room)from 7am on 18Apr2021 and left at 3:50pm that same day against medical advise due to they did not have a neurologist. They wanted to admit him and transfer him to another facility because they didn''t have a neurologist available. She clarified her fiance''s adverse event as ptosis of his right eye. She said her fiance had diagnostics and blood work performed while at the Emergency Room. She said she wasn''t positive if the blood work performed was a CBC and basic blood chemistry, but the blood work results were normal. She said the hospital she brought her fiance to did not have a neurologist on staff. She said the hospital wanted to admit and transfer her fiance to a specialized hospital with a neurologist on the premises. She said her fiance''s condition did not worsen while at the Emergency Room, but she felt her fiance was not being monitored closely, and was not getting any care. She said since her fiance was not receiving anything at the Emergency Room, and the Emergency Room didn''t have the bandwidth to address his issues, and nothing was done to transport him to another hospital, her fiance left the Emergency Room against medical advice (AMA). She said her fiance went to a neurologist on Monday (19Apr2021). Emergency Room Visit Treatment: Stated her fiance was given Oxycodone while at the Emergency Room. She said she did not know the Oxycodone dose, NDC, Lot, and Expiration Date. She said the Oxycodone was administered for leg pain (both legs) caused by a pre-existing condition her fiance had. She said her fiance normally took Ropinirole for his leg pain. Consumer reported her fiance had follow-up testing done at the neurologist on Monday (19Apr2021), and was waiting for the test results to come back. She clarified the neurologist was doing the follow-up testing to confirm or rule-out a diagnosis of Myasthenia Gravis. Consumer reported when she took her fiance to the Emergency room she thought he was going to be assessed for a possible TIA or stroke, but when it was mentioned her fiance may have Myasthenia Gravis, it was equally concerning. Neurologist Visit Treatment: She stated the neurologist prescribed Pyridostigmine 60mg on Monday (19Apr2021) for her fiance to start taking while the doctor waited for the blood work and repetitive nerve conduction study results to come back. She said the doctor''s logic was to take the Pyridostigmine 60mg, and see if the ptosis resolved, and if the ptosis resolved the doctor would know the cause of the ptosis. She said her fiance''s right eye ptosis had not improved, changed, or resolved since he started taking the Pyridostigmine 60mg. She said she did not have the Pyridostigmine 60mg NDC, Lot, and Expiration Date. The patient underwent lab tests and procedures which included blood gases (ABG): unknown on 18Apr2021, Vital capacity: normal on 18Apr2021, Blood test: unknown on 18Apr2021, COVID-19: negative on 18Apr2021; vital signs measurement: normal on 18Apr2021 . Therapeutic measures were taken as a result of ptosis of right eye. Outcome of the event ptosis of right eye was not recovered. Outcome of the event leg pain (both legs) was unknown.


VAERS ID: 1294840 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-04-18
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac flutter, Pyrexia, Rib fracture
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Accidents and injuries (narrow), Tachyarrhythmia terms, nonspecific (narrow), Osteoporosis/osteopenia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SKYRIZI [RISANKIZUMAB]
Current Illness: Plaque psoriasis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20211

Write-up: Heart flutter; Fever; Hurt self in the toilet/broken ribs; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CARDIAC FLUTTER (Heart flutter) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Plaque psoriasis. Concomitant products included RISANKIZUMAB (SKYRIZI [RISANKIZUMAB]) from 01-Mar-2021 to an unknown date for Plaque psoriasis. On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Apr-2021, the patient experienced RIB FRACTURE (Hurt self in the toilet/broken ribs). On an unknown date, the patient experienced CARDIAC FLUTTER (Heart flutter) (seriousness criterion medically significant) and PYREXIA (Fever). At the time of the report, CARDIAC FLUTTER (Heart flutter), RIB FRACTURE (Hurt self in the toilet/broken ribs) and PYREXIA (Fever) outcome was unknown. The patient reported after started Skyrizi, she hurt herself in the toilet. She went to the emergency room on 18-Apr-2021 as she had broken ribs and physician prescribed medication, but she could not recall name. She reported after receiving Moderna vaccine she experienced heart flutter and fever in 2021. Company comment: Very limited information regarding these events has been provided at this time. The events are probably related to the patient''s comorbidities. A causal relationship cannot be excluded for the pyrexia event.; Sender''s Comments: Very limited information regarding these events has been provided at this time. The events are probably related to the patient''s comorbidities. A causal relationship cannot be excluded for the pyrexia event.


VAERS ID: 1156222 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-04
Onset:2021-04-17
   Days after vaccination:44
Submitted: 0000-00-00
Entered: 2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ? CRI (chronic renal insufficiency) ? GERD (gastroesophageal reflux disease) ? HTN (hypertension ? Breast cancer
Allergies: Phenytoin - Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: 03/17/21: patient [resented and was admitted through the ED for chills and shortness of breath for the last few days. 2 x rapid antigen test and tested COVID PCR positive. Per the EUA, hospitalizations to be reported irrespective of attribution to vaccine.


VAERS ID: 1209960 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT ON CARD / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Electrocardiogram, Laboratory test, Pain, Pain in extremity, Pericarditis, Troponin increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: On 4/11 was found to have high triponin levels but when tested with ECG the heart seemed healthy as ever.
CDC Split Type:

Write-up: On Saturday night (4/10) I had some chest pains that seemed to not go away in my upper left chest and left arm. I tried to sleep it off until the pain was unbearable at around 7:00 am on Monday (4/11). I then admitted myself to the ER and was given an ECG and multiple EKG?s as well. Upon lab results I had high triponin levels (28) leading the doctors to believe I had a heard attack of some sort, eventually they ruled it as acute pericarditis possibly due to my second dose of the Pfizer vaccine.


VAERS ID: 1211952 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Fibrin D dimer, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HIT (heparin induced thrombocytopenia) High blood pressure Esophogectomy from EC
Allergies:
Diagnostic Lab Data: EKG - 11/14 CT''s with contrast - 11/14 D-Dimer - 11/14 bloodwork- 11/13
CDC Split Type:

Write-up: pulmonary embolisms


VAERS ID: 1216676 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: Same
Other Medications: Levothroxine, multi vitimins, adrenal caps
Current Illness:
Preexisting Conditions: Down syndrome
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Seizure like activity


VAERS ID: 1222541 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Labored breathing, almost blacked out (I quite possibly did, for a minute or 2), very low BP.


VAERS ID: 1223259 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-29
Onset:2021-04-17
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: met forming 500mg. Per day Aspirn 87 mg. Per day Potassium 20 x2. Per day Celecoxib 200mg 1x per day Chlorthalidone25mg 1x per day Lovastatin 40 mg tablet 1x per day Losartan 1x per day Amlodipine 10 mg tablet 1x per day Venlafaxine 75mg 1x
Current Illness: N/A
Preexisting Conditions: hypertension Diabetes Spinal arthritis Depression
Allergies: N/A
Diagnostic Lab Data: na
CDC Split Type:

Write-up: severe chills and weakness, mild leg muscle calf pain.


VAERS ID: 1223774 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Pruritus, Rash, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: Rosuvastatin 10 mg, Citalopram 20mg Biotin, Centrum Silver, Caltrate, CoQ10, Vit D, ASA, Melatonin
Current Illness: None. HX of kidney stones
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria -macular papular rash on extremities (arms and legs), sides, back, face, very itchy. The rash started at 5pm on 4/17/2021, one week after receiving the vaccine. Urticaria got progressively worse. was given 50mg of Benadryl PO at 6:45pm. At 7:45pm the urticaria is gradually subsiding but is still present. I also contacted Janssen and spoke with a Pharmacist. I also reported this to Premier to the on call physician which is his PCP group. The on-call physician suggested I also administer Pepcid which I gave him 20mg. did have a sore arm several days after the injection. He is not having chills or an elevated temperature.


VAERS ID: 1224505 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
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: Contraceptives
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense headache


VAERS ID: 1225587 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-19
Onset:2021-04-17
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Brain natriuretic peptide, Chest X-ray, Computerised tomogram abdomen, Computerised tomogram thorax, Electrocardiogram, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Pulmonary embolism, Troponin I, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: on 4/18: CBC, CMP, troponin I, BNP, EKG, PT/INR, PTT, CXR, CT abd/pelvis, CT Pulm Angio, bedside echo, HITA, SRS
CDC Split Type:

Write-up: Pt found to have bilateral subsegmental pulmonary emboli. No right heart strain. Otherwise determined to be low-risk PE but will require anticoagulation.


VAERS ID: 1225631 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-04-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Erythema, Hypoaesthesia, Pallor, Paraesthesia, Platelet count normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Migraine with vomiting 2 days before reaction
Preexisting Conditions:
Allergies: Sulphuric based antibiotics and penicillin
Diagnostic Lab Data: They took my blood to see if platelets were abnormal or if there was a marker for clotting . Blood test showed normal platelets.
CDC Split Type:

Write-up: The left hand and foot developed bruising spontaneously at 2 pm, finger went numb and white., with tingling. Skin on hands reddened. These symptoms continue today, the day after, though lessened. Hands remain tingly and redness of skin is ongoing.


VAERS ID: 1225733 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ? / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderal, Xanax, &. Mucinex (over the counter cold & flu medication being taken as an aid to curb aside recent onset of flu-like symptoms; I.e. nasal congestion, watery ?snot?,? mucus, and slight nausea/urge to , at times, vomit)
Current Illness: Not applicable
Preexisting Conditions: ADHD & ANXIETY (hints the Adderall and Xanax being taken/prescribed by a doctor...full disclosure, the prescription (s) are being provided by a ?street pharmacist,? but I know to be true that the medication(s) I?m taking come straight from a pharmacy; which in turn are prescribed by a doctor. I.e. I am prescribed (by defacto. )
Allergies: Not applicable
Diagnostic Lab Data: ? (No clue)
CDC Split Type:

Write-up: None. Just taking Mucinex


VAERS ID: 1225761 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site swelling, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The next day I had swelling at injection site, and aches and pains . Yesterday I woke up with hives on both arms between elbows and wrists and legs above the knees. I haven''t eaten anything or been anywhere or changed soaps or detergents.


VAERS ID: 1226025 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Burning sensation, Pain in extremity
SMQs:, Peripheral neuropathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ibuprofen, levonorgestrel, and levothyroxine
Current Illness:
Preexisting Conditions: hypothyroidism, and history of DVT in same leg with leg pain
Allergies: latex, gabapentin, azithromycin, and hydromorphone
Diagnostic Lab Data: Patient referred to Emergency Department for ultrasound to rule out thrombosis.
CDC Split Type:

Write-up: Patient is reporting right-sided leg pain and burning sensation.


VAERS ID: 1226261 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Headache, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None Took tylenol after 4 hours start getting feeling of fever.
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: I feel severe headache yesterday and today i took Tylenol and i felt better today again same time headache start and i feel like little dizzy, sharp pain in my legs between ankle and knee,


VAERS ID: 1226415 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Inflammation, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin, Pristiq, Adderall, Vitamin D, Vitamin B12, Reishi, Glutathione, Magnesium, Ginseng
Current Illness:
Preexisting Conditions: Type 1 Diabetes; Celiac Disease
Allergies: Celiac Disease
Diagnostic Lab Data:
CDC Split Type:

Write-up: Painful swelling and inflammation of hands and arms


VAERS ID: 1226934 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram
SMQs:

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Citalopram
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: All done on 4/17- lots of tests and CT scan
CDC Split Type:

Write-up: Appendicitis and emergency appendectomy.


VAERS ID: 1226950 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Urinary tract infection
SMQs:

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

Write-up: PATIENT DEVELOPED A UTI 10 DAYS POST-VACCINATION


VAERS ID: 1227008 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Headache
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: Atorvastatin 10mg Amlodipine 10mg Aspirin 325mg
Current Illness: Diabetes HBP hypertension Prostatitis
Preexisting Conditions: Diabetes HBP Protatitis
Allergies: N/A
Diagnostic Lab Data: I haven?t see Dr. yet and will see him. In them of April 20,0
CDC Split Type:

Write-up: At night sleep on April 17, I wake up by a sharp pain on top my left head and on and off since then until April 18 morning. And the pain were not severe and keep on and off through out April 18. I felt right armpit and a rounding area bold vessels hurt since April 16.


VAERS ID: 1227400 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021B21A / 2 RA / SYR

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

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

Write-up: Fever (101.5), Body Aches, Headache, Fatigue


VAERS ID: 1227412 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Hypoaesthesia, Malaise, Palpitations, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (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: unknown
Current Illness: Patient stated after the vaccine had been administered that she is in the middle of a cardiac workup. She had worn a vest to monitor her heart rate and was schedule in a week for a Cardiac stress test.
Preexisting Conditions: none disclosed.
Allergies: several: adhesive, amitryptiline, augmetin, clarithromycin, clindamycin, codeine, compazine, erythromycin, norco, isotretinoin, ketoroloac, metoclopramide, naproxen, zofran, paxil, premarin, pristiq, progesterone, ranitidine, tetracycline, tompamax, aspirin, penicliin, risperidone, ssri/s, sulfamethoxazole, tca''s venlafaxine, macrolide antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient spent an hour being monitored. At first she complained of an itchy site and being sweaty. About 15 minutes later she said that her fingers on that hand were numb and her pulse was racing. I gave her ice water (she took it with her numb hand) and offered to walk her to the emergency room (we are situated in Hospital just by the ER). Patient declined and stated she didn''t want to be around sick people. She then asked me if it could be related to the heart problems she has been having lately and stated she is between various cardio tests. She continued to rest in a seated position and I continued to monitor her every 5 minutes. I offered her a benadryl unit dose 25mg. She accepted, opened the blister pack with both hands, and swallowed capsule and told me that she had a general unwell feeling. She swallowed benadryl at 5:04 pm. At 5:15 pm she said she was better and that benadryl had cured the numbness. I cam to check on her at 5:20 and she had left the premises.


VAERS ID: 1227455 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore muscles, fever,


VAERS ID: 1228255 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal tenderness, Dizziness, Headache, Injection site haemorrhage, Vision blurred
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular 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: Collagen
Current Illness:
Preexisting Conditions:
Allergies: Nothing known
Diagnostic Lab Data:
CDC Split Type:

Write-up: As soon as I received it, about 2 minutes after, it was a drive thru event and my mom was also with me in the car receiving the vaccine also. I was still waiting for the nurse to replace her bandaid since she was bleeding a little more than normal. As soon as the car got out of the tent, I was driving, it felt like my head was being drilled, my vision blurred, everything turned dark, I could not hear, I had a bad headache almost about to faint but I kept on driving slowly to get to the waiting area. By the time I parked, I removed my mask, open the car window and relaxed and just started inhaling deeply. I felt better soon after and spoke to the nurse there and she recommended drinking fluids the next 48 hrs. I felt dizzy, tired but not very sore like the first dose. 2 days later, I still feel dizzy, vision is blurry sometimes and occasional headache, a little tenderness on abdomen and feeling like I am catching my breath sometimes.


VAERS ID: 1228313 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / 1 RA / IM

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

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

Write-up: Patient in observation. Patient experienced syncope for approximately 10 seconds. Patient awakens. Patient vital signs BP-179/79 HR-76 T-98.6. When patient awaken, AOx3 and she began drinking a bottle of water. Patient monitored. Patient husband and daughter in car. Patient monitored. Vital signs retaken BP-138/78 HR-64 R-16. Patient verbalizes feeling better and anxiety has decreased. Patient and family educated on worsen symptoms and when to seek medical attention.


VAERS ID: 1228362 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: Valtrex 500mg, Amitriptyline 10mg, Cymbalta 60mg, Levoceterizine 5mg, Topiramate 50mg, Amoxicillin 500mg, Ibuprofen 800mg
Current Illness: Toothache
Preexisting Conditions:
Allergies: Codeine, Sulfates
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: I woke up Saturday morning, April 17 between the hours of 730 and 8 AM with an unexplainable rash in the middle of my right arm. This is the arm where I had my COVID-19 injection. The rash is itchy, patchy and bumpy. I do not know how to treat it; therefore I have not put anything on it.


VAERS ID: 1228403 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Freezing phenomenon, Headache, Pain in jaw, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Osteonecrosis (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: Fluoxetine, levothyroxine, Famotinine, Trospium Chloride, Montelukast, Syrtec, Vitamin D, Turmeric Curcumin and Centrum one a day
Current Illness:
Preexisting Conditions: Acid reflux, Hypo thyroid
Allergies: Seasonal, Dogs and Cats
Diagnostic Lab Data:
CDC Split Type:

Write-up: 14 hours after Chills and freezing for the next few hours, 18 hours after shot 102.7 fever - headache - jaw hurt, fever slowly went down through out the day, about 30 hours after rash on legs under knees both legs. about 48 hours after still have a rash on legs


VAERS ID: 1228569 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, atorvastatin, ezetemibe, isosorbide mononitrate, losartan, metoprolol tartrate, omeprazole
Current Illness: Patient did have COVID at the beginning of April 2021
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data: CT chest revealing small right superior pulmonary arterial PE (4/17/21) D-dimer 630 (4/17/21)
CDC Split Type:

Write-up: Patient received their COVID vaccine on 4/7/21. Recently admitted for COVID (3/24/21 - 4/2/21) discharged on room air, doing well. Returned 4/17/2021 with acute onset and persistent right sided chest pain.


VAERS ID: 1228685 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Headache, Influenza like illness, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I had heart issues after my small pox vaccination
Other Medications: None
Current Illness: None
Preexisting Conditions: I have eczema and I had STV
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had flu like symptoms. I had a massive headache that still hasn''t gone away. I was very weak and light headed about ten hours after the injection. I had chills that turned into a fever and it last about 24 hours. In addition, the injection site was hot to the touch for two days.


VAERS ID: 1228756 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Laboratory test
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, lisinopril/HCTZ, Glipizide, gabapentin
Current Illness: Diabetes, hypertension
Preexisting Conditions: Diabetes, hypertension
Allergies: Ultram, hydrocodone
Diagnostic Lab Data: CT head, labs
CDC Split Type:

Write-up: CVA, hospitalized


VAERS ID: 1228884 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Headache
SMQs:

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

Write-up: mod-severe headache onset 5 days post vaccine


VAERS ID: 1228964 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Infarction, Magnetic resonance imaging head abnormal
SMQs:, Myocardial infarction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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: MRI showed multiple acute infarcts within left frontal, left parietal, left post central gyrus, left occipital lobe


VAERS ID: 1229029 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Full blood count, International normalised ratio, Metabolic function test, Pain in extremity, Prothrombin time, Rash, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Xopenex, Simvastatin
Current Illness:
Preexisting Conditions: Anxiety/Depression, Asthma, Hyperlipidemia
Allergies: Avelox, PCN
Diagnostic Lab Data: CT Brain & Venous Doppler of LE both done 4/17/21 CBC, CMP, & PT/INR all done on 4/16/21
CDC Split Type:

Write-up: Leg pain/rash, hand pain/rash Pt treated with Morphine in ER Seen in dr office today & treated with Prednisone for continued symptoms


VAERS ID: 1229057 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest discomfort, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None on file
Preexisting Conditions: None on file
Allergies: No known allergies
Diagnostic Lab Data: 4/17/2021 - Positive for SARS-CoV-2 via PCR NP swab
CDC Split Type:

Write-up: Pt received her 1st and only needed dose of the Janssen COVID-19 vaccine on 4/2/2021. After the 2 weeks needed to be considered fully vaccinated, She presented to the ED with cough, SOB, and chest discomfort on 4/17 and was diagnosed with COVID pneumonia. She was treated but not admitted.


VAERS ID: 1229312 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-08
Onset:2021-04-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase normal, Basophil count decreased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatinine normal, Blood glucose increased, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone normal, Blood urea normal, Carbon dioxide normal, Chest X-ray normal, Differential white blood cell count normal, Eosinophil count normal, Erythroblast count normal, Fibrin D dimer normal, Full blood count, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Immature granulocyte count increased, Lymphocyte count, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count, Monocyte count increased, Neutrophil count, Neutrophil count normal, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width normal, Tachycardia, Troponin I normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? atorvaSTATin (LIPITOR) 10 MG tablet, Take 10 mg by mouth daily, Disp: , Rfl: ? cholecalciferol (VITAMIN D) 25 MCG (1000 UT) tablet, Take 1,000 Units by mouth daily, Disp: , Rfl: ? metFORMIN (GLUCOPHAG
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CKMB [247900288] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Creatine Kinase-MB 0.8 0.0 - 3.6 NG/ML Troponin Series [247900289] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Troponin I 0.00 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel [247900293] (Abnormal) Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Glucose 147High 65 - 100 MG/DL Blood Urea Nitrogen 18 7 - 18 MG/DL Creatinine 1.2 0.7 - 1.3 MG/DL Sodium 139 136 - 145 MMOL/L Potassium 4.7 3.5 - 5.1 MMOL/L Chloride 104 98 - 107 MMOL/L Co2 28 21 - 32 MMOL/L Calcium 9.2 8.5 - 10.1 MG/DL Protein Total 7.5 6.4 - 8.2 G/DL Albumin 4.0 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 96 46 - 116 U/L Alt (SGPT) 50 16 - 63 U/L AST(SGOT) 25 15 - 37 U/L Bilirubin, Total 0.7 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 67Low $g90 ML/MIN/1.73sq.m Magnesium [247900294] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Magnesium 2.2 1.8 - 2.4 MG/DL TSH Third Generation [247900299] Collected: 04/17/21 1000 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 TSH 2.57 0.30 - 3.04 uIU/mL D-dimer, quantitative [247900291] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1001 D-Dimer <100 0 - 400 NG/ML FEU XR Chest Portable [247900296] Collected: 04/17/21 0935 Order Status: Completed Updated: 04/17/21 1000 Narrative: EXAMINATION: PORTABLE CHEST SINGLE VIEW, 4/17/2021 at 0926 hours CLINICAL INFORMATION: Tachycardia COMPARISON: None FINDINGS: The cardiomediastinal silhouette is upper limits of normal in size. There is no significant consolidation or effusion. Osseous structures are without acute abnormality. IMPRESSION: Negative. CBC w Auto Diff [247900292] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 0938 White Blood Cell Count 7.7 4.8 - 9.6 THOUS/uL Red Blood Cell Count 4.98 4.33 - 5.59 MIL/uL Hemoglobin 15.8 13.1 - 16.8 GM/DL Hematocrit 46.0 38.8 - 49.0 % Mean Corpuscular Volume 92.4 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 31.7 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 34.3 32.4 - 35.7 G/DL Rdwcv 12.7 11.6 - 13.9 % Rdwsd 42.7 36.0 - 46.1 FL Platelet Count 202 154 - 364 THOUS/uL Mean Platelet Volume 9.1 8.7 - 11.7 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 60.7 34.0 - 67.9 % Lymphs 27.6 19.1 - 41.2 % Monocytes 9.6 6.1 - 12.3 % Eos 1.3 0.9 - 7.6 % Basos 0.5 0.2 - 1.5 % Neutrophils Absolute Count 4.7 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 2.1 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 0.7 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.1 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.3 0.2 - 0.9 % Abs Imm Gran 0.02 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 4/17/21 ER HPI: 56 y.o. male who presents with asymptomatic tachycardia. The patient purchased a home blood pressure monitoring device approximately 2 weeks ago and at that time he noted that the machine recorded his pulse at 150-160 beats per minute. The patient has repeatedly taking his blood pressure at home with this device and every time and has recorded his pulse in the same range. He denies fevers chills chest pain palpitations syncope lightheadedness peripheral edema or dyspnea. He presents today for evaluation of this as the machine again indicated that his pulse was 100 50-160 beats per minute


VAERS ID: 1230372 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Injection site pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fenofibrate 160mg, Atorvastatin 80mg, seroqel 400mg, fluoxetine 60mg, alprazolam .5mg
Current Illness: sourness at injection site located in right arm, chills with mild fever day of, and after vaccination.
Preexisting Conditions:
Allergies: Rx: all ciliin related drugs including penicillin Food allergies: peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine on 4-9, same day experienced chills, fever, light headedness, and soreness around injection site. Symptoms persisted throughout weekend. On 4-17, broke out in hives on arms, neck, and backs of hands.


VAERS ID: 1230590 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Furuncle, Pain
SMQs:

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

Write-up: Patient reports getting a stingy boil that''s 3/4ths of an inch that appeared on the same arm as the vaccinated arm on 4/17/21, it popped today on 4/19/21 and a clear substance came out.


VAERS ID: 1230608 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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: Prolonged pain at injection site in left arm from flu vaccine on 1/06/2021. FLUZONE QUAD/IM/Lot UT7115NA/Sanofi-Pasteur
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Amoxicillin
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Developed itchy rash all over body 6 days after receiving covid-19 shot. Took Benadryl (25mg) every 4 hours. Rash is starting to diminish on day 3


VAERS ID: 1230895 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pain, Vital signs measurement
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: The patient is a 28 y.o. male evaluated for left sided body aches and 6/10 head pain that began approximately two weeks ago following the administration of the Johnson and Johnson COVID-19 vaccine. Given the patient''s current presentation on exam and history provided low concern from vaccine complication or infection. He has normal vital signs here and his symptoms were somewhat reproducible, in particular with the tenderness of the midline T-spine and left scapula. Primarily concerned for musculoskeletal strain, likely worsened from his physical labor at work. At this time I do not feel that further emergent workup is warranted and the patient is medically stable for discharge with instructions to rest and ice the area of tenderness. He has significant change in disposition once explained that this was unlikely to be the result of vaccination. The patient was informed of all pertinent findings today. They were informed of their diagnosis and home management plan. They were informed about the importance of close follow up with their primary care doctor. They were told to return to the ED for any new or worsening symptoms. They had an opportunity to ask questions and all questions were answered. They agree with the plan for discharge and management plan.
CDC Split Type:

Write-up: The patient is a 28 y.o. male who presents to the Emergency Department with left sided body aches and 6/10 head pain that began approximately two weeks ago following the administration of the Johnson and Johnson COVID-19 vaccine. The patient is present with a chaperone at bedside who helps provide history and translates for the patient. Since the administration of the vaccine the patient states he''s been experiencing these symptoms. The patient reports that he began experiencing his symptoms approximately 30 minutes following the vaccine administration and have worsened since onset. He reports that he took oral Tylenol yesterday with minimal relief. The patient states that movement and exertion exacerbate his symptoms and reports that he was not able to attend work today secondary to his pain. The patient denies any associated symptoms of fever, chills, nausea, vomiting, diarrhea, constipation, or any visual changes.


VAERS ID: 1231118 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER EW0158 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dysstasia, Eye swelling, Headache, Muscular weakness, Pyrexia, Rash, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Migraine
Preexisting Conditions: Migraine
Allergies: None
Diagnostic Lab Data: Non yet.
CDC Split Type:

Write-up: Fever, severe headache, muscle weakness, no Strength to stand, vomitting, swollen left eye, rashes on abdomen.


VAERS ID: 1231245 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-04
Onset:2021-04-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head, Fatigue, Headache, Immunoglobulin therapy, Migraine, Petechiae, Platelet count increased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Brain ct scan for bleeding 4/18 Lots of blood draws 4/18 and 4/19 IV immunoglobulin transfusion 4/19 Steroid (decadron) IV 4/18 and 4/19 and continuing.
CDC Split Type:

Write-up: Headache and tired for three days after shot. Then 14 days after shot I got a migraine. 15 days after shot I broke out in petechiae. Went to the hospital and had blood platelet count of 1,000. Receiving steroids and IV IG. At risk of fatal internal bleeding.


VAERS ID: 1231260 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Nothing reported
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: I was contacted by physician assistant who informed us that patient was at HCF being treated for clotting believed to be secondary to having received the Janssen Covid19 vaccination. He said that she was diagnosed as having a focal dural venous thrombosis in the superior sagittal sinus and was being treated with Eliquis. He requested that we report this event to VAERS.


VAERS ID: 1231351 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 500 mg three times a day Tylenol #3 Prn from a dental procedure Benadryl Women?s one a day Vitamin D
Current Illness: No
Preexisting Conditions: No
Allergies: Nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am starting to have a rash all over my body. It started 8 days after vaccination.


VAERS ID: 1231356 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Injection site pain, Nausea, Pain, Pyrexia, Sleep disorder, Tinnitus, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular 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: Mirena (52mg) - IUD
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day of: Hydrated pre-vaccination. Soreness at injection site onset approx. 3 hours after vaccination and has lasted a few days. Refrained from massaging muscle or sleeping on that side. At approx. 5-6 hours post-vaccination, aches and chills onset. No fever throughout the evening. Nausea onset approx. 7-8 hours post-vaccination. Took 1,000mg of NSAID containing acetaminophen and went to bed @9pm to try to sleep it off. Day after: Woke up at 12:15am and 12:45am vomiting. Continued to have aches, chills, and fever (ranging from 99.9? to 101.5?) throughout the day. Took 1,000mg of fast acting Tylenol in the afternoon, drank fluids and rested. Two days after: Woke up @8:30am and felt faint (whistling in ears as well) for approx. 20 minutes. Continued to feel fatigued and weak throughout the day but fever and chills subsided.


VAERS ID: 1231362 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Feeling hot, Heart rate increased, Hyperhidrosis, Pain in extremity, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norco-10, taken one pill around 7:00am that morning.
Current Illness: Had cough few weeks prior w runny nose. Tested negative for Covid on 4/3/21
Preexisting Conditions: Chronic lower back problems; smoker, asthma few times year and use provental inhaler when/if necessary.
Allergies: Gabapentin
Diagnostic Lab Data: Monitors my heartbeat, O2, pulse, breathing and blood pressure while watching me. No medications given for weird reaction BG to moderna first shot. Had video visit with my general practitioner this morning about what happened two days ago. Had sore arm from shot for first day and a half and feel fine tonight.
CDC Split Type:

Write-up: About 6 minutes after a got first shot of moderna, I had felt fin. Then within 20-30 seconds I realized that my chest was heavy/pressure on my sternum, arms and torso went warm and sweaty, a bit light headed and had fast heart rate. I asked medical team for assistance. They took blood pressure/O2 levels and listen to my heart and lungs. Had epi pen ready, but never administered. Watched me like this for about hour and a half until my bp came back down to normal levels.


VAERS ID: 1231383 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Fatigue, Migraine, Mobility decreased, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol succ er 100mg Losartan potassium 100mg Lunesta 3mg at night Lorazepam 1 mg at night Flonase Wal dryl Tramadol 50mg every 6 hrs as needed Aspirin 81mg Hydrochlorithiazide 25mg
Current Illness:
Preexisting Conditions: IBS High Blood Pressure
Allergies: Codine Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, extreme body pain (entire body), nausea, diarrhea migraine, fatigue. April 17, progressed throughout day, starting @ 2am with diarrhea and vomiting, Sunday April 18 was unable to move eat nor drink the entire day, Monday April 19th still unable to eat nor drink without throwing up, headache still present slight fatigue, body aches easing up.


VAERS ID: 1231387 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Dizziness, Headache, Heart rate increased, Nausea, Pain, Pruritus, Pyrexia, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Levothyroxine
Current Illness: Nono
Preexisting Conditions: Diabetes Hypothyroidism
Allergies: Not known
Diagnostic Lab Data: None done
CDC Split Type:

Write-up: Nausea, severe rashes (hives) red and burning and itchy throughout the body, second high fever that went up to 102.1 followed by chills and body ache, light headed ness and headache. Rashes occurred 10-12hrs after vaccine and got worse till was treated at a medical clinic and er. Had heavy heart rate of 120+ IV administered with diphenhydramine which is continued even now as slight rashes still exists and prednisone was given on Sunday April 19 2021 at 11:50am Later since rashes still persisted was advised by the urgent clinic to go to ER where hydroxyzine was given


VAERS ID: 1231393 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site rash, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 101.1, soreness, exhaustion, diarrhea for approximately the first 36 hours; rash at injection site after 48 hours


VAERS ID: 1231446 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Influenza like illness, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Nausea, Pain, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins C and D3, hair and nail supplement, Allegra, and Flonase
Current Illness: None
Preexisting Conditions: Seasonal allergies, low-blood sugar, near-sighted, and adult-onset scoliosis. Less frequently, migraines and IBS.
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Experienced flu like symptoms starting 24 hours after shot, including low grade fever, chills, fatigue, headache, nausea, and body aches. These all started to improve Sunday evening, 4/18,, and I was able to eat a meal. Around 9:00 pm on 4/18, I noticed a red area around the injection site on my arm. It felt warm to the touch. It didn?t seem too swollen, so I went to bed. I woke up around 2:00am on 4/19 and my upper arm had a large, hard swollen lump at injection site. It was still red and hot. I have been taking ibuprofen which is helping with the swelling. I still have some swelling, a red ?sunburned? area around the injection, and warm to the touch. I do not have pain or itching? at least at this point at 11:45pm on 4/19. I was surprised to have a new symptom almost 2.5 days after my shot.


VAERS ID: 1231449 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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: Tetanus age 48
Other Medications: Lexapro 20 mg 1 time a day
Current Illness: None
Preexisting Conditions: None
Allergies: Severe reactions to bug bites and stings no epipen needed as yet just Benadryl
Diagnostic Lab Data: None
CDC Split Type:

Write-up: ?Covid arm?. Injection site and about 1.5 inch around red and swollen hot and painful to touch Similar reaction to what I get with bug bites but a bit milder


VAERS ID: 1231478 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Oxycodone, Acetaminophen
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: None knkwn
Diagnostic Lab Data: None at this time. If condition persists, I will see my doctor.
CDC Split Type:

Write-up: Three (so far) episodes of VERY severe nosebleeds lasting up to 30 minutes. Not normal for me.


VAERS ID: 1231686 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Injection site erythema, Injection site nodule, Injection site rash, Injection site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tumeric, vitamin e, vitamin c, amlodipine, and triamterene
Current Illness: none
Preexisting Conditions: Blood pressure, arthritis
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Woke Saturday morning around 12:00am with patient and bed sweated wet and patient had chills. Extremely tired to point could barely move. Sunday morning still extremely tired, red rash around injection area about three inches around, large knot under armpit of injection site the size of a softball. Monday morning still tired but not as extreme. Still had rash at injection site and entire upper arm swollen. Still had knot below armpit.


VAERS ID: 1231970 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Lungs lost a lot of capacity which I was able to gauge by my swimming as well as being easily out of breath which is not normal


VAERS ID: 1232005 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)

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

Write-up: MODERN 0.5 ML FOR IM LOT 038B21A EPX:09/25/2021 No known adverse events.


VAERS ID: 1232015 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: Unseen/ unknown reportedly had heart attack 6 days post vaccination. Reported from facility.


VAERS ID: 1232035 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre 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: oxybutynin CR 10 mg
Current Illness:
Preexisting Conditions: MS, urge incontinence, osteopenia
Allergies: NKMA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: dizziness and weakness, after $g4 hrs from time of vaccination in pt with active Multiple Sclerosis diagnosis. No treatment sought


VAERS ID: 1232053 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Blood test, Herpes zoster, Pruritus, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse-30mg
Current Illness: N/A
Preexisting Conditions: Psoriasis
Allergies: Morphine
Diagnostic Lab Data: Blood work.
CDC Split Type:

Write-up: On Saturday morning, I woke up with a red rash on the left side of my face. Throughout the day, the rash turned into itchy, blisters. I followed up with my primary care physician who diagnosed me with Shingles. Stating it could have been a correlation to the vaccine that compromised my immune system. I am on methyllpredinsone and valacyclovir HCL.


VAERS ID: 1232085 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042021A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure abnormal, Chills, Headache, Heart rate abnormal, Injection site pruritus, Injection site rash, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (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: Metoprolol
Current Illness: None
Preexisting Conditions: Arrhythmia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, body aches, chills, headache, elevated heart rate, elevated blood pressure, itching and rash at injection site


VAERS ID: 1232298 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dofetilide, pantrapazole,eliquis, toprol
Current Illness: occasional arrhythmia
Preexisting Conditions: occasional arrhythmia
Allergies: qunidine
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Severe shoulder pain


VAERS ID: 1232510 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Electrocardiogram, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: h/o migraine
Allergies: None
Diagnostic Lab Data: EKG normal 4/19/21
CDC Split Type:

Write-up: Chest tightness, heaviness evening of 4/17/21, along with light headed. Tingling in left arm (injection arm). EKG normal 4/19/21. Chest pain continues 4/20/21 , describes as a "zap" or static feeling upper left chest. No SOB.


VAERS ID: 1232561 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50mg Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin Doxycycline
Diagnostic Lab Data: CBC count over next two weeks
CDC Split Type:

Write-up: Hives on arms and legs, not responding to allergy medication and have been continuous for 4 days.


VAERS ID: 1232695 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel 400mg, Fluoxetine 60mg, Alprazolam .5mg
Current Illness:
Preexisting Conditions:
Allergies: Penicillin and all cilin related drugs, peanuts
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Chills, light headedness, fever, the same day as received. Then on 4-17-2021 broke out in hives on arms, legs, and neck.


VAERS ID: 1233157 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-04-17
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Nasal congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: vaccinated on 3/5/2021 with Janssen Covid vaccine. Developed symptoms of covid (runny nose, congestion, cough, shortness of breath) on 4/17/2021 after an exposure to covid.


VAERS ID: 1233266 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-04-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Dry skin, Erythema, Fatigue, Full blood count, Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia, Peripheral coldness, Peripheral swelling, Skin discolouration, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFER BASED ANTIBIOTICS, PENICILLIN, ALCOHOL
Diagnostic Lab Data: CBC at emergency room 4/17/21
CDC Split Type:

Write-up: Sudden onset of bruise in left ring finger and on left foot, left of big toe, both appeared at once while eating lunch. Left ring finger went numb, white and cold, with bruise appearing on the middle digit. Other finger tips turned pink. Skin turned red onhands with tingling sentation. Right hand blood vessels came to the surface and began to swell at intersections. Skin on rt. hand looked whiter and dry. The sudden onset sent me to the emergency room, the condition began to fade in 3 hours, not completely. The same reaction occured the next day at 12 noon. I took a hot shower and the condition improved followed by extreme tiredness. *At the time of vaccination, & on both of these events I had a stiff neck/red skin.


VAERS ID: 1233818 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Skin discolouration, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Purple , looking like blood clots on the back of her leg


VAERS ID: 1233931 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201HZ1A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Headache, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: One week after shot, experiencing an intermittent headache, tingling/numbness in left hand, pain in leg and arm that comes and goes, tingling/numbness in left foot. Chest discomfort that comes and goes


VAERS ID: 1234036 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Erythema, Inflammation, 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: Finasteride .4 mg, Tamsulosin .5mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I called the clinic and all they did was ask a bunch of questions but never told me to take any action. I did take Benadryl (2) tablets which after an hour or so helped reduce the itching and redness.
CDC Split Type:

Write-up: Inflammation of hands and feet, redness and severe itching. Redness and mosquito bite like bumps on the back of legs, small of back and upper arms that itch.


VAERS ID: 1234106 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Severe headaches.


VAERS ID: 1234481 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head, Dyspnoea, Fatigue, Fibrin D dimer, Full blood count, Headache, Paraesthesia, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PO iron, hydrochlorothiazide 12.5mg
Current Illness:
Preexisting Conditions: Hypertension
Allergies: NDA
Diagnostic Lab Data: I ordered head CT, d-dimer and CBC , do not have results yet.
CDC Split Type:

Write-up: The patient was vaccinated at an outside clinic. She reports severe HA, tingling sensations in her tongue and face, mild exertional SOB, and fatigue.


VAERS ID: 1235389 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lansoprozole 30mg/day, famitodine 40mg/day
Current Illness:
Preexisting Conditions:
Allergies: ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed shingles around 8/9 days after vaccination. shingles on right lower back. currently still have.


VAERS ID: 1235447 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-22
Onset:2021-04-17
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid abnormal, Ear pain, Headache, Hypoaesthesia, Jugular vein thrombosis, Migraine, Thrombosis, Transverse sinus thrombosis, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram 20 mg daily, levothyroxine 125 mcg daily, Vyvanse 60 mg daily, MILI 0.25-0.035 mg 1 tablet daily, buspirone 15 mg 1 tablet twice daily
Current Illness: Office visit on 3/3/21 for concern for bilateral tinnitus and Meniere''s given family history.
Preexisting Conditions: Hypothyroidism, ADHD, mild major depression, tongue anomaly, situational anxiety, obesity BMI 37, menometroorrhagia
Allergies: No Known Allergies
Diagnostic Lab Data: CT head and neck with contrast shows thrombosis of the left transverse and sigmoid sinuses and left internal jugular vein.
CDC Split Type:

Write-up: Patient presented to the ER on 4/20/21 with headache. On Saturday (4/17/2021), the patient had "the worst headache I have ever had" along with severe inner left ear pain. Patient took an ibuprofen which helped with the pain for about an hour then the pain came back. Pain got worse 2 hours later when she drove home from work. She called the RN line and was told to take ibuprofen and follow up in the AM. The next day 4/18/2021, patient went to urgent care and received Toradol and was told it was a migraine. Today 4/20/21, patient still had pain and noted feeling left sided facial numbness and blurry vision that correlated with when she got the headache. Patient went to an urgent care today and CT scan revealed a blood clot. She was then sent to the ED for evaluation. In the ED, she has no headache and facial numbness and has minimal left ear pain. Her headache is localized to the left side of her head. Patient denies fever, chills, and COVID symptoms. Patient was started on argatroban drip per hematology recommendation.


VAERS ID: 1235624 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA Q26B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Levothyroxine 75 mcg Losarton 37.5 mg
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, starting 4/17/21, 5:00 pm, 100.3, reaching a high of 102.9 on 4/18/21 at 6:30 pm, last recording of fever of 99.7 on 4/19/21 at 10:30 am. Very bad headache starting 4/17/21 at 5:00 pm. Very painful at injection site starting 4/17/21 at 2:30 pm.


VAERS ID: 1235632 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Menstruation irregular
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

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

Write-up: Extreme stomach cramping and start of painful period despite having birth control that prevents it and not having one for 13 years. Still ongoing.


VAERS ID: 1235645 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Heart rate increased, Hyperhidrosis, Nausea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: immediate reaction; trouble breathing/shortness of breath, sweating, dizziness, hives, nausea, fast heart rate


VAERS ID: 1235648 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Chest discomfort, Decreased appetite, Dyspnoea, Fatigue, Injection site pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, fatigue, body aches, loss of taste, loss of appetite burning at injection site immediately and hotness around site for three days, heaviness in chest all the way through to back, shortness of breath


VAERS ID: 1235654 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Pain, Pain in extremity, Skin irritation, Skin reaction
SMQs:, Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Very achy the next day but my arm continues to worsen 4 days after vaccine. It?s very red and irritated.


VAERS ID: 1236124 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-23
Onset:2021-04-17
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: 4 days of right upper extremity pain and swelling with diagnosis of right upper extremity axillary vein DVT that was treated with DOAC apixaban.


VAERS ID: 1236311 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-04-17
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipina/Valsartan/HCT 5mg/160mg/12.5mg Ezetimibe/Rosuvastatina 10/10mg
Current Illness: None
Preexisting Conditions: OSA( Obstructive sleep Apnea) in CPAP
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pulmonary embolism


VAERS ID: 1237793 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-04-17
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Breakthrough COVID-19 infection in fully vaccinated individual


VAERS ID: 1237803 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Computerised tomogram thorax, Gene mutation identification test negative, Hypoaesthesia, Muscular weakness, Myocardial strain, Pulmonary embolism
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro Trazodone Etonogestrel (implanted progestin)
Current Illness: None
Preexisting Conditions: Asthma GERD Migraines Anxiety Depression Obesity, BMI 31.6
Allergies: NKA
Diagnostic Lab Data: 4/18 CTA shows multifocal PE with right heart strain. Factor v Leiden and factor II mutation analyses were negative. No coagulopathy conditions identified.
CDC Split Type:

Write-up: Presented to ED 4/18 with severe L sided chest pain since 4/17. Arm weakness and numbness 4/18 that lasted a few hours but resolved. No vision changes. O2 sat was 100% on room air. Diagnosed with PE. No recent mobilization. Does not smoke or use illicit drugs. Was admitted to the hospital telemetry unit 4/18-4/20. Discharged on apixaban. I do not have any information on the vaccine Lot number received.


VAERS ID: 1237941 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-16
Onset:2021-04-17
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Deep vein thrombosis, Discomfort, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: perforated PUD status post embolization and laparoscopic repair, previous alcohol abuse, alcoholic cirrhosis, hepatitis C, COPD, HTN, anxiety, chronic pain on methadone, chronic DVT/past PE post IVC filter, not on OAC.
Allergies: codeine
Diagnostic Lab Data: High-resolution venous duplex technique was used to investigate the right and left lower extremity venous systems where accessible to study. Chronic appearing thrombus is seen within the proximal, middle and distal portions of the right femoral vein. Clot in this vessel was seen on the prior study. Acute thrombus is present within the left popliteal vein, new from prior. The popliteal thrombus is nearly occlusive.
CDC Split Type:

Write-up: Patient presented to the ER with chest pain, non radiating, heavy weight. Patient was found to have acute DVT.


VAERS ID: 1238288 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-04-17
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None documented
Allergies:
Diagnostic Lab Data: Positive PCR test for COVID-19. SARS-CoV-2 N gene Resp Ql NAA+probe. Test date is 04/17/21. Sample received 04/18/21. Findings Resulted and Reported on 04/18/21.
CDC Split Type:

Write-up: Client tested positive for COVID-19 on 04/17/21. Client states that they are asymptomatic. Client is being followed by a case manager with the Health Dept.


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