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

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



Case Details (Reverse Sorted by Onset Date)

This is page 272 out of 8,010

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VAERS ID: 1700176 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-19
Onset:2021-09-04
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Confusional state, Mental status changes, Pyrexia, SARS-CoV-2 test positive, Sepsis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imodium, Atorvastatin, Cilostazol, Levetiracetam, Prednisone, Tylenol, COlace, Nitrostat, Proventil HFA, Ecotrin, Cardizem, Lexapro, Flonase, Lasix, Lyrica, Singulair, Glimepride, Januvia, Dulera, Incruse Elipta, Spiriva, ALbertrol-ipratrop
Current Illness: unknown
Preexisting Conditions: Asthma, COPD, Dementia, Pacemaker, Hemorrhagic CVA, DM, CHF, PVD, HTN, Peripheral neuropathy
Allergies: Milk, no known medication allergies
Diagnostic Lab Data: 09/04/21 SARS COV2 COVID 19 PCR (POSITIVE) 09/05/21 SARS COV2 COVID 10 PCR (POSITIVE)
CDC Split Type:

Write-up: 09/04/21 he patient presents with 96 year old female with a medical Hx of Dementia, COPD, hypertension, congestive heart failure, paced rhythm, peripheral vascular disease. Presents to the ED Altered mental status per EMS. EMS reports of met sepsis criteria, patient being tachycardic and febrile, they report that over the last couple of days patient has become more confused at her nursing facility. History is limited at this time.l. The onset was 3 days ago.


VAERS ID: 1700249 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-28
Onset:2021-09-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Dyspnoea, Peripheral swelling, Pulmonary embolism
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: trulicity, lantus insulin, lyrica, carvedilol, cymbalta, humalog insulin, glipizide, zetia, norvasc, cozaar, hctz
Current Illness:
Preexisting Conditions: type 2 diabetes, bladder cancer , ckd, htn, hyperlipidemia
Allergies: levaquin, niacin, ditropan, thimersol in eye drops, septra, vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient devleloped shortness of breath 9/4 and was vaccinated on 8/28. He then developed acute leg swelling and was then admitted and found to have DVT and bilateral PE


VAERS ID: 1700322 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-10
Onset:2021-09-04
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Cough, Fatigue, Feeling cold, Influenza like illness, Malaise, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: After the shot I did have a minor reaction and had a little soreness in shoulder. Approximately September 4 I started coming down with cough, cold, fever, ickiness, fatigue. September 8 I went and got tested and two days later I got the results and I was positive for Covid-19. I''ve been isolating since and feeling better now the last couple of days. It felt like a minor low grade flu. Monday, September 13 I started feeling better.


VAERS ID: 1700324 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-31
Onset:2021-09-04
   Days after vaccination:157
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray abnormal, Endotracheal intubation, Extubation, Intensive care, Pneumonia, Respiratory failure
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, COPD, Asthma, elevated cholesterol
Allergies: KNA
Diagnostic Lab Data: CXR + for pneumonia
CDC Split Type:

Write-up: EMS called to nursing home, pt. in resp. failure, immediately intubated in ER, admit to ICU. As of 9/15/2021 pt is extubated, improved, remains in hospital.


VAERS ID: 1700342 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Rash erythematous, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: IVIG
Current Illness:
Preexisting Conditions: Asthma. ABPA, PID
Allergies: Latex, sulfa, penicillin, compazine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Facial swelling, red rash, shortness of breath, abdominal cramping


VAERS ID: 1700388 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Gingival pain, Headache, Periorbital swelling, Swelling face, Toothache
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gingival disorders (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine 125mcg tablet, olmesartan 40 mg daily, HCTZ 12.5mg daily, pantoprazole 40mg daily, trazodone 50mg at bedtime, tropsium ER 60mg daily, D-Mannose twice a day
Current Illness: None
Preexisting Conditions: anxiety, hypertension, overactive bladder, GERD, hypothyroid, insomnia, migraines
Allergies: No known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The morning after the 2nd Pfizer, her left eye was very puffy and her face was red and she had a bad headache. The headache persisted for 10 days. The second morning she had pain in her teeth and gums and it hurt to brush and floss for 10 days.


VAERS ID: 1700466 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Tinnitis


VAERS ID: 1700495 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Lethargy, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, chills, vomiting, tired/ lethargic


VAERS ID: 1700501 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Lethargy, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Fever, chills, tired/ lethargic, vomiting


VAERS ID: 1700551 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction, Urticaria, Vaccination site erythema, Vaccination site reaction, Vaccination site warmth
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl Tylenol Acyclovir Proair
Current Illness: PVC causing chest pain
Preexisting Conditions: Asthma
Allergies: Shellfish
Diagnostic Lab Data: I did not see a medical doctor at the time of the event.
CDC Split Type:

Write-up: Red hot welt at vaccine site-immediately About 30 min after receiving the first vaccine I started to get hives all over my chest, back, and both arms. I took Benadryl every 4-6 hours for 3 days until the hives subsided. Extreme headaches for 3 days. Dizziness x 6 days.


VAERS ID: 1700650 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-02-27
Onset:2021-09-04
   Days after vaccination:189
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Bordetella test negative, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough, Diarrhoea, Dysphagia, Dyspnoea, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza B virus test, Malaise, Mycoplasma test negative, Nausea, Oxygen therapy, Pyrexia, Respiratory distress, Respiratory syncytial virus test negative, Respiratory tract congestion, SARS-CoV-2 test positive, Tachypnoea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: dexAMETHasone (DECADRON) 6 mg tablet FLAXSEED OIL (LINSEED OIL MISC) fluticasone (FLONASE) 50 mcg/actuation nasal spray gemfibroziL (LOPID) 600 mg tablet glucosamine/chondr su A sod (OSTEO BI-FLEX ORAL) levothyroxine (SYNTHROID) 75 mcg
Current Illness:
Preexisting Conditions: Respiratory Asthma Sinusitis Acute respiratory failure with hypoxia (CMS/HCC) Pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Circulatory Essential hypertension Digestive Malignant neoplasm of colon (CMS/HCC) Gastroenteritis due to COVID-19 virus Genitourinary Kidney cyst, acquired Benign prostatic hyperplasia without lower urinary tract symptoms Endocrine/Metabolic Hypercholesterolemia Hypothyroidism Hypokalemia Hematologic Leukopenia Other Impotence of organic origin High glucose
Allergies: NKA
Diagnostic Lab Data: 09/13/21 2320 Respiratory virus detection panel Collected: 09/13/21 1836 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 09/10/21 1959 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/10/21 1022 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result DetectedCritical 09/10/21 1959 COVID-19 PCR Collected: 09/10/21 1022 | Final result | Specimen: Swab from Nasopharynx Procedure Component Value Ref Range Date/Time X-ray chest 1 view - Portable Resulted: 09/14/21 0713 Order Status: Completed Updated: 09/14/21 0713 Narrative: Single view portable chest INDICATION: Sepsis, cough, pneumonia, encounter initial Frontal portable chest film. Comparison 2015. Patchy bilateral lower lobe peripheral infiltrates are seen suspicious for Covid 19 infection. No effusion or pneumothorax. No congestive failure, cardiomegaly, or acute osseous finding. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.
CDC Split Type:

Write-up: FEVER, DRY COUGH, CONGESTION, DIARRHEA - OUTPATIENT PROGRESS NOTE 09/13/21 ASSESSMENT AND PLAN Diagnoses and all orders for this visit: Pneumonia due to COVID-19 virus Patient was hypoxemic to 8 7% on 2 L of oxygen on my exam today. He was also in mild respiratory distress due to hypoxia and tachypnea. 991 was called in for urgent transfer of the patient to the hospital. SUBJECTIVE Patient is a 70 y.o. male who presented with his wife for evaluation of cough, shortness of breath, nausea, vomiting and positive Covid test results. Patient has been having the symptoms for past few days. Initially he had over-the-counter Covid test which was negative, he tried taking over-the-counter medication and repeated his Covid test which came back positive. He called our office to get the Covid test on 9/10 recently been positive. Patient reports he has intermittent severe cough and sometimes noted difficulty in swallowing food. Denies any chest pain or shortness of breath but does report getting short of breath when he coughs. Denies headache, abdominal pain or swelling in the legs. Patient also noticed loose bowel movement this morning. Patient had both doses of COVID vaccine in March. He didn''t take his regular medication in last few days due to feeling sick. ED to Hosp-Admission Discharged 9/13/2021 - 9/14/2021 (22 hours) Hospital - Acute respiratory failure with hypoxia DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Hypoxemia Acute respiratory failure with hypoxia COVID-19 virus infection Hospital Course Patient is an 70 y.o. male with past medical history of hypertension, hyperlipidemia, hypothyroidism presented to the emergency room with 1 week history of cough, generalized fatigue and shortness of breath. Patient was noted to be hypoxic at 87% at room air at PCPs office and sent over here. Initially patient was on 2 L of oxygen via nasal cannula. Patient was diagnosed with COVID-19 last Thursday but having symptoms for at least 10 days. After initiation of remdesivir and steroid we were able to wean patient off oxygen and today patient saturating 94 to 95% at room air and was able to ambulate without any symptoms. Though his cough is still persisting. Blood culture did not grow any organism. Patient is stable from our standpoint to be discharged home on p.o. steroid for another 10 days. I recommend patient to come back to hospital if worsening symptoms including fever


VAERS ID: 1700911 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-09-04
   Days after vaccination:177
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Chills, Dyskinesia, Electrocardiogram, Eyelid function disorder, Fatigue, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (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: Calcium, Vitamin D, Remicade
Current Illness: none
Preexisting Conditions: chrohn''s disease
Allergies: codeine
Diagnostic Lab Data: EKG bloodwork
CDC Split Type: vsafe

Write-up: After the vaccine, I had fever, chills, fatigue, and arm soreness. On 9/4/2021, I woke up at 6:30AM and noticed I could not spit or smile and could not control my mouth movement. I also could not close my left eye. The right side of my face was not affected. I went to the ER and was diagnosed with Bells Palsey and discharged with antiviral medications and steroids. I have finished the course of medications. I am still having symptoms of unable to control the left side of my face and mouth movement. I am having no trouble swallowing.


VAERS ID: 1700931 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Abdominal pain upper, Blood pressure fluctuation, Blood test, Chills, Flatulence, Gastrooesophageal reflux disease, Malaise, Myalgia, Nausea, Pyrexia, Ultrasound biliary tract, Ultrasound liver, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Levothyroxine, Vitamin D3 and Viibryd
Current Illness: No
Preexisting Conditions: Autoimmune Disorder
Allergies: No
Diagnostic Lab Data: While in the ER they ran blood test and they gave me an ultrasound of my liver and gallbladder which came back inconclusive. They told me they wanted me to do a CT scan but that it would be several hours before they could get to me and I had two children that still needed my care. The diagnostic imaging report stated that portions of the aorta, IVC and pancreas are partially obscured by what they thought is bowel gas.
CDC Split Type:

Write-up: The second day after the shot I experienced muscle aches, fever of 103, chills, nausea and abdominal pain. This went on for 2 to 3 days after the vaccination. The fever and chills went away after a few days but the abdominal pain did not? I kept feeling lots of pressure in my upper abdominal area. I started throwing up stomach acid and bile and had a hard time keeping any food down. I then went to the emergency room at Hospital on 9/8/2021. They started mixing Covid negative patients with Covid positive patients, there were dried blood stains in the waiting area after triage, it was very obvious that the people there were overworked and understaffed and the patients were paying the price for it. I tried to call ER hospital in the same area and they said they were so packed with Covid patients that they could not help me. As was a smaller ER. I couldn?t stop throwing up at the ER but I also didn?t want to be surrounded by Covid positive patients so I left the ER due to the fact that they told me they couldn?t run the CT scan they wanted for another five hours because they were busy and also another nurse told me that they straight up did not have room for me to begin with. The following day I made an appointment with my primary care provider. He gave me a bunch of medication for acid reflux and that was about it. He told me it would probably be best for me to try and follow up with a gastroenterologist for more in-depth help. I am still waiting to see gastro as we speak. My blood pressure has been up and down and I am still sick to my stomach with upper abdominal pain.


VAERS ID: 1701319 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gout, 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), Arthritis (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: None
Current Illness: None
Preexisting Conditions: Degenerative Disk Disease
Allergies: Shellfish
Diagnostic Lab Data: None Doctor looked at it and said it was gout.
CDC Split Type:

Write-up: Intense pain, swelling, and tenderness in my right hand pinky finger the next day. Throbbing sensation as well. Went a 4 days later to the doctor and was told I have gout as a 22 year old female with an active lifestyle and healthy eating habits. Was given a steroid shot and the prescribed antibiotics and steroids to take. Took them as recommended and 7 days later I still have swelling and tenderness in my pinky.


VAERS ID: 1701345 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Condition aggravated, Fibromyalgia, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Constant abdominal pain, worse after eating began ~24 hours after injection and has continued through date of report. Large increase in fibromyalgia pain beginning one week after injection.


VAERS ID: 1701926 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Myalgia, Paraesthesia, Pharyngeal swelling, Rash, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: COQ10, VIT B COMPLEX, EMERGENC, CURCUMIN, ASEA, VIT D/K, VIT C LIPOSSOMIC, COD LIVER OIL
Current Illness: Gadolinium deposition disease
Preexisting Conditions: Gadolinium deposition disease
Allergies: GADOLINIUM
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Rash developed in the LT arm followed by a warmth sensation from the bottom of spine all the way to the throat which started to get swollen and constricted about 38 min after the vaccination. Self treated with 1 dose of claritin which relived partially the throat constriction and rash 10 min later. Throat constriction lasted for 6 hours, developed subsequent muscle pain and tingling sensation in all muscles that is not going away till today


VAERS ID: 1704058 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Diarrhoea, Fatigue, Gastrointestinal pain, Migraine, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Systemic Lupus, fibro myalgia, chronic fatigue, essential tremors, copd
Preexisting Conditions: Systemic Lupus, fibro myalgia, chronic fatigue, essential tremors, copd
Allergies:
Diagnostic Lab Data: None, pharmacy recommends no further covid19 shots should be given to her. Also recommends she see her doctor and have labs to determine if she has enough antibodies to fight off covid if she gets it.
CDC Split Type:

Write-up: Major migraine, severe intestinal stuff, diarrhea, nausea, severe fatigue, beyond what I normally have.


VAERS ID: 1704105 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

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

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

Write-up: fever, chills, malaise


VAERS ID: 1704224 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-08-16
Onset:2021-09-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysstasia, Eating disorder, Gait inability, Pain, Psychomotor hyperactivity, Walking aid user
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (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: flu
Other Medications: dexalinent , Tylenol, diclofenac 75mg cyclobenfzaein ,Trazodone ,one a day vitamin multi vitamin sucralsate 1mg metformin , rybelsus , buprotion 150mg , nirtazapine 45mg risperidone ciclopirox ,
Current Illness:
Preexisting Conditions: diabetic, depression
Allergies: shell fish ,lactose
Diagnostic Lab Data:
CDC Split Type:

Write-up: a week after bot vaccines total body aches . went to er and doctor was given a walker wit seat . unable to stand or walk for long periods . ccould not tolerate solid foods , liquids only . Diagnosis hyperactive syndrome


VAERS ID: 1704308 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

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

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

Write-up: Per patient she broke out in whelpts all over her body 2 days after the injection. Currently there is a reddish rash and scattered whelpts all over her body. Patient has pictures of diffused irritations and whelpts from when it first started. Denies wheezing, SOB, or taking any medications. Benadryl 25mg 1-2 caps Q 6hrs ordered for patient, if needed.


VAERS ID: 1704348 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dysphagia, Pain in extremity, Pharyngeal swelling, SARS-CoV-2 test negative, Sinus disorder, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ANXIETY MEDICATION
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data: I HAD TO GET TESTED FOR COVID BUT IT WAS NEGATIVE.. ALL MY DR SAID WAS IF IT GETS WORSE TO GO TO THE ER
CDC Split Type:

Write-up: I EXPERIENCED PAINFUL ARM, CHILLS, SHAKES, DIZZINESS BUT NO FEVER. MY SINUSES GOT SO BAD AND MY THROAT SWELLED MAKING IT DIFFICULT TO SWALLOW, THERE WERE TIMES I FELT LIKE I COULD NOT AND HAD TO TAKE A SIP OF WATER TO MAKE MYSELF SWALLOW


VAERS ID: 1704695 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 LA / IM

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

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

Write-up: Tinnitus from the evening of getting the shot until present time. Still has not gone away


VAERS ID: 1704728 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-08-23
Onset:2021-09-04
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

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

Write-up: Received vaccine on 08/23/21, felt symptomatic (facial paralysis) on 09/04/21, and went to Emergency Room on 09/10/21. Was diagnosed with Bell''s Palsy and was treated with Prednisone.


VAERS ID: 1705474 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2539 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Muscle spasms, Presyncope
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Hypotonic-hyporesponsive episode (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: Propranolol, topiramate, iron supplement, neo-40, vitamin d3, multivitamin, magnesium oxide, Co Q10
Current Illness: Extrapulmonary mycoplasma pneumonia (+2 years)
Preexisting Conditions: Postural orthostatic tachycardia syndrome (POTS), dysautonomia, migraines, visual snow syndrome
Allergies: egg, dairy, wheat/gluten, corn, pinto beans, apple, beef, soy, strawberry, tomato
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe muscle spasms in the left shoulder, neck, and left side of the face starting occasionally within 24 hours and progressively became more constant and intense. Vasovagal syncope-like events starting at the same time as muscle spasms, but are less frequent and have occurred multiple times. Exhaustion. No reduction in symptoms after two weeks (present date).


VAERS ID: 1705955 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Syncope, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: Pt had passed out after 5 mins of vaccine administration. Pt came to and ambulance was called for check up


VAERS ID: 1705977 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 2 LA / IM

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

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

Write-up: Error: Wrong Dose of Vaccine - Too High-


VAERS ID: 1706915 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

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

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

Write-up: Site: Redness at Injection Site-Mild


VAERS ID: 1707084 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-15
Onset:2021-09-04
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature, Body temperature increased, Heart rate, Heart rate increased, Inappropriate schedule of product administration, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ELIQUIS; METFORMIN
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: Body temperature; Result Unstructured Data: temperature is about 100F; Test Date: 20210904; Test Name: Heart beat; Result Unstructured Data: Patient feels like his heart is beating a little bit too fast with 97 beats per minute
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Inappropriate schedule of vaccine administered(15-AUG-2021 Dose 1/2nd dose of Moderna vaccine 03Sept2021); achy; feels like heart is beating too fast; slightly elevated temperature; This spontaneous case was reported by a consumer and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered(15-AUG-2021 Dose 1/2nd dose of Moderna vaccine 03Sept2021)), MYALGIA (achy), HEART RATE INCREASED (feels like heart is beating too fast) and BODY TEMPERATURE INCREASED (slightly elevated temperature) in a 41-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 040C21A and 014F21A) for COVID-19 vaccination. No medical history was provided by the reporter. Concomitant products included METFORMIN for Diabetes, APIXABAN (ELIQUIS) for an unknown indication. On 15-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 03-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced MYALGIA (achy), HEART RATE INCREASED (feels like heart is beating too fast) and BODY TEMPERATURE INCREASED (slightly elevated temperature). On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered(15-AUG-2021 Dose 1/2nd dose of Moderna vaccine 03Sept2021)). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Inappropriate schedule of vaccine administered(15-AUG-2021 Dose 1/2nd dose of Moderna vaccine 03Sept2021)) had resolved and MYALGIA (achy), HEART RATE INCREASED (feels like heart is beating too fast) and BODY TEMPERATURE INCREASED (slightly elevated temperature) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Sep-2021, Body temperature: 100f (High) temperature is about 100F. On 04-Sep-2021, Heart rate: 97 beats per minute (High) Patient feels like his heart is beating a little bit too fast with 97 beats per minute. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient taken concomitant drug Blood pressure pill Treatment information was not provided


VAERS ID: 1707108 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Decreased activity, Fatigue, Headache, Hyperhidrosis, Lymphadenopathy, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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: USMODERNATX, INC.MOD20213

Write-up: not feeling well/feel so sick after taking the Moderna booster; not able to do anything/still laying around unable to do anything; swelling underneath armpit/swollen lymph nodes; swelling underneath armpit/swollen lymph nodes; headache; muscle aches; fatigue/fatigued; have chills; This spontaneous case was reported by a consumer and describes the occurrence of MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes) and HEADACHE (headache) in a 65-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. No Medical History information was reported. On 04-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes), HEADACHE (headache), MYALGIA (muscle aches), FATIGUE (fatigue/fatigued) and CHILLS (have chills). At the time of the report, MALAISE (not feeling well/feel so sick after taking the Moderna booster), DECREASED ACTIVITY (not able to do anything/still laying around unable to do anything), HYPERHIDROSIS (swelling underneath armpit/swollen lymph nodes), LYMPHADENOPATHY (swelling underneath armpit/swollen lymph nodes), HEADACHE (headache), MYALGIA (muscle aches), FATIGUE (fatigue/fatigued) and CHILLS (have chills) had not resolved. No concomitant medication was provided by reporter. No treatment information was provided was provided by reporter. The patient was completely fine after receiving the second dose of vaccine. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 04-Sep-2021: Follow up received included updated outcome of all events


VAERS ID: 1707131 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-01-01
Onset:2021-09-04
   Days after vaccination:246
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Product dose omission issue
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: chest pain; missed second dose; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (chest pain) and PRODUCT DOSE OMISSION ISSUE (missed second dose) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In January 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced CHEST PAIN (chest pain) and PRODUCT DOSE OMISSION ISSUE (missed second dose). At the time of the report, CHEST PAIN (chest pain) outcome was unknown and PRODUCT DOSE OMISSION ISSUE (missed second dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. Treatment medication was not provided by the reporter. Reporter did not allow further contact


VAERS ID: 1707186 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: body ache; headache; This spontaneous case was reported by a consumer and describes the occurrence of MYALGIA (body ache) and HEADACHE (headache) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced MYALGIA (body ache) and HEADACHE (headache). At the time of the report, MYALGIA (body ache) and HEADACHE (headache) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. Treatment drugs were not reported.


VAERS ID: 1707196 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: USMODERNATX, INC.MOD20213

Write-up: mixed vaccine of Pfizer and Moderna was administered to a patient; This spontaneous case was reported by a pharmacist and describes the occurrence of OFF LABEL USE (mixed vaccine of Pfizer and Moderna was administered to a patient) in a 22-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. No Medical History information was reported. On 04-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced OFF LABEL USE (mixed vaccine of Pfizer and Moderna was administered to a patient). On 04-Sep-2021, OFF LABEL USE (mixed vaccine of Pfizer and Moderna was administered to a patient) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant product was provided by the reporter. No treatment medication was provided.


VAERS ID: 1707244 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-07
Onset:2021-09-04
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011D21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abnormal dreams, Panic attack, Vaccination site pain
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug allergy (Prozac)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Extremely vivid dreams about killing herself; Panic attacks; Extreme pain on injection site; This spontaneous case was reported by a consumer and describes the occurrence of ABNORMAL DREAMS (Extremely vivid dreams about killing herself) and PANIC ATTACK (Panic attacks) in a 23-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011D21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Drug allergy (Prozac). On 07-Aug-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced ABNORMAL DREAMS (Extremely vivid dreams about killing herself) (seriousness criterion life threatening), PANIC ATTACK (Panic attacks) (seriousness criterion life threatening) and VACCINATION SITE PAIN (Extreme pain on injection site). At the time of the report, ABNORMAL DREAMS (Extremely vivid dreams about killing herself), PANIC ATTACK (Panic attacks) and VACCINATION SITE PAIN (Extreme pain on injection site) outcome was unknown. Concomitant products were not provided. Treatment information was not reported. Company Comment: Very limited information regarding these events has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.


VAERS ID: 1707255 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 0582EZ1A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Experiencing side effects 4 days after the first dose; low grade fever; Chills; headache; Side effects make her tired; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (Experiencing side effects 4 days after the first dose), PYREXIA (low grade fever), CHILLS (Chills), HEADACHE (headache) and FATIGUE (Side effects make her tired) in a 27-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0582EZ1A) for COVID-19 vaccination. No Medical History information was reported. On 31-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced VACCINATION COMPLICATION (Experiencing side effects 4 days after the first dose), PYREXIA (low grade fever), CHILLS (Chills), HEADACHE (headache) and FATIGUE (Side effects make her tired). At the time of the report, VACCINATION COMPLICATION (Experiencing side effects 4 days after the first dose), PYREXIA (low grade fever), CHILLS (Chills), HEADACHE (headache) and FATIGUE (Side effects make her tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant product was not provided by the reporter Treatment information was not provided Most recent FOLLOW-UP information incorporated above includes: On 06-Sep-2021: Follow-up information received included new event (Vaccination complication).


VAERS ID: 1707285 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Influenza like illness, Oropharyngeal pain, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of INFLUENZA LIKE ILLNESS (Flu like symptoms), PYREXIA (Fever), COUGH (Cough), OROPHARYNGEAL PAIN (Sore throat) and RHINORRHOEA (Runny nose) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported.On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced INFLUENZA LIKE ILLNESS (Flu like symptoms), PYREXIA (Fever), COUGH (Cough), OROPHARYNGEAL PAIN (Sore throat) and RHINORRHOEA (Runny nose). At the time of the report, INFLUENZA LIKE ILLNESS (Flu like symptoms), PYREXIA (Fever), COUGH (Cough), OROPHARYNGEAL PAIN (Sore throat) and RHINORRHOEA (Runny nose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medication was not provided Treatment information was not reported


VAERS ID: 1707286 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blister, Rash, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), 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: METHOTREXATE; FOLIC ACID
Current Illness: Crohn''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: almost looks like a little blister on the fingers; little red dots on arm and legs; breaking out in a rash; This spontaneous case was reported by a consumer and describes the occurrence of RASH (breaking out in a rash), BLISTER (almost looks like a little blister on the fingers) and RASH ERYTHEMATOUS (little red dots on arm and legs) in a 20-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037F21A) for COVID-19 vaccination. Concurrent medical conditions included Crohn''s disease. Concomitant products included METHOTREXATE and FOLIC ACID for Crohn''s disease. On 04-Sep-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced RASH (breaking out in a rash). On an unknown date, the patient experienced BLISTER (almost looks like a little blister on the fingers) and RASH ERYTHEMATOUS (little red dots on arm and legs). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) ongoing since an unknown date for Rash, at an unspecified dose and frequency. At the time of the report, RASH (breaking out in a rash), BLISTER (almost looks like a little blister on the fingers) and RASH ERYTHEMATOUS (little red dots on arm and legs) outcome was unknown. Symptoms: It was reported that after receiving second dose of vaccine the patient started experiencing rash on his fingers and hands, looked like blisters, he experienced rash on his right arm.


VAERS ID: 1707304 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020F21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, Body temperature, Chest pain, Feeling abnormal, Headache, Pain, Pyrexia, Vaccination site erythema, Vaccination site swelling, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: Fever at 103.5 F; Test Name: Body temperature; Result Unstructured Data: Fever at 100 F
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Not being able to smell; Not being able to taste; Chest hurt when she breathed in deep; Felt horrible; Body aches; The injection site was very swollen; The injection site was red; Vomiting; Headache in her eyes; Ran a fever of 103.5 F/ Now fever is about 100 F; This spontaneous case was reported by a consumer and describes the occurrence of ANOSMIA (Not being able to smell), AGEUSIA (Not being able to taste), CHEST PAIN (Chest hurt when she breathed in deep), FEELING ABNORMAL (Felt horrible) and PAIN (Body aches) in a 63-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 020F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in February 2021. On 04-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced ANOSMIA (Not being able to smell), AGEUSIA (Not being able to taste), CHEST PAIN (Chest hurt when she breathed in deep), FEELING ABNORMAL (Felt horrible), PAIN (Body aches), VACCINATION SITE SWELLING (The injection site was very swollen), VACCINATION SITE ERYTHEMA (The injection site was red), VOMITING (Vomiting), HEADACHE (Headache in her eyes) and PYREXIA (Ran a fever of 103.5 F/ Now fever is about 100 F). The patient was treated with IBUPROFEN for Adverse event, at a dose of UNK UNK, q4h and PARACETAMOL (TYLENOL) for Adverse event, at a dose of UNK, q4h. At the time of the report, ANOSMIA (Not being able to smell), AGEUSIA (Not being able to taste), CHEST PAIN (Chest hurt when she breathed in deep), FEELING ABNORMAL (Felt horrible), PAIN (Body aches), VACCINATION SITE SWELLING (The injection site was very swollen), VACCINATION SITE ERYTHEMA (The injection site was red), VOMITING (Vomiting) and HEADACHE (Headache in her eyes) outcome was unknown and PYREXIA (Ran a fever of 103.5 F/ Now fever is about 100 F) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 103.5 (High) Fever at 103.5 F and 100 (High) Fever at 100 F. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. The concomitant medication was not reported. The patient''s boss was positive for COVID and the patient wanted to know if loss of taste or smell is a side effect of the vaccine. The patient experienced same event when had COVID in February and the patient was planning for test.


VAERS ID: 1707341 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-07-31
Onset:2021-09-04
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: COVID test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (side effect/still having the side effect as of today), INFLUENZA (flu) and VACCINATION COMPLICATION (tight symptoms/severe) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported.On 31-Jul-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. In August 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced VACCINATION COMPLICATION (side effect/still having the side effect as of today). On 07-Sep-2021, the patient experienced VACCINATION COMPLICATION (tight symptoms/severe). On an unknown date, the patient experienced INFLUENZA (flu). At the time of the report, VACCINATION COMPLICATION (side effect/still having the side effect as of today), INFLUENZA (flu) and VACCINATION COMPLICATION (tight symptoms/severe) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. No relevant concomitant medications were reported. No treatment information was provided.


VAERS ID: 1707342 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Chills, Dyspnoea, Fatigue, Headache, Pain in extremity, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive; Test Date: 20210906; Test Name: SARS-CoV-2 test; Test Result: Negative ; Result Unstructured Data: Negative
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Difficulty of breathing; Chest pain; sore in the arm; Headache; Chills; Fatigued; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (Difficulty of breathing), CHEST PAIN (Chest pain), PAIN IN EXTREMITY (sore in the arm), HEADACHE (Headache) and CHILLS (Chills) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 052E21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 in January 2021. On 04-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced PAIN IN EXTREMITY (sore in the arm), HEADACHE (Headache), CHILLS (Chills) and FATIGUE (Fatigued). On 05-Sep-2021, the patient experienced DYSPNOEA (Difficulty of breathing) and CHEST PAIN (Chest pain). The patient was treated with ACETAMINOPHEN for Adverse event, at an unspecified dose and frequency. At the time of the report, DYSPNOEA (Difficulty of breathing) had not resolved and CHEST PAIN (Chest pain), PAIN IN EXTREMITY (sore in the arm), HEADACHE (Headache), CHILLS (Chills) and FATIGUE (Fatigued) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In January 2021, SARS-CoV-2 test: positive (Positive) Positive. On 06-Sep-2021, SARS-CoV-2 test: negative (Negative) Negative. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant product information was provided. Patient did lab tests on the heart, lungs, took blood pressure, took blood, and everything was normal. Additional information about patient''s past COVID-19 infection include that she did not have any fever but a light headache for only one day. Patient did not feel difficulty of breathing, just a little chill, lost smell and ached for 1 day. Patient just stayed at home for 14 days. Patient doesn''t have a history of heart problems, myocarditis/pericarditis.


VAERS ID: 1707367 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-25
Onset:2021-09-04
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025A21A / 2 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Muscle spasms, Myalgia, Nausea, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CODEINE; TRAZODONE; ZOFRAN [ONDANSETRON HYDROCHLORIDE]; WARFARIN; EVOXAC; ALBUTEROL SULFATE; METOPROLOL; LIDOCAINE; FLONASE [FLUTICASONE PROPIONATE]; PREDNISONE; TORSEMIDE; GABAPENTIN; LATANOPROST; LIPITOR; PANTOPRAZOLE; PROBIOTICS NOS; VIT
Current Illness: Fibromyalgia; Rheumatoid arthritis; Sjogren''s
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Right hand swelled up, looked like a mitten; Fatigue; Nausea; Sore arm,achy all over,serious body aches; Cramping,muscle cramps in both hands; This spontaneous case was reported by a consumer and describes the occurrence of MUSCLE SPASMS (Cramping,muscle cramps in both hands), PERIPHERAL SWELLING (Right hand swelled up, looked like a mitten), MYALGIA (Sore arm,achy all over,serious body aches), FATIGUE (Fatigue) and NAUSEA (Nausea) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 036C21A, 025A21A and 030B21A) for COVID-19 vaccination. Concurrent medical conditions included Sjogren''s, Rheumatoid arthritis and Fibromyalgia. Concomitant products included CODEINE, TRAZODONE, ONDANSETRON HYDROCHLORIDE (ZOFRAN [ONDANSETRON HYDROCHLORIDE]), WARFARIN, CEVIMELINE HYDROCHLORIDE (EVOXAC), ALBUTEROL SULFATE, METOPROLOL, LIDOCAINE, FLUTICASONE PROPIONATE (FLONASE [FLUTICASONE PROPIONATE]), PREDNISONE, TORASEMIDE (TORSEMIDE), GABAPENTIN, LATANOPROST, ATORVASTATIN CALCIUM (LIPITOR), PANTOPRAZOLE, PROBIOTICS NOS, ERGOCALCIFEROL (VITAMIN D2), CALCIUM and ZOLMITRIPTAN (ZOMIG) for an unknown indication. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 02-Sep-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced MUSCLE SPASMS (Cramping,muscle cramps in both hands) and MYALGIA (Sore arm,achy all over,serious body aches). On an unknown date, the patient experienced PERIPHERAL SWELLING (Right hand swelled up, looked like a mitten), FATIGUE (Fatigue) and NAUSEA (Nausea). At the time of the report, MUSCLE SPASMS (Cramping,muscle cramps in both hands), MYALGIA (Sore arm,achy all over,serious body aches), FATIGUE (Fatigue) and NAUSEA (Nausea) had not resolved and PERIPHERAL SWELLING (Right hand swelled up, looked like a mitten) was resolving. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No treatment medication was reported by patient. Patient reported that she was still experiencing symptoms, but hand was not as swollen.


VAERS ID: 1707391 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Extra dose administered, Fatigue, Myalgia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Congestive heart failure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Chills; an ache all over feeling; Fatigue; Ache all over feeling, specially in the area where I got the booster shot; Received a booster shot; This case was received via an unknown source (no reference has been entered for a health authority or license partner) on 05-Sep-2021 and was forwarded to Moderna on 07-Sep-2021. This spontaneous case was reported by a consumer and describes the occurrence of CHILLS (Chills), MYALGIA (an ache all over feeling), FATIGUE (Fatigue), VACCINATION SITE PAIN (Ache all over feeling, specially in the area where I got the booster shot) and EXTRA DOSE ADMINISTERED (Received a booster shot) in a 77-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Congestive heart failure. On 04-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced EXTRA DOSE ADMINISTERED (Received a booster shot). On an unknown date, the patient experienced CHILLS (Chills), MYALGIA (an ache all over feeling), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Ache all over feeling, specially in the area where I got the booster shot). On 04-Sep-2021, EXTRA DOSE ADMINISTERED (Received a booster shot) had resolved. At the time of the report, CHILLS (Chills), MYALGIA (an ache all over feeling), FATIGUE (Fatigue) and VACCINATION SITE PAIN (Ache all over feeling, specially in the area where I got the booster shot) outcome was unknown. No concomitant medications were not provided. No treatment information was provided.


VAERS ID: 1707410 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Expired product administered, Product lot number issue
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Wrong expiration; Incorrect lot number; This spontaneous case was reported by a consumer and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (wrong expiration) and PRODUCT LOT NUMBER ISSUE (incorrect lot number) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (wrong expiration) and PRODUCT LOT NUMBER ISSUE (incorrect lot number). On 04-Sep-2021, EXPIRED PRODUCT ADMINISTERED (wrong expiration) had resolved and PRODUCT LOT NUMBER ISSUE (incorrect lot number) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant product use was not provided by the reporter. Treatment information was not provided.


VAERS ID: 1707466 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-09-04
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chest pain, Hypoaesthesia eye, Paraesthesia, Trismus
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dystonia (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Corneal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Chest pain; back pain; left eye numbness; tingling feeling at left side of the jaw; jaw keeps locking up; This spontaneous case was reported by a consumer and describes the occurrence of CHEST PAIN (Chest pain), BACK PAIN (back pain), HYPOAESTHESIA EYE (left eye numbness), PARAESTHESIA (tingling feeling at left side of the jaw) and TRISMUS (jaw keeps locking up) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced CHEST PAIN (Chest pain), BACK PAIN (back pain), HYPOAESTHESIA EYE (left eye numbness), PARAESTHESIA (tingling feeling at left side of the jaw) and TRISMUS (jaw keeps locking up). At the time of the report, CHEST PAIN (Chest pain), BACK PAIN (back pain), HYPOAESTHESIA EYE (left eye numbness), PARAESTHESIA (tingling feeling at left side of the jaw) and TRISMUS (jaw keeps locking up) outcome was unknown. Reportedly, Patient was advised to consult the doctor for further assessment. Consent for follow up was affirmative. Patient had not visited Healthcare Professional Concomitant product use was not provided. Treatment product information was not provided.


VAERS ID: 1707519 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-09-04
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 078C21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Nausea, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Cerebellar ataxia (neurological condition)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: felt like she should go to bed and sleep; vomiting/Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting; nausea/Bad nausea/ Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting; extreme fatigue which made her so tired; This spontaneous case was reported by a consumer and describes the occurrence of SOMNOLENCE (felt like she should go to bed and sleep), VOMITING (vomiting/Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting), NAUSEA (nausea/Bad nausea/ Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting) and FATIGUE (extreme fatigue which made her so tired) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 017E21A and 078C21A) for COVID-19 vaccination. Concurrent medical conditions included Cerebellar ataxia (neurological condition). On 06-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced SOMNOLENCE (felt like she should go to bed and sleep). 04-Sep-2021, the patient experienced VOMITING (vomiting/Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting), NAUSEA (nausea/Bad nausea/ Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting) and FATIGUE (extreme fatigue which made her so tired). At the time of the report, SOMNOLENCE (felt like she should go to bed and sleep) and FATIGUE (extreme fatigue which made her so tired) outcome was unknown and VOMITING (vomiting/Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting) and NAUSEA (nausea/Bad nausea/ Today morning (08Sep2021), after having tea with breakfast caller felt nauseated and felt like vomiting) had not resolved. Concomitant medications were not reported No treatment information was provided. On 04-Sep-2021, The patient developed some side effects, including nausea, vomiting and extreme fatigue which made her so tired and felt like she should go to bed and sleep. On 04-Sep-2021 and 05-Sep-2021, The patient tried to eat a little bit but could not keep it down in her stomach due to bad nausea and vomiting. On 06-Sep-2021 and 07-Sep-2021, The patient could eat a little and could keep it down. On 08-Sep-2021, Morning after having tea with breakfast patient felt nauseated and felt like vomiting.


VAERS ID: 1707520 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Condition aggravated
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: OMEPRAZOLE; SUCRALFATE
Current Illness: Stomach cancer; Unspecified functional disorder of stomach (Stomach problems)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: stomach irritation pain; worsening stomach problems; This spontaneous case was reported by a consumer and describes the occurrence of ABDOMINAL PAIN UPPER (stomach irritation pain) and CONDITION AGGRAVATED (worsening stomach problems) in an 82-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Concurrent medical conditions included Stomach cancer and Unspecified functional disorder of stomach (Stomach problems). Concomitant products included OMEPRAZOLE and SUCRALFATE for an unknown indication. On 03-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced ABDOMINAL PAIN UPPER (stomach irritation pain) and CONDITION AGGRAVATED (worsening stomach problems). On 05-Sep-2021, ABDOMINAL PAIN UPPER (stomach irritation pain) and CONDITION AGGRAVATED (worsening stomach problems) had resolved. Treatment information was not provided. Most recent FOLLOW-UP information incorporated above includes: On 08-Sep-2021: Follow up document contains no new information.


VAERS ID: 1707527 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 3 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Chills, Diarrhoea, Feeling abnormal, Hot flush, Hyperhidrosis, Insomnia, Ocular discomfort
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Little pressure in my chest; Pressure in my eyes; Sweats,Perspiration; Anxiety; Really wired; Difficulty Sleeping; Chills; Hot flashes; Diarrhea; This spontaneous case was reported by a patient and describes the occurrence of DIARRHOEA (Diarrhea), HOT FLUSH (Hot flashes), CHEST DISCOMFORT (Little pressure in my chest), OCULAR DISCOMFORT (Pressure in my eyes) and HYPERHIDROSIS (Sweats,Perspiration) in a 77-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 03-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 04-Sep-2021, the patient experienced DIARRHOEA (Diarrhea). On 05-Sep-2021, the patient experienced HOT FLUSH (Hot flashes), OCULAR DISCOMFORT (Pressure in my eyes), HYPERHIDROSIS (Sweats,Perspiration), ANXIETY (Anxiety), FEELING ABNORMAL (Really wired), INSOMNIA (Difficulty Sleeping) and CHILLS (Chills). On 08-Sep-2021, the patient experienced CHEST DISCOMFORT (Little pressure in my chest). The patient was treated with PARACETAMOL (TYLENOL) at a dose of 1 dosage form. On 08-Sep-2021, HOT FLUSH (Hot flashes) had resolved. At the time of the report, DIARRHOEA (Diarrhea), CHEST DISCOMFORT (Little pressure in my chest), OCULAR DISCOMFORT (Pressure in my eyes), HYPERHIDROSIS (Sweats,Perspiration), ANXIETY (Anxiety), FEELING ABNORMAL (Really wired), INSOMNIA (Difficulty Sleeping) and CHILLS (Chills) outcome was unknown. No Concomitant medications was provided. Reporter did not allow further contact


VAERS ID: 1707566 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-18
Onset:2021-09-04
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21A / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMITRIPTYLINE; PROPRANOLOL; PROZAC; CYMBALTA
Current Illness: Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Swelling on neck; All the shoulder area down to her breasts/swelling all around; All muscles feel tight or something; It''s not comfortable; Can feel 2 or 3 lymph nodes swollen; This spontaneous case was reported by a consumer and describes the occurrence of SWELLING (Swelling on neck), SWELLING (All the shoulder area down to her breasts/swelling all around), MUSCLE TIGHTNESS (All muscles feel tight or something), DISCOMFORT (It''s not comfortable) and LYMPHADENOPATHY (Can feel 2 or 3 lymph nodes swollen) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 020821A and 026A21A) for COVID-19 vaccination. Concurrent medical conditions included Migraine. Concomitant products included AMITRIPTYLINE and PROPRANOLOL for Migraine, FLUOXETINE HYDROCHLORIDE (PROZAC) and DULOXETINE HYDROCHLORIDE (CYMBALTA) for an unknown indication. On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced SWELLING (Swelling on neck), SWELLING (All the shoulder area down to her breasts/swelling all around), MUSCLE TIGHTNESS (All muscles feel tight or something), DISCOMFORT (It''s not comfortable) and LYMPHADENOPATHY (Can feel 2 or 3 lymph nodes swollen). At the time of the report, SWELLING (Swelling on neck), SWELLING (All the shoulder area down to her breasts/swelling all around), MUSCLE TIGHTNESS (All muscles feel tight or something), DISCOMFORT (It''s not comfortable) and LYMPHADENOPATHY (Can feel 2 or 3 lymph nodes swollen) outcome was unknown. No treatment information was provided. This case was linked to MOD-2021-313305 (Patient Link).


VAERS ID: 1708495 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-08-20
Onset:2021-09-04
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blood pressure increased, Blood test, Chest X-ray normal, Chest pain, Dizziness, Echocardiogram normal, Electrocardiogram ambulatory, Electrocardiogram normal, Heart rate decreased, Malaise, Myocardial infarction, Ocular discomfort, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3, Vitamin C, Prenatal
Current Illness:
Preexisting Conditions: IBS
Allergies: Propofol; Morphine; Horses; Goats; Bees; wasps; Dust
Diagnostic Lab Data: Chest x ray, normal; Ekg, normal; Echocardiogram, waiting on results; Blood work, waiting on results; Heart halter, waiting on results; Allergist, scheduling.
CDC Split Type:

Write-up: At 1:30 pm September 4th I suddenly felt crushing f chest pain, lightheadedness, dizziness, almost passed out, a popping sensation inside my abdomen, a feeling of something making its way behind my eye, my heart was racing, I thought I was having a heart attack. I went to the ER where they did an ekg and chest xray. My bp was high, especially my diastolic. I have had a racing heart beat, chest pain, palpitations, and my heart rate wouldn''t go below 85. I am currently still having chest pain and feeling unwell. I had a echocardiogram and wore a heart monitor for two days. I haven''t had caffeine or sodium since September 4th. I am waiting on a blood panel and have talked to my PCP.


VAERS ID: 1708585 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Discomfort, Gallbladder disorder, Inflammation, Liver disorder, Ultrasound scan normal
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Gallbladder related disorders (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: Lovastatin, Calcium, HCL, Beta plus, Vitamin C, IBGuard, Multivitamin, Magnesium, CoQ10, Glucosamine/chondroitin
Current Illness: None
Preexisting Conditions: High cholesterol, osteoporosis
Allergies: Most antibiotics give me C-diff
Diagnostic Lab Data: Blood work and sonogram seem to be OK.
CDC Split Type:

Write-up: Shortly after going to bed I felt a discomfort in the upper right side of the ribs. During the night and into Sunday the discomfort became more acute and spread to under the rib cage on the right side. I tried lemon water as a way of detoxing. I tried ice on the area to decrease inflamation as it felt like my liver/gall bladder area was swollen. When that failed I contacted my doctor who order blood work and a sonogram. To this point the tests are OK.


VAERS ID: 1708631 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brief resolved unexplained event, Cardiac disorder
SMQs:, Acute central respiratory depression (narrow), Neonatal disorders (broad), Respiratory failure (narrow)

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

Write-up: Pt reported being hospitalized with life threatening heart problem


VAERS ID: 1708655 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: pain at injection site. pain radiating down arm. pain at elbow. pain at wrist.


VAERS ID: 1708805 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Oropharyngeal pain, Pain, Pain of skin, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: covid 19-negative
CDC Split Type:

Write-up: sore, fever, skin hurt, chills, congestion, sore throat, cant smell or taste


VAERS ID: 1708861 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count, Impaired work ability, Loss of personal independence in daily activities, Metabolic function test, Muscle contractions involuntary, Muscle spasms, Tic
SMQs:, Dementia (broad), Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NAC. Ibuprofen.
Current Illness: Hpylori
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Treated at Er. CBC. CMP. Is all I know of.
CDC Split Type:

Write-up: Started as muscle tiks. Now progressing to full blown spasms and yesterday contractions began throughout body. I cannot get in to see a neurologist for months and I?m terrified it will progress into something more extreme. I cannot work or take my children to school.


VAERS ID: 1708957 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B214 / 2 LA / IM

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

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

Write-up: RASH, URTICARIA TO LEFT ARM STARTED THE DAY OF VACCINE.


VAERS ID: 1709013 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-08-25
Onset:2021-09-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Catheterisation cardiac, Computerised tomogram thorax, Myocarditis, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvastatin
Current Illness: Obesity Hyperlipidemia
Preexisting Conditions:
Allergies: No known drug allergy
Diagnostic Lab Data: left heart catherization, CT angiogram pulmonary artery on 9/7/2021
CDC Split Type:

Write-up: Back pain, palpitations and diagnosed with mild myocraditis.


VAERS ID: 1709079 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dyanavel 7cc daily clonidine 0.2mg daily
Current Illness: None
Preexisting Conditions: Adhd insomnia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented with vaginal ulcers diagnosed as lipschutz ulcer provides topical cream for treatment


VAERS ID: 1709184 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Feeling abnormal, Hot flush, Insomnia
SMQs:, Dementia (broad)

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

Write-up: Has increased the number and intensity of my menopausal hot flashes. I had been getting hot flashes due to menopause, but since the vaccine, 2 weeks ago tomorrow, they have been out of control. They are occurring more frequently, more intense and lasting longer. I''m not getting any sleep because of them, it has been miserable.


VAERS ID: 1709663 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Caesarean section, Exposure during pregnancy, Premature baby, Premature separation of placenta
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Neonatal disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 33 5/7 weeks, less than 24 hours after receiving the Janssen Covid 19 Vaccine, patient experienced a plancental abruption that resulted in an emergency cesarean delivery of a premature infant, who has had to be in the NICU since delivery.


VAERS ID: 1711018 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-08-04
Onset:2021-09-04
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Hypoaesthesia, Musculoskeletal stiffness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PREMARIN
Current Illness: Glaucoma (Eye drops for glaucoma.)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: She has tingling and numbness in fingers of both hands.; She has tingling and numbness in fingers of both hands.; Stiffness in both hands; 2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.; 2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.; This spontaneous case was reported by a consumer and describes the occurrence of PARAESTHESIA (She has tingling and numbness in fingers of both hands.), HYPOAESTHESIA (She has tingling and numbness in fingers of both hands.), MUSCULOSKELETAL STIFFNESS (Stiffness in both hands), MYALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.) and ARTHRALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.) in an 80-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027B21A and 027B21A) for COVID-19 vaccination. Concurrent medical conditions included Glaucoma (Eye drops for glaucoma.). Concomitant products included ESTROGENS CONJUGATED (PREMARIN) for an unknown indication. On 04-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced MYALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.) and ARTHRALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.). On an unknown date, the patient experienced PARAESTHESIA (She has tingling and numbness in fingers of both hands.), HYPOAESTHESIA (She has tingling and numbness in fingers of both hands.) and MUSCULOSKELETAL STIFFNESS (Stiffness in both hands). The patient was treated with IBUPROFEN for Adverse reaction, at an unspecified dose and frequency and PREDNISONE for Adverse reaction, at an unspecified dose and frequency. At the time of the report, PARAESTHESIA (She has tingling and numbness in fingers of both hands.), HYPOAESTHESIA (She has tingling and numbness in fingers of both hands.), MUSCULOSKELETAL STIFFNESS (Stiffness in both hands), MYALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.) and ARTHRALGIA (2-3 days later(after 2nd dose), she started getting muscle and joint aches all over her body.) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant medications includes Eye drops for glaucoma. Most recent FOLLOW-UP information incorporated above includes: On 11-Sep-2021: Added treatment medication (Prednisone) and new event (Stiffness in both hands).


VAERS ID: 1711780 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Angina pectoris, Chest discomfort, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Other ischaemic heart disease (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101161617

Write-up: he felt heavy heart pain for 5 or 6 times on and off since the 2nd dose of the vaccine; he felt heavy heart pain for 5 or 6 times on and off since the 2nd dose of the vaccine; pain started the next morning the vaccine shot; he had fever for few hours; stomachache; vomiting; This is a spontaneous report from a contactable consumer or other non-healthcare professional. A 12-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: FC3181), second dose via an unspecified route of administration, administered in left arm on 03Sep2021 at 04:30 (at the age of 12-year-old) as dose 2, single for COVID-19 immunisation. Medical history was reported as none. No concomitant medications were not reported. No known allergies were reported. The patient previously received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Batch/Lot Number: FC3180), first dose via an unspecified route of administration, administered in left arm on 10Aug2021 at 09:15 (at the age of 12-year-old) as dose 1, single for COVID-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received any other medication within 2 weeks was reported as none. The patient did not diagnose with COVID-19 prior to vaccination. The patient had not been tested for COVID-19 since the vaccination. On 04Sep2021 at 16:00,It was reported that he felt heavy heart pain for 5 or 6 times on and off since the 2nd dose of the vaccine(Friday 4pm) the paint started the next morning the vaccine shot. each times the pain last at least 5 minutes. beside heart pain, he had fever for few hours, stomachache, vomiting. all these symptoms stop on 3rd day (Monday morning). the symptom about the heart pain worry me that is one of the rare side effects that Inwould like it be tracked. Adverse events resulted in doctor or other healthcare professional office/clinic visit. No treatment was received for the events. The outcome of the events was reported as unknown.


VAERS ID: 1711783 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-08-25
Onset:2021-09-04
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: sars-Cov-2-Test; Test Result: Positive ; Comments: she tested positive on Saturday and her daughter tested positive today.
CDC Split Type: USPFIZER INC202101162062

Write-up: they are now testing positive for COVID 19; This is a spontaneous report from a contactable consumer (patient). A female patient of unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: unknown), via an unspecified route of administration on 25Aug2021 as DOSE 1, SINGLE for COVID-19 immunisation. Medical history and concomitant medication were not reported. The patient was received her first dose of the Pfizer COVID 19 vaccine on 25Aug2021. The patient states that they have not been exposed to anyone with COVID 19 and that they are now testing positive for COVID 19. The patient states that it has been 8-9 days and the patient tested positive on Saturday (04Sep2021). The patient would like to know if this is because of the vaccine and that they really don''t have the virus. The patient makes an example of when people get the flu shot and then get sick with the flu. The patient states that it''s the same because the vaccine is COVID that they put in their body. The patient was like to know if she can still get her second dose of the vaccine now since she has tested positive after the first dose. The patient states that this vaccine was the virus so that was why patient was testing positive right, patient states that the vaccine puts the virus in your body. Outcome of the event was unknown. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1711788 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Limb discomfort, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DAYQUIL
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: Pre-hashimotos
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101162308

Write-up: Severe arm pain into the joints; Severe arm pain into the joints; Inability to lift arm; This is a spontaneous report from a contactable other hcp (patient). A 26-years-old non pregnant female patient received first dose of bnt162b2 (BNT162B2, solution for injection) via an unspecified route of administration, administered in arm right on 04Sep2021 12:30 (Batch/Lot Number: Fc3184) (at the age of 26-years-old) as SINGLE for covid-19 immunization at Pharmacy or Drug Store. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had no known allergies. Patient medical history included pre-hashimotos from an unknown date and unknown if ongoing. Patient concomitant medication(s) included dextromethorphan hydrobromide, guaifenesin, paracetamol, pseudoephedrine hydrochloride (DAYQUIL) taken for an unspecified indication, start and stop date were not reported. On 04Sep2021 at 14:00, The patient experienced severe arm pain into the joints and had inability to lift her arm. The patient did not received any treatment for the events. The outcome of events was not recovered.


VAERS ID: 1711794 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Chest pain, Dyspnoea, Electrocardiogram, Headache, Neck pain, Pain, Troponin, X-ray
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: blood test; Result Unstructured Data: Test Result:unknown results; Test Date: 2021; Test Name: EKG; Result Unstructured Data: Test Result:unknown results; Test Date: 2021; Test Name: troponin blood test; Result Unstructured Data: Test Result:unknown results; Test Date: 2021; Test Name: x-ray; Result Unstructured Data: Test Result:unknown results
CDC Split Type: USPFIZER INC202101162422

Write-up: Headache; body/neck aches; body/neck aches; chest pain; difficulty breathing; lower back pain; This is a spontaneous report from a contactable consumer. This 16-year-old male consumer (patient) reported for himself that. A 16-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration, administered in Arm Right on 03Sep2021 16:00 (Age at time of vaccination 16-years-old) as DOSE 2, SINGLE for covid-19 immunization. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Batch/Lot number was not reported) administered in Arm Right On Aug2021 15:30 for covid-19 immunization. The patient previously took amoxicillin and experienced drug hypersensitivity. The patient medical history, concomitant medications were not reported. No other medical history. He eats healthy and is muscular and physically fit. Ethnicity information is available. Device Date was 05Sep2021. COVID-19 vaccine was administered in Hospital. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient not received any other medications within 2 weeks of vaccination. The patient was not diagnosed with COVID-19, Prior to vaccination. Since the vaccination, the patient has not been tested for COVID-19. On 2021 The patient underwent lab tests and procedures which included blood test: unknown results, electrocardiogram: unknown results, troponin: unknown results, x-ray: unknown results. On 04Sep2021 15:00 The patient experienced headache, body/neck aches, chest pain, difficulty breathing, lower back pain. Therapeutic measures were taken as a result of all events. AE resulted in Emergency room/department or urgent care. Events were consider as non serious. The outcome of events were resolving. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.


VAERS ID: 1711838 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD8448 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature, Body temperature increased, Diarrhoea, Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: SARS-CoV-2 infection (But her husband and her both had a pretty heavy case of Covid in March of last year); Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Fever; Result Unstructured Data: Test Result:101.3-101.8.; Comments: ranged between 101.3-101.8.; Test Date: 20210904; Test Name: Fever; Result Unstructured Data: Test Result:99.8; Comments: her fever is currently 99.8; Test Date: 202003; Test Name: Covid-19; Result Unstructured Data: Test Result:Covid in March
CDC Split Type: USPFIZER INC202101168882

Write-up: diarrhea; stomach cramping; sore throat; running a temperature; lymph node in right arm same side as shot is swollen the size of goose egg; This is a spontaneous report from a contactable consumer (patient). A 46-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: FD8448, Expiration date: 31Oct2021) via an unspecified route of administration, administered in arm right on 04Sep2021 13:00 (age at vaccination: 46-years-old) as dose 1, single for COVID-19 immunization. The patient medical history included both herself and her husband had a pretty heavy case of covid-19 in Mar2020. Relevant medical history and concomitant medications included none. On 04Sep2021, the patient had experienced running a temperature, lymph node in right arm same side as shot was swollen to the size of goose egg, diarrhea, stomach cramping and sore throat. The patient underwent lab tests and procedures which included sars-cov-2 test: covid-19 in Mar2020; body temperature: 99.8 on 04Sep2021, and on unknown date in 2021 it was 101.3-101.8. Therapeutic measures were taken as a result of running a temperature, lymph node in right arm same side as shot was swollen to the size of goose egg, diarrhea, stomach cramping, sore throat and included Tylenol and Imodium. The outcome of the event running a temperature was recovering and other events was not recovered.


VAERS ID: 1711861 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Psychotic disorder
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Bladder disorder (Verbatim: Bladder problems); Environmental allergy; Latex allergy; Penicillin allergy; Pollen allergy; Psychosis; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101169854

Write-up: she has had a full blown psychosis episode; This is a spontaneous report from a contactable consumer. This contactable consumer (Patient''s mother) reported for 34-year-old female patient. A 34-year-old female patient received a dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered on 04Sep2021 (at the age of 34-year-old) as dose 2, single for COVID-19 immunization. Patient received a dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered in right arm on 12Aug2021 (at the age of 34-year-old) as dose 1, single for COVID-19 immunization and experienced the patient was a little bit off/different but she didn''t think much of it since she had not had a psychosis episode in a long time. Patient also received pneumonia vaccine on 13Aug2021 at the age of 34 years. The patient medical history includes Psychotic disorder, Allergy, pneumonia vaccine, Penicillin allergy, Shellfish allergy, Latex allergy, Pollen allergy, and Bladder disorder, Environmental allergy, and concomitant medications were not reported. Past drug event includes MAGNESIUM induced unknown reaction, SUMATRIPTAN induced unknown reaction and IODINE induced unknown reaction. On 04Sep2021, after the vaccination, the patient experienced a full-blown psychosis episode. The psychosis started the night of 04Sep2021, and it was full blown psychosis by the next morning 05Sep2021. Caller reports that she couldn''t get the patient to take any of her meds and she was going to take her to the Emergency Department. The outcome of the events was not recovered. No follow-up attempts possible. No further information expected.


VAERS ID: 1712005 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 50FC3182 / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101191223

Write-up: knock him back deafness rash; knock him back deafness rash; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 57-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, formulation: solution for injection, lot number: 50fc3182) via an unspecified route of administration on 03Sep2021 (at the age of 57-years-old) as dose 1 single for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 04Sep2021, the patient experienced knock him back deafness rash. The outcome of the events was unknown. Information on Lot/Batch number was available. Additional information has been requested.


VAERS ID: 1712023 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-28
Onset:2021-09-04
   Days after vaccination:99
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Menstruation irregular, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Prior to vaccination, was the patient diagnosed with COVID-19?:Yes)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101192491

Write-up: Sharp pain in right hip; Right leg muscular pain; Irregular period; This is a spontaneous report from a contactable consumer, the patient. A 32-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0179) via an unspecified route of administration in the right arm on 28May2021 at 10:00 (at the age of 32-years old) as a single dose for COVID-19 immunisation. Medical history included COVID-19 from an unknown date. Prior to the vaccination, the patient was diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EP8036) via an unspecified route of administration in the right arm on 07May2021 at 10:00 (at the age of 32-years old) as a single dose for COVID-19 immunisation. On 04Sep2021, the patient experienced sharp pain in right hip, right leg muscular pain and irregular period. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. Therapeutic measures were not taken as a result of the event. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events sharp pain in right hip, right leg muscular pain and irregular period was not recovered at the time of report.


VAERS ID: 1713283 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fall, Hyperhidrosis, Influenza like illness, Loss of consciousness, Pyrexia, Skin laceration, Syncope
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), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: vasovagal syncope with loss of consciousness for unknown length of time (est. 10-30min), resulting in forehead laceration from fall severe fever, sweats, chills for 60min flu-like symptoms for 24hrs


VAERS ID: 1713355 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: New York  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Headache, Heart rate increased, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant 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), Dehydration (broad)

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

Write-up: Rapid heart beat, headache, nausea, heavy breathing,


VAERS ID: 1713524 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Head injury, Headache, Loss of consciousness, Pallor, Syncope
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), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Attendee received first dose Pfizer vaccine at shortly before 16:45 in the arm. Lot# unknown. Attendee was watching her father get vaccinated, when she fainted and hit her head with a loss on consciousness of 10 seconds in duration. No fall injuries noted. 16:45 - Attendee''s skin was Cool, clammy and pale. Complains of dizziness/lightheadedness. HR: 75 BP: 96/58 RR: 20 O2Sat%: 99 16:47 ? 911 called 16:50 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. HR 91 BP: 108/66 RR: 20 O2Sat%: 98 16:55 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. HR: 92 BP: 112/74 RR: 20 O2Sat%: 96. 17:00 - Attendee laying down on the floor waiting for EMS. Alert and oriented x 4. Attendee has developed a headache. HR: 93 BP: 118/76 RR: 20 O2Sat%: 97 17:04 - EMS arrived on scene and took over care of the attendee. HR: 96 BP: 122/72 RR: 20 O2Sat%: 100 17:09 - EMS attempted to get standing vital signs and the attendee fainted again, so she was placed on the gurney and taken via ambulance to the emergency room.


VAERS ID: 1713876 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-08-13
Onset:2021-09-04
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Dyspnoea, Headache, Heavy menstrual bleeding, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Breathing difficulties, swollen lymph nodes for a week, heavy menstruated cycle, headache, lower back pain.


VAERS ID: 1714072 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Testicular pain, Testicular swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Sexual dysfunction (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: Sulfa meds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Testicular pain for about an hour and felt swollen, severe tiredness and headache.


VAERS ID: 1714165 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-07-06
Onset:2021-09-04
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Blood creatine phosphokinase increased, Blood creatinine increased, COVID-19, Chest X-ray, Leukocytosis, Muscle spasms, SARS-CoV-2 test positive, Urine analysis, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: History of positive COVID-19 test 10 days ago, history of right knee pain and injury in the past, history of right shoulder surgery. Obesity.
Allergies: None
Diagnostic Lab Data: 9/04/21 COVID19: positive 9/15/21 chest xray: Borderline heart size. Otherwise, no acute cardiopulmonary disease.
CDC Split Type:

Write-up: This is a 22-year-old gentleman who is a student of a local college here who has been immunized against COVID-19 in August. Then about 10 days ago, he had to have a COVID-19 test done because he was exposed to somebody on his football team who had COVID-19 and he did test positive. He just came out of quarantine yesterday and had a long workout session for his football team, but was not drinking enough fluid, started to have abdominal cramps and then arms and leg cramps and therefore came to the emergency room where his creatinine was found to be 1.6, without a baseline in our system. Also, his CPK was 791, which after a L of fluid actually went to 832. The patient says he feels a whole lot better right now and his cramps are almost resolved. We will give him a couple more L of fluids and recheck his CPK and BMP in a few hours and then make a decision whether the patient can be discharged from the ER or be admitted for his possible AKI and elevated CPK. He also has a slight white count of 11.43, but he is denying any chest pain, shortness of breath or cough, fever or chills. No urinary s/s.. Mild leukocytosis with a recent COVID-19 infection. Checking chest x-ray and urinalysis. Patient denies any fever, chills, or cough or any urinary symptoms. No diarrhea either. Given fluids and discharged on 9/17/21


VAERS ID: 1714190 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM

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

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

Write-up: Moderna vaccine, lot # 048C21A) was received on 7/16/2021 and placed under refrigerated temperature. 3 vials were transferred to another store where 20 doses were administered beyond use date.


VAERS ID: 1714202 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 LA / IM

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

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

Write-up: Moderna vaccine (lot # 048C21A) was received at the pharmacy on 7/16/2021 and placed under refrigerated temperature. 3 vials were transferred to another pharmacy where 20 doses were administered beyond use date.


VAERS ID: 1714214 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM

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

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

Write-up: Moderna vaccine (NDC--80777-0273-99, lot # 048C21A) was received at store on 7/16/2021 and placed under refrigerated temperature. 3 vials were transferred to another store location where 20 doses were administered beyond use date.


VAERS ID: 1714224 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM

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

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

Write-up: Moderna vaccine (lot # 048C21A) was received at the pharmacy on 7/16/2021 and placed under refrigerated temperature. 3 vials were transferred to another pharmacy where 20 doses were administered beyond use date.


VAERS ID: 1714233 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 2 RA / IM

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

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

Write-up: Moderna vaccine (NDC--80777-0273-99, lot # 048C21A) was received at store on 7/16/2021 and placed under refrigerated temperature. 3 vials were transferred to store where 20 doses were administered beyond use date.


VAERS ID: 1714251 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Pelvic pain, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lyrica Effexor 37.5 for neuro pain Lisinopril Coreg Ambien cr
Current Illness: Neuro vascular CRPS LATE STAGE POST surgery 2007 Hbp controlled w meds Thoracic, lumbar disc protrusion DDD stenosis DEMYELENATiON of lower.spine q hemangiomas lesions
Preexisting Conditions: Above
Allergies: Morphine
Diagnostic Lab Data: Urine sample-negative
CDC Split Type:

Write-up: Abdominal and pelvic pain severe enough to believe I had a UTI .


VAERS ID: 1714667 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Axillary pain, Blood pressure measurement, Bone pain, Chills, Confusional state, Dizziness, Fatigue, Head discomfort, Heart rate, Lymph node pain, Myalgia, Palpitations, Parosmia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE; VITAMIN D3
Current Illness: Allergy; Long QT
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: Blood pressure; Result Unstructured Data: Normal; Test Date: 20210904; Test Name: heart rate; Result Unstructured Data: highest was 110and the lowest was 100
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: slight pressure in left temple; some aches in the bones; light headedness for 2 days; brain fog; smelling a burnt smell/smelling burnt leaf smell; runny nose; fatigue for a couple of days; arm sore at left shoulder/left side muscle pain; axillary area sore for couple days; left lymph node sore for couple days; rapid heart rate/highest heart rate 110; half hour of chills; This spontaneous case was reported by a consumer and describes the occurrence of PALPITATIONS (rapid heart rate/highest heart rate 110), HEAD DISCOMFORT (slight pressure in left temple), BONE PAIN (some aches in the bones), DIZZINESS (light headedness for 2 days) and CONFUSIONAL STATE (brain fog) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Long QT and Allergy. Concomitant products included LEVOTHYROXINE and VITAMIN D3 for an unknown indication. On 04-Sep-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-Sep-2021, the patient experienced PALPITATIONS (rapid heart rate/highest heart rate 110). On an unknown date, the patient experienced HEAD DISCOMFORT (slight pressure in left temple), BONE PAIN (some aches in the bones), DIZZINESS (light headedness for 2 days), CONFUSIONAL STATE (brain fog), PAROSMIA (smelling a burnt smell/smelling burnt leaf smell), RHINORRHOEA (runny nose), FATIGUE (fatigue for a couple of days), MYALGIA (arm sore at left shoulder/left side muscle pain), AXILLARY PAIN (axillary area sore for couple days), CHILLS (half hour of chills) and LYMPH NODE PAIN (left lymph node sore for couple days). At the time of the report, HEAD DISCOMFORT (slight pressure in left temple), BONE PAIN (some aches in the bones), DIZZINESS (light headedness for 2 days), CONFUSIONAL STATE (brain fog), PAROSMIA (smelling a burnt smell/smelling burnt leaf smell), RHINORRHOEA (runny nose), MYALGIA (arm sore at left shoulder/left side muscle pain), AXILLARY PAIN (axillary area sore for couple days), CHILLS (half hour of chills) and LYMPH NODE PAIN (left lymph node sore for couple days) had resolved and FATIGUE (fatigue for a couple of days) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 04-Sep-2021, Blood pressure measurement: normal (normal) Normal. On 04-Sep-2021, Heart rate: 110-100 (High) highest was 110and the lowest was 100. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No treatment information was provided. ? Most recent FOLLOW-UP information incorporated above includes: On 10-Sep-2021: Non-Significant follow-up contain no new information


VAERS ID: 1715164 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH SD8448 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Decreased activity, Hypoaesthesia, Steroid therapy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Sexual dysfunction (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: Just days after the vaccine the patient woke up with the left side of his face numb and inactive. He was shortly after diagnosed with Bells palsy. And has been prescribed a steroid pack for the bells palsy.


VAERS ID: 1715202 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paroxetine - 5 mg (1/2 of 10 mg) daily
Current Illness:
Preexisting Conditions:
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainted 2+ hours after receiving vaccine.


VAERS ID: 1715390 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816027 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Approximately 12h after injection developed fever/chills/rigors/nausea that lasted for about 1 hour


VAERS ID: 1715572 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-26
Onset:2021-09-04
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 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? 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: Covid positive contact unknown


VAERS ID: 1715622 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-24
Onset:2021-09-04
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-09-20
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? 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: Covid positive contact unknown


VAERS ID: 1715677 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Cough, Dizziness, Headache, Pain in extremity, Rhinorrhoea, SARS-CoV-2 test, Vitreous floaters
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bayer aspirin, Aleve
Current Illness:
Preexisting Conditions: Migraines
Allergies: Pineapple, latex
Diagnostic Lab Data: Covid test, I am waiting for imaging to call me to set up a CT scan of the blood vessels in my brain. Waiting on my Dr. to consult with other colleagues for a treatment plan.
CDC Split Type:

Write-up: Since the day after the shot I woke with a headache that as of this date has yet to go away, I have severe dizzy spells, I have had an episode where I have seen different color floating dots when I close my eyes and silver what looks likes glitter was thrown up in front of me, upset stomach, pain on and off in the lower left leg above my ankle bone, running nose and slight cough.


VAERS ID: 1715696 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-10
Onset:2021-09-04
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001B21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Alanine aminotransferase normal, Angiogram, Angiogram normal, Anion gap, Aortic arteriosclerosis, Aspartate aminotransferase increased, Asthenia, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin normal, Blood chloride normal, Blood creatinine increased, Blood glucose normal, Blood lactate dehydrogenase increased, Blood lactic acid, Blood potassium normal, Blood sodium decreased, Blood thyroid stimulating hormone normal, Blood urea increased, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Carbon dioxide decreased, Chest X-ray, Chest X-ray abnormal, Constipation, Cough, Dehydration, Diarrhoea, Dyspnoea, Echocardiogram, Glomerular filtration rate decreased, Glycosylated haemoglobin, Hyponatraemia, Hypophagia, Hypovolaemia, Hypoxia, Inappropriate antidiuretic hormone secretion, Lung infiltration, Lung opacity, Lymphadenopathy, Physical deconditioning, Pneumonia bacterial, Post-acute COVID-19 syndrome, Proteinuria, Pyrexia, Rash, Rash maculo-papular, Rash pruritic, SARS-CoV-2 test positive, Spinal osteoarthritis, Sputum discoloured, Superinfection, Troponin I increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (narrow), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prior to Admission Medications Outpatient Home Medications Taking? Albuterol (PROAIR/PROVENTIL/VENTOLIN) 90 mcg/actuation Inhl HFAA Never Took Sig: Inhale 2 Puffs by mouth every 4 hours as needed for shortness of breath . 100 days supply fo
Current Illness: Pt with knee OA and pes anserinus tendinosis
Preexisting Conditions: PMHx DM2 (insulin dep, last A1c 6.6 8/2021), hypertension, hyperlipidemia, osteoarthritis, severe obesity, benign prostatic hypertrophy, chronic kidney disease (baseline creatinine 1.3-1.7
Allergies: Lovastatin- Rhabdomyolysis
Diagnostic Lab Data: Results for patient as of 9/20/2021 13:14 9/4/2021 10:32 NA: 133 (L) K: 4.8 CL: 104 CO2: 18 (L) BUN: 31 (H) CREAT: 1.96 (H) ANION GAP4 SERPL: 11 GLUC: 144 TROPONIN I: 0.04 LDH: 253 BNP: 105 (H) ALT: 45 AST: 49 (H) ALKP: 123 (H) TBILI: 0.8 COMMENT, GLOMERULAR FILTRATION RATE: SEE NOTE ALB: 3.4 (L) CRP, SER QL: 27.0 (H) LACTATE: 1.0 TP: 6.4 Narrative XRAY CHEST ** HISTORY **: 69 years old, COUGH Possible COVID patient ** TECHNIQUE **: 1 view of the chest acquired. COMPARISON: None available. ** FINDINGS **: LUNGS: Right upper lobe and left lung base pulmonary consolidation consistent with pneumonia (including COVID-19 pneumonia). No pleural effusion. MEDIASTINUM/OTHER: Normal cardiomediastinal silhouette. ** HISTORY **: 69 years old, R/O PULMONARY EMBOLISM ** TECHNIQUE **: CT angiogram images of the chest acquired with 100 mL Omnipaque 300 intravenous contrast. Multiplanar reformations performed. CTDI: 50.78,18.76 mGy DLP: 50.78,665.13 mGy-cm COMPARISON: None available. ** FINDINGS **: PULMONARY ARTERIES: The pulmonary trunk and bilateral pulmonary arteries opacify homogeneously. Evaluation of the segmental and subsegmental arteries is limited by motion artifact, particularly within the lower lobes. Within limits of this exam, no occlusive filling defect is present. HEART AND GREAT VESSELS: Heart size normal. Aortic atherosclerosis. LYMPH NODES: Mildly enlarged mediastinal lymph nodes, none suspicious by CT size criteria. OTHER MEDIASTINUM: No significant abnormality. LUNGS: Multifocal pulmonary consolidation, most prominently at the right lung apex and left lower lobe. PLEURAL SPACE: Normal. UPPER ABDOMEN: The spleen measures 14.8 cm in AP dimension. SOFT TISSUES: No significant abnormality. BONES: Mild degenerative changes of the thoracic spine.
CDC Split Type:

Write-up: 69 Y male w PMHx DM2 (insulin dep, last A1c 6.6 8/2021), hypertension, hyperlipidemia, osteoarthritis, severe obesity, benign prostatic hypertrophy, chronic kidney disease (baseline creatinine 1.3-1.7) p/w SOB/cough and found to be COVID positive. Prolonged hospitalization for Hypoxic Respiratory failure from COVID PNA. COVID Pneumonia, Acute hypoxemic Respiratory failure complicated by Pneumonia - Symptom onset on 8/29/21. COVID positive on 8/30/21. Last fever 102.6 on 9/5. Pt at facility from 9/4 to 9/18/21. He received 10 days of Decadron and Remdesivir daily for 4 days (9/5 - 9/8). It was stopped 1 day early due to new generalized itchy rash. CTA chest obtained on 9/10 and no PE seen. Given his prolonged cough, persistent infiltrates and elevated wbc and yellow sputum 9/14 started Levaquin to treat bacterial superimposed PNA. CXR from 9/12 with retrocardiac opacity. After starting this his cough and sputum production improved and he was weaned off of 2-3L O2 - satting 94% on RA since 9/17. 0-2L at rest and 2L with exertion. Goal O2 sat $g92% Weakness- Likely deconditioning + weak from long course of steroids and being a COVID LONGHAULER. TTE done prior to discharge, which was normal. TSH normal - HH PT Mild Hyponatremia due to SIADH - cw free water restriction to 1L and NaCL 1g bid Maculopapular Rash. Looked like a drug rash, on the trunk and extremities. Started rather suddenly on night of 9/8. Very itchy. No desquamation or blisters. Rashes related to remdesivir are uncommon but it is a new medication him and more likely to cause rash than dexamethasone so stopped Remdesivir one day early. - resolved Acute on chronic kidney disease with proteinuria: suspected volume depletion from dehydration, decr po intake and diarrhea. Baseline is 1.3-1.7. On admission 1.96. Improved with gentle hydration - Cr worse than usual after resuming Jardiance? Will hold and defer to PCP if he should resume DM2: prior to admission on insulin (NPH 35 U every morning), jardiance, and metformin. Hold metformin. Blood Sugars running high at times. - Increased NPH to 35u qam, started 5 U NPH in the evening. - resume home metformin - pt instructed to check bg 3-4 times a day Hypertension/hyperlipidemia: Stable. Prior to admission on lisinopril, cardura and atorvastatin. - Continue doxazosin 8 qhs and Atorvastatin -.Holding Lisinopril Benign prostatic hypertrophy: Continue pta doxazosin. Constipation - bowel regimen- colace, senna and miralax. Lower back pain- hx of LBP. 2/2021MRi normal- likely MSK as it was reproducible - lidoderm patch - p rn tylenol Subjective: Says he felt better! Cough continues to improve on antibiotics. Still suctioning out clear and some opaque secretions but feels better. Still SOB and exhausted with exertion, but this is better


VAERS ID: 1715925 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC 3183 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Loss of personal independence in daily activities, Mobility decreased, Myalgia, Photophobia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Days 1-2 after vaccine: Fever and chills and severe fatigue, muscle aches, loss of appetite, headaches, Tylenol better than ibuprofen for reducing fevers. Days 3: fever resolved, other symptoms still present Day 4-5 : same as day 1-2, fever and chills returned, headaches, photophobia, hard to leave bed. Days 6-10, continued severe exhaustion, headaches. Photophobia, no appetite, hard to get out of bed. Ibuprofen a little better than Tylenol for headaches. Day 6, appointment by Telehealth with pediatrics office, confirmed that some kids are this sick for up to 2 weeks after second vaccine dose, told to continued fluids and rest. Day 11-14, returned to school, but could hardly get through the day, exhausted, muscle aches, loss of appetite, headaches, had to nap after school. Day 15 -a little more energy, maybe 60% Day 16 - first day the he felt 90% back to himself


VAERS ID: 1716107 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

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

Write-up: Persistent fever, chills, aches, and fatigue over 72-hr period. Patient bedridden for duration of symptoms.


VAERS ID: 1716349 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Bacterial infection, Chest X-ray, Chest discomfort, Chest pain, Chills, Cough, Diarrhoea, Dyspnoea, Fatigue, Hot flush, Injection site pain, Nasal congestion, SARS-CoV-2 test negative, Throat irritation, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Camilla, venlafaxine, buspirone
Current Illness: None
Preexisting Conditions: Mild intermittent asthma
Allergies: Possible sulfa, pumpkin
Diagnostic Lab Data: 9/16 PCR for COVID-19 9/18 PCR for covid-19 chest x ray
CDC Split Type:

Write-up: Soreness in injection sight, shortness of breath the following morning, fatigue, 1 week and 2 days after injection began having symptoms of covid scratchy throat mild cough. Tightness in chest, diarrhea, feeling weak and shaky, cough worsened, nasal congestion chest tightness tested for COVID 9/16 PCR negative results. Sent home with antibiotics for bacterial infection 2 inhalers and nasal spray. 9/18 felt worse went to Emergency room and had a chest x ray. Weakness burning in chest pain in chest. Hot flashes, chills another PCR preformed also negative.


VAERS ID: 1718013 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-30
Onset:2021-09-04
   Days after vaccination:158
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Diarrhoea, Dry mouth, Headache, Hyperhidrosis, Influenza like illness, Pyrexia, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? 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: USMODERNATX, INC.MOD20213

Write-up: doesn''t feel good; flu-like symptoms; very weak; mouth is very dry, like sticky, inside; watery diarrhea; pajamas were all wet/chest was wet; got worse and worse; fever; constant headache on the left side; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (doesn''t feel good), INFLUENZA LIKE ILLNESS (flu-like symptoms), HYPERHIDROSIS (pajamas were all wet/chest was wet), CONDITION AGGRAVATED (got worse and worse) and ASTHENIA (very weak) in a 70-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025B21A and 044A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Sep-2021, the patient experienced HEADACHE (constant headache on the left side). On 06-Sep-2021, the patient experienced HYPERHIDROSIS (pajamas were all wet/chest was wet), CONDITION AGGRAVATED (got worse and worse), DIARRHOEA (watery diarrhea) and PYREXIA (fever). On an unknown date, the patient experienced VACCINATION COMPLICATION (doesn''t feel good), INFLUENZA LIKE ILLNESS (flu-like symptoms), ASTHENIA (very weak) and DRY MOUTH (mouth is very dry, like sticky, inside). At the time of the report, VACCINATION COMPLICATION (doesn''t feel good), INFLUENZA LIKE ILLNESS (flu-like symptoms), HYPERHIDROSIS (pajamas were all wet/chest was wet), CONDITION AGGRAVATED (got worse and worse), ASTHENIA (very weak), DRY MOUTH (mouth is very dry, like sticky, inside), DIARRHOEA (watery diarrhea), HEADACHE (constant headache on the left side) and PYREXIA (fever) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication were provided No treatment medication were provided


VAERS ID: 1718265 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: New York  
Vaccinated:2021-08-31
Onset:2021-09-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIRAMATE; LISINOPRIL; HCT; METOPROLOL SUCCINATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic migraine; Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101162385

Write-up: Syncopal episode; Urticaria from neck to feet; This is a spontaneous report from a contactable nurse. A 45-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for Injection, Batch/Lot number: FC3184) via an unspecified route of administration, administered in Arm Left on 31Aug2021 at 09:00 as DOSE 2, SINGLE (at the age of 45-year-old) for covid-19 immunisation. The patient received first dose on 10Aug2021 at 9:00 AM on left arm (lot number: EW0181) for covid-19 immunisation. Medical history included migraine, hypertension. Concomitant medications included topiramate; lisinopril; hydrochlorothiazide (HCT); metoprolol succinate. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 04Sep2021 the patient experienced urticaria from neck to feet starting day 4 post injection lasting till present time. Syncopal episode on day 5 (05Sep2021) post injection, resolving once patient hit the floor. It was unknown if patient received the treatment or not. The outcome of the events was not resolved.; Sender''s Comments: Based on the temporal relation, the association between the event of syncope and the suspect product of BNT162B2 cannot be completely ruled out. 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: 1718267 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Back pain, Cardiac disorder, Chest pain, Crying, Feeling abnormal, Hallucination, auditory, Headache, Pain in extremity, Panic attack
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Panic attack (22 years ago)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101162517

Write-up: auditory hallucination; I don''t know if it was a panic attack or a little heart issue; I don''t know if it was a panic attack or a little heart issue; my chest hurt badly in the middle; my back hurt in the middle; my head hurt; my legs hurt; started crying; very strange reaction; anxiety; This is a spontaneous report from a contactable consumer (the patient reported for self). A 57-years-old (non-pregnant) female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, lot number: FE3592), via an unspecified route of administration, administered in arm right on 04Sep2021 10:30 as dose 1, single (at the age of 57-years-old) for covid-19 immunization. Medical history included panic attack (22 years ago). There were no known allergies. There were no concomitant medications. other medications in two weeks None. The patient did not receive any other vaccine in four weeks and also patient did not receive any other medication in two weeks. The patient had not diagnosed with COVID prior to vaccination. It was reported that the about 9 hours after the vaccine (on 04Sep2021 19:30), patient had a very strange reaction. She did not know if it was a panic attack or a little heart issue. Suddenly her chest hurt badly in the middle, and then back hurt in the middle, and then head hurt, and then legs hurt. Patient was full of anxiety and started crying. It lasted about 10 or 15 minutes and then everything went away and patient was back to perfectly normal. A few seconds before this episode patient had an auditory hallucination which was the first and only one ever had. Nothing else unusual or out of the ordinary happened on this day except for the vaccine. The patient was in a normal good mood and had a normal day before it happened, and it went away as fast as it came after about 10 - 15 minutes. The patient did not receive any treatment for the events. Patient was not tested for COVID post vaccination. The outcome of all the events had recovered. Device Date : 06Sep2021 Follow-up attempts were completed. No further information was expected.


VAERS ID: 1718352 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-09-04
Onset:2021-09-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 3 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Feeling abnormal, Off label use, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; VITAMIN B12 [CYANOCOBALAMIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic obstructive pulmonary disease (COPD); Congestive heart failure (CHF)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101211089

Write-up: Feeling awful; Fever; Third dose administered/Booster dose; Third dose administered/Booster dose; This is a spontaneous report from a contactable consumer, the patient. A 45-year-old non-pregnant female patient received third dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: FF2587) via an unspecified route of administration in the left arm on 04Sep2021 at 13:00 (at the age of 45-years-old) as a single dose for COVID-19 immunisation. Medical history included chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included acetylsalicylic acid (ASPIRIN) and cyanocobalamin (VITAMIN B12); both from an unknown date for an unknown indication and unknown if ongoing. The patient previously received first dose of COVID-19 VACCINE (MANUFACTURER UNKNOWN; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date and also second dose of COVID-19 VACCINE (MANUFACTURER UNKNOWN; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date as a single dose for COVID-19 immunisation. On 04Sep2021 at 16:00, the patient experienced fever. The patient reported that she had a fever daily in the sundown hours since the vaccine. It was her booster third dose. It was reported that she felt awful every evening. The events did not result in doctor or other healthcare professional office or clinic visit and emergency room or department or urgent care. No therapeutic measures were taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events fever and feeling awful was not resolved at the time of this report.


VAERS ID: 1718824 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-09-01
Onset:2021-09-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 5 mg lexapro
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: diarrhea for 2 weeks so far


VAERS ID: 1718856 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-08-27
Onset:2021-09-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017E21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abortion spontaneous, Exposure during pregnancy, Pregnancy test
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins Ubiquinol Q10 Probiotics
Current Illness: None
Preexisting Conditions: Pancreatitis
Allergies: None
Diagnostic Lab Data: Two separate HCG test were conducted and confirmed miscarriage
CDC Split Type:

Write-up: 4 weeks pregnant when received the vaccines. Started having sharp abdominal pain approximately one week later, which led to miscarriage at 5 weeks


VAERS ID: 1718963 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-02
Onset:2021-09-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3181 / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pruritus, Headache, Pain, Photophobia, Pruritus
SMQs:, Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Pfizer covid 19 shot 1/08/2021
Other Medications: Flonase, atilastin, levothryxin, ezetembe, metropolil, omeprezole Calcium/magnesium, vit D, super omega 3, votes, B-complex, baby aspirin
Current Illness: None
Preexisting Conditions: Meniere?s, neuropathy, allergies, asthma, high blood pressure.
Allergies: Penicillin, tramadol, Rapatha, morphine Raw apples, raw strawberries, raw carrots,
Diagnostic Lab Data: Eye exam on 9/14/2021
CDC Split Type:

Write-up: Left eye started itching, then expanded to face and head, headaches, pain, light sensitivity


VAERS ID: 1718993 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adenovirus test, Antinuclear antibody, Antinuclear antibody negative, Bordetella test negative, Cardiac telemetry abnormal, Chest X-ray normal, Chest pain, Chlamydia test negative, Complement factor C3, Complement factor C4 decreased, Coronavirus test negative, Diarrhoea, Double stranded DNA antibody, Echocardiogram abnormal, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Enterovirus test negative, Fatigue, Full blood count normal, Human metapneumovirus test, Human rhinovirus test, Hypokalaemia, Influenza A virus test negative, Influenza B virus test, Intensive care, Left ventricular dysfunction, Metabolic function test abnormal, Mycoplasma test negative, Pericardial effusion, Pyrexia, Respiratory syncytial virus test negative, Respiratory viral panel, Rheumatoid factor negative, SARS-CoV-2 test negative, Sinus arrhythmia, Troponin increased, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 09/06/2021 16:00 EDT SARS CoV 2 by PCR Not Detected RSV by PCR Not Detected Adenovirus Not Detected Coronavirus 229E by PCR Not Detected Coronavirus HKU1 by PCR Not Detected Lab Test and Results Continued: Coronavirus NL63 by PCR Not Detected Coronavirus OC43 by PCR Not Detected Metapneumovirus Not Detected Rhino/Entero by PCR Not Detected Influenza A Not Detected H1N1 (Swine) Not Detected Influenza A H1 by PCR Not Detected Influenza A H3 by PCR Not Detected Influenza B Not Detected Parainflu 1 Not Detected Parainflu 2 Not Detected Parainflu 3 Not Detected Parainfluenza 4 by PCR Not Detected Bordetella pertussis by PCR Not Detected Bordetella Parapertussis PCR Not Detected Chlamydia pneumoniae by PCR Not Detected Mycoplasma pneumoniae by PCR Not Detected RPP Commment * , Lab results 09/08/2021 05:34 EDT Troponin iSTAT 7.94 ng/mL HI 09/07/2021 06:37 EDT Troponin iSTAT 13.52 ng/mL HI 09/06/2021 17:03 EDT Troponin iSTAT 10.07 ng/mL HI 09/06/2021 16:54 EDT ANA Pattern None Detected ANA Titer <=1:10 ds-DNA Quant <30.00 IU/mL NA ds-DNA Ab Intrp Neg TPOG Quant <25.00 IU/mL NA TPOG Interp Neg SSA Ab Index 2.388 SSA Ab Interp Negative SSB Ab Units 4.511 NA SSB Ab Interp Neg SM/RNP Ab Index 2.580 SM/RNP Ab Interp Negative SCL70 Ab Units 5.665 NA SCL70 Ab Interp Neg JO 1 Ab Index 3.563 JO 1 Ab Interp Negative C3 Complement 106.0 mg/dL C4 Complement 21.2 mg/dL RF <<8.6 IU/mL SM Ab Units 4.640 NA SM Ab Interp Neg 09/06/2021 16:00 EDT SARS CoV 2 by PCR Not Detected RSV by PCR Not Detected Adenovirus Not Detected Coronavirus 229E by PCR Not Detected Coronavirus HKU1 by PCR Not Detected Coronavirus NL63 by PCR Not Detected Coronavirus OC43 by PCR Not Detected Metapneumovirus Not Detected Rhino/Entero by PCR Not Detected Influenza A Not Detected H1N1 (Swine) Not Detected Influenza A H1 by PCR Not Detected Influenza A H3 by PCR Not Detected Influenza B Not Detected Parainflu 1 Not Detected Parainflu 2 Not Detected Parainflu 3 Not Detected Parainfluenza 4 by PCR Not Detected Bordetella pertussis by PCR Not Detected Bordetella Parapertussis PCR Not Detected Chlamydia pneumoniae by PCR Not Detected Mycoplasma pneumoniae by PCR Not Detected RPP Commment * 09/06/2021 07:21 EDT Troponin iSTAT 20.73 ng/mL HI 09/06/2021 01:47 EDT Troponin iSTAT 40.05 ng/mL HI . Radiology results: CXR 09/06/21 FINDINGS: The lungs are clear. The heart size within normal limits. The trachea is not deviated. CONCLUSION: No acute cardiopulmonary disease seen radiographically. Signature Line ***** Final ***** Thank you for the opportunity to participate in the health care of this patient. I have personally reviewed the images and the report. ECHO 09/06/21 CONCLUSIONS: - No structural abnormalities seen. Normal valvular function. Qualitatively mildly depressed left ventricular systolic function globally. Qualitatively normal right ventricle function. Trivial inferior pericardial effusion.
CDC Split Type:

Write-up: 9/6/21 - Patient is a 15 year old male with no significant PMHx. presenting with chest pain, fever x 1 day, emesis, and diarrhea. Patient received the 2nd dose of Pfizer vaccination on 9/3, and symptoms began on 9/4. Mother also reports some fatigue and tiredness in this period. He denies any palpitations, shortness of breath, exertional dyspnea, orthopnea or peripheral edema. No dizziness, syncopal episodes or seizures. No recent travel, sick contacts or Covid exposures. Due to persistence of the chest pain, he initially went to a local Hospital where CBC was done and unremarkable; BMP revealed hypokalemia (3). EKG done with some non specific ST changes. Troponin was elevated to 44,585 ng/L (44.5 ng/mL). Chest x-ray was unremarkable. SARS-CoV-2 PCR was negative. He was given ibuprofen x1, potassium chloride x1, and referred to ER for further management. At ED, he was vitally stable and without reported chest pain. Repeat EKG was done. Troponin at 40 ng/mL. Patient was then admitted to CICU. 9/7/21 - Patient examined with mother at bedside. He reports chest pain recurred last night around 7 pm. It had the same characteristics as described initially on presentation, lower intensity (6/10) and resolved 40 min after ibuprofen was administered. 9/8/21 - Pt seen with mother at bedside. Mother denies adverse events overnight. No further chest pain and patient was able to tolerate well his walk around the floor last afternoon. VS wnl on room air and only synus arrhythmia seen on telemetry overnight. Patient is improved, stable and medically cleared to continue treatment at home with prescribed medications (lisinopril qDay and Motrin PRN) and follow up apointments as detailed below (Cardiology, ID, Rheum and PCP).


VAERS ID: 1719072 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3182 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Night sweats, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevastatin - 80 mg; Lorsartiin 100 mg; Metformin 1000 mg 2 x p/day; Pantoprazole Sod 40 mg; Duloxetine 60 mg 2x p/day; Carvedilol tabs 6.25 2 x p/day; Ozempic Pen .25 mg 1x p/wk; Vitamin D 5000 Mg; Super B-Complex 2 p/day; Stool Softner 2
Current Illness: Stomach flu; headaches
Preexisting Conditions: Diabetes 2; High Blood Pressure; Long COVID
Allergies: Sulfur
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Severe Arm pain, fever (only up to 100), body aches, head ache, brain fog, dizzyness; shortness of breath; profuse sweating, fatigue; nite sweats; stomach pain LASTED FOR 10 DAYS


VAERS ID: 1719101 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-03
Onset:2021-09-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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: Cyclobenzaprine 10mg BID, Flovent HFA 220mcg/actuation, hydrocodone 5/325mg Q 12 hours PRN, Lidocaine 5% patch Q day, Lyrical 25mg BID, omeprazole 20mg Q day, QNASL 80mcgnasal spray 2/nostril daily, vitamin D 2,000iu daily,
Current Illness:
Preexisting Conditions: OSA, GERD, Asthma
Allergies: Clindamycin, prednisone, pantaprazol, Fluticasone, Chlorpheniramine, ibuprofen, pseudoephedrine, cortizone, gabapentin, Pfizer Covid vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was awakened by grandson at 4 AM, with uncontrolled shaking. Family members on her husband''s side of the family have seizure disorders, and she states that was what it was like. Reports she was "groggy" through Saturday and Sunday, more so on Saturday. Other symptoms, were injection site soreness and fatigue for a few days.


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